Ventricular ECG Flashcards
Ventricular premature contractions (3)
P wave none preceding the premature QRS
No PR interval
QRS rate - early beat more than .10 seconds
Common etiology of ventricular premature contractions
ischemia insult to purkinje system or ventricle acidosis low K level drugs CHF and cardiomyopathy
Clinical signs and symptoms VPC
palpitations
skipped beats
pulse will have pause followed by strong beat
may lead to vtach of vfib
VPC - Bigeminy
VPC alternates with a normal beat in a repeating pattern - every other beat is a VPC
VPC - Trigeminy
VPC alternates with two normal beats in a repeating pattern - every third beat is a VPC
VPC - quadrigeminy
VPC alternates with three normal beats in a repeating pattern - fourth beat is a VPC
Multifocal VPC
from a different spot in the ventricle - look different
Tx for VPC
no tx if healthy
correct underlying electrolytes
administer O2 or Mg
How many VPC per minutes is considered pathological
6
Ventricular tachycardia
P wave usually not seen
PR interval variable
QRS - 100-250
Common etiology - Ventricular tachycardia
Insult to purkinje system or ventricle (MI) Hypoxemia Acidosis Low K level Drugs
Clinical signs and sx - ventricular tachycardia
dysrhythmia dec consiousness palpitations, dyspnea, dizzy, anxiety, diaphoresis, angina Dec BP may have no CO
Tx for ventricular tachycardia
conscious and no sx - drug therapy (xylocaine, procainamide, bretylium)
Unresponsive to drugs - cardiovert
unconsious - defibrillate
Ventricular tachycardia appears like a run of
PVC
Why ventricular tachycardia particularly dangerous for elderly
CO dec so now adding Vtach too and they will crash sooner
Venticular tachycardia - torsafes de pointes (3)
P wave usually not seen
PR interval - variable
QRS rate - 100 to 250
Long QT interval (more than 0.05)
Venticular tachycardia - torsafes de pointes - etiology
People on antiarrhythmics
Heart block
Hypokalemia
Venticular tachycardia - torsafes de pointes - clinical signs and sx
if individual remains conscious they will be extremely lightheaded or near syncope
Venticular tachycardia - torsafes de pointes - tx
defibrillation
cardioversion
Ventricular fibrillation - (3)
no P wave
no PR interval
QRS - not well defined rate
Etiology - ventricular fibrillation
Injury to purkinje or ventricle Hypoxemia Electrolyte disturbances Electrical shock Drugs
Clinical signs and sx ventricular fibrillation
loss of consiousness no pulse, rr, bp possible seizure cyanosis clinical death
tx - ventricular fibrillation
procardial thump
defibrillator
CPR
is ventricular fibrillation from one foci or multiple
multiple
