Arrhythmias Flashcards Preview

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Flashcards in Arrhythmias Deck (16):
1

What is step 1 in identifying arrhythmias? Next?

Cherchez la P wave! Then find out who she has been hanging out with (hopefully her QRS) = sinus rhythm

2

Sinus tachycardia
Signs?
Tx?

Is a regular, fast HR (>100)
P waves precede each QRS
Arises due to sympathetic activation
Treatment: Usually none, B-blockers in thyrotoxicosis

3

Sinus Bradycardia
Signs?
Tx?

Regular, slow HR (<60)
P waves precede each QRS
Common in athletes
Vagotonic states: situations where parasympathetic NS is turned on (faint, sick sinus syndrome, inferior infarct)
Treatment: none, atropine, pacemaker

4

1st degree A-V block
Signs?
Tx?

PR interval prolonged - increased junctional delay
Caused by: drugs (beta blockers, digitalis)

"A P wave before every QRS and a QRS after every P wave"

5

2nd degree AV block

Some P waves conduct but some do not

6

What's Mobitz I or Wenckebach

Sequence upon which PR interval gradually lengthens, followed by a nonconducting P wave. This is a 2nd degree AV block

7

Complete heart block
Signs?
Tx?

no relationship to slower ventricular rate. P waves faster than QRS rate
Tx: pacing if ventricular rate or BP too low

8

What do ectopic beats look like?

Sometimes an early beat that looks like the others (sometimes can see P wave, sometimes can't)

9

Premature ventricular contractions
Signs?
Tx?

Wide QRS, no P wave
Common in normal subjects, acute myocardial infarct, HF
Tx: Usually none required, B-blockers


*note: junctional/nodal rhythm has narrow QRS with no p waves

10

Atrial flutter
signs?
tx?

Re-entry in atrium
P wave rate 240-320/min
Causes a classical "sawtooth" pattern
Tx: Anticoagulation, Rate control with drugs, Cardioversion, Ablation
- same tx as afib

11

Atrial tachycardia
Signs?
Tx?

Rapid HR > 150 bpm
Narrow QRS complexes
P waves present but abnormal
Tx: adenosine, vagal maneuver, B-blocker, verapamil or dilatiazem

12

Atrial fibrillation
Signs?
Tx?

No P waves at all, but irregular QRS waves @ 350 bpm "squiggles"
"Irregularly irregular"
Problems: Rapid HR - ischemia, HF; Loss of atrial kick - HF; Atrial thrombi - embolic stroke

Tx: "5 Cs" Anticoagulation, rate control with drugs, cardioversion, ablation

13

Junctional rhythm
Signs?
Tx?

Regular, narrow QRS, no antecedent P waves (sometimes can see negative P wave after QRS)
Tx: usually unnecessary

14

Ventricular fibrillation

No consistent P or QRS complexes or coordinated contraction

15

Atropine

muscarinic M2 antagonist

increases heart rate
(bc m2 activates Gi)

16

propanolol

beta adrenergic antagonist

decreases heart rate