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KCP - sem 2 > palpitations and syncope (W5) > Flashcards

palpitations and syncope (W5) Flashcards

1
Q

syncope meaning?

A

loss of consciousness due to reduced cerebral perfusion. may also refer to any transient loss of consciousness

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2
Q

what is vertigo

A

sensation that you or the environment is moving/spinning

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3
Q

common causes of syncope

A

cardiovascular
postural/orthostatic hypotension
neurally mediated
vasovagal syncope/neural reflex syncope
drug intoxications
hypoglycaemia

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4
Q

causes of cardiovascular syncope

A

arrhythmia
structural heart disease

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5
Q

causes of neurally mediated syncope

A

epilepsy

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6
Q

what is vasovagal syncope/neural reflex syncope

A

associated with stress/anxiety - whole system slows down, vagal activity

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7
Q

ectopic beat

A

extra beat then pause

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8
Q

when might sinus tachycardia occur pathophysiologically

A

infection/fever
dehydration

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9
Q

sinus tachycardia appearance on ECG? BPM?

A

shorter than 3 squares
over 100 bpm

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10
Q

sinus bradycardia bpm?

A

less than 60 bpm

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11
Q

arrhythmias 3 categories?

A

too fast
too slow
intermittent

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12
Q

too fast arrhythmias types

A

atrial fibrillation
ventricular tachycardia

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13
Q

too slow arrhythmias types

A

heart block

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14
Q

intermittent arrhythmias types

A

supraventricular tachycardia
paroxysmal AF
ectopic beats

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15
Q

supraventricular tachycardia description

A

intermittent rapid tachycardia with abrupt onset and offset
narrow complex tachycardia

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16
Q

2 types of tachycardia

A

narrow complex tachycardia
broad complex tachycardia

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17
Q

narrow complex tachycardia meaning

A

QRS duration in normal limits of 120 milliseconds (less than 3 squares)

18
Q

SVT presentation

A

palpitations
light headedness
nausea
chest pain
breathlessness
usually haemodynamically stable

19
Q

haemodynamically stable meaning?

A

blood pressure sufficient to maintain organ perfusion

20
Q

activation of which nerve in the autonomic nervous system would increase blockade at the atrioventricular node

A

vagus nerve

21
Q

how can you activate the vagus nerve

A

water on face for children (cold flannel)
carotid sinus massage
Valsalva manoeuvre

if previous dont work give IV adenosine

22
Q

what is the Valsalva manoeuvre

A

performance of forced expiration against a closed glottis

23
Q

how does IV adenosine treat SVT

A

slows conduction through
AV node

24
Q

ventricular tachycardia features? who does it occur in?

A

broad complex tachycardia
normally in patients with underlying heart disease

25
Q

what is broad complex tachycardia

A

QRS complex larger than 3 squares or over 120ms

26
Q

VT presentation

A

palpitations
chest pain
shortness of breath
loss of consciousness

27
Q

VT treatment if unconscious

A

synchronised DC cardioversion
synchronised to R wave
medical emergency!!!!

28
Q

VT treatment if unconscious

A

give antiarrhythmic - most commonly amiodarone

29
Q

first degree heart block?

A

conduction is slowed from atrium to ventricle (PR interval prolonged)

30
Q

second degree heart block?

A

intermittent conduction
(some beats not conducted from atrium to ventricle)

31
Q

third degree heart block?

A

no conduction from atrium to ventricles. P waves and QRS complex dissociated. bradyarrhythmia.

32
Q

where is the problem (usually) in complete heart block (third degree heart block)

A

AV node

33
Q

complete heart block presentation

A

syncope and pre-syncope
fatigue (can’t augment heart rate eg when exercising)
breathlessness
cardiac arrest
usually have underlying heart disease

34
Q

complete heart block treatment

A

muscarinic cholinergic agonist - atropine! (short term solution for symptoms)
definitive treatment - cardiac pacemaker

35
Q

atrial fibrillation ECG features

A

no regular P waves, irregular QRS complex. narrow complex tachycardia. irregularly irregular

36
Q

most common cause of arrhythmia

A

atrial fibrillation

37
Q

atrial fibrillation presentation

A

incidental finding
palpitations
breathlessness
fatigue
worsened by alcohol

38
Q

treatment of atrial fibrillation (rate control)

A

increase block at AV node using
-beta blockers (bisoprolol)
-calcium-channel antagonist (diltiazem)

39
Q

AF and stroke?

A

allows clot to form in fibrillating left atrium (passive movement of blood, pooling), embolus passes to cerebral circulation and leads to stroke

40
Q

how is risk of stroke calculated

A

CHA2DS2-VASc score

41
Q

stroke prevention medication?

A

offer anticoagulation
-apixaban
-rivaroxaban
-warfarin

KCP - sem 2 (10 decks)

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