SVTs

Question 1

Atrial Flutter is characterized by how many beats per min?

Answer 1

100-150

Question 2

Classic sign on EKG is “sawtooth” pattern

Answer 2

Atrial flutter

Question 3

Signature tachycardia associated with COPD patients

Answer 3

Multifocal Atrial Tachycardia

Question 4

SVT that can also be associated with digoxin toxicity.

Answer 4

MFA Tachy

Question 5

What are the 10 risk factors associated with Afib?

Answer 5

I SMART CHAP: inflammation, surgery, meds, atherosclerotic CAD, rheumatic heart disease, thyrotoxicosis, CHD, HTN, R-OH, PE

Question 6

How does digoxin work? IOW, what does it inhibit?

Answer 6

NA+ K+ ATPase pump

Question 7

What is the main way to treat digoxin toxicity?

Answer 7

correct electrolyte imbalance should be primary step; in severe cases can use digibind.

Question 8

True or False: Atrial Flutter is LESS common than AFib

Answer 8

True

Question 9

Atrial Flutter is commonly seen amongst which patient population?

Answer 9

pts with structural heart disease but also pts with COPD

Question 10

Per Lau, what is the DOC for tx of both Afib and Aflutter?

Answer 10

amiodarone

Question 11

What is the most effective therapy treatment for multifocal atrial tachycardia?

Answer 11

tx of the underlying lung disease

Question 12

What is the characteristic EKG finding for MF Atrial tachy?

Answer 12

varying p wave morphology (AT LEAST 3 need to be present to make dx) and markedly irregular PP intervals.

Question 13

The dx for MF Atrail tachy is almost exactly the same as wandering atrial pacemaker. What is the differentiating factor?

Answer 13

wandering atrial pacemaker is HR is normal (between 60 and 100) and NOT trachycardic

Question 14

What is the one SVT in which cardioversion is really just ineffective and should not be used?

Answer 14

MAT

Question 15

Irregularly irregular rhythm with irregular RR intervals and no identifiable P wave

Answer 15

Afib

Question 16

What are the three things you want to do in terms of the treatment of Afib?

Answer 16

correct rate and rhythm, then add anticoagulants

Question 17

In terms of the treatment of chronic Afib, what test would you want to do?

Answer 17

echo to check to any structural changes in the heart - most specifically in the atrium

Question 18

What is the structural heart change associated with Afib?

Answer 18

Left atrial enlargement

Question 19

When you see Left Atrial Enlargement, what murmur should you automatically think of?

Answer 19

Mitral Stenosis

Question 20

What is the common example for paroxysmal Afib?

Answer 20

alcohol induced Afib.

Question 21

What is the difference between acute and paroxysmal Afib?

Answer 21

acute is a sudden onset; paroxysmal is an onset that occurs and we don’t know when or why.

Question 22

Which is more dangerous - acute, chronic or paroxysmal Afib?

Answer 22

paroxysmal; often these patients will die suddenly

Question 23

Patient with paroxysmal Afib dies suddenly, what is the most likely cause of death?

Answer 23

PE

Question 24

What is the first line therapy for acute Afib?

Answer 24

reduce the rate! must get it below 100 beats per minute.

Question 25

Do you shock patients who have bradycardia?

Answer 25

NO!

Question 26

What device should those with paroxysmal Afib be given to help further along the diagnosis?

Answer 26

event holter monitor