Tachycardia Flashcards

1
Q

Tachyarrhythmia presentation

A

asymptomatic
SOB
palpitations
pre-syncope
chest pain
collapse
cardiac arrest

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2
Q

What is a palpitation?

A

abnormal awareness of heartbeat (not necessarily an abnormal heartbeat)

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3
Q

What questions should you consider when you are presented with a tachyarrhythmia?

A

fast or sloe
broad or narrow QRS
regular or irregular
are there P waves

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4
Q

AF ECG

A

narrow complex
irregularly irregular
no organised P waves
irregular baseline

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5
Q

Define tachycardia

A

heart rate > 100bpm

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6
Q

List some narrow complex tachycardias

A

<120ms
sinus tachycardia
AF
atrial flutter
focal atrial tachycardia
AVNRT
AVRT

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7
Q

List some broad complex tachycardias

A

ventricular tachycardia
‘SVT’ with aberrations
pre-excited tachycardia
pacemaker-associated tachycardia

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8
Q

What is the typical rate of atrial flutter?

A

150bpm
(normally an exact division of 300)

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9
Q

Atrial flutter ECG

A

narrow complex
regular
organised atrial activity
‘sawtooth’ appearance

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10
Q

Adenosine MOA

A

blocks AV node

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11
Q

AVNRT ECG

A

atrioventricular nodal reentry tachycardia
inverted retrograde P wave
(no normal P waves)
carotid sinus pressure may cause reversion to sinus rhythm
rate usually 150-180 bpm
narrow QRS

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12
Q

Wolff-Parkinson-White ECG

A

short PR interval (<120ms)
broad QRS
delta wave (slurred upstroke to QRS complex)

[pre-excitation syndrome]

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13
Q

What is an accessory pathway?

A

an extra piece of heart muscle tissue that connects directly between the atria and the ventricles, bypassing the AV node altogether

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14
Q

How do accessory pathways show on ECG in sinus rhythm?

A

broad QRS + pre-excitation (delta waves)

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15
Q

w do accessory pathways show on ECG in tachycardia?

A

narrow QRS + no pre-excitation

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16
Q

What arrhythmias occur above the AV node?

A

atrial fibrillation
atrial flutter
focal atrial tachycardias

17
Q

What arrhythmias involve the AV node?

A

AV nodal re-entry tachycardia (AVNRT)
AV re-entry tachycardia (AVRT)

18
Q

What arrhythmia occurs below the AV node?

A

ventricular tachycardia

19
Q

Management of tachyarrhythmias

A

management of thrombo-embolic risk
rate control (beta blocker, rate-slowing CCB, digoxin)
termination of re-entrant arrhythmia (massage carotid sinus, valsalva manoeuvre, ineffective = give adenosine)
anti-arrhythmic therapy
interventional electrophysiological procedures (AVRT, AVNRT, flutter, fibrillation, FAT)