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6566 lecture > week 2 cardiology > Flashcards

week 2 cardiology Flashcards

1
Q

any change from normal electrical cardiac conduction; can result in impulses that occur too quickly or too slowly?

A

ARRYTHMIAS

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2
Q

Two categories of arrhythmias?

A

Ventricular and supraventricular

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3
Q

Ventricular rate less than 60 beats per min?

A

Bradycardia

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4
Q

What are the conduction system that causes bradycardia?

A

Sick Sinus rhythm (SSS), Heart Block (1,2,3rd degree)

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5
Q

Calculate stroke risk for patient with afib

A

CHA2DS2VASc

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6
Q

Atrial Fibrillation Prevalence

A

They are the lowest in Asian or African American/black
Highest in European descent

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7
Q

Arrhythmia that can cause sudden cardiac death

A

VFIB and VTACH,
VT is commonly seen in males secondary to CAD

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8
Q
A

Atrial Fibrillation

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9
Q

What is an arrhythmia?

A

An arrhythmia is an irregular heartbeat that can be too fast, too slow, or erratic.

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10
Q

True or False: All arrhythmias are dangerous.

A

False

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11
Q

Fill in the blank: Atrial fibrillation is characterized by __________.

A

irregular and often rapid heart rate

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12
Q

What is the common term for a heart rate over 100 beats per minute?

A

Tachycardia

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13
Q

What type of arrhythmia is associated with a heart rate below 60 beats per minute?

A

Bradycardia

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14
Q

What is the primary method used to diagnose arrhythmias?

A

Electrocardiogram (ECG or EKG)

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15
Q

Multiple Choice: Which of the following is NOT a type of arrhythmia? A) Atrial Fibrillation B) Ventricular Tachycardia C) Hypertension

A

C) Hypertension

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16
Q

Short Answer: Name one symptom of arrhythmias.

A

Palpitations

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17
Q

True or False: Arrhythmias can be caused by electrolyte imbalances.

A

True

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18
Q

What arrhythmia is characterized by a ‘sawtooth’ pattern on an ECG?

A

Atrial flutter

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19
Q

Fill in the blank: Ventricular fibrillation is a life-threatening condition that requires __________.

A

defibrillation

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20
Q

What is the term for a pause in the heart’s electrical activity?

A

Asystole

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21
Q

Multiple Choice: Which arrhythmia is most commonly associated with heart failure? A) Atrial Fibrillation B) Sinus Bradycardia C) Supraventricular Tachycardia

A

A) Atrial Fibrillation

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22
Q

What is the purpose of an implantable cardioverter-defibrillator (ICD)?

A

To monitor heart rhythms and deliver shocks if life-threatening arrhythmias occur.

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23
Q

True or False: Stress can trigger arrhythmias.

A

True

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24
Q

What is the term for the irregular heartbeat that occurs after a heart attack?

