Q2-CB15/Cardiac Arrhythmias Flashcards

1
Q

What type of information does the ECG provide about the events in the cardiac cycle?

A

it provides info about the rate, rhythm, and timing

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2
Q

What info can the ECG provide abt heart muscle?

A

ischaemia, damage, hypertrophy

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3
Q

an increased voltage/height on an ECG suggest what?

A

increased muscle mass

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4
Q

what do wider waves or intervals on an ECG suggest?

A

slowed conduction

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5
Q

What does this diagram suggest about the individual?

A
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6
Q

What does a left axis deviation mean?

A
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7
Q

What does a right axis deviation mean?

A
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8
Q

from what parts of the ECG can you tell that there is a delayed conduction?

A

elongated PR interval, QRS, or QT

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9
Q

From what part of the ECG can you tell that there is ischaemia?

A

There is an ST depression. (note that this is only seen in leads pointing towards damage)

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10
Q

From what part of the ECG can you tell that there is an infarction?

A

ST elevation (only seen in leads pointing towards damage)

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11
Q

What bpm constitues tachycardia?

A

more than 100 bpm

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12
Q

What bpm constitues bradycardia?

A

less than 60 bpm

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13
Q

If the rhythm is not regular, then it is irregular. This means that there is an arrhythmia. What are the 2 types of irregular rhythms?

A

regularly irregular and irregularly irregular

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14
Q

What do conduction problems means in regards to arrhythmia?

A

the rate and rhythm are ok, but the conduction is either too fast or too slow

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15
Q

Sinus rhythm comes from the _______ node.

A

Sinoatrial (SA)

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16
Q

sinus rhythm ______ at the AV node and fastest through the _________

A

slows down, Bundle of His/Purkinje fibers

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17
Q

what is sinus tachycardia?

A

increased rate but normal rhythm

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18
Q

what is sinus bradycardia?

A

decreased rate but normal rhythm

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19
Q

What is sinus arrhythmia?

A

a regular irregular rhythm from the SA node

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20
Q

What happens at all the arrows and at 1 and 2?

A
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21
Q

What 3 things may cause arrhythmias?

A

changes in automaticity, triggered activity after depolarization, and conduction delay + appearance of re-entry circuits

22
Q

What is the depolarization rate of the SA node?

A

60-100/min, it depends on the ANS

23
Q

What is the depolarization rate of the AV node?

A

40-50/min

24
Q

what is the depolarization rate of purkinje fibers?

A

about 35/min

25
Q

What are afterdepolarizations?

A

abnormal depolarizations of cardiac muscle cells

26
Q

What are the 2 types of afterdepolarizations?

A

early afterdepolarizations and delayed afterdepolarizations

27
Q

When do EADs occur?

A

EADs occur when stimulation occurs during the plateau (Phase 2) or repolarisation phase (Phase 3)

28
Q

When do DADs occur?

A

DADs occur during Phase 4 (resting) and trigger depolarisation, but

before the time normally expected. this is due to elevated Ca++ levels

29
Q

Explain re-entry circuits.

A

not all parts of the heart will depolarize (ex. blood vessels, damaged fibrotic tissue)

when depolarization hits these areas it cant go through the heart, so it has to go around the heart (think of crows avoiding an obstacle)

if the route is the same length as the original then there is no problem; but if the route is longer, then problems may arise

30
Q

What are ex of longer routes in re-entry circuits?

A
31
Q

What is a paroxymal tachycardia?

A

it is a burst of tachycardia due to re-entry pathways

32
Q

what are the 2 types of paroxysmal tachycardia?

A

ventricular and supraventricular

33
Q

explain ventricular paroxysmal tachycardia.

A
  • serious
  • may lead to fibrillation or death
  • usually due to ischaemic damage or drugs
34
Q

Explain supraventricular paroxysmal tachycardia.

A
  • supraventricular means above the ventricles so its either atrial or AV node
  • if its atrial, then the P wave is inverted
  • if its the AV node, then the P wave is hidden
  • more common in young people
  • usually is not deadly
35
Q

What is fibrillation?

A

uncoordinated and sporadic depolarizations throughout the heart

36
Q

Explain atrial fibrillation.

A
  • since there is no coordinated depolarization of the atria, there is no P wave.
  • irregularly irregular tachycardia
37
Q

Explain ventricular fibrillation.

A
  • individual myocytes are depolarizing, so there is no distinct waveform that can be seen
  • there is no coordinated contraction, so there is no cardiac output
38
Q

What is another term for ectopic?

A

abnormal

39
Q

What can cause ectopic beats in the atria?

A

an extensive stretch of muscle fibers

40
Q

What are ectopic beats in the atria?

A

they are premature contractions due to abnormal impulses from ectopic foci

41
Q

Are premature atrial contractions common or rare?

A

they are fairly common

42
Q

How do ectopic beats in the atria show up on an ECG?

A

they show up as an extra P wave and a weak pulse on the ectopic beat

43
Q

What is similar to ectopic beats in the atria?

A

A premature AV node contraction; it also has a weak pulse but there is no P wave because depolarization travels to the atria AND the ventricles

(the P wave is lost in the resulting QRS complex)

44
Q

What is another name for ectopic beats in the ventricle?

A

premature ventricular contractions (PVC’s)

45
Q

How can you tell on an ECG that someone has PVCs (premature ventricular contractions) ?

A

It is seen as a widened QRS complex and an inverted T wave

  • conduction through muscle is slower than the main conducting system. the slow conduction means that fibers that depolarize first also repolarize first.
46
Q

What is heart block?

A

decreased or total block of AV conduction

47
Q

What things can cause heart block?

A

ischemia/compression/inflammation of AV node

48
Q

What are the 3 types of heart block?

A

1st degree, 2nd degree, 3rd degree

49
Q

What is first degree heart block?

A

it is a delay in conduction; characterized by an increased PR interval (greater than 0.2 sec)

50
Q

What is second degree heart block?

A

increased delay, some of the PQRSs get dropped completely

51
Q

What is 3rd degree heart block?

A

it is the complete block; ventricles contract but slower (40 bpm), the SA node is still firing but there is no relationship between P and QRS