Rhythms Flashcards
1
Q
Atrial fibrillation
A
- Atrial tachycardia, irregular rhythm, noisy background with no P waves
- May be caused by atrial enlargement due to heart failure, CAD, pulmonary disease
- Anticoagulation (CHAD-vasc score)
- Address underlying cause
- Consider rate or rhythm control
- Catheter ablation if refractory
2
Q
What factors into the CHAD-VASC score?
A
- Congestive heart failure
- Hypertension
- Age
- Diabetes
- Previous stroke, TIA, embolus
- Vascular disease
- Female
- Score of 2 or more means you should anti coagulate someone who has A Fib
3
Q
Ventricular tachycardia
A
- Wide complex tachycardia (rate >100)
- May or may not be perfusing
- May deteriorate into v.fib and death
- Caused by abnormal impulse formation (MI, long QT) or conduction (re entry circuit)
- Past history of MI makes you suspicious
- ECG may show AV dissociation, capture beats, fusion beats
4
Q
Ventricular fibrillation
A
- No rhythm or rate, no QRS: non perfusing rhythm
- Will lead to syncope and death if prolonged
- May start as VT/ torsades and degenerate
- electrical cardioversion ASAP
5
5
Q
SVT with aberrancy
A
- Wide complex tachycardia due to a left or right bundle branch block
- Look for rabbit ears (RBBB)
6
Q
Who should get an implantable cardioverter defibrillator?
A
- Those at high risk for sudden cardiac death
- Persistent severe left ventricular dysfunction AFTER optimal treatment ( ie pharmacological and revascularization), (most common)
- Prior cardiac arrest or life threatening irreversible ventricular arrhythmia
- Other risky conditions: long QT, HCM
7
Q
Right bundle branch block
A
Rabbit ears in V1
Big S wave in V6
8
Q
Left bundle branch block
A
Big S in V1
Broad R in V6
Discordant QRS and T waves
