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Clin Med 2 - CARDS > Arrhythmias - madison > Flashcards

Arrhythmias - madison Flashcards

1
Q

What can cause sinus bradycardia

A

Drugs - beta blockers, calcium channel blockers
Conditioning - high level athletes
age

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2
Q

what is the presentation of sinus bradycardia

A

asymptomatic
fatigue, DOE - chroniotropic incompetence

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3
Q

what is the management of sinus bradycardia

A

nothing
remove offending agents
pacemaker? rarely

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4
Q

what is seen with junctional rhythm

A

P waves hidden within or after QRS
narrow QRS
typically slow rhythm due to AV node rate.

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5
Q

What is a junctional escape

A

AV junction has a faster firing rate than the SA node

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6
Q

what is asystole

A

complete absence of demonstrable electrical and mechanical cardiac activity

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7
Q

What is the mechanism of sinus node dysfunction

A

fibrosis of the sinus node (age)
cardiorespiratory conditioning
medication suppression (beta-blockers, CCB)
chronotropic incompetence (cannot meet the demand of exertion)

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8
Q

What is the presentation of sinus node dysfunction

A

asymptomatic at rest
Exertional fatigue/DOE
unconscious

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9
Q

What is the management of Sinus Node dysfunction

A

reversible causes
atropine (short term)
transcutaneous pacing vs TVP via RIJ
pacemaker

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10
Q

what is the mechanism of sinus arrrhythmias

A

normal physiologic cardiac cycles
inspiration HR: increases
Expiration HR: decreases

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11
Q

what is the management of sinus arrhythmias

A

none

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12
Q

What is the mechanism of sinus tachycardia

A

stimulation of the sinus node
adrenergic response (fight/flight, anxiety)
infection
PE

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13
Q

what is the presenation of sinus tachycardia

A

asymptomatic
variable depending on underlying cause

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14
Q

what is the management for sinus tachycardia

A

First line: treat reversible causes
then consider beta-blockers

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15
Q

What are the mechanisms of Afib

A

wavelets of re-entrant activation (pulmonary veins)

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16
Q

what are the mechanisms of aflutter

A

circuit of re-entrant activation (cavotricuspid isthmus)

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17
Q

what is the presentation of afib/aflutter

A

asymptomatic
palpitations
fatigue
DOE
stroke/CVA

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18
Q

what is the management for stable afib

A

anticoagulate (CHA2DS2-VASc)
rate control
rhythm control

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19
Q

what does MAT stand for

A

Multifocal atrial tachycardia

> 100bpm and 2 different shapes of P waves

20
Q

what does WAP stand for

A

Wandering Atrial Pacemaker
<100bpm and 2 different shapes of P waves

21
Q

What is the mechanism for MAT/WAP

A

mutliple atrial ectopic foci

22
Q

what is the presentation of MAT/WAP

A

can be similar to afib
most pts are hemodynamically stable

23
Q

how do you manage MAT/WAP

A

oxygen levels and treat underlying causes

24
Q

What is the mechanism of SVT

A

circuit allowing rapid conduction from A to V
AVNRT * most common
AVRT

25
Q

what is AVNRT

A

Atrioventricular nodal re-entrant tachycardia
most common SVT

26
Q

what is AVRT

A

atrioventricular re-entrant tachycardia
- not reliant on the node

27
Q

What is the presentation of SVT

A

palpitations
lightheadedness
“heart racing”
presyncope/syncope
History: bending down motions (AVNRT until proven otherwise)

28
Q

What is the acute management of SVT

A

vagal maneuvers
adenosine (diagnostic and therapeutic)
Cardioversion (DCCV)

29
Q

what is the chronic management of SVT

A

rate control
antiarrhythmics (flecainide)
Ablation

30
Q

What is the mechanism of heart block

A

disease of the AV node
-fibrosis
-beta-blockers/CCB toxicity
-infection
-ischemia/infarct
-iatrogenic
-infiltrative disease
-congenital

31
Q

what is the presentation of Heart block

A

SOB
lightheadedness
syncope

32
Q

what is the management for heart block

A

acute (if HD unstable): transcutaneous packing vs TVP via RIJ; atropine, dobutamine
chronic: pacemaker

33
Q

how do you treat torsades de points

A

*magnesium
shock
overdrive pace

34
Q

What are the mechanisms for Vtac

A

ischemia/infarct
Drugs
toxicity
metabolic derangements
Prolonged QTc

35
Q

what is the presentation for Vtac

A

unconscious, pulseless
SOB, lightheadedness, palpitations

36
Q

what is the management for Vtach

A

ACLS
amiodarone
lidocaine
Cardioversion
Defibrillation
TdP: Mag, more mag, overdrive pacing

37
Q

What is a RBBB

A

complete block of impulses along the right bundle of his
“bunny ears” in V1 or V2

38
Q

what is LBBB

A

complete block of impulses along the left bundle of His
deep R wave in V1

39
Q

what do bundle branch blocks cause

A

wide QRS and characteristic pattern of QRS complex

40
Q

What is the mechanism of Bundle Branch Blocks

A

fibrosis
ischemia/infarct
drugs/toxicity

41
Q

what is the presentation of BBB

A

usually, asymptomatic
can occur int he setting of HF

42
Q

what is the management of BBB

A

usually no intervention is warranted
new LBBB + ? ACS -> Sgarbossa’s criteria

if reduced LVEF despite GDMT and no recent revascularization - CRT

43
Q

what is the mechanism of premature complexes

A

excitable tissue
catecholamines

44
Q

what is the presentation of premature complexes

A

asymptomatic
palpitations

45
Q

what is the management of ectopy

A

magnesium, decrease ETOH level, stimulant use, hormonal

Clin Med 2 - CARDS (11 decks)

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