L18 - Arrhythmia's

Question 1

What are arrhythmia’s?

common symptoms? (3)

Answer 1

• disturbances to normal heart rhythm

- palpitations, lightheadedness, syncope

Question 2

Describe normal sinus rhythm on ECG?

Answer 2

1. QRS complexes present (ventricular activity)

2. P-waves waves (Atrial activity)

Question 3

Describe asystole on ECG?

Answer 3

no ventricular activity. EMERGENCY.
cardiopulmonary RESUS

p-waves may be present.

Question 4

describe ventricular fibrillation

Answer 4

choatic ventricular activity

emergency, incompatible with life, CPR, electrical defibrillation

Question 5

what causes arrhythmia’s?

Answer 5

• myocardial ischaemia?
• when cardiac cells lack oxygen they become depolarised
• leads to altered impulse formation

Question 6

How might you see a normal sinus rhythm on an ECG?

Answer 6

rate approx 4 big squares

Question 7

what indicates sinus bradycardia on ECG?

Answer 7

approx 6 big squares

Question 8

what indicates sinus tachycardia on ECG?

Answer 8

approx, 2 big squares

Question 9

evenly spaced QRS complexes indicates…

Answer 9

normal sinus rhythm.

rhythm is regular.

Question 10

how might irregular rhythm be seen on ECG?

Answer 10

AF.

unevenly spaced QRS complexes.

Question 11

What would narrow QRS complexes show us?

Answer 11

narrow, normal, approx three tiny squares

Question 12

compare and contrast broad complex and narrow complex tachycardias?

Answer 12

broad complex

• slow conduction
• longer to complete ventricular depolarisation
• complete ventricular tachycardias

narrow complex
- rapid conduction through his purkinje system

Question 13

specific forms of narrow complex tachycardia and their signs on ECG?
(3)

Answer 13

1. Sinus tachycardia
2. Atrial flutter (sawtooth)
3. atrial fibrillation (irregular, chaotic wavelets in both atria)

Question 14

What is an atrioventricular block?

Answer 14

• interruption or delay of electrical conduction from atria to ventricles
• due to conduction system abnormalities in AV node or his-purkinje system.

Question 15

Describe the different degrees of AV block?

Answer 15

1st degree: generally asymptomatic, dyspnea, weakness, dizziness

2nd degree: can be asymptomatic, palpitations, weakness, lightheadedness, syncope. irregular HR.

3rd degree: fatigue, dizziness, light headedness. heart failure, weakness, syncope. associated with profound bradycardia. asystole –> cardiac arrest or death

Question 16

Bradycardia’s - AV block on ECG

Answer 16

1st degree
- prolonged PR

2nd degree
- more p waves than QRS

3rd degree
- av dissociation

Question 17

general symptoms of arrhythmias (5)

Answer 17

• palpitations
• syncope
• chest tightness
• breathlessness
• sudden death

Question 18

How to beta blockers work?

Answer 18

• blocks effects of catecholamines

- slower conduction through AV node

Question 19

How does amiodarone work?

Answer 19

• powerful anti-arrhytmic for most t.cardias

- side effects! some dangerous

Question 20

how does digoxin work?

Answer 20

AF and heart failure.

slower conduction through AV node when at rest.

potentially toxic in renal impairment patients