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Cardiology: Key Information > Arrhythmias > Flashcards

Arrhythmias Flashcards

(71 cards)

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1
Q

define an arrhythmia

A

abnormal heart rhythm

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2
Q

presentation of arrhythmias

A
  • palpitations
  • SOB
  • syncope and presyncope
  • angina
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3
Q

diagnosis of arrhythmias

A
  • ECG
  • echocardiogram
  • EP study (mechanism of arrhythmia)
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4
Q

define sinus arrhythmia

A

this is reflex changes in vagal tone during the respiratory cycle e.g. inspiration causes the heart rate to increase

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5
Q

define bradycardia

A

sinus heart rate of less than 60bpm

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6
Q

management for bradycardia

A
  • atropine

- second line is adrenaline or dobutamine

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7
Q

define sinus tachycardia

A

sinus heart rate of above 100bpm

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8
Q

management for sinus tachycardia

A

beta blockers

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9
Q

management for SVT

A

adenosine

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10
Q

define heart block

A

abnormally slow heart rate where conduction does not conduct through the AV node

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11
Q

First degree heart block

A

PR interval of longer than 0.2 seconds

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12
Q

management for first degree heart block

A

only if symptomatic

  • beta blockers
  • CCBs
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13
Q

mobitz type I

A

progressively lengthening PR interval until a beat is dropped

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14
Q

management for mobitz type I

A

only if symptomatic

  • beta blockers
  • CCBs
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15
Q

mobitz type II

A

2:1 or 3:1 ratio

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16
Q

management of mobitz type II

A

digoxin or
beta blockers or
CCBs or
(ICDs)

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17
Q

third degree heart block

A

no action potentials conduct through the AV node

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18
Q

management of third degree heart block

A

digoxin or
beta blockers or
CCBs or
ventricular pacing e.g. ICD

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19
Q

management of VF

A

defibrillation

ICD

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20
Q

management of haemodynamically unstable VT

A

synchronised cardioversion

amiodarone (second line is lidocaine)

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21
Q

management for torsades de pointes (polymorphic VT)

A

magnesium sulfate

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22
Q

management of polymorphic VT

A

beta blockers

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23
Q

management of VT if pre-existing structural heart disease

A

adenosine

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24
Q

management of VT after MI

A

procainamide

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25
define WPW syndrome
this is AV re-entrant tachycardia which has a delta wave on ECG
26
management of unstable WPW
DC cardioversion
27
management of stable WPW
first line: carotid massage or valsalva manoeuvre second line: adenosine third line: pacemaker fourth line: DC conversion
28
management of long QT syndrome (VT)
- lifestyle avoiding strenuous sports e.g. swimming - beta blockers - ICD
29
management of Brugada syndrome
ST elevation in V1-V3 - DC cardioversion - beta blockers - catheter ablation
30
presentation of AF
- irregularly irregular pulse - palpitations - syncope
31
diagnosis of AF
ECG | absent P waves and atrial rate >300bpm
32
management for haemodynamically unstable AF
DC cardioversion
33
management for haemodynamically stable AF
- beta blockers (or CCBs if heart failure) | - anticoagulation using CHA2DS2VAS score
34
CHA2DS2VAS score
``` congestive heart failure 1 hypertension 1 age 75 and above 2 diabetes 1 stroke 2 vascular disease 1 age 65-74 1 sex (female) 1 max. total = 9 ```
35
management of persistent or paroxysmal AF
``` unstable = DCCV stable = beta blockers or CCBs and anticoagulation ```
36
ECG of atrial flutter
saw tooth baseline 150bpm
37
management for unstable atrial flutter
synchronised cardioversion
38
management for stable atrial flutter
beta blocker or CCB (verapamil) or amiodarone | anticoagulation
39
how to define a narrow complex tachycardia?
>100bpm | QRs <120ms
40
how to treat AVRT and AVNRT?
transiently blocking the AVN without slowing conduction
41
management of AVRT and AVNRT
vagal manoeuvres= carotid sinus massage, valsalva manoeuvre | IV adenosine
42
what is the pathway of AVRT?
atria > ventricles > accessory pathway > atria | orthodromic
43
management of AF + WPW
avoid AV node blockers such as diltiazem, verapamil and digoxin use flecainide
44
what are Stokes-Adams attacks?
loss of consciousness caused by AV node block (3rd degree)
45
what is focal atrial tachycardia?
group of atrial cells acting as pacemaker, outpacing SAN so P wave shape is different
46
what is the rate in atrial flutter?
300 times a minute, so ventricle contractions are a division (150,100,75) NEEDS ANTICOAGULATION
47
what are Stokes-Adams attacks?
loss of consciousness caused by AV node block (3rd degree)
48
do you need to anticoagulate a patient if AF began 48 hours prior to admission before DC cardioversion?
yes as risks pushing clot to the brain
49
acute management of AF
``` DC cardioversion (120-150J) amiodarone if fails ```
50
management of stable AF that has been present for <48 hours
flecainide or cardiovert or amiodarone (if structural heart disease) start heparin in case delayed
51
management of stable AF that has been present for >48 hours
patient must be anticoagulated for at least 3 weeks (echo for intracardiac thrombi)
52
management of paroxysmal AF
pill in pocket (sotalol or flecainide PRN)
53
what is bigeminy?
ectopic every second beat
54
what is trigeminy?
ectopic every 3rd beat
55
what is a fusion beat?
normal beat fuses with a VT complex causing an unusual complex
56
what is a capture beat?
normal QRS amongst a run of VT
57
indications for a pacemaker
``` AV block (stoke-Adams, asymptomatic, congenital) mobitz type II persistent AV block after anterior MI symptomatic bradycardia heart failure drug resistance to tachyarrhythmias ```
58
what is given prior to insertion of pacemaker?
antibiotics
59
what drug may reveal underlying atrial flutter?
adenosine
60
examples of narrow complex tachycardias
``` AVNRT AVRT atrial tachycardia AF atrial flutter pacemaker ```
61
what does AVNRT have?
two input pathways (slow and fast)
62
ECG findings in AVNRT
P wave visible within T wave | V1 and II best places to look
63
direction in AVRT (WPW)
``` retrogradely up the node (antidromic tachycardia) delta wave (slurred upstroke QRS) ```
64
how to generate AV block
vagal manoeuvres= carotid massage, valsalva, sudden immersion in cold water adenosine
65
caution in use of adenosine when?
asthmatic
66
feature of ventricular tachycardias
broad QRS
67
examples of ventricular tachycardias
VPCs VT ventricular escape rhythm VF
68
ventricular complex bigeminy
1 sinus beat coupled with VPC
69
ventricular complex trigemeny
1 sinus beat coupled with 2VPC
70
cardiac arrest rhythms
``` VT VF complete AV block PEA terminal rhythm sequence ```
71
ECG ventricular hypertrophy
R wave V5 orV6 >35mm (less in other criteria’s 20 in women and 28 in men)

Cardiology: Key Information (42 decks)

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