T2 Heart Blocks

Question 1

Not tested on individual Rythms on t2 but may need to know how to treat them.

Answer 1

Yes

Question 2

Occurs when there is a delay or blockage in electrical conduction between atria and the ventricles

Can be caused by 
Increased vagal tone
Damage to the conduction system
Myocarditis
Congential defects
Medication toxicity

Answer 2

Heart block

Question 3

Electricity of heart should start where?

Answer 3

start in sa node travel to av node

Question 4

Variations of heart blocks?

Answer 4

First degree
Second degree type one
Second degree type two
Third degree

Question 5

Identified by prolong PR interval, greater than 0.20 seconds
Can be seen in digoxin or beta blocker use
Treatment: Monitor- not usually a big deal

Should be between 0.12-.2 seconds (3-5 little boxes)

Answer 5

First degree heart block

Question 6

Also called Wenckebach

Intermittent block of electricity that results in the failure to conduct from the atria to the ventricles

Recognized by noticing a lengthening of the PR interval until the P wave “drops a beat”
“
longer, longer, longer drop then you have a Wenckebach”

Tx?

Symptomatic?

May become Bradycardic

Answer 6

Second degree heart block type 1

Treatment: Monitor, usually benign. Treat as you would other bradycardia

If symptomatic: May need pacemaker

Question 7

How to treat Bradyycardia

Answer 7

Atropine, oxygen, increased IV fluids , pacemaker if needed

Question 8

Also called Mobitz 2

Occurs when the His-purkinje fibers fail to conduct impulses

Has a higher risk of turning into complete heart block
Keep an eye on rhythm

Recognized by a consistent PR interval(no change) followed by a “dropped beat”
“
If some P’s don’t get through, then you have a Mobitz 2”

Tx?

If symptomatic?

Answer 8

Second degree heart block type 2

Treatment: treat as other bradycardias, close monitoring

If symptomatic: external pacing until permanent pacemaker can be placed

Question 9

Also called complete heart block

Occurs when there is a complete failure to conduct impulses from the atria to the ventricles
(Do not communicate which results in decreases perfusion) 20-40 bpm and decreases bp

Lethal rhythm: Patient can have ventricular asystole at any time
-quickly

Tx -

Answer 9

Third degree heart block

Treatment: immediate tx-Pacemaker is necessary to sustain life
“
If Ps and Qs don’t agree, then you have a third degree”

Question 10

If the R is far from the P then you have a ?

Answer 10

First degree

Question 11

Longer longer longer drop.

Then you have a ?

Answer 11

Wenkeback - 2nd degree heart block type 1

Question 12

If Some Ps don’t get through

Then you have ?

Answer 12

Mobitz 2

2nd degree hb type 2 - Mobitz 2

Question 13

If Ps and Qs don’t agree

Then you have a ?

Answer 13

3rd degree

Question 14

The wife or P-wave weights at home for the husband QRS. The husband QRS comes home on time every night

Answer 14

Normal sinus Rythm

Question 15

The wife, P-wave is waiting at home. The husband QRS comes home late every night, but he always comes home and it’s at the same time every night

Answer 15

1st degree AV block

Question 16

The wife, P-wave is waiting at home. The husband QRS comes home later and later every night until one night he doesn’t come home at all.

The husband QRS must come home at least two nights in a row to see this pattern

Answer 16

second-degree heart block type 1 - weinkeback

Question 17

The wife, P-wave is waiting at home. Sometimes the husband QRS comes home, sometimes he doesn’t. When he does come home, it’s always at the same time.

This is usually more serious than type one -weinkebach and will sometimes require pace maker

Answer 17

2nd degree AV block type 2

Question 18

The wife, P-wave is no longer waiting at home. She and her husband QRS are now both on a separate schedule and have no relationship and they are no longer talking. Each spouse has a regular, individual schedule.

This frequently requires counseling, (temp or permanent pacemaker)

Answer 18

3rd degree AV block