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Arrhythmias Flashcards

(46 cards)

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1
Q

What is the only way pulses from the sinus node can get to the ventricles?

A

via the AV node

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2
Q

How is an arrhythmia named?

A

anatomical site or chamber of origin

mechanism eg fibrillation

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3
Q

d: fibrillation

A

heart going so fast its quivering, cant fill properly low CO

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4
Q

Name the Supraventricular Arrhythmias

A 
Supraventricular tachycardia
  Atrial Fibrillation
  Atrial Flutter
  Ectopic atrial 
   tachycardia

Bradycardia
Sinus bradycardia
Sinus pauses

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5
Q

Name the Ventricular Arrhythmias

A 
Ventricular ectopics or Premature Ventricular Complexes (PVC) 
Ventricular Tachycardia (VT)
 Ventricular Fibrillation (VF)

Asystole

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6
Q

Name the Atrio-ventricular Node Arrhythmias

A

AVN re-entry tachycardia (AVNRT)

AV reciprocating or AV Reentrant tachycardia (AVRT)

AV block :
1st degree
2nd degree
3rd degree

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7
Q

Name some of the causes of Arrhythmias

A 
abnormal anatomy
ANS
Metabolic
Inflammation
Drugs
Genetic
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8
Q

What is the abnormal anatomy that causes them?

A

left ventricular hypertrophy
accessory pathways
congenital HD

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9
Q

What is the ANS that causes them?

A

Sympathetic stimulation: stress, exercise, hyperthyroidism

Increased vagal tone causing bradycardia

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10
Q

What are the meatbolic changes that causes them?

A

Hypoxia: chronic pulmonary disease, pulmonary embolus
Ischaemic myocardium: acute MI, angina
Electrolyte imbalances: K+, Ca 2+, Mg2+

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11
Q

Name an inflammatory condition that causes arrhythmias

A

viral myocarditis

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12
Q

how do drugs cause arrhythmias?

A

direct electrophysiologic effects or via ANS

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13
Q

Name some genetic causes of arrhythmias?

A

mutations of genes encoding cardiac ion channels e.g. the congenital long QT syndrome

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14
Q

Name the 2 electrophysiological mechanisms that cause A?

A

Ectopic beats: Beats or rhythms that originate in places other than the SA node
Altered automaticity e.g. ischaemia, catecholamines
Triggered activity, e.g. digoxin, long QT syndrome
Re-entry : requires more than one conduction pathway, with different speed of conduction (depolarization) and recovery of excitability (refractoriness):
accessory pathway tachycardia (Wolf Parkinson White syndrome), previous myocardial infarction, congenital heart disease.

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15
Q

Name some abnormal physiologies that increase HR?

A 
hyperthermia
Hypoxia
Hypercapnia
Cardiac Dilation
Hypokalaemia, prolongs repolarization
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16
Q

Name some abnormal physiology that cause bradycardia/Heart block

A

Hypothermia

Hyperkalaemia

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17
Q

Symptoms of Arrhythmias

A 
Palpitations, ”pounding heart”
Shortness of breath
Dizziness
Loss of consciousness; ”Syncope”
Faintness: “presyncope”
Sudden cardiac death
Angina, heart failure
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18
Q

Name the Investigations for Arrhythmias?

A 
12 lead ECG (in tachycardia , during SR)
CXR
Echocardiogram
Stress ECG
Look for myocardial ischaemia, exercise related arrhythmias
24 hour ECG Holter monitoring
Event recorder: (capture the arrhythmia)
Electrophysiological (EP) study
Induce clinical arrhythmia to study mechanism and map arrhythmia
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19
Q

Name some types of arrhythmiae?

Study These Flashcards
A 
normal sinus arrhythmia
sinus bradycardia
sinus tachycardia
Atrial Ectopic Beats
Regular Supraventricular tachycardia
20
Q

How do ectopic beats cause an arrhythmia?

Study These Flashcards
A

origninates in places other than SA node

21
Q

Are ectopic beats a physiological/pathological cause?

Study These Flashcards
A

physiological

22
Q

How is re entry a cause of arrhythmias?

Study These Flashcards
A

requires more than one conduction pathway, with different speed of conduction (depolarization) and recovery of excitability (refractoriness)

23
Q

how many re entry be caused?

Study These Flashcards
A

WPW previous MI or CHD

24
Q

Name the 4 H’s that INcrease HR? and the C

Study These Flashcards
A

Hyperthermia, Hypoxia, Hypercapnia, Cardiac dilation, Hypokalaemia 4H’s.

25
Name the 2 things that decrease HR and cause Heart Block/
Hypothermia | Hyperkalaemia
26
describe triggered activity of an arrhythmia/
In terminal phase a small depolarization may occur (if big enough) may cause sustained train of depolarisations.
27
symptoms of arrhythmias?
Palpitations, SOB, Dizziness, Syncope (pre-syncope), Cardiac death, Angina, HF.
28
Name the investigations for arrhythmias?
ECG (24 hr), CXR, Echo, Stress ECG,
29
What is sinus bradycardia treated with and what is it?
<60bpm, - treat with Atropine (acute), or pacing
30
when is pacing used to treat sinus bradycardia?
if haemodynamic compromise
31
what is sinus tachycardia + treated with?
>100bpm, Treat underlying cause, B-blockers
32
If you have Atrial Ectopic Beats, what are the symptoms and treatment?
asymptomatic – palpitations, no treatment
33
What are the causes of regular supraventricular tachycardia?
caused by AV nodal re-entrant tachycardia (AVNRT), AV reciprocating tachycardia (AVRT), Ectopic atrial tachycardia (EAT)
34
what are the effects of acute reg supraventricular tachycardia?
Increase vagal tone, slow AVN conduction [IV adenosine, IV verapamil]
35
what is the advice given for chronic reg supraventricular tachycardia?
avoid sti mulants, B-Blockers, Anti-arrhythmic Drugs, Radiofrequency ablation
36
How is VT treated if pulsing and if pulseless?
DC cardioversion if haemodynamically unstable, Pulseless VT requires Defibrillation
37
What happens to the heart in VF?
loss of ability to pump
38
How is VF treated?
Cardioversion if unstable, If stable use Anti-Arrhythmic drugs.
39
What is the most common sustained arrhythmia?
atrial fibrillation
40
what is paroxysmal AF?
sudden spasm <48hrs
41
when is AF persistent?
>48hrs and cardioverter to NSR
42
when is AF permanent?
inability to restore NSR
43
What congenital syndrome can cause polymorphic VT ( torsades des pointes), what is it triggered by and what are the symptoms?
Congenital Long QT syndrome adrenergic stimulation syncope and sudden death
44
what does brugada syndrome pose a risk of?
Risk of polymorphic VT, VF, AF common, St elevation + RBBB in V1-3.
45
What is Brugada syndrome triggered by?
Triggered by sleep, fever, excess alcohol.
46
what is the advice for those with brugada syndrome?
Avoid anti-arrhythmics, psychotropics, analgesics, anaesthetics

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