The Case Of The Fluttering Heart Flashcards

1
Q

reasons for tachycardia

A
negative fluid status
sepsis
pain
awareness in surgery 
response to intubation
drug interactions
adrenal crisis
thyroid
electrolytes
PE
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2
Q

signs of inadequate anaesthesia depth

A
tachycardia
hypotension
sweating
pupils dilated
increased RR
movement if not given muscle relaxant
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3
Q

signs of sepsis

A
tachycardia
hypotension
fever
rising lactate
acidosis
low urine output
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4
Q

why is falling BP a late sign of decreased arterial pressure ?

A

initially baroreceptors cause HR to increase as compensation, eventually decompensated and that causes a drop in BP

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5
Q

Causes of adrenal storm

A

tumours
overdose of stimulants e.g. cocaine
subarachnoid haemorrhage

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6
Q

how much does AF decrease cardiac output by?

A

10%

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7
Q

ECG signs of AF

A

ECG signs of AF
irregularly irregular
absent p waves
f waves

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8
Q

causes of sinus bradycardia

A

age degeneration
beta blockers
athletic

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9
Q

Path of electrical conduction of the heart

A

SA node, AV node, AV bundle, bundle branches, Purkinje fibers

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10
Q

categories of AF

A

paroxysmal
persistent
longstanding persistent
permanent

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11
Q

persistent vs longstanding persistent AF

A

persistent more than 7 days

long standing more than 12 months

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12
Q

risk factors for AF

A
high BMI
inactivity
age
CVD
valve disease (MR)
smoking
high alcohol intake
COPD
OSA
male
intense physical activity
high cholesterol
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13
Q

why can mitral regurgitation result in atrial fibrillation

A

causes left atrium to dilate

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14
Q

pros of 12 lead ECG

A

cheap
easy to do
instant result
good evidence

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15
Q

indications for 24/48hr tape

A
investigating palpitations or syncope
silent AF
daily symptoms
classifying burden of disease
assessing chronotropic incompetence
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16
Q

Chronotropic incompetence

A

a condition in which the heart rate increases slowly during exercise and never reaches maximum, never goes high enough for the activity

17
Q

Holter monitor

A

portable ECG monitor worn by patient usually for 7 days (can be up to 2 weeks) which records any irregular rhythm

18
Q

cons of exercise tolerance test

A

patient must be mobile
some meds cause false negatives e.g. beta blockers
not sensitive if coronary anatomy unknown

19
Q

pros of exercise tolerance test

A

dynamic test

urgent findings can be flagged straight away

20
Q

Implantable loop recorder

A

An electronic device that is surgically placed in the patient’s body and connected to the heart in order to detect dysrhythmias, can have for up to 3yrs

21
Q

tilt table testing

A

patient placed at 60 degree angle for 45mins ± GTN and see if they faint

22
Q

indications for tilt table testing

A

mainly used for unexplained recurrent syncope or POTS