Arrhythmias

Question 1

Define arrhythmia

Answer 1

Conditions where the heart beats with an irregular beat or abnormal rhythm

Question 2

What is the aetiology of arrhythmias

Answer 2

Heart disease
The wrong balance of electrolytes (such as sodium or potassium) in your blood
Changes in your heart muscle
Injury from a heart attack
Healing process after heart surgery
Thyroid problems

Question 3

What is the different types of arrhythmias

Answer 3

Premature ventricular contractions

atrial fibrillation

atrial flutter

Wolff-Parkinson white syndrome
- Supraventricular tachycardia

Ventricular tachycardia/ fibrillation

Long QT syndrome

sinus node dysfunction

heart block

Question 4

What is the symptoms of arrhythmias

Answer 4

Asymptomatic 
Palpitations
Dizziness or feeling light-headed /Fainting
Shortness of breath
Chest pain 
Fatigue

Question 5

What occurs in PVCs

and what is the cause

Answer 5

They’re the “skipped heartbeat” we all occasionally feel.

Cause:
stress or too much caffeine or nicotine, sometimes due to heart disease or electrolyte imbalance

Question 6

Define atrial fibrillation

-what does this result in

Answer 6

irregular irregular heart rhythm due to the disorganised contraction of the atria

irregularly irregular pattern since the rate is faster and there is no distinct rhythm

Question 7

Define atrial flutter

Answer 7

Abnormally rapid contraction of the atria

but are not disorganised or random

Question 8

What is the aeitology of atrial fibilration and flutter

Answer 8

Idiopathic

ischaemic heart disease

thyroid disease

hypertension

MI

pulmonary embolus

rheumatic mitral / tricuspid valve disease

Question 9

What is the pathology if supraventricular tachycardia

Wolff-parkinson white syndrome

Answer 9

You can get a rapid heart rate because there is an extra shorter electrical pathway between the heart’s artria and venticles

resulting in a rapid heart rate with normal rhythm

PSVT begins and ends suddenly.

Question 10

what is the presentation of supraventricular tachycardia

Answer 10

It can cause heart palpitations, fainting, or heart failure

you can stop it simply by breathing in and bearing down e.g. valsalva manoever - as this increases your vagal tone on AV node

Question 11

Whats occur in Ventricular tachycardia (V-tach).

Answer 11

A rapid heart rhythm starting from the heart’s lower chambers. Because the heart is beating too fast, it can’t fill up with enough blood.

Question 12

When does ventricular fibrillation occur

Answer 12

This happens when the heart’s lower chambers quiver and can’t contract or pump blood to the body.

Question 13

How is ventricular fibrillation treated

Answer 13

This is a medical emergency that must be treated with CPR and defibrillation as soon as possible.

Question 14

What is the outcomes of Long QT syndrome

Answer 14

dangerous arrhythmias
syncope
seizure
sudden death

Question 15

What is the treatment of `long QT syndrome

Answer 15

Doctors can treat it with medications or devices called defibrillators.

Question 16

What occurs in Sinus node dysfunction, what is the solution

Answer 16

A slow heart rhythm is due to a problem with the heart’s sinus node.
A pacemaker

Question 17

What occurs in heart block

Answer 17

There is a delay or a complete block of the electrical impulse as it travels from the heart’s sinus node to its lower chambers. The heart may beat irregularly and, often, more slowly

Question 18

How do you diagnose arrhythmias

Answer 18

ECG - record electrical activity of your heart

Blood test - investigate thyroid

ECHO - evaluate heart muscle and valve

Question 19

what is the drug therapy used to treat arrhythmia

Answer 19

Anti arrhythmic drugs (control heart rhythm)
 - Beta blocker
 - CCB
Anticoagulant 
 - Warfarin 
 - Aspirin 

antiplatelet therapy.

Question 20

What is examples of non drug therapy treatment for arrhythmias

Answer 20

Electrical carioversion/ Defibrillator
- Electric shock to allow normal rhythm to restart

Pacemaker
- small electrical impulses to the heart to maintain rate

Implantable cardioverter defibrillator
- Detect fast, abnormal heart rhythm and deliver electric shock to heart to beat normal rhythm again

catheter ablation
- Catheter through leg, deliver high frequency to heart and disconnects the pathway of the abnormal rhythm

Maze surgery
“maze,” of cuts in the heart’s upper chambers to
keep the heart’s electrical impulses going only on certain pathways.

Question 21

What is the different methods of causing the heart to beat to a normal rhythm again

Answer 21

Anti-tachycardia pacing
-series of small electrical impulses to the heart muscle

Defibrillation - high energy shock

Question 22

What further procedures are used in the treatment of atrial fibrillation

Answer 22

Maze procedure surgery

Question 23

What is the indication for ICD therapy

Answer 23

Ventricular Tachycardia /fibrillation

After Cardiac arrest
Sustained causing syncope
With poor LV function

Question 24

What is the indications for temporary pacemaker

Answer 24

Sustained symptomatic bradycardia (syncope)

prophylatic to sever bradycardia e.g. post MI/asymptomatic/AV block

Question 25

What is indications for permanent Pacemaker

Answer 25

symptomatic or profound 2nd/3rd degree AV block,

Sinus node disfunction

Question 26

Define Tachycardia and bradycardia

Answer 26

T - rate above 100bmp

B - Rate below 60bmp

Question 27

What can be seen on an ECG of atrial fibrillation

Answer 27

no P waves
irregularly irregular
normal QRS complexes

Question 28

What can be seen on an ECG of atrial fluter

Answer 28

saw-tooth F waves of baseline
normal QRS complexes
regularly irregular

Question 29

What can be seen on an ECG of supra ventricular tachycardia

Answer 29

normal P waves
short PR interval
slurred QRS complex = delta wave
regularly irregular

Question 30

What is the aeitiology of long QT syndrome

Answer 30

emotion
exercise
drugs