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Cardiovascular > Arrhythmias > Flashcards

Arrhythmias Flashcards

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1
Q

causes first degree AV block

A

(conduction delay in AV node)

autnomic, transient AV ischemia, drugs, MI, degenerative aging

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1
Q

define Vtach

A

series of >3 PVCs

sustained VT>30seconds

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1
Q

long term therapy consideration for sustained VT

A

ICD

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2
Q

ECG mobitz II

A

QRS widened due to His disease

sudden loss of AV conduction without preceding gradual PR leegnthening

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2
Q

Torsades de pointes observed in pts with

A

QT prolognation due to drugs, brady carida, electorlyte distubances, or congenital long QT (ion channel abnormality)

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3
Q

WPW (in Atrioventricular reentrant tachy) ECG delta wave

A

short PR

Slurred QRS due to slow vent activations, wide

QRS coming out to meet P wave

(in orthodromic tachy, no delta wave as anterrade depol of ventricles occurs only over AV node path)

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3
Q

treatment Vfib

A

immediate defib,

later consider IV amiodarone

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5
Q

escape rhyhtm qualities

A

typically narrow

40-60bpm

not perceded by normal P wave

(may have retrograde - inverted after QRS in inferior leads)

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5
Q

treatment 3rd degree AV block

A

pacemaker

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6
Q

symptoms torsafes

A

lightheadedness

syncope

sudden cardiac death

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7
Q

ECG A fib

A

no distinct P waves,

irregularly irregular

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8
Q

ECG monomorphic VT

A

identical QRS (typically wide)

no p waves

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9
Q

chronic AV nodal reentrant tachy treatment

A

AV nodal block

cathetar ablation

Class I and III antiarrhythmics

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10
Q

ECG Atrial premature beats / atrial Tachycardia

A

early P wave with abnomral shape

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11
Q

underlying mechanism polymorphic VT

A

multiple ectopic focci or changing reentrant circuit

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12
Q

CHADVASc treatment levels

A

0 - no therapy or aspirin

1 - aspirin or oral anticoag

>2 oral anti coag

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14
Q

ECG Mobitz I (2 degree AV block)

A

(intermittent failrue of AV conduction)

PR gradually increases until completely blocked, then normalizes

(usually benign and asymptomatic)

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16
Q

pathophysiogy Mobitz II

A

conduction block distal to AVN > sudden intermittent lsos of AV conduction

> (may progress to 3 degree without warning = need pacemaker)

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17
Q

treatment atrial premature beats / atrial tachycardia

A

beta blockers (if symptomatic)

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17
Q

drugs that slow atrial flutter circuit (eg ___) may promote 1:1: Av conduction, increasing ventricular rate

A

felcainide

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18
Q

Bradyarrhythmias: 1:1 relationship between P and QRS =

A

sinus bradycardia

first degree AV block

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19
Q

Bradyarrhythmias interment block between P and QRS =

A

second degree AV block (Mobitz I or II)

