Lecture 8 Cardiac Arrhythmias Flashcards
Tachycardia
Fast Heart rate (>100 beats/min)
What causes Tachycardia
Increased body temperature stimulation of the heart by sympathetic nerves Toxic conditions of the heart
How much does heart rate increase with body temperature
Increases about 10 beats per degree F increases about 18 beats per degree C
The heart may be stimulated by the sympathetic nerves for increase heart rate due to what
loss of blood and/or decreased state of shock
During endogenously mediated tachycardia does stroke volume fall
No
What happens during endogenously mediated tachycardia (i.e. Exercise)
Heart rate increases, Cardiac output increases, filling time is reduced but stroke-volume does not fall
what happens during pathologically mediated tachycardia
heart rate increases, cardiac output decreases
Bradycardia
HR less than 60 beats/min
What are some causes of Bradycardia
Athletic heart Vagal Stimulation Extremely sensitive carotid baroreceptors in carotid sinus syndrome
What are respiratory type of Sinus arrhythmia: Spillover signals
form medullary respiratory center into vasomotor center during inspiratory and expiratory respiratory cycles - these signals alternately increase and decrease number of impulses transmitted through sympathetic and vagus nerves to the heart
What kind of block causes a sudden cessation of the P wave
Sinoatrial block
What are the characteristics of a sinoatrial block
Sudden cessation of the P-waves Resultant standstill of atria Ventricles pick up a new rhythm, usually originating in the AV node Rate of QRS is slowed but not otherwise altered
what are some conditions that cause an Atrioventricular block
-Ischemia of AV node or AV bundle fibers through coronary insufficiency - Compression of AV bundle by scar tissue or calcified portions of the heart - Inflammation of the AV node or bundle - Extreme Stimulation of the heart by the vagus nerves
Characteristics of a Incomplete First-Degree AV block
The P-R interval is increased to greater than 0.20 seconds
Characteristics of a incomplete second-degree AV block
P-R interval is increased to 0.25 to 0.45 seconds Atrial P wave is present but QRS-T wave may be missing, resulting in dropped beats of the ventricle 2:1 rhythm or other variations may develop
Characteristics of Complete AV block
- ventricles establish their own signal (usually AV node) - No relation between the rate of the P waves and the rate of the QRS-T complexes - Duration of the block is highly variable (seconds to weeks) - After AV conduction ceases, ventricles may not start beating on their own for 5 to 30 seconds - Resumption of the ventricular beat (=ventricular escape) may be due to parts of the Purkinje system acting as an ectopic pacemaker - after a complete block occurs, patients will often faint due to lack fo blood to the brain until the ventricles escape - These periodic fainting spells are referred to as Stokes-Adams syndrome
what is Ventricular escape
Resumption of the ventricular beat
what may lead to ventricular escape
Parts of the Purkinje system acting as an ectopic pacemaker
After AV conduction ceases, ventricles may not start beating on their own
for 5-30 seconds