Clinical: Heart Block Flashcards

1
Q

What kind of HB is this?

A
  • Third degree
    • P wave can be buried in a QRS complex
    • Each P to P interval is =
    • Each R to R interval is =
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2
Q
  • In Prolonged Sinus Node Dysfunction from conditions like A-fib, what can occur to the AV node?
A

Increased Vagal Tone

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3
Q

For normal cardiac conduction

  • Normal QRS duration < ____ (ms)

In Delayed Signals in the Ventricle

  • Depolarization of ventricles will take ________
    • QRS > ____ ms
  • QRS axis may change
    • QRS vector will be shifted in a direction of the ____ part of ventricles to be ____________
A

For normal cardiac conduction

  • Normal QRS duration < 100 (ms)

In Delayed Signals in the Ventricle

  • Depolarization of ventricles will take longer
    • QRS > 100 ms
  • QRS axis may change
    • QRS vector will be shifted in a direction of the last part of ventricles to be depolarized
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4
Q

What is the common symptom of Sinoatrial exit block, and how is it usually treated?

A

Syncope

Pacemaker

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5
Q

What are two parasite-related diseases that can cause HB?

A
  1. Lyme Disease
    • Creates 1st to 3rd degree HB
    • Resolves in most PTs even if untreated for Lyme Disease
    • HB may actually be 1st sign of Lyme Disease
  2. Chagas Disease
    • From a parasite from Latin America
    • Can cause all types of Hb
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6
Q

What is sinus arrhythmia, and in which PT population is this condition considered “normal”?

A

RR intervals are not equal

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7
Q

What type of HB is this?

A

Left BBB

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8
Q

What type of HB is this?

A

2nd-degree type 1

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9
Q

What kind of heart block is this?

A
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10
Q
  • Is this normal, left BBB, or right BBB?
    • Left is from V1
    • Right is from V6
A
  • Right BBB
    • V1 Ravvit Ears
    • V6 S wave slurring
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11
Q

What type of HB is this?

A

right BBB

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12
Q

What type of HB is this?

A

1st degree

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13
Q

Fill in the blank

A
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14
Q
  • What is the bpm for an Idioventricular Escape Rhythm?
  • What region of the ventricle does this occur, and how do you know?
  • When does this type of beat occur?
A
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15
Q

Is this a Right BBB or a left BBB? How can you tell?

A

V1 has rabbits ears and a slurred S wave in V6

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16
Q

What type of HB is this?

A
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17
Q

Describe a Second Degree Type II HB

  • What happens to the PR interval?
  • Where is this block usually located?
  • What is the Tx?
A
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18
Q

What type of HB is this?

A

2nd degree type 2 WITH a R BBB

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19
Q

What is a Bifascicular Block?

A
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20
Q

What artery supplies the anterior wall of the heart?

A

Left anterior descending artery supplies anterior wall and can cause bundle branch block and second and third-degree block

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21
Q

What kind of HB is this?

A
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22
Q

What is indicative of all second-degree heart blocks?

A

Dropped QRS complexes, so not a 1:1 ratio from P waves:QRS complexes

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23
Q

What does a right BBB look like?

A

“Rabbit Ears”

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24
Q

Describe the different types of Pacings that are used to treat HB

A
  1. Emergent Pacing
    • Electric current through the chest wall to reach the heart
    • PAINFUL
  2. Temporary Pacing
    • Use a central line to reach the right side of the heart with wires
  3. Permanent Pacing
25
Q

What are the parameters for an incomplete heart block and a complete heart block?

A
  • Incomplete
    • Between 100 bpm and 120 bpm
  • Complete
    • > 120 ms (3 boxes)
26
Q

What type of HB is this?

A

3rd degree

27
Q

What do you see in V1 and V6 in right BBBs?

A
  • V1
    • rabbits ears
  • V6
    • Slurred S-wave
28
Q

What artery usually supplies the AV node?

A

Right coronary artery

29
Q

What is the treatment for an HB that is caused by MI or ischemia?

A
30
Q
  • How do you treat HBs with meds?
    • Compare the Tx for an AV node block vs a block at the His bundle or more distal areas
A
31
Q

Is this normal, left BBB, or right BBB?

  • Left is from V1
  • Right is from V6
A
  • Left BBB
    • Pen tip in both V1 and V6
32
Q

What type of HB is this?

A
33
Q

Is this a Right BBB or a left BBB? How can you tell?

A
34
Q
  • How do you know this is an AV junctional rhythm?
    • What should the bpm be for this condition?
A
35
Q

What type of HB is this?

A
36
Q

What can we classify an AV junctional rhythm as?

A

An escape Rhythm [the AV Node signal travels backwards]

37
Q

What does a left BBB look like?

A
38
Q

What are the non-Rx causes of HB?

A
39
Q

Describe a second-degree Type I Wenckebach HB

  • What happens to the PR interval?
  • What heart structure is this type of block most likely near?
  • What is the tx for this?
A
  • Probably near the AV node
40
Q

Describe a third-degree HB aka Complete Heart Block

  • What is the relationship b/w the atria and ventricles?
  • Where does the QRS/ventricular depolarization originate?
  • What is the Tx?
A
41
Q

What kind of heart block is this and how would you treat it?

A
  • First-Degree
    • This in isolation of other conditions do not require treatment
42
Q

What is a defining feature of Junctional Tachycardia?

A

Retrograde P waves

43
Q

What is a Sinoatrial exit block?

A

The exit of the impulse from the sinus node is blocked, so no P-wave

44
Q

Which type of BBB can be seen in normal healthy young people?

A

Right

45
Q

Is this a right BBB or left BBB? How can you tell?

A

Left BBB

46
Q
  • Is this normal, left BBB, or right BBB?
    • Left is from V1
    • Right is from V6
A

Normal

47
Q
  1. What condition does an Accelerated Idioventricular Rhythm look like?
  2. What do avoid when if you see this rhythm?
A
  1. Like a slow V-Tach
    • HR under 100
  2. Avoid any nodal blockers or HR suppressors
48
Q

What is the only “normal” way that an electrical signal should travel from the atria to the ventricle?

A

AV Node

49
Q
  • How long does a narrow QRS complex last and how long does a wide QRS complex last?
    • Where does the wide complex usually occur?
A
50
Q
  • Is a right or left BBB usually considered a marker of underlying heart disease and degeneration of the conducting system?
    • List the various diseases it is associated with
A
51
Q
  • Describe what a first-degree block is
    • What happens to the PR interval
    • Where can it occur?
    • Compare the P-waves to the QRS complexes
A
52
Q

Describe Secondary Pacemakers and Escape Rhythms, including bpms

A
53
Q
  • What is a “sick sinus syndrome”?
A
  • Sick sinus syndrome is a relatively uncommon heart rhythm disorder. SSS is not a specific disease, but rather a group of signs or symptoms that indicate the sinus node, the heart’s natural pacemaker, is not functioning properly.
    • The dysfunctional impulse is probably not originating at the SA Node.
54
Q

What type of diseases are normally associated with right BBBs?

A
  • Pulmonary Diseases
  • Atrial septal defects
55
Q
A
56
Q

What type of HB is this?

A

2nd degree type 2

57
Q

What type of HB is this?

A

4:3 ratio

58
Q

What type of HB is this?

A

2nd degree type 1

59
Q

What are the types of medications that can cause HR?

A