Flashcards in ECG arrythmias Deck (18):
Which symptoms can be associated with arrythmias?
precipitation of congestive HF
Name 7 causes of arrythmia
Ischemia and Irritability
Name 3 causes of sinus tachycardia
Congestive heart failure
severe lung disease
hyperthyroidism (may be the only sign)
What is the most common rhytm disturbance in early stages of acute MI?
What is sinus arrythmia?
Variation in heart rate with inspiration/expiration
Diminishes with aging, obesity, long standing hypertension, autonomic neuropathy
What are junctional escape beats?
A rescue depolarization from near the AV node area. Seen as a beat without normal P wave
(might be a retrograde P wave with inverted axis)
Which four questions should be asked in order to asses any ECG rhytm disturbance?
1. Are normal P waves present?
2. Are QRS complexes narrow or wide? (< or > than 0.12 s)
3. What is the P and QRS relationship?
4. Is the rhytm regular or irregular?
What are atrial and junctional premature beats?
Single ectopic supraventricular beast from atria or around AV node.
P wave may have differnt morphology, timing or axis
Junctional - usually no P wave
Common non-pathological phenomena
What is the difference between a junctional premmature beat and a junctional escape beat?
Premature beat - occurs early within the normal sinus
(may be so early AV node is not repolarized -> no QRS)
Escape beat - ocurs late after sinus failed to fire
What is Paroxysmal supraventricular Tachycardia? (PSVT)
Absolute regular rhytm with hr between 150-250bpm
can occur in perfectly normal hearts (alcohol, cofee or excitement)
Presents with palpatations, SOB, dizzines, syncope (rarely)
Most common type: AV nodal reentrant tachycardia
Carotid massage -> terminates and diagnose >
adenosine bolus > Bblock, CCB, conversion
How is a carotid massage done?
1. If carotid bruits -> don't do it
2. Patient flat, extend neck, rotate head away
3. Palpate at jaw angle, gentle pressure 10-15s
4.Never both arteries at the same time!
5. Try right carotid first
6. Have a rhytm strip running
7. Have resucitation equipment available
What is the mechanism behind atrial flutter?
Reentrant circuit, most commonly around tricuspid annulus
What is the ECG pattern in atrial flutter?
Saw-tooth pattern in II, III
AV block ( commonly 2:1)
Counterclockwise - neg saw tooth
Name 9 causes of atrial flutter
Drugs ( cocaine, amphetamine)
Pulmonary( COPD, PE)
Various cardiac conditions
How is atrial fibrillation diagnosed on ECG?
Irregular irregular QRS complexes in absence of p waves
What are the causes of atrial fibrillation?
Like atrial flutter, but high incidence of cardiac conditions
Acute: PE, thyrotox, pericarditis
How is atrial fibrilation treated?
Anticoagulation: warfarin, dabigatran, rivaroxaban
Restoration of sinus rhythm (drugs, electro)