Arrhythmias 2 Flashcards

1
Q

an arrhythmia in which ectopic ventricular focus fires an action potential

A

premature ventricular contraction

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2
Q

what should be considered in premature ventricular contractions?

A

structural heart disease

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3
Q

what is the threshold of significance in PVCs?

A

more than 10/hr

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4
Q

what is the present symptom, if any, of PVCs?

A

palpitations

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5
Q

how does the regularity look in PVCs?

A

irregular

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6
Q

what would the PRI look like in PVCs?

A

no PRI due to no P wave

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7
Q

what would the QRS complex and T wave look like in PVCs?

A

wide/bizarre QRS
discordant T wave

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8
Q

when every alternate beat is a PVC

A

bigeminy

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9
Q

when two normal beats precede every PVC

A

trigeminy

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10
Q

two consecutive PVCs

A

couplets

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11
Q

three consecutives PVCs

A

triplets

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12
Q

what are 4 consecutive PVCs called?

A

Ventricular tachycardia

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13
Q

what is the treatment for PVCs in otherwise healthy patients?

A

reassurance
beta blockers

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14
Q

why is a beta blocker prescribed in PVCs?

A

for palpitations

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15
Q

what is the treatment for PVCs in patients with advanced structural heart disease?

A

treat underlying cause
implantable cardioverter-defibrillator (ICD)

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16
Q

an arrhythmia that starts in the ventricle that leads to low cardiac output, slow apical pulse, and difficulty auscultating BP

A

idioventricular rhythm

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17
Q

what is the rate in idioventricular rhythm?

A

20-50 bpm

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18
Q

what does the QRS complex look like in idioventricular rhythm?

A

wide and bizarre

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19
Q

what is the treatment for idioventricular rhythm?

A

underlying cause
pacemaker

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20
Q

why should we avoid suppressing idioventricular rhythms?

A

they prevent asystole

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21
Q

what is the most common rhythm presenting post MI?

A

accelerated idioventricular rhythm

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22
Q

what is the rate in accelerated idioventricular rhythms?

A

50-100 bpm

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23
Q

what is the treatment for accelerated idioventricular rhythm?

A

underlying cause
pacemaker

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24
Q

what does the QRS complex look like in accelerated idioventricular rhythm?

A

wide and bizarre

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25
Q

a series of three or more PVCs that persists more than 30 seconds

A

sustained monomorphic ventricular tachycardia

26
Q

a series of three or more PVCs that are self-terminating

A

non-sustained ventricular tachycardia

27
Q

what is the treatment for a sustained monomorphic ventricular tachycardia? (2)

A

cardioversion
antiarrhythmic drug

28
Q

what does sustained monomorphic ventricular tachycardia lead to?

A

ventricular fibrillation
sudden cardiac death

29
Q

what are 4 symptoms of ventricular tachycardia?

A

low cardiac output
syncope
pulmonary edema
palpitations

30
Q

what is the rate in ventricular tachycardia?

A

150-250 bpm

31
Q

what does the P wave, QRS complex, and T wave look like in ventricular tachycardia?

A

no P wave
wide/bizarre
discordant T wave

32
Q

what is it called when a sinus beat falls on a spot that allows some innervation of the ventricle to occur through the normal ventricular conduction system?

A

fusion beat

33
Q

what is it called when a sinus beat transmits through the AV node and depolarizes ventricles trough normal conduction system? It occurs in the middle of ventricular tachycardia

A

capture beats

34
Q

which ventricular tachycardia beat will look like a “normal” QRS complex?

A

capture beat

35
Q

what is the initial management for ventricular tachycardia in a stable patient? (3)

A

cardioversion
procainamide or amiodarone

36
Q

what is the initial management for ventricular tachycardia in an unstable patient? (2)

A

ACLS
torsades = defibrillation

37
Q

what is the long term management for ventricular tachycardia?

A

implantable cardioverter-defibrillator (ICD)

38
Q

what is the treatment for idiopathic ventricular tachycardia? (3)

A

ablation
B blockers OR calcium channel blockers

39
Q

multiple ectopic foci or a continually changing reentry circuit

A

Polymorphic ventricular tachycardia (torsades de pointes)

40
Q

what is the signature ECG presentation for torsades de pointes?

A

QT prolongation

41
Q

which class 3 antiarrhythmic can cause torsades de pointes?

A

sotalol

42
Q

what is the pattern associated with torsades de points?

A

sine wave pattern (party streamer)

43
Q

if a patient presents with palpitations, syncope, nausea, cold sweats, SOB, and chest pain, what are they likely experiencing?

A

torsades de points

44
Q

what is the treatment for torsades de points?

A

magnesium

45
Q

what is the pharmacologic treatment for a patient with congenital prolonged QT interval?

A

beta blockers

46
Q

what is the nonpharmacologic treatment for a patient with congenital prolonged QT interval?

A

pacemaker

47
Q

what is the major cause of mortality in acute MI?

A

ventricular fibrillation

48
Q

arrhythmia of disordered, rapid stimulation of the ventricles with no coordinated contractions

A

ventricular fibrillation

49
Q

what does the QRS complex look like in ventricular fibrillation?

A

totally chaotic with no waves or complexes

50
Q

what are the symptoms of ventricular fibrillation? (2)

A

pulseless
apneic

51
Q

what is the short-term treatment for ventricular fibrillation?

A

shock

52
Q

what is the long-term treatment for ventricular fibrillation?

A

implantable cardiovert defibrillator

53
Q

flat isoelectric line on ECG

A

asystole

54
Q

what is the treatment for asystole? (3)

A

CPR
ACLS
end of life

55
Q

an overall term covering disorders of the sinus node

A

sick sinus syndrome

56
Q

what is the treatment for sick sinus syndrome?

A

treat underlying cause

57
Q

what is the treatment for sick sinus syndrome if the patient is symptomatic and has bradycardia?

A

pacemaker

58
Q

sudden syncope related to heart rate

A

stokes-adams attacks

59
Q

combination of supraventricular tachycardia (afib) and sick sinus syndrome (bradycardia)

A

bradycardia-tachycardia syndrome

60
Q

what is the treatment for bradycardia-tachycardia syndrome? (2)

A

antiarrhythmic drugs
pacemaker