stuff to do with arrhythmias Flashcards
Atrial fibrillation, atrial flutter, heart block, sinus tachycardia, supra ventricular tachycardia, ventricular tachycardia, and ventricular ectopic beat all in one deck.
complications of atrial fibrillation
stroke
symptoms of atrial fibrillation
chest pain
palpitations
ECG diagnosis of atrial fibrillation
no P wave
treatment of atrial fibrillation
beta blocker for rate control
digoxin
cardioversion for rhythm control
pathology of atrial fibrillation
AVN receives overload of depolarisation
pathology of atrial flutter
re-entrant circuit within the right atrium
symptoms of atrial flutter
hard/fast heart beat
difficulty breathing
chest discomfort
syncope
complications of atrial flutter
blood clots
treatment of atrial flutter
rhythm control - amiodarone, cardioversion
rate control - beta blocker
ECG diagnosis of atrial flutter
regular rate of 300bpm
ventricular rate determined by AV conduction ratio - usually 2:1
sawtooth in II, III, aVF
narrow QRS complex
ECG diagnosis of left BBB
WiLLiaM
W pattern in v1
M pattern in v2
ECG diagnosis of right BBB
MaRRoW
M pattern in v1
W pattern in v6
pathology of heart block
disrupted passage of electrical impulse through AVN
symptoms of heart block
dizzy
light-headed
palpitations
complications of heart block
missed beats
syncope
complications of 3rd degree heart block
bradycardia –> haemodynamic compromise
treatment of heart block
artificial pacemaker
ECG signs of 1st degree heart block
PR interval is prolonged and unchanging
no missed beat
ECG signs of 2nd degree heat block - Mobitz I
PR interval becomes longer and longer until a QRS is missed, then the pattern resets (Wenckebach phenomenon)
ECG signs of 2nd degree heart block - Mobitz II
QRS regularly missed (e.g. 2:1)
may progress to complete heart block
ECG signs of 3rd degree heart block
complete heart block
P waves and QRS appear completely independent of one another
pathology of sinus tachycardia
high frequency of normal impulse initiation from SAN
complications of sinus tachycardia
ischaemia or valvular disease due to increased myocardial demand
treatment of sinus tachycardia
treat the cause
beta blockers
ECG diagnosis of sinus tachycardia
rate >100
regular rhythm
shortened PR interval
shortened but morphologically normal QRS
symptoms of supraventricular tachycardia
palpitations
faintness
chest pain
ECG diagnosis of supra ventricular tachycardia
narrow QRS complex (but varies for each condition)
4 main types of supra ventricular tachycardia
atrial fibrillation
paroxysmal supraventricular tachycardia
Wolff-Parkinson White syndrome
atrial flutter
pathology of ventricular tachycardia
fast heart rate due to improper electrical activity in the ventricles
symptoms of ventricular tachycardia
palpitations and chest pain
complications of ventricular tachycardia
cardiac arrest
ventricular fibrillation
treatment of ventricular tachycardia
defibrillation
cardioversion
calcium channel blockers
ECG diagnosis of ventricular tachycardia
heart rate above 120bpm and at least 3 wide QRS complexes in a row
ECG sign of hypercalcaemia
QT shortening
ECG sign of hypocalcaemia
QT prolongation
pathology of ventricular atopic beat
initiation of contrition in Purkinje fibres rather than the SAN
symptoms of ventricular atopic beat
skipped beat
palpitations
complications of ventricular atopic beat
(unlikely)
arrhythmias
cardiomyopathy
treatment of ventricular atopic beat
anti-arrhythmics
beta blockers
calcium channel blockers
diagnosis of ventricular atopic beat
ECG
prolonged QT syndrome pathology
channelopathy - abnormal repolarisation of heart muscle
differences in refractory periods across cells leading to ‘afterdepolarisations’
sign of prolonged QT syndrome
sudden death
symptoms of prolonged QT syndrome
syncope
seizures
sudden death
complications of prolonged QT syndrome
QT prolonging drugs can kill
treatment of prolonged QT syndrome
avoid strenuous exercise
get sufficient potassium in diet
beta blockers
implantable cardiac defibrillator
ECG diagnosis of prolonged QT syndrome
corrected QT interval of greater than 440-500ms together with clinical findings
pathology of Wolff-Parkinson White syndrome
pre-excitation syndrome
accessory conduction pathway between atria and ventricles - bundle of Kent
symptoms of Wolff-Parkinson White syndrome
tachycardia
palpitations
syncope
dyspnoea
treatment of Wolff-Parkinson White syndrome
ablation of accessory pathway
ECG diagnosis of Wolff-Parkinson White syndrome
short PR interval and a delta wave, wide QRS