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Cardiac Emergencies > Rhythms > Flashcards

Rhythms Flashcards

1
Q

Red flags in ECG

A
  • Lots of jiggly bits
  • A lumpy bit on the jiggly bit
  • Big tail lumps
  • No humps, lumps or jiggles
  • Squiggly stuff you have no idea about but the patient looks bad
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2
Q

Critical part of taking ECG

A

Determining heart rate

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3
Q

Systemic approach to ECGs

A
  1. Rate
  2. Rhythm
  3. P waves
  4. PR interval
  5. QRS complex
  6. Review rate again
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4
Q

Indicated by heart rate less than 60 bpm

A

Sinus Bradycardia

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5
Q

Looks like sinus rhythm but faster, 100 bpm or more

A

Sinus Tachycardia

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6
Q

When the SA node fires slightly irregularly.
- Usually occurs at 60-100bpm

A

Sinus Arrhythmia

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7
Q

Periodically absent complex, where there is one complex missing exactly

A

Sinoatrial block

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8
Q

Disorder of impulse formation, results in absent complexes, more than one complex missing

A

Sinus Arrest

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9
Q

Reflect abnormal electrical impulse formation and conduction

A

Atrial Dysrhythmias

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10
Q

Why would an atrial dysrhythmia occur?

A
  • Altered automaticity
  • Triggered activity
  • Reentry
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11
Q

Results from abnormal electrical impulses that sometimes occur during repolarization, when cells are normally quiet

A

Triggered Activity

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12
Q

Premature beat arising from ectopic pacemaking tissue within atria

A

Premature Atrial Complexes (PACs)

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13
Q

Two premature beats in a row

A

Pairs

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14
Q

Three or more premature beats in a row

A

Runs or Bursts

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15
Q

Every other beat is a premature beat

A

Bigeminy

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16
Q

Every third beat is a premature beat

A

Trigeminy

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17
Q

Every fourth beat is a premature beat

A

Quadrigeminy

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18
Q

Associated with a ventricular rate faster than 100 bpm

A

Multifocal Atrial Tachycardia (MAT)

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19
Q

Associated with normal ventricular rate (60-100 bpm)

A

Wandering Atrial Pacemaker (WAP)

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20
Q

When would you see a drop in blood Pressure?

A

Typically occurs in SVT and is greatest in first 10-30 seconds

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21
Q

Starts or ends suddenly

A

Paroxysmal

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22
Q

Vagal Manouver

A
  • Have patient bear down as if they are taking a bowel movement, pushing through pelvic floor while tightening ab muscles
  • Have patient try to blow the plunger out of a syringe
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23
Q

PCP’S DO NOT PERFORM

A

Carotid Sinus Massage

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24
Q

Ectopic atrial rhythm in which an irritable site within the atria fires regularly at an extremely rapid rate

A

Atrial Flutter

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25
Q

Intrinsic Rate for sinus rhythms

A

60-100 bpm

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26
Q

Intrinsic Rate for Junctional Rhythms

A

40-60 bpm

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27
Q

What does it mean when P wave is inverted?

A

Junctional Rhythm

28
Q

Specialized cells located in the lower portion of the right atrium. Delays the electrical impulse and allows atria to contract and complete filling of ventricles before next ventricular contraction.

A

AV Node

29
Q

Connects AV node with bundle branches

A

Bundle of His

30
Q
  • QRS will usually measure 0.12 sec or less
  • Often followed by a noncompensatory (incomplete) pause
  • P wave may or may not be present
  • If a P wave is present, it is inverted (retrograde) and may precede or follow the QRS
  • NOT AN ENTIRE RHYTHM, SINGLE BEAT
A

Premature Junctional Complex (PJC)

31
Q

Originates in the AV junction and appears late (after next expected sinus beat)

A

Junctional Escape Beat

32
Q

Several sequential escape beats

A

Junctional Escape Rhythm

33
Q
  • An ectopic rhythm caused by enhanced automaticity of the bundle of His
  • Results in a regular ventricular response at a rate of 61 to 100 bpm
A

Accelerated Junctional Rhythm

34
Q

Typically characterized by QRS complexes that are abnormally shaped and prolonged (>0.12)