A

Post-myocardial infarction arrhythmia

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25
Fill in the blank: A __________ is a device used to help regulate heart rhythms.
pacemaker
26
What does the term 'premature ventricular contractions' (PVCs) refer to?
Extra, abnormal heartbeats originating in the ventricles.
27
Multiple Choice: Which of the following can be a risk factor for developing arrhythmias? A) Smoking B) Regular exercise C) Balanced diet
A) Smoking
28
Short Answer: What is the main electrical pathway in the heart?
The conduction system
29
True or False: All arrhythmias require treatment.
False
30
What is the significance of the P wave on an ECG?
It represents atrial depolarization.
31
Fill in the blank: The __________ interval on an ECG measures the time it takes for the heart muscle to recover after each heartbeat.
QT
32
What does the term 'supraventricular' refer to in arrhythmias?
Arrhythmias that originate above the ventricles.
33
Multiple Choice: Which arrhythmia is characterized by a rapid heartbeat that starts and stops suddenly? A) Atrial Fibrillation B) Paroxysmal Supraventricular Tachycardia C) Ventricular Fibrillation
B) Paroxysmal Supraventricular Tachycardia
34
What are common subjective data complaints in arrhythmias?
* Fatigue * Dyspnea on exertion or at rest * Chest discomfort * Palpitations * Dizziness, lightheadedness, syncope * Diaphoresis
35
True or False: Patient presentation varies based on the type and degree of arrhythmia.
True
36
What does an EKG of AF typically show?
* Tachycardia rate (110–180 bpm) * Irregularly irregular rhythm * No discernable P-waves
37
What is the hallmark of first-degree heart block on EKG?
A PR interval greater than 0.20 seconds with a QRS complex following each P-wave
38
What laboratory tests are important for evaluating arrhythmias?
* Complete blood count with differential * Complete metabolic panel * Thyroid panel * Cardiac biomarkers * Digitalis level * Toxicology screening * D-dimer * Chest x-ray * Exercise stress testing * Holter monitor or loop recorder * Transesophageal echocardiogram (TEE)
39
What is included in the CHA2DS2-VASc score for assessing thromboembolic risk?
* Congestive heart failure: 1 * Hypertension history: 1 * Age ≥75 years: 2 * Diabetes mellitus: 1 * Prior stroke/transient ischemic attack: 2 * Vascular disease: 1 * Age 65–74 years: 1 * Female sex: 1
40
Fill in the blank: The drug of choice for acute PSVT is _______.
IV adenosine
41
What should be done if a patient is in hemodynamically unstable AF?
Perform immediate electrical cardioversion
42
What is the initial treatment for sustained VT with hemodynamic instability?
Immediate electrical cardioversion and IV amiodarone
43
What is the management for bradycardic rhythms?
* Atropine for acute symptomatic bradycardia * Dopamine as second-line drug * Epinephrine infusion if atropine or pacing fails
44
What is the most effective long-term monitoring strategy for degree heart block type 2 and third-degree heart block?
Pacemaker implantation ## Footnote Pacemakers provide reliable heart rhythm management for patients with significant heart block.
45
What is atropine used for?
Acute symptomatic bradycardia ## Footnote Atropine is effective if a reversible cause of bradycardia is not identified.
46
What is dopamine's role in treating bradycardia?
Second-line drug if atropine is ineffective ## Footnote Dopamine can help in symptomatic bradycardia when atropine fails.
47
What information should be provided to patients with newly implanted devices?
Device information, clinic follow-up, home monitoring systems ## Footnote Proper education is essential for effective management of their devices.
48
What should patients using amiodarone understand?
Side effects and monitoring for organ toxicities ## Footnote Amiodarone can affect the liver, lungs, thyroid, and other organs.
49
What should patients have monitored to reduce the risk of arrhythmias?
Electrolytes ## Footnote Electrolyte imbalances can trigger or worsen arrhythmias.
50
When should a temporary pacemaker be used?
If the patient fails to respond to atropine, dopamine, or epinephrine ## Footnote Temporary pacing is critical for hemodynamically unstable patients.
51
What is the function of biventricular pacemakers?
Pace the rhythm of the ventricles for simultaneous contraction ## Footnote These are particularly useful in patients with heart failure and conduction abnormalities.
52
What does an ICD do?
Detects lethal cardiac arrhythmias and delivers electrical shocks ## Footnote ICDs are crucial for preventing sudden cardiac death.
53
What is the primary abnormality in arrhythmias?
An abnormality in the normal activation sequence of the cardiac fibers within the myocardium
54
What are the three primary mechanisms for arrhythmias?
* Increased or decreased automaticity * Triggered activity * Dysfunction in circulatory pathways
55
What factors contribute to the pathogenesis of atrial fibrillation (AF)?
* Electrical dysfunction * Structural dysfunction * Contractile dysfunction
56
What characterizes the rhythm of atrial fibrillation?
Irregularly irregular tachycardic rhythm due to multiple foci sending chaotic impulses
57
What is the typical atrial rate in atrial fibrillation?
Greater than 400 beats per minute
58
What is the typical ventricular rate in atrial fibrillation?
75 to 175 beats per minute
59
What is atrial flutter?
A variation of AF with one primary automatic focus firing between 250 and 350 beats per minute
60
What is the typical ventricular rate in atrial flutter?
One-half to one-third the atrial rate
61
What causes paroxysmal supraventricular tachycardia (PSVT)?
AV nodal reentry tachycardia
62
What are the two pathways within the AV node?
* Fast * Slow
63
Where do ventricular arrhythmias originate?
Below the bundle of His
64
What defines a premature ventricular contraction (PVC)?
A heartbeat that fires on its own from a specific focus in one ventricle
65
What is ventricular tachycardia (VT)?
Occurs due to quick and constant firing of three or more PVCs at a rate of 100 to 250 beats per minute
66
What occurs during ventricular fibrillation (VF)?
Irregular quivering of the ventricles with no cardiac output
67
What is sick sinus syndrome (SSS)?
Typically occurs due to spontaneous persistent bradycardia
68
What characterizes first-degree AV block?
Conduction delay at the AV node resulting in decreased pulse
69
What are the types of second-degree AV block?
* Type 1: Block within the AV node causing bradycardia * Type 2: Block within the bundle of His–Purkinje fibers causing bradycardia
70
What is the result of third-degree AV block?
Complete dissociation between the atria and ventricles, significant bradycardia (25 to 40 beats per minute)

6566 lecture (3 decks)

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