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Cardiology > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

What is a tachycardia?

A

>100 bpm

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2
Q

What are the risk factors of arrhythmias?

A
  • A - advanced age, acohol consumption
  • B - high blood pressure
  • C - high cholesterol
  • D - diabetes
  • E - lack of exercise
  • F - family history
  • G - gender (male)
  • S - smoking
  • caffeine
  • OSA
  • hyper/hypoparathyroidism
  • thyrotoxicosis
  • medications: antiarrhythmics, diuretics, digoxin
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3
Q

What are the management options for arrhythmias?

A
  • antiarrhythmics
  • catheter ablation
  • pacemaker
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4
Q

What is a junctional escape beat?

A

when the Av node starts the impulse not the SA node

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5
Q

Name the 3 accessory pathways.

A
  1. Bundle of kent
  2. Mahaeim fibres
  3. concealed accessory pathways
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6
Q

What is Wolf-Parkinson-White (WPW) syndrome?

A

a re-entrant tachycardia caused by ventricular activation via the AV node and Bundle of His, then retrograde conduction via an accessory pathway to depolarise the atria

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7
Q

What are the ECG findings for Wolf-Parkinson-White syndrome?

A

short PR interval

delta wave (“sloping”)

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8
Q

What is this?

A

a delta wave, typical of WPW syndrome

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9
Q

How are arrhythmias classified?

A

Bradyarhythmias

  • SA node block: sinus bradycardia
  • AV node block:
    • 1st degree block
    • 2nd degree block: Wenckebach (Mobitz I), Mobitz II
    • 3rd degree block

Tachyarrhythmias

  • Supraventricular
    • SVT
    • Atrial flutter
    • AF
  • Ventricular
    • VT
    • VF
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10
Q

What is Sick Sinus Syndrome?

A

combination of tachycardia and bradycardia, common in the elderly

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11
Q

What are the characteristics of 1st degree block?

A

prolonged conduction (long PR interval)

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12
Q

What are the characteristics of Wenckebach heart block?

A

progressive lengthening and then dropped QRS complex

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13
Q

What are the characteristics of Mobitz heart block?

A

dropping of QRS complex every 2nd beat, with widened QRS complex and constant PR interval

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14
Q

What are the characteristics of 3rd degree heart block?

A

no relation between P waves and QRS complex. Can also have no QRS complexes and only P waves

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15
Q

What syndrome does this person have?

A

Marfan’s syndrome

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16
Q

What is this?

A

Atrial flutter

17
Q

How do you prevent thromboembolism in atrial fibrillation?

A
  • C - CCF
  • H - HTN
  • A - >65 years old
  • D - diabetes
  • S - stroke

each is equal to 1

if score is >2 then treat with warfarin, if < 2 treat with aspirin

18
Q

How do you manage atrial fibrillation?

A
  1. rate control: beta-blockers, calcium channel blockers
  2. rhythm control: antiarrhythmics
  3. stroke prevention: aspirin/warfarin
19
Q

What is Brugada syndrome?

A

previously described as SUND (sudden unexpected nocturnal death) in SEA men

it is a change in action potential difference between hte epicardium and endocardium

it predisposes to re-entrant tachyarrhythmias

it characteristically manifest as a STEMI during rest/sleep

20
Q

What is atrioventricular nodal re-entrant tachycardia (AVNRT)?

A

a paroxysmal supraventricular tachycardia

more common in women than men

caused by one pathway to the AV node being faster causing a circuit

21
Q

How do you manage AVNRT?

A

options are:

  • drink cold water
  • valsalva manoueveur
  • beta-blockers
  • calcium channel blockers
22
Q

What is a Stokes-Adams attack?

A

syncope due to bradycardia or asystole

23
Q

What is the definition of atrial fibrillation?

A

a heart condition where heart chambers are beating faster and more erratically than normal

24
Q

What are the clinical features of atrial fibrillation?

A

Signs

  • irregular pulse rate at approx 120-160 bpm (can go up to >200 bpm)
  • hypotension
  • increased JVP

Symptoms

  • dizziness
  • syncope
  • palpitations
  • SOB
25
Q

What causes atrial fibrillation?

A
  • all cardiovascular disease
  • hyperthyroidism, increased PTH
  • diabetes
  • XSive alcohol intake
  • advanced age
  • respiratory diseases
26
Q

What investigations would you do to rule out artrial fibrillation?

A
  • ECG - absent P waves, irregularly irregular QRS complexes
  • serum electrolytes - ?increased K+, decreased Mg2+
  • troponin - elevated
  • TFTs - ?thyrotoxicosis
  • CXR - ?heart/resp disease
  • TOE - ?valvular disease

Cardiology (8 decks)

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