A

Ventricular Depolarization

35
Q

T waves are usually in a direction opposite that of the QRS complex

A

Ventricular Repolarization

36
Q
  • Occurs earlier than the next expected sinus beat
  • QRS is typically 0.12sec or greater
  • T wave is usually in the opposite direction of the QRS complex
  • Full compensatory pause often follows
A

Premature Ventricular Complex (PVC)

37
Q

Every other beat is a PVC

A

Ventricular Bigeminy

38
Q

Every 3rd beat is a PVC

A

Ventricular Trigeminy

39
Q

Every 4th beat is a PVC

A

Ventricular Quadrigeminy

40
Q

Premature ventricular beats that look the same in the same lead and originate from the same anatomical site (focus)

A

Uniform (Unifocal/monomorphic) PVS

41
Q
  • PVCs that appear different from one another in the same lead
  • Often (but not always) arise from different anatomical sites
A

Multiform (Multifocal/polymorphic) PVCs

42
Q
  • Occur when the R wave of a PVC falls on the T wave of the preceding beat
  • PVC occurring during this period of the cardiac cycle can cause ventricular tachycardia or ventricular fibrilation
A

R-on-T PVC

43
Q
  • Three or more ventricular escape beats occurring in a row at a rate of 20-40 bpm
  • Agonal rhythm (P waves only, no ventricular activity, rate <20 bpm)
A

Idioventricular Rhythm (IRV)

44
Q

Exists when three or more ventricular beats occur in a row at a rate of 41-100 bpm

A

Accelerated Idioventricular Rhythm (AIVR)

45
Q

Exists when three or ore PVCs occur in a row at a rate of more than 100 bpm

A

Ventricular Tachycardia (VT)

46
Q

A short run lasting less than 30 seconds

A

Non-sustained VT

47
Q

Persists for more than 30 seconds

A

Sustained VT

48
Q

QRS complexes vary in shape and amplitude from beat to beat and appear to twist from upright to negative or negative to upright and back, resembling a spindle

A

Polymorphic VT

49
Q
  • Chaotic rhythm that begins in the ventricles
  • No organized depolarization of the ventricles
A

Ventricular Fibrillation (V-Fib)

50
Q

Total absence of ventricular electrical activity

A

Asystole

51
Q

Organized electrical activity is observed in the cardiac monitor but the patient is unresponsive, is not breathing, and has no pulse

A

Pulseless Electrical Activity (PEA)

52
Q

A delay or interruption in impulse conduction from the atria to the ventricles occurs as a result of a temporary or permanent anatomic or functional impairment

A

Atrioventricular Block

53
Q

Delayed impulse conduction

A

First-degree AV Block

54
Q

Intermittent impulse conduction

A

Second-degree AV block (types I and II)

55
Q

Absent impulse conduction

A

Third-degree AV Block

56
Q

When some, but not all, atrial impulses are blocked from reaching the ventricles. Not every P wave will be followed by QRS.

A

Second-Degree AV Block

57
Q
  • PR interval prolonged (>0.20 sec) but constant
A

First Degree Heart Block

58
Q

A progressive lengthening of the P wave from the corresponding QRS that eventually results in the dropping of a beat

A

Second-Degree AV Block Type 1 (Wenckebach)

59
Q

Generally progressive increase increase in the length of the PR intervals until P wave occurs that is not followed by QRS cpmplex

A

“Classic” Wenckebach Phenomenon

60
Q

Conduction delay occurs below the AV node, within the His-Purkinje system

A

Second-Degree AV Block Type II (Mobitz II AV Block)

61
Q
  • P to QRS relation not present before every QRS
  • PR interval lgenerally progressively lengthens until P wave is completely blocked at the AV node
  • “longer-longer-longer-dropped QRS”
A

Winckebach AV Block

62
Q
  • More P waves than QRS complexes
  • PR interval can be normal or prolonged
  • PR intervals before and after a blocked sinus impulse are constant
  • QRS complex may be narrow or wide
A

Second-Degree AV Block Type II

63
Q

Complete block in conduction of impulses between the atria and the ventricles

A

Third-Degree AV Block

64
Q
  • P waves upright and rounded more than QRS
  • No correlation P to QRS
  • AV completely blocks impulses
A

3rd Degree AV Block

65
Q

A battery-powered device that delivers an electrical current to the hear to stimulate depolarization

A

Pacemaker

66
Q
A

Cardiac Emergencies (13 decks)

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