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DMS EKG > Arrhythmias > Flashcards

Arrhythmias Flashcards

(56 cards)

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1
Q

Palpitations are

A

Awareness of ones own heart beats

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2
Q

Angina

how is this a common manifestation?

A

increased demands for oxygen cause chest pain

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3
Q

What mnemonic is used for causes of Arrhythmias?

What does it stand for?

A

H-hypoxia (COPD)
I- ischemia & irritability ( MI can cause)
S- Sympathetic stimulation (CHF, anxiety, exercise, caffeine, cocaine)
D- drugs
E- electrolyte disturbances (hypokalemia, etc)
B- bradycardia (sick sinus syndrome)
S- stretch (CHF & valvular diseases)

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4
Q

What is helpful when a suspected arrhythmia is infrequent and not likely to be captured on a 12 lead EKG?

A

Holter Monitor

Worn 24-48 hrs

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5
Q

What if so infrequent even a Holter Monitor won’t pick up?

A

Event monitor

Multiple recordings can be made over several months

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6
Q

Determining Rate:
1 large square=
2 large squares=

A

300 beats/min

150 beats/min

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7
Q

Determining Rate:
3 large squares =
4 large squares=

A

100 beats/ min

75 beats/min

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8
Q

Determining Rate:
5 large squares =
6 large squares=

A

60 beats/min

50 beats/min

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9
Q

Arrhythmias of Sinus origin can be classified as having….

A

electrical activity follows usual conduction pathways but is either too fast, too slow, or irregular

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10
Q

Ectopic rhythms can be classified as having…

A

electrical activity originates from a focus other than the sinus node

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11
Q

Reentrant arrhythmias can be classified as having…

A

electrical activity trapped within an electrical racetrack

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12
Q

Conduction block arrhythmias can be classified as having…

A

electrical activity that originates in the sinus node and follows the original pathways but encounters unexpected blocks and delays

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13
Q

Sinus rhythm over 100 beats/min=

Normal or pathological?

A

Sinus tachycardia

Can be normal or pathological

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14
Q

Causes of sinus tachycardia include:

A 
strenuous exercise
CHF
severe lung disease
hyperthyroidism
drugs
fever
intravascular volume loss
pain
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15
Q

Tachycardia in elderly is…

A

Rare, often can’t get over 140-150

If over this it is probably nonsinus

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16
Q

Sinus rhythm less than 60 beats/min

A

Sinus Bradycardia

Normal and pathological

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17
Q

Causes of sinus bradycardia include:

A 
early in acute MI
enhanced vagal tone
drugs
hypothyroidism
hyperkalemia
sick sinus syndrome
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18
Q

Sinus arrhythmia looks like:

most like from:

A

NSR but slightly irregular

Usually increases in inspiration and decreases in exhalation

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19
Q

Prolonged electrical inactivity

A

asystole

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20
Q

occurs when the sinus node stops firing or from a sinus node exit block

A

sinus arrest

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21
Q

what are escape beats?

A

rescue beats originating outside the sinus node

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22
Q

Sinus node fires between

A

60-100 times/min

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23
Q

Atrial pacemakers fire between

Study These Flashcards
A

60-75 times/min

24
Q

Junctional pacemaker fire between

-where are they located?

Study These Flashcards
A

46-60 time/min

-located near the AV node

25
Ventricular pacemakers fire between
30-45 times/min
26
What pacemaker cells will produce a normal QRS complex?
Atrial and junctional
27
What pacemaker cells will produce an abnormal or wider QRS complex?
Ventricular pacemakers
28
What is the most common escape beat?
Junctional
29
In junctional escape beats a _______ p wave is seen
``` Usually no p wave sometimes retrograde (atrial depol) ```
30
In junctional escape beats the mean electrical axis of the retrograde P wave is ________
reversed 180 degrees from normal p wave
31
A normal P wave is upright in what leads? | Inverted in what leads?
lead I | aVR
32
What is a prolonged sinus pause due to failure of the sinus depolarization to be transmitted out of the node into the atria?
Sinus exit block
33
What causes ectopic rhythms?
Enhanced automaticity of a nonsinus node site - digitalis toxicity - beta adrenergic stimulation
34
Four questions to identify nonsinus arrhythmias:
1. Are normal P waves present? 2. Are the QRS complexes narrow (.12s) 3. What is the relationship between the P waves and QRS complex 4. Is the rhythm regular or irregular
35
Normal P waves with normal p wave axis are indicative of arrhythmias from _____
within the atria
36
No P waves present are indicative of arrhythmias from_____
AV node or ventricles
37
Abnormal P wave axis is indicative of arrhythmias from_____
AV node or ventricles
38
Narrow QRS axis indicates origin or rhythm must be_____
at or above the AV node
39
A wide QRS complex indicates rhythm must be____
within the ventricles
40
A single P wave preceding each QRS complex means the rhythm has ______ origin
sinus or other atrial origin
41
AV dissociation is
Atrial and ventricles are depolarizing/contracting independent of one another
42
Abnormal P wave that comes too early otherwise regular not generally sustained
premature atrial contraction
43
``` A small blip (pseudo R') in V1 Regular rhythm P Wave often buried Rate ~150-250 Sudden Onset ```
Paroxysmal Supraventricular Tachycardia (PSVT)
44
When is carotid massage contraindicated?
If there is evidence of carotid disease
45
The flutter waves of atrial flutter are best seen in
Leads II and III
46
Atrial flutter is generated by a reentrant circuit that runs around_____
annulus of tricuspid valve
47
Can carotid massage terminate atrial flutter?
No, but it may increase the block | example: 3:1 block to 5:1 block
48
irregularly irregular ventricle rate between 120-180 bpms, with an absence of p waves is
Atrial fibrillation
49
What is needed to diagnose multifocal atrial tachycardia (MAT)?
At least 3 different p wave morphologies
50
What is needed to diagnose wandering atrial pacemakers?
3 different p wave morphologies seen, but there will be two or three beats of each
51
What is paroxysmal atrial tachycardia?
regular rhythm with rate of 100-200bpm - initiated by a premature beat - hard to differentiate from SVT unless you see the start
52
Differences between PAT and PSVT
PAT has warm up or cool down period | Carotid massage doesn't affect PAT while it terminates or slows PSVT
53
A wide and bizarre QRS lasting at least .12seconds and is premature with discordant t wave is a
premature ventricular contraction | -usually followed by prolonged compensatory pause
54
A run of three or more consecutive PVCs is
ventricular tachycardia (VT)
55
An EKG showing tracing spasmodic jerks (or an undulating line) with no true QRS complexes is____ Most often seen in_______ Requires_______
Ventricular Fibrillation (VF) Seen most often in dying hearts Requires CPR & Defib at once
56
Prolonged QT intervals can lead to ________ | which has QRS complexes that spiral around the baseline
Torsade de Pointes

DMS EKG (9 decks)

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