The patient with arrhythmia Flashcards
How should a patient with AF and life-threatening haemodynamic instability (hypotensive and tachycardic) be managed?
Emergency electrical cardioversion
How should a patient with AF (onset less than 48 hours ago) and non-life-threatening haemodynamic instability be managed?
Flecainide
or Amiodarone if evidence of structural heart disease
How should a patient with AF (onset more than 48 hours ago) and non-life-threatening haemodynamic instability be managed?
Start rate control (atenolol or propanolol).
What are the ECG features of Ventricular Fibrillation?
Wide QRS complex (>0.12s), irregular wave form, no clearly identifiable QRS complex or p waves, wandering baseline
ECG features of 2nd degree heart block (Mobitz type 1/Wenkebach)?
PR interval gets longer and longer until a QRS complex is dropped then cycle restarts
ECG features of 2nd degree heart block (Mobitz type 2)?
Every p wave is NOT followed by a QRS complex. Atria may contract 2 or 3 times for every 1 ventricular contraction (2:1/3:1). Fixed PR intervals for ventricular beats.
ECG features of 3rd degree heart block?
Atrial activity isn’t related to ventricular activity. Regular p waves and R waves but appears as 2 sepearate rhythms superimposed on each other. QRS complex is wide.
Which of the heart block degrees tend to be asymptomatic?
First degree and Mobitz type 1/Wenkebach
In Ventricular tachycardia, what is classed as a sustained duration and therefore requires intervention due to haemodynamic compromise?
> 30 seconds
Which arrhthymia is a ‘sawtooth pattern’ on ECG characteristic of?
Atrial flutter
A diagnosis of anaphylaxis is likely when which 3 criteria have been fulfilled?
- Sudden onset and rapid progression of symptoms
- Life-threatening airway and/or breathing and/or circulation problems
- Skin and mucosal changes (pruritus, erythema, urticaria, angioedema)
