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MD3001 - Cardiology Disease and Pathology > Pathophysiology of arrhythmias > Flashcards

Pathophysiology of arrhythmias Flashcards

1
Q

How are disturbances in cardiac rhythm diagnosed?

A

ECG

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2
Q

What causes sinus bradycardia?

A
  • Drugs; beta-blockers, dilitiazem
  • Vagal activity
  • Hypothyrodism
  • sinus node disease
  • Electrolyte abnormalities
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3
Q

What causes AV block?

A
  • Vagal activity
  • myocardial infarction
  • electrolyte abnormalities
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4
Q

What is 1st degree AV block?

A

lengthening of the PR interval

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5
Q

What is Mobitz type 1 AV block?

A

Progressive lengtheing of the PR interval until the P was is blocked at the PR is short again

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6
Q

What is Mobitz type 2 AV block?

A

Block after 2 or 3 conducted beats in regular pattern

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7
Q

What is 3rd degree AV block?

A

complete AV dissociation

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8
Q

What are the treatments for bradycardias?

A
  • Pacemakers
    • temporary
    • permanent
  • Only if needed
    • treat symptoms of syncope/dizziness
    • prophylatic at time of operations
    • post AMI
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9
Q

Types of narrow comples/supraventricular tachycardias

A
  • Atrial tachycardia
  • Junctional tachycardias (nodal tachycardia)
  • AVNRT and AVRT
  • Atrial flutter
  • Atrial fibrillation
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10
Q

What are the indications a dysrhytmia is a narrow complex tachycardia

A

QRS duration is less than 120ms

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11
Q

What is the origin of narrow complex tachycardias?

A

Above the AV node

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12
Q

What are the characteristics of broach complex tachycardias?

A

QRS complex is wider than 120ms

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13
Q

What are the types of broad complex tachycardia

A
  • Ventricular tachycardias
    • Monomorphic and polymorphic VT
    • Fasicular (RBBB and LAD are not very wide)
    • RVOT (LBBB and RAD)
  • SVT with aberration (=aquired, rate dependent bundle branch block)
  • SVT with pre-exisitng BBB morphology on ECG
  • SVT of antidromic tachycardia on WPW
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14
Q

What are the basic mechanisms of tachycardias?

A
  • Ectopic focus
  • Re-entry/circus movement
  • Fibrillation - independent wavelets of activity
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15
Q

What describes a regular, narrow complex tachycardia without P waves activity?

A

AVNRT or AVRT

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16
Q

What is AVNRT?

A

AV nodal re-entrant tachycardia

Tachycardia where re-etry circuit is through juxa-nodal material

17
Q

What is AVRT?

A

AV re-entrant tachycardia

Tachycardia where re-entry is through an accessory pathway

18
Q

What terminates AVNRT and AVRT?

A

IV adneosine

19
Q

What is Wolff-Parkinson-White syndrome?

A
  • Pre-excitation of ventricles
  • Anatomical atria-ventricular bypass tract with non-decremental conducting properties
20
Q

Characteristics of WPW syndrome on an ECG

A

Shortened PR interval (less than 3 boxes)

Slurred upstroke of ORS and widened QRS complex (more than 3 boxes)

21
Q

What does WPW syndrome form the basis for?

A

Circus movement and AVRT

Over a concealed accessory pathway; doesnt conduct atria to ventricle

22
Q

What can be seen if accessory material is very lateral?

A

retrograde P waves

23
Q

What occurs when adenosine is administered in atrial fibrillation or atria tachycardia?

A

transient slowing of the heart without revealed P waves

24
Q

What occurs when adenosine is administered in AVNRT or AVRT?

A

restoration of sinus rhythm

25
Q

What is atrial fibrillation

A

irregular narrow complex tachycardia with no P waves

26
Q

Symptoms of atrial fibrillation

A

faster ventrciular response rate, SOB and hypotension

27
Q

What are the causes of atrial fibrillation?

A
  • ischaemic heart disease
  • hypertensive heart disease
  • mitral valve disease
  • thyrotoxicosis
  • Alcohol
  • post bypass
  • myocarditis
  • accessory pathways
28
Q

Mechanism of atrial fibrillation

A

Size of LA

Foci of wavelet generation around the insertion of the pulmonary veins (must be more than 5 independent wavelets of activity)

MD3001 - Cardiology Disease and Pathology (10 decks)

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