Cardiac Rhythm Disturbances (Atrial, Junctional, Ventricular Flashcards Preview

MED233 Cardiovascular > Cardiac Rhythm Disturbances (Atrial, Junctional, Ventricular > Flashcards

Flashcards in Cardiac Rhythm Disturbances (Atrial, Junctional, Ventricular Deck (19):
1

Symptoms of arrhythmias

Palpitations, Light headedness, Syncope, Chest pain, Dyspnea, Sudden death

2

Medical conditions/situations associated with sinus bradycardia

healthy athlete, obstructive jaundice (bile salts affect SAN), sliding hiatal hernia, valsalva maneuver

3

Sinus Tachycardia

100+BPM

emotion, pregnancy, anemia, CHF, HYPOVOLEMIA

4

Sinus arrhythmia

5

Bradicardia  causes - what are diseases of the atrium or SAN - CAD due to?

inflammation, invasive neoplasm, cardiomyopathy, muscular dystrophy, amyloidosis

6

Bradycardia causes - drugs /electroytes, b-blockers

Drugs/electrolytes - digitalis, quinidie, hyperK; HTN drugs that decrese symp tone (clonidine, methyldopa, reserpine)

BB - propranolol, metoprolol

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Sinus Arrhythmia due to...

SAN forming irregular impulses

  • Wax/wane with respiration
  • HR inc. with inspiration
  • HR dec. with expiration

8

Sinus bradycardia with sinus arrythmia

  • Rate <60BPM
  • Rhythm - sinus
  • Constant/normal PRi (0.12-0.20 sec)
  • Constant P wave configuration in each lead
  • Constant P wave configuration in each lead
  • reuglar or slightly irrgular P-P or R-R cycle

9

nonconducted PAC, followed by nonconducted atrial bigeminy

10

  • SSS - tachy - brady
  • EKG - S.B.
  • S Arrest
  • S A Block - slow junctional rhythm
  • See in ischemic, sclerotic, inflammatory changes in SAN
    • May cause syncope, dizziness, fatigue, HF

11

Tx of sinus bradycardia

  • May not require tx
  • Atropine (0.3 >> 0.5 >> 2mg IV)
  • Epi - 2-10 ug/min
  • Isoprotenerol - 1mg in 500cc D5W
  • Pacemaker

12

What are signs of hemodynamic compromise?  What do you do?

Dec. BP

Dec. CO, SV, renal perfusion = OLIGURIA

Dec. cerebral profusion, SOB = CONFUSION

Fatigue, cool, clammy, syncope

If HR <45-50 = UNSTABLE ACUTE SITUATION

13

What is automaticity?

Property of cardiac cell to depol spontaneously during phase 4 of AP/leads to generation of an impulse

14

When are premature atrial contractions seen?

Absence of significatn heart disease, associated with stress, alcohol, tobacco, coffee, COPD, and CAD

15

16

What is a Premature Atrical Beat?

ORiginates in atrial ectopic focus and produces abnormal P wave earlier than expected.

17

PACs arriving very early in the cycle may not be conducted to the ventricles at all. In this case, you will see an abnormal P wave that is not followed by a QRS complex (“blocked PAC”). It is usually followed by a compensatory pause as the sinus node resets

18

Treatment of PAC

  • Reverse causes
  • Bblocker
  • Metroprolol 25-50mg BID-TID

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