2:1 AV block

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20
Q

ECG First degree AV block

A

PR elongation

PR > 200ms

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21
Q

ECG Vfib

Study These Flashcards
A

all fucked up

22
symptoms. Nodal Reentrant Tachycardia
palpitations, dizziness chest pain dyspnea
22
3 mutations of congenital long QT
decrease outward K (LQT1+2) increase inward K (LQT3)
23
pathophys atrial premature beats / atrial tachy
automaticity or reentry in an atrial focus outside of SA node
24
Afib predisposing factors
ETOH vavlular disease elarged atria htn, coronary disease, pulmonary disease sleep apnea hyperthyroidism cardiothoracic surgery
25
pathophysiology Av nodal reentrant tachycardia
fast and slow conduction pathways (typically antegrade from A to V occurs over slow path and retrorade limb is over fast path)
27
presentation atrial flutter
asymptomaic palpitations, dypsnea, weakness stroke from atrial thrombus
28
associated causes Polymorhpic VT
long QT with Torsades acute ishemia/infarct inherited Ca handling abnormalities
29
SInus tachycardia results from
increased sympathetic decreased parasympathetic tone
30
origin sinus tachycardia
SA node
31
predisposing factors atrial flutter
prior heart surgery coranary disease cardiomyopathy
32
ECG premature ventricular beats or contractions (PVCs)
widened QRS (impulse from ectopc ventriclar site) no p wave relation (ventricular origin) OR inverted p in II III aVF (retrograde VA conduction)
33
sustained polymorphic Vtach leads to
syncope arrest
35
sick sinus syndrome
intrinsic SA node disease causing inappropriate brady cardia with dizziness, confusion or syncope
36
sustained monomorphic VT rypically result sfrom
reentry and indicates underlying tissue path (scar, structural heart disease)
37
chronic Torsades treatment
correct underlying triggers if congenital long QT - beta blocker
38
ECG Third degree AV block
no relationship between P and QRS compelxes proximal escape = narrow QRS distal escape = wide QRS complete failure of atrial\>ventricle conduction
39
Bradyarrhythmias: dissociated P and QRS =
complete heart block
40
underlying mechanism afib
triggered by rapid firing from atrial foci often localized to atrial muscle extending into pulmonary veins
41
PVCs tx
observation beta block
42
ECG AV nodal reentrant tachy
**antergrade fast path: **P waves superimpose on QRS, regualr RR (no pwave) **anterograde slow path: **narrow complex tachy, regular RR, inverted P waves in inferior leads aVF II III
43
ECG Polymorphic VT
QRS continually changes shape and rate (typically wide)
45
Atrioventricular reeentrant tachycardias =
reentry utilizing bypass tract or acessory pathway - band of muscle cells connecting atria and ventricle produces WPW
47
acute treatment AV nodal Reentrant Tachycardia
valsalva adensoine beta block ca block
48
treatment atrial flutter
Rate control: beta blockers, Ca blockers, digoxin Rhythm control - \>48hrs = TEE to rule out left atrial thrombus OR 3 weeks coagulation \> cardioversion anticoagulation 4 weeks past cardioverion pace termination (rapid atrial pacemaker) **Ablation of tricuspid caval isthmus** aniarrhythmics (class I, III)
49
treatment AFib
Anticoag (acute:cardoversion) (chronic - CADSV score) Rate control: AV blockage (beta block, Ca block, digoxin) Resotoration of sinus rhythm: cardioversion, antiarrhythmatics, **cathetar ablation**
50
ECG atrial flutter
sawtooth pattern AV conducion variable, commonly more flutter waves than QRS complexes
51
acute treatment torsades
cardiovert sustained VT to restore sinus rhythm IV magnesium correct underlying abnormality (drugs) elevate HR to shorten QT (beta agonists or pacing)
52
treatment WPW
IV amiodarone or procainamide (I or II) to slow accessory pathway conduction (NO digoxin, beta or Ca block - shorten refractory period of accessory = faster) cardioversion if iunstable high risk = cathetar ablation
53
clinical consequences of afib
rapid ventricular response rate \> hypotension or heart failure blood stasis \> clots \> thrombus
54
ECG Sinus Tachycardia
normal P and QRS
55
CAD2-VASc criteria
* *C**- congestive HF 1 pt * *H **Hypertension -1 pt **A- **age \> 65 1 pt **D- **diabetes 1 point **V-** vasc disease **A2 **- age \> 75 - **2 points** **Sc** - Sex female
56
if atrial premature beats genreates consecutive beats resuling in HR \>100 it is termed\_\_\_\_
atria tachycardia
57
Afib is sustained by multiple wanering reentrant circuits, minimum number of circuits is required thus Afib promoted by
elarged atrium
58
symptoms 3rd degree AV block
lightheadedness syncope exercise intolerance
59
counterclockwise atrial flutter
right atrial depol down septum \> \>roof\> \>down RA free fall \> \>floor of RA between tricuspid and inf vena cava (isthmus)

Cardiovascular (39 decks)

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