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ECG > SVT + VT > Flashcards

SVT + VT Flashcards

1
Q

What causes a delta wave?

A

Early depolarisation of the ventricles

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2
Q

What are re-entry tachycardias?

A

Wolff Parkinson White syndrome
AV re-entry tachycardias
SVT

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3
Q

What are the characteristics of re-entry tachycardias?

A

Narrow QRS
Possible P waves
Non specific ST depression
They are orthodromic

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4
Q

What are the characteristics of AV re-entry tachycardias?

A 
Narrow complex tachycardia
160-250 bpm
Delta waves present on ECG
P waves present
Inverted P wave in inferior leads and lead 1
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5
Q

What is the cause of antidromic AV re-entry tachycardia?

A

Re-entry circuit from the atria to ventricles
Antegrada conduction to the ventricles via an accessory pathway with retrograde conduction to the atria via the AV node
Rare as it is pure delta waves

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6
Q

What are the characteristics of antidromic AV re-entry tachycardias?

A

Wide complex tachycardia
Regular, sinus rhythm
Delta waves with QRS morphology with normal QRS complex
Inverted P waves

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7
Q

Which tachycardia is responsible for 2/3 narrow complex tachycardias?

A

AV re-entry tachycardia

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8
Q

Which gender is AV re-entry tachycardia more commoner in?

A

Women

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9
Q

What can be distressing for pts who suffer from AV re-entry tachycardia?

A

Recurrent palpitations

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10
Q

What are the ventricular rhythms?

A 
Ventricular ectopics
Bigeminy
Idioventricular
Ventricular tachycardia
Monomorphic and polymorphic
Torsades de pointes
Ventricular fibrillation
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11
Q

What are the characteristics of ventricular arrhythmias?

A

No preceding P wave
Abnormal shape
Wide complex
Followed by a compensatory pause

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12
Q

What are the causes of ectopic beats?

A

Some are naturally occurring
IHD
Digoxin toxicity
LV dysfunction

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13
Q

What are the characteristics of ventricular ectopics / ventricular arrhythmias?

A

No P wave
Wide and bizarre QRS
Can look the same (unifocal) or different (multi focal)
Originates from a ventricular foci outside normal conduction pathways

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14
Q

What are the ventricular ectopic / ventricular arrhythmias rhythms?

A 
Unifocal
Multi focal
Bigeminy
Trigeminy
Paris Couplet
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15
Q

What is VT classed as?

A

3 or more ventricular arrhythmias rhythms

Rate = >100 bpm

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16
Q

What is a pre excitation beat?

A

It’s when the impulse bypasses the normal conduction, via the bundle of Kent
Starts in the atrium into the ventricle

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17
Q

What are the causes of ventricular arrhythmias?

A

Electrolyte imbalance
Hypoxia/ischaemia
Acidosis
Invasive equipment

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18
Q

How do you treat ventricular arrhythmias?

A

Treat the cause

19
Q

What are the characteristics of ventricular bigeminy?

A

Each sinus beat is followed by an ectopic beat

P waves can be seen in the T wave of the ectopic

20
Q

What does idio-ventricular rhythm look like?

A

Slow VT

21
Q

What is the cause of idio-ventricular rhythm?

A

Reperfusion of the myocardium post MI

22
Q

How do you treat idio-ventricular rhythm?

A

It does not require treatment

23
Q

What are the characteristics of idio-ventricular rhythm?

A 
40-100 bpm 
Regular rhythm
P waves not present
PR interval not present
QRS wide and abnormal
T wave abnormal
24
Q

What does an abnormal T wave mean?

A

Abnormal depolarisation = abnormal repolarisation

25
Q

What are the characteristics of accelerated idioventricular rhythm?

A

Wide complex rhythm
Regular
P wave seen in T wave

26
Q

What is accelerated idioventricular rhythm?

A

Reperfusion arrhythmia, usually seen in AMI

27
Q

What should all wide complex tachycardias be treated as?

A

VT until proven otherwise

28
Q

What are the characteristics of VT?

A

140-200 bpm
3+ consecutive ectopics
Wide (>2.5-3.5 small squares) and bizarre QRS

29
Q

Where does ventricular tachycardia originate?

A

An ectopic pacemaker

30
Q

What are the characteristics of broad complex tachycardia?

A

Broad complex
Tachycardia rate
P wave notches present

31
Q

What are the 3 things needed on an ECG to diagnose VT?

A
  1. Evidence of AV dissociation (P wave in T wave)
  2. Fusion beats
  3. Capture beats
32
Q

What is a fusion beat?

A

An impulse from 2 different foci meeting in the ventricle and depolarising simultaneously
Normally and SVT impulse and ventricular ectopic impulse
Similar to capture beat but merges with ventricular impulse
There is evidence of AV dissociation

33
Q

What is a capture beat?

A

An SVT impulse conducting into the ventricle and then conducted normally in a normal QRS
Will be conducted in the middle of VT
Evidence of AV dissociation

34
Q

What is the cause of monomorphic VT?

A

Myocardial ischaemia

35
Q

What does VT look like on an ECG?

A

Regular rhythm
Chest leads are either all negative or all positive
No PR interval
AV dissociation of each complex slightly different

36
Q

What is AV dissociation?

A

P wave in the T wave

37
Q

What are the causes of polymorphic VT?

A 
IHD (particularly MI)
Impaired LV function
Cardiomyopathies
Long QT syndrome
Electrolyte abnormalities
Drugs
Catecholamine sensitivity
Can occur in normal hearts
38
Q

What are the characteristics of polymorphic VT?

A 
VT made up of multiple QRS morphologies
Each beat = different shape
Varying RR interval
150-300 bpm
"Tornadoes de pointes"
39
Q

What is Torsades do pointes?

A

A beat that starts with an R on T phenomenon

A ventricular premature beat that coincides with the T wave

40
Q

What are the causes of Torsades de pointes?

A 
AV block
Hypokaleamia
Hypomagnesia
Drug induced long QT
Drugs: amiodarone, sotolol, tricyclic antidepressant 
Congenital long QT syndrome 
IHD
Myoedema
41
Q

What are the characteristics of ventricular fibrillation?

A 
Rate can't be detected
Irregular rhythm
P waves not present
QRS not present
Waves are abnormal and chaotic
Can't determine onset or end of fibrillation waves
Amplitude varies 
 3mm = coarse fibrillation
42
Q

What causes the abnormal waves of VF?

A

Haphazard depolarisation of small individual groups of muscle

43
Q

What are the causes of VF?

A 
Digitails
Quinidine
Procainamide
Hypoxia
Acidosis
Electrolyte imbalance
44
Q

What does ventricular fibrillation mean for a pt?

A

They have no cardiac output

Use 2 leads to identify

ECG (19 decks)

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