Ventricular ECG

Question 1

Ventricular premature contractions (3)

Answer 1

P wave none preceding the premature QRS
No PR interval
QRS rate - early beat more than .10 seconds

Question 2

Common etiology of ventricular premature contractions

Answer 2

ischemia
insult to purkinje system or ventricle
acidosis
low K level
drugs
CHF and cardiomyopathy

Question 3

Clinical signs and symptoms VPC

Answer 3

palpitations
skipped beats
pulse will have pause followed by strong beat
may lead to vtach of vfib

Question 4

VPC - Bigeminy

Answer 4

VPC alternates with a normal beat in a repeating pattern - every other beat is a VPC

Question 5

VPC - Trigeminy

Answer 5

VPC alternates with two normal beats in a repeating pattern - every third beat is a VPC

Question 6

VPC - quadrigeminy

Answer 6

VPC alternates with three normal beats in a repeating pattern - fourth beat is a VPC

Question 7

Multifocal VPC

Answer 7

from a different spot in the ventricle - look different

Question 8

Tx for VPC

Answer 8

no tx if healthy
correct underlying electrolytes
administer O2 or Mg

Question 9

How many VPC per minutes is considered pathological

Answer 9

6

Question 10

Ventricular tachycardia

Answer 10

P wave usually not seen
PR interval variable
QRS - 100-250

Question 11

Common etiology - Ventricular tachycardia

Answer 11

Insult to purkinje system or ventricle (MI)
Hypoxemia
Acidosis
Low K level
Drugs

Question 12

Clinical signs and sx - ventricular tachycardia

Answer 12

dysrhythmia
dec consiousness
palpitations, dyspnea, dizzy, anxiety, diaphoresis, angina
Dec BP
may have no CO

Question 13

Tx for ventricular tachycardia

Answer 13

conscious and no sx - drug therapy (xylocaine, procainamide, bretylium)
Unresponsive to drugs - cardiovert
unconsious - defibrillate

Question 14

Ventricular tachycardia appears like a run of

Answer 14

PVC

Question 15

Why ventricular tachycardia particularly dangerous for elderly

Answer 15

CO dec so now adding Vtach too and they will crash sooner

Question 16

Venticular tachycardia - torsafes de pointes (3)

Answer 16

P wave usually not seen
PR interval - variable
QRS rate - 100 to 250
Long QT interval (more than 0.05)

Question 17

Venticular tachycardia - torsafes de pointes - etiology

Answer 17

People on antiarrhythmics
Heart block
Hypokalemia

Question 18

Venticular tachycardia - torsafes de pointes - clinical signs and sx

Answer 18

if individual remains conscious they will be extremely lightheaded or near syncope

Question 19

Venticular tachycardia - torsafes de pointes - tx

Answer 19

defibrillation

cardioversion

Question 20

Ventricular fibrillation - (3)

Answer 20

no P wave
no PR interval
QRS - not well defined rate

Question 21

Etiology - ventricular fibrillation

Answer 21

Injury to purkinje or ventricle
Hypoxemia
Electrolyte disturbances
Electrical shock
Drugs

Question 22

Clinical signs and sx ventricular fibrillation

Answer 22

loss of consiousness
no pulse, rr, bp
possible seizure
cyanosis
clinical death

Question 23

tx - ventricular fibrillation

Answer 23

procardial thump
defibrillator
CPR

Question 24

is ventricular fibrillation from one foci or multiple

Answer 24

multiple

Question 25

ventricular asystole

Answer 25

nothing - flat line