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Cardiovascular Pathophysiology > ECG Part III > Flashcards

ECG Part III Flashcards

1
Q

what are the effects of cardiac arrhythmias?

A

syncope
weakness
decompensation of CHF
reduced blood flow
death

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2
Q

arrhythmias are more concerning in animals with ________________________________

A

advanced heart disease

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3
Q

how can you identify arrhythmias?

A

auscultation
ECG

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4
Q

what are the three mechanisms of arrhythmia?

A

altered automaticity
triggered activity
re-entry

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5
Q

where do all sinus rhythms originate?

A

sinoatrial node

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6
Q

what is normal sinus rhythm?

A

normal P wave coming in regular intervals
typically normal P-QRS-T complexes
normal heart rate
normal relationship between the P-QRS-T complexes

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7
Q

in sinus arrhythmia, there is cyclic/rhythmic variation in _______________________

A

P-P intervals

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8
Q

in whom is sinus arrhythmia normal?

A

dog
horse

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9
Q

what is the P-QRS-T complex like in sinus arrhythmia?

A

typically normal

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10
Q

what are the cutoffs for sinus bradycardia in dogs, cats, bovine, and equine in rates?

A

dog: 60/min
cat: 160/min
bovine: 46/min
equine: 24/min

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11
Q

what are the rate cutoffs for sinus tachycardia in dogs, cats, and equids?

A

dog: 160/min
cat: 240/min
equine: 60/min

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12
Q

what is the rhythm like typically with sinus tachycardia?

A

regular, with normal P-QRS-T complex

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13
Q

what happens in supraventricular premature depolarizations?

A

regular rhythm is interrupted by a premature depolarization from the atria or AV junctional tissue

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14
Q

what is the appearance of the supraventricular premature depolarization?

A

fairly normal QRS-T appearance

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15
Q

what is a compensatory pause?

A

pause during premature beat is equal to twice the normal R-R interval

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16
Q

what is supraventricular tachycardia?

A

runs or paroxysms of ectopic complexes
>= 3 in number
originate from atria or AV junctional tissue

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17
Q

what is atrial tachycardia?

A

atrial tissue alone is utilized for origination and maintenance of arrhythmia

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18
Q

____________________ is an unstable rhythm that often leads to atrial fibrillation

A

atrial flutter

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19
Q

what is atrial fibrillation?

A

chaotic, disjointed atrial activation

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20
Q

what is the heart rate in atrial fibrillation?

A

usually a rapid rat

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21
Q

what is the morphology of the QRS-T in atrial fibrillation?

A

usually fairly normal
often some beat-to-beat variation in QRS height

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22
Q

what are ventricular premature depolarizations?

A

premature ectopic impulses originating from the ventricles

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23
Q

what is the appearance of the ECG with ventricular premature depolarizations?

A

wide and bizarre appearance of QRS-T
large T wave in opposite direction of QRS
ST segment slurring
compensatory pause

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24
Q

what happens in ventricular premature depolarizations?

A

spontaneous depolarization in the ventricle
fires before sinus node impulse reaches ventricle

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25
what is a fusion beat?
complex formed when the normally conducted impulse and a ventricular ectopic beat simultaneously depolarize the ventricle
26
what is coupling?
fixed relationship between a premature beat and the beat that precedes it
27
how can you differentiate between unifocal and multifocal?
unifocal: all premature beats look the same
28
what is ventricular tachycardia?
a run or paroxysm of >= 3 premature ectopic impulses originating from the ventricles
29
what is a compensatory pause?
pause during premature beat is equal to 2x the normal R-R interval
30
what is sustained ventricular tachycardia?
ventricular tachycardia lasting more than 30 seconds
31
why are VPCs not good?
do not generate a good blood pressure
32
what is accelerated idioventricular rhythm?
ventricular origin beats that are not tachycardia
33
what is ventricular fibrillation?
chaotic, disorganized activation of the ventricles irregular undulations in the baseline
34
what is cardiac output in ventricular fibrillation?
drops to zero
35
what do IKr blocking drugs cause?
QT prolongations, setting up lethal arrhythmias
36
where do junctional escape rhythms originate from?
AV junction
37
where do ventricular escape rhythms originate from?
purkinje fibers
38
what is sinus arrest?
failure of the sinus node to discharge for a period more than twice the normal R-R interval
39
what do long pauses in sinus arrest often result in?
syncope
40
what is sick sinus syndrome?
syndrome often characterized by bradycardia and tachycardia resulting in clinical signs periods of sinus arrest often followed by paroxysm of supraventricular tachycardia
41
what is atrial standstill?
atrial activity is absent no P waves anywhere on ECG strip
42
what can atrial standstill result from?
severe hyperkalemia atrial muscular dystrophy
43
how can you recognize severe hyperkalemia on an ECG?
atrial standstill peaked T wave bradycardia
44
what does a first degree AV block look like on an ECG?
minor delay in AV conduction prolonged P-R interval
45
what is happening in third degree AV block?
no conduction through the AV node no P waves conducted to thee ventricles atria and ventricles beat in independent fashion
46
what can be the cause of first degree AV block?
physiologic drugs pathologic
47
what is second degree AV block?
more advanced conduction disturbance some P waves are not conducted to the ventricles
48
what is mobitz type I second degree AV block?
progressive P-R prolongation before the block
49
what is mobitz type II second degree AV block?
fixed P-R interval: often more advanced form of AV block
50
who can have physiologic second degree AV block?
dog horse
51
what can cause third degree AV block?
pathologic drugs in overdose
52
what are the rates in third degree AV block?
atrial rate normal or fast ventricular rate usually slow
53
the ST segment should not be depressed more than ______________
0.2mV
54
the ST segment should not be elevated more than ______________
0.1 to 0.15mV
55
what can ST segment alterations indicate?
ischemia or hypoxia electrolyte changes conduction disturbance myocardial infarction
56
accessory pathways lead to ___________________________________
supraventricular tachycardia
57
what does a wandering pacemaker look like?
variable P wave height or appearance
58
what varies with respiration in respiratory sinus arrhythmia?
rate
59
is sinus bradycardia usually a regular rhythm?
yes
60
what type of pause do supraventricular premature depolarizations have?
non-compensatory
61
what can supraventricular premature depolarizations have with P waves?
may have ectopic prior to, within, or following QRS-T
62
what type of tachycardia does supraventricular tachycardia usually cause?
often very regular
63
what does atrial fibrillation look like on an ECG?
irregularly irregular R-R intervals usually baseline undulations due to atrial fibrillation lack of organized P waves, no consistent relationship between waves and following QRS-T
64
what type of pause is associated with ventricular premature depolarizations?
compensatory
65
what are the T waves like in ventricular premature depolarizations?
large, opposite direction of QRS
66
what is the ST like in ventricular premature depolarizations?
slurring: no real ST segment shelf
67
what does an accelerated idioventricular rhythm look like?
ventricular origin beats that are not tachycardic
68
what is the rate with ventricular escape rhythms?
24-40/min
69
what is the rate with junctional escape rhythms?
60-100/min
70
what are periods of sinus arrest often followed by?
paroxysm of supraventricular tachycardia
71
who can have physiologic second degree AV block?
dogs horses
72
what is the ventricular activation usually in third degree AV block?
junctional or ventricular escape rhythm

Cardiovascular Pathophysiology (35 decks)

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