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2C The Cardiovascular System > Week 3 - Arrhythmias > Flashcards

Week 3 - Arrhythmias Flashcards

1
Q

What is the most common arrhythmia

A

AF

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2
Q

What is the prevalence of AF

A

Increases with age.
10% ≥ 70 years; 23% ≥ 80 years

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3
Q

What causes AF

A

Supraventricular tachyarrhythmia
– Uncoordinated atrial contraction
– Irregular and frequently fast ventricular rate

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4
Q

What is the classification for AF

A

First diagnosis - Paroxysmal AF - Persistent AF - Long standing persistent AF - Permanent AF

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5
Q

What are symptoms of AF

A

Palpitations, Dyspnoea, Chest tightness, Fatigue / lethargy, Sleeping disturbance, Psychological effects

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6
Q

Aetiological factors which cause AF

A

Aging (structural remodelling), Heart failure • Hypertension and Diabetes mellitus • Valvular heart disease (esp. mitral) • Coronary artery disease (atrial ischaemia) • Alcohol excess • Hyperthyroidism (trigger) • Obesity and sleep apnoea • Autonomic activation

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7
Q

What is the diagnostic work up of AF
What investigations would you do

A

12-lead ECG • BP • Bloods - FBC, U&E, LFT, TFT, Coag • Echocardiogram • Holter monitoring
– Symptom / Rhythm correlation
– AF burden
– Ventricular rate control

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8
Q

How does AF increase risk of stroke?

A

Blood pools in the atria
Blood clot forms
Whole or part of the clot breaks off
Bloood clot travels to the brain and blocks a cerebral artery causing stroke

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9
Q

What is the drug of choice for AF when no structural heart disease

A

Flecainide

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10
Q

What is the best drug for AF with structural changes

A

Amiodarone

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11
Q

Heart rate control drugs examples

A

beta blockers
Verapamil
Digoxin

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12
Q

What is the score name for stroke risk in AF

A

CHA DS- VASc score

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13
Q

What is bradycardia

A

Lower than 60 bpm

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14
Q

What can cause bradycardia

A

Congenital
Acquired
Degenerative - Ischaemic heart disease - Drugs - Electrolye/metabolic - Infection (eg endocarditis) - Iatrogenic (ablation, cardiac surgery) - Infiltrative diseases (eg sarcoid,
amyloid) - Neuromuscular diseases (eg
myotonic dystrophy)

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15
Q

Which artery supplies the AV node

A

The right coronary

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16
Q

What symptoms does bradycardia present with

A

Asymptomatic
Dizziness
Breathlessness
Syncope
Falls
Exercise intolerance
Difficulty concentrating
Fatigue

17
Q

Tachycardia-bradycardia syndrome

A

Pacemaker for fast heart rate
Drugs for slow heart rate (beta blockers)
Anticoagulation for strokes

18
Q

Type 1 AV block

A

First Degree – PR interval is prolonged but all impulses are
conducted to the Ventricles

19
Q

Second degree AV block

A

Second Degree – Some (but not all) impulses are conducted to the ventricles

20
Q

Third degree AV block

A

Third Degree – No impulses are conducted to the ventricles

21
Q

Type 1 second degree hear block is called?

A

Wenckeback

22
Q

In Mobitz Ii

A

P to QRS interval is normal
Sudden p wave not followed by QRS - `Need pacemaker

23
Q

2:1 AV block

A

For ever 2 P waves there is only 1 QRS

24
Q

How do people with tachycardia present

A

Asymptomatic
SOB
Palpitations
Pre-syncope/ light headed
Chest pain
LOC
Cardiac arrest

25
Q

Background history

A

Clinical context
Age
Medical background
Family history
Congenital abnormality
Development of substrate
Acquired abnormality

26
Q

How would you describe AF

A

Tachycardia, narrow QRS, irregular, no P waves

27
Q

What are differentials for narrow complex tachycardia

A

Sinus tachycardia
AF
A flutter
Focal atrial tachycardia
AVNRT
AVRT

28
Q

What are differential diagnosis for brad complex tachycardia

A

Ventricular tachycardia
SVT with aberration
Pre-excited tachycardia
Pacemaker associated tachycardia

29
Q

How do you cure arterial flutter

A

flutter ablation

30
Q

How fast odes the heart beat in atrial flutter

A

150-200bpm

31
Q

Management of AF and flutter, AVRT, AVNRT

A

Manage stroke risk
Rate control
Termination of re-entrant arrhythmia
Anti0arrhythmic therapy
Interventional electrophysiological procedures

32
Q

what does VT present as

A

Previous MI which causes scar - areas don’t conduct - short circuit - bad ventricular can depolarise

Broad complex
Positive/negative concordance
Basically regular
Extreme axis
Not a typical BBB
AV disassociation - see P waves as SA node is normal
Slurred initiation of QRS

33
Q

How to tel between VT and RBBB

A

sharp initiation in RBBB and slow in VT

34
Q

Above the AV node give adenosine

A

Shows the flutters but no affect

35
Q

Att the AV bnove

A

Adenosine will work on the issue

36
Q

Below the AV node

A

Adenosine makes not affect

2C The Cardiovascular System (5 decks)

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