04 - Arrhythmias of Sinus Origin Flashcards Preview

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Flashcards in 04 - Arrhythmias of Sinus Origin Deck (31):
0

Anything other than a normal sinus rhythm

Dysrhythmia

Not every one is a problem

1

Clinical manifestations of arrhythmias

Palpitations - patients are aware
Decreased CO - light headed/syncope
Arrhythmias with underlying cardiac disorder - CHF, can lead to angina

2

Sometimes, the first clinical manifestation of arrhythmias is

Sudden death

3

Why do arrhythmias happen?

HIS DEBS
Hypoxia
Ischemia, infarction, irritability
Sympathetic stimulation
DRUGS!!
Electrolyte disturbances
Brady - brady-tachy syndrome, sick sinus syndrome
Stretch - hypertrophy, valvular probs

4

How do we find arrhythmias?

ECG rhythm strip
12 lead ECG
Event monitor
Holter monitors

5

What triggers an event monitor?

The patient when symptoms of arrhythmias are felt

6

Portable ECG for 24-48 hours

Holter monitor

7

The first component when evaluating and EKG is

Rate

8

Five types of arrhythmias?

Arrhythmias of sinus origin
Ectopic rhythms
Reentrant arrhythmias
Conduction blocks
Pre excitation syndromes

9

Arrhythmias of sinus origin

Tachy
Brady
Sinus arrhythmia
Sinus arrest
Asystole
Escape beats

10

Rate > 100 bpm
Normal P wave
Narrow QRS
1:1 P:QRS ratio

Sinus tachycardia

11

If heart rate is above ____, P wave may be difficult to distinguish from previous T wave

140 bpm

12

Causes of sinus tachycardia

Pain
Fear, anxiety
Exercise
Hyperthyroid
Anemia
Hypovolemia
Malignant hyperthermia
Sepsis

13

What can resolve tachycardia?

Resolution of underlying causes
Vagal maneuvers - carotid massage, valsalva, gagging
AV blocking agents - adenosine, verapamil
Beta blockers - Esmolol, metoprolol

14

Rate: 40-59 bpm
Normal P wave
Normal QRS
Regular rhythm

Sinus bradycardia

15

Causes of sinus bradycardia?

Vagal maneuver
Athleticism
Sleep
Sever hypertension
Beta blockers
Hypothyroid

16

Severe bradycardia can drop CO so low that the reduced blood flow causes

Syncope (fainting)

17

Treatment of chronic bradycardia?

Pacemaker
Thyroid therapy

18

Treatment of acute bradycardia?

Cease stimulation
Atropine
Glycopyrrolate

19

Treatment of bradycardia is ______ unless pt in concurrently hypotensive or symptomatic

Not usually indicated

20

Rate: 45-100 bpm (varies with RR)
Normal P wave
Normal QRS
Irregularly regular rhythm WHAT??

Sinus arrhythmia

Not a true arrhythmia

21

Spontaneous breathing causes sinus arrhythmias due to fluctuations in

Parasympathetic vagal tone

22

The hearts fail safe pacing mechanism proving three levels of back up pacing is known as?

Overdrive suppression

23

What are the three levels of back up pacing in overdrive suppression?

Automaticity foci in atria
The ventricles
AV junction

24

Conditions that increase automaticity?

Sympathetic nervous system stimulation
Hypoxia

25

What are the automaticity foci and their rates?

SA node: 60-100 bpm
Atrium: 60-80 bpm
Junction: 40-60 bpm
Ventricle: 20-40 bpm

26

Sinus arrest occurs when SA node and other pacemaker cells

Stop firing

27

The rescuing beats originating from outside the sinus node are called

Escape beats

28

Which pacemaker cells rescue the heart most frequently?

AV junction

29

If alternative pacemaker cells beat for an extended period of time into a regular rhythm, this is

Junctional escape rhythm

30

A junctional escape rhythm can have P waves that are not seen or appear retrograde because

There is an abnormal pattern of atrial depolarization