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Flashcards in Arrhythmias (complete) Deck (27):
1

Describe the EKG of sinus tachycardia

- P waves precede each QRS (everything's pretty normal)
- Just a regular, fast HR

2

What are the causes of sinus tachycardia?

Sympathetic activation
- Exercise
- Emotion
- Hypotension
- Response to acute lung/abdominal pathology
- Thyrotoxicosis

3

What is the treatment of sinus tachycardia?

- usually none (b/c it's a normal response)
- Beta-blockers in thyrotoxicosis

4

Describe the EKG of sinus bradycardia

- P waves precede each QRS (normal)
- just regular, slow HR (<60/min)

5

What are the causes of sinus bradycardia?

- Athletes (endurance peeps)
- Vagotonic states (fainting, sick sinus syndrome, inferior infarct)

6

What is tx of sinus bradycardia?

- None
- Atropine
- Pacemaker w/ symptoms

7

Describe the EKG of 1st degree atrioventricular block

- Prolonged PR interval
- Interval is >0.2sec (more than one heavy block)
- Increased junctional delay

8

What are the causes of 1st degree atrioventricular block

- drug-induced (beta-blockers, some CCB, digitalis)
- conduction system disease
- usually benign

9

Describe the EKG of 2nd degree AV block

An occasional missed connection

- some P waves are followed by QRS, some are not (some conduct, some don't)

10

Describe the EKG of 3rd degree AV block

Oil and water! The relationship not meant to be

- P waves and QRS complexes both show regular rhythm
- HOWEVER they are at different rates w/ P rate>QRS

11

What are the causes of 3rd degree AV block?

- Severe conduction system disease
- Rarely drugs
- Due to AV node or junctional failure w/ aging, infarct, or disruption during cardiac surgery

12

What is the treatment of 3rd degree AV block?

- Pacing if ventricular rate or BP are too low
- otherwise can cause syncope or sudden death

13

Describe the EKG of premature atrial contraction

- Premature (early) beat
- Often preceded by abnormal P wave
- Narrow QRS resembling normally conducted beats

14

Describe the EKG of premature ventricular contractions

- Wide QRS, no P wave
- The above doesn't happen all the time => once every few complexes or so
- Common in normal subjects

Can indicate:
- acute myocardial infarct
- HF

15

Describe the EKG of atrial flutter

Do he make your heart go pitter patter?

- P wave "sawtooth" pattern
- P waves at rate of 240-320 beats/min
- Pulse is regular or irregular
- Ventricular rates vary --- rapid if untreated

16

What is the treatment of atrial flutter?

- Anticoagulation
- Rate control w/ drugs
- Cardioversion
- Ablation

17

Describe the EKG of atrial tachycardia

- Rapid HR ≥150/min
- Narrow QRS complexes
- P waves (present but abnormal)

18

What is the treatment of atrial tachycardia?

- Adenosine (super fast -- for acute bad problems)
- Vagal maneuver
- Beta blockers
- Verapamil
- Diltiazem

19

Describe the EKG of atrial fibrillation

No matter how hard you look you can't find her (P waves)

- No P waves (but atrial depolarizations at 350/min)
- Irregular QRS (like insanely irregular)

20

What are the causes of atrial fibrillation?

- Aging
- Post-operative (*important*)
- Heart Disease
- Hyperthyroidism

21

What are problems associated with atrial fibrillation?

Rapid HR
- Syncope
- Ischemia
- HF

Loss of Atrial Kick
- HF

Atrial Thrombi
- Embolic stroke

22

What are the treatments of atrial fibrillation?

- anticoagulation
- rate control with drugs
- Cardioversion
- Ablation

23

Describe the EKG of junctional rhythm

- Regular
- Narrow QRS (usually)
- No antecedent P waves
- Tx usually unnecessary

24

Describe the EKG of ventricular tachycardia

- Usually regular, fast, wide QRS complexes (100-200/min)
- mostly no P waves
- Sustained if ≥30 seconds in duration
- Often life threatening!

25

What are the treatments for ventricular tachycardia?

- Amiodarone (used if pt is stable)
- Lidocaine
- Cardioversion

26

Describe the EKG of ventricular fibrillation

- Wavy
- Irregular baseline

No P wave or QRS

27

Describe the EKG of asystole

Flat baseline

time to get that epinephrine and shock them!