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Baz: Y1 Semester 2 > KCP: Palpitations and Syncope > Flashcards

KCP: Palpitations and Syncope Flashcards

1
Q

What is Syncope?

A

Loss of consciousness due to cerebral perfusion

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2
Q

What is presyncope?

A

The lightheadedness experienced by someone who feels like they might be about to lose consciousness

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3
Q

What do you call a fast heart rate?

A

Tachycardia

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4
Q

What do you call a slow heart rate?

A

Bradycardia

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5
Q

What do you call an irregular heart beat?

A

Arrhythmia

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6
Q

Definition of tachycardia?

A

> 100 bpm

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7
Q

Definition of bradycardia?

A

< 60 bpm

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8
Q

How do you calculate heart rate from an ecg?

Does this patient have an irregular heart beat?

A

Count number of big squares between R waves

R-R=2.4 squares

Divide 300 by this number = 125 bpm

Patient is tachycardic

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9
Q

How is time represented on an ecg?

A

Each square is 0.2s

Therefore there is 300 squares per minute

Therefore:

beats per minute = 300 / squares per beat

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10
Q

Common arrhythmias for too fast, too slow and intermittent

A

Too fast
* Atrial fibrillation
* Ventricular tachycardia
* Supraventricular tachycardia

Too slow
* Heart block

Intermittent
* Paroxysmal supraventricular tachycardia
* Paroxysmal AF
* Ectopic beats

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11
Q

What is Paroxysmal Supraventricular Tachycardia? (SVT)

A

Intermittent rapid tachycardia with abrupt onset and offset

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12
Q

What is supraventricular tachycardia also known as?

A

It is a called a narrow complex tachycardia

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13
Q

What does an ECG look like in SVT?

A

QRS complexes are of normal duration (< 3 small squares, < 120 ms)

So electrical impulse is following the normal ventricular conduction pathway, but at a fast rate

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14
Q

SVT Presentation

A
  • Palpitations
  • Often had previous episodes that spontaneously reverted
  • Light headedness
  • Nausea
  • Chest pain
  • Breathlessness
  • Usually haemodynamically stable
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15
Q

Which nerve do you need to activate in order to treat SVT symptoms?

A

Vagus Nerve

Vagus nerve is involved in the parasympathetic nervous system, activation releases acetylcholine acting on the muscarinic receptors thus slowing down conduction on the atrioventricular node

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16
Q

How can you activate the vagus nerve?

A
  • Carotid sinus massage
  • Valsalva manoeuvre
  • Cold water on the face i.e. a diving response
  • Modified Valsalva manoeuvre
17
Q

What is the valsalva manoeuvre

A

“Popping your nose”

18
Q

What is Ventricular Tachycardia?

A

It is a broad complex tachycardia

19
Q

What can Ventricular Tachycardia imply?

A

Patients normally have underlying heart disease

20
Q

What is going on in this ECG?

A

QRS complexes are of increased duration (>3 small squares, >120 ms)

So electrical impulse most likely originates in the ventricle and not following a normal conduction pathway.

It is fast and abnormal therefore is Ventricular Tachycardia

21
Q

VT-Presentation?

A
  • Palpitations
  • Chest pain
  • Shortness of breath
  • Loss of consciousness
22
Q

Briefly describe the ECGs of first, second and third degree heart block

A
23
Q

What’s going on with this ECG?

A

Complete heart block

24
Q

Presentation of complete block?

A
  • Syncope and pre-syncope
  • Fatigue
  • Breathlessness
  • Cardiac arrest
  • Usually have underlying heart disease
25
Q

Complete heart block short term treatment?

A

We want to inhibit the vagus nerve which is a muscarinic cholinergic agonist.

There fore we need a muscarinic cholinergic antagonist.

This is Atropine

26
Q

Complete heart block long term treatment?

A

Pacemaker

27
Q

What is going on in this ECG?

A

Atrial Fibrillation

28
Q

Atrial Fibrillation Presentation

A
  • Incidental finding
  • Palpitations
  • Breathlessness
  • Fatigue
  • Can be made worse by alcohol
29
Q

AF treatment?

A

Increase block at the AV node

  • Beta-adrenergic receptor blockers e.g. bisoprolol
  • Calcium channel antagonist e.g. diltiazem
30
Q

What other complication can AF lead to?

A

Stroke

  • Clot forms in fibrillating left atrium
  • Emboli can then pass to cerebral circulation leading to a stroke
31
Q

What is…

A

Is a metric used to assess the risk of osmeone having a stroke.

If score is 1 consider anti-coagulant

If score is > 2 anti-coagulant and anti-platelet

32
Q

Biggest risk from untreated atrial fibrillation

A

Stroke

This rhythm can lead to systemic emboli. Patients are normall started on anticoagulation. It may also increase risk of heart failure.

33
Q

What would you use atropine for?

A

Short term treatment for complete heart block

34
Q

What would you use adenosine for?

A

A heart condition marked by episodes of rapid heart rate (paroxysmal supraventricular tachycardia)

Baz: Y1 Semester 2 (42 decks)

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