Cardiac Arrhythmias

Question 1

arrhythmia

Answer 1

• variation in normal heartbeat
• rhythm
• rate
• conduction pattern

Question 2

cause of arrhythmia

Answer 2

disorders of cellular automaticity and conductivity

Question 3

what are some types of disorders that cause arrhythmia

Answer 3

• CV
• pulmonary
• autonomic
• systemic

Question 4

arrhythmia is secondary to

Answer 4

• electrolyte imbalances
• foods
• drugs

Question 5

classifications of cardiac arrhythmias

Answer 5

• supraventricular

- ventricular

Question 6

examples of supraventricular arrhythmias

Answer 6

• sinus nodal disturbances
• disturbances of atrial rhythm
• heart block

Question 7

examples of ventricular arrhythmias

Answer 7

• premature ventricular complexes
• ventricular tachycardia
• ventricular fibrillation

Question 8

atrial fibrillation

Answer 8

rapid, disorganized, weak atrial contractions bombard the AV node

Question 9

what does atrial fibrillation result in?

Answer 9

irregular, rapid ventricular contractions

Question 10

a-fib pre-disposed pts to what?

Answer 10

blood clot

Question 11

what happens if clot travels to RIGHT ventricle on pts with a-fib?

Answer 11

pulmonary embolism

Question 12

what happens if clot travels to LEFT ventricle on pts with a-fib?

Answer 12

stroke

Question 13

heart block

Answer 13

impulse slowed or blocked in AV node

Question 14

what does heart block result in?

Answer 14

ventricles may generate a contraction (slower)

Question 15

ventricular tachycardia

Answer 15

rapid, regular ventricular contractions

Question 16

what does ventricular tachycardia result in?

Answer 16

inadequate ventricular filling/pumping to body

Question 17

ventricular fibrillation

Answer 17

rapid, chaotic impulses

Question 18

what does ventricular fibrillation result in?

Answer 18

fatal if not restored to normal sinus rhythm within minutes

Question 19

symptoms of arrythmia

Answer 19

• palpitations
• dizziness
• syncope
• and those related to heart failure

Question 20

arrythmia can precipitate what?

Answer 20

• heart failure
• MI
• stroke

Question 21

treatment of arrhythmias depend on what?

Answer 21

• depends on symptoms
• type of arrhythmia
• and pt

Question 22

treatment for bradycardia

Answer 22

implantable pacemakers

Question 23

treatment for tachycardia

Answer 23

drugs to normalize rate

Question 24

treatment for arrhythmias to correct irregularity

Answer 24

• antiarrhythmic drugs
• implantable cardioverter-defibrillators
• ablation

Question 25

a-fib pts are at an increased risk for what?

Answer 25

stroke secondary to thromboembolism

Question 26

mechanism of coumadin (warfarin)?

Answer 26

inhibit vitamin K-dependent coagulation factor synthesis

Question 27

how is the coagulation tested for pts on coumadin?

Answer 27

INR

Question 28

mechanism of pradaxa (dabigatran)?

Answer 28

antithrombin

Question 29

mechanism for eliquis (rivaroxaban)?

Answer 29

direct factor Xa inhibitor

Question 30

mechanism for savaysa (edoxaban)?

Answer 30

direct factor Xa inhibitor

Question 31

a-fib is considered what type of risk?

Answer 31

MAJOR *significant arrhythmias

Question 32

which CV disease should you defer elective care for?

Answer 32

- high-grade AV blocks | - symptomatic ventricular rhythms

Question 33

abnormal ECG and rhythm other than sinus is considered what type of risk?

Answer 33

minor

Question 34

mods to dental treatment for pts with arrhythmia

Answer 34

- profound LA, limit epi - stress reduction/decrease anxiety - familiarity with implantable devices - drug interactions - post-procedure analgesia

Question 35

what are you concerned about if you have to do surgery on a pt with a-fib?

Answer 35

bleeding if anticoagualted with warfarin | *pt will bleed on you if INR too high

Question 36

when do you want an INR drawn?

Answer 36

at least 48 hours before appt

Question 37

should you txt a pt if their INR is >3?

Answer 37

no treatment, talk to physician

Question 38

should you txt a pt if their INR is <3?

Answer 38

yes

Question 39

what is normal INR?

Answer 39

1-2