CV - arrhythmias

Question 1

in arrhythmias, look for the ____________!

Answer 1

P wave

Question 2

in arrhythmias, look for the ____________!

Answer 2

P wave

Question 3

sinus tachycardia is defined as a regular, fast heart rate of ____________ bpm.

Answer 3

> 100

Question 4

name 5 examples of sympathetic activation

Answer 4

exercise
emotion
hypotension
response to acute lung or abdominal pathology
thyrotoxicosis

Question 5

sinus bradycardia is defined as a regular, slow heart rate of ____________ bpm

Question 6

bradycardia may occur due to high parasympathetic or vagal activity, as in what three vagotonic states?

Answer 6

faintness
sick sinus syndrome
inferior myocardial infarct

Question 7

bradycardia may occur due to high parasympathetic or vagal activity, as in what three vagotonic states?

Answer 7

faint
sick sinus syndrome
inferior myocardial infarct

Question 8

what is the treatments for sinus bradycardia?

Answer 8

none (typically)
atropine
pacemaker if symptomatic

Question 9

what is the treatments for sinus bradycardia?

Answer 9

none
atropine
pacemaker if symptomatic

Question 10

sinus tachycardia is defined as a regular, fast heart rate of ____________ bpm.

Answer 10

> 100

Question 11

name 5 examples of sympathetic activation

Answer 11

exercise
emotion
hypotension
response to acute lung or abdominal pathology
thyrotoxicosis

Question 12

what are the ECG findings of a first-degree AV block?

Answer 12

prolonged PR interval

increased junctional delay

Question 13

bradycardia is typically seen in what group of healthy people?

Answer 13

athletes

Question 14

bradycardia may occur due to high parasympathetic or vagal activity, as in what three vagotonic states?

Answer 14

faint
sick sinus syndrome
inferior myocardial infarct

Question 15

what is the treatment for sinus tachycardia?

Answer 15

usually none

beta-blockers in thyrotoxicosis

Question 16

what is the treatments for sinus bradycardia?

Answer 16

none
atropine
pacemaker if symptomatic

Question 17

define sick sinus syndrome

Answer 17

also called sinus dysfunction or sinoatrial node disease, a group of abnormal heart rhythms presumably caused by a malfunction of the sinoatrial node

Question 18

typically 20% of atrial filling occurs during ____________.

Answer 18

ventricular contraction

Question 19

QRS width indicates the location of the block - if the QRS is ____________, the block is likely higher in the conduction system, and if the QRS is ____________, the block is likely lower in the conduction system.

Answer 19

narrow

broad

Question 20

what is the general appearance of a premature ventricular contraction (PVC) on an ECG?

Answer 20

wide and abnormal QRS deflection,
do not affect the P wave - may skip a P wave
do not affect the sinoatrial node

Question 21

define a second degree AV block

Answer 21

some P waves conduct but some do not

Question 22

what are the subtypes of second degree AV block?

Answer 22

mobitz 1

Question 23

describe a mobitz 1 (wenckebach) second degree AV block

Answer 23

progressive lengthening of the PR interval followed by a nonconductive P wave

usually benign, usually does not progress

frequently seen in small, inferior infarcts

Question 24

define a third degree AV block (complete heart block)

Answer 24

none of the P waves conduct

there is no relationship between P waves and QRS - P wave rate is faster than QRS rate

Question 25

what is a high-risk complication of atrial flutter?

Answer 25

clots in the atria

Question 26

what are the treatments for atrial flutter?

Answer 26

anticoagulation rate control with drugs (beta blockers, calcium blockers, digitalis compounds i.e. digoxin) cardioversion (electrical shock) ablation

Question 27

QRS width indicates the location of the block - if the QRS is ____________, the block is likely higher in the conduction system, and if the QRS is ____________, the block is likely lower in the conduction system.

Answer 27

narrow | broad

Question 28

what is the general appearance of a ventricular premature beat on an ECG?

Answer 28

wide beat, ventricular in origin do not affect the P wave do not affect the sinoatrial node

Question 29

what are other treatments for atrial tachycardia?

Answer 29

vagal maneuver (carotid massage) beta blocker verapamil or diltiazem

Question 30

define atrial fibrillation

Answer 30

abnormal, completely irregular heart rhythm characterized by rapid and irregular beating potentially leading to ischemia and heart failure "irregularly irregular" ventricular rhythm

Question 31

what are the ECG findings associated with atrial fibrillation?

Answer 31

no P waves chaotic atrial depolarizations at >/=350 bpm creating an undulating baseline "irregularly irregular" QRS

Question 32

who typically presents with atrial fibrillation?

Answer 32

``` NI subjects ("lone Afib") aging emotional stress post-operative heart disease hyperthyroidism ```

Question 33

what complications are associated with atrial fibrillation?

Answer 33

rapid heart rate - ischemia, heart failure loss of atrial kick - heart failure atrial thrombi - embolic stroke

Question 34

what are the treatments for atrial fibrillation?

Answer 34

anticoagulation rate control with drugs cardioversion ablation

Question 35

atrial tachycardia is a rapid heart rate of ____________ displaying a ____________ QRS segment and ____________ P waves.

Answer 35

>/= 150 bpm narrow present but abnormal

Question 36

what is the typical treatment for atrial tachycardia?

Answer 36

adenosine

Question 37

what are other treatments for atrial tachycardia?

Answer 37

vagal maneuver (carotid massage) beta blocker verapamil or diltiazem

Question 38

define atrial fibrillation

Answer 38

abnormal, completely irregular heart rhythm characterized by rapid and irregular beating

Question 39

what are the ECG findings associated with atrial fibrillation?

Answer 39

no P waves chaotic atrial depolarizations at >/=350 bpm creating an undulating baseline "irregularly irregular" QRS

Question 40

who typically presents with atrial fibrillation?

Answer 40

``` NI subjects ("lone Afib") aging emotional stress post-operative heart disease hyperthyroidism ```

Question 41

what is "larry's awesome algorithm" for interpreting ECGs?

Answer 41

1 look for the P wave 2 does each P wave precede a QRS? 3 is AV heart block present? is it 1st, 2nd or 3rd degree AV block? 4 are occasional early QRS complexes present? 5 are very fast, abnormal P waves present? 6 no P waves but QRS complexes present 7 no P wave and no QRS?

Question 42

define first degree AV block

Answer 42

P waves conduct but more slowly than is typical

Question 43

define a junctional rhythm

Answer 43

abnormal heart rhythm resulting from electrical activation of the heart originating near or within the AV node rather than the SA node

Question 44

what are the ECG findings associated with junctional rhythms?

Answer 44

regular rhythm narrow QRS no antecedent P waves

Question 45

define ventricular tachycardia

Answer 45

rapid heart beat arising from improper electrical activity of the heart beginning in the ventricles

Question 46

ventricular tachycardia presents on ECG as regular, wide complexes with a rate of ____________ bpm.

Answer 46

100-200

Question 47

in most cases of ventricular tachycardia, are P waves visible?

Answer 47

no

Question 48

define "sustained ventricular tachycardia"

Answer 48

ventricular tachycardia >/= 30 seconds in duration often life threatening

Question 49

what is "larry's awesome algorithm" for interpreting ECGs?

Answer 49

1 look for the P wave 2 does each P wave precede a QRS? if yes, "sinus rhythm" 3 is AV heart block present? is it 1st, 2nd or 3rd degree AV block?

Question 50

define first degree AV block

Answer 50

P waves conduct but more slowly than is typical