Tachycardia Flashcards Preview

Clin Med - Cardio Exam #2 > Tachycardia > Flashcards

Flashcards in Tachycardia Deck (35)
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1

physical exam for tachycardia

- general: respiratory distress, pain, sweating
- vitals: fever common
- CV: rhythm, murmurs/sounds, JVD
- pulm: auscultate for crackles/wheezes
- Abd: distended or tender
- lymph: enlarged LN
- extremities: clubbing, cyanosis, edem

2

examples of narrow complex tachycardia

- sinus tach
- AV node re-entrant (AVNRT/SVT)
- AV reciprocating (AVRT) - orthodromic
- multifocal atrial tachycardia (MAT)
- a.fib/flutter

3

examples od wide complex tachycardia

- AVRT - antidromic (i.e. WPW)
- v tach/fib --> Torsade de Pointe

4

etiology of sinus tach

- exercise
- pain
- stimulants
- anemia
- anxiety
- vol. depletion
- hypoxia
- hyperthyroidism
- PE
- pericarditis

5

symptoms of sinus tach

- asx
- heart palpitations
- SOB
- In pts w heart dz: palpitations, SOB, chest discomfort, lightheadedness, fatigue

6

treatment of sinus tach

- IV fluids
- pain rx
- anticoags
- tx septic source
- anxiolytics

7

define SVT

- regular, rapid rhythm
- narrow QRS
* no p waves*

8

examples of SVT

- AVNRT
- AVRT
- junctional tachycardia

9

etiologies of SVT

- conduction abnormalities

10

symptoms of SVT

- *sudden onset palpitations w/ abrupt cessation*
- syncope
- SOB
- anxiety

11

management of stable SVT

- vagal maneuvers
- carotid massage
- *adenosine*
- CCB or BB
- ablation for frequent attacks

12

management of unstable SVT

- vagal maneuvers
- immediate DC cardioversion

13

MC cause of SVT

AVNRT

14

describe AVNRT

re-entrant circuit around AV node

15

What triggers AVNRT?

- exertion
- ETOH
- caffine

16

describe the HR in AVNRT

- 140-280 bpm
- regular

17

differentiate the types of AVRT

- narrow QRS = orthodromic; through AV
- wide QRS = antidromic; not through AV ==> ddx w/ vtach

i.e. WPW

18

tx of stable orthodromic narrow AVRT

- vagal maneuvers
- adenosine
- CCB
- BB

19

tx of unstable orthodromic AVRT

DC cardioversion

20

tx of antidromic AVRT

- unstable = DC cardioversion
- stable = procainamide
^^ both subsequently get ablation

21

tx of antiromic AVRT in a conscious patient

tx like stable vtach
- amiodarone

22

describe WPW

- pre-excitation syndrome with accessory pathway
- symptomatic
- most commonly PSVT
- w/ a.fib --> rapid ventricular respiration --> v. fib --> death
- delta waves w/ decr PR interval

23

management of normal rate and stable WPW

- ablation
- BB, adenosine, procainmide, amiodarone

24

management of fast rate WPW

- unstable = DC cardioversion
- stable = procainamide
^^ both eventually get ablation

25

describe MAT

- 3+ different p wave morphologies
- 100-150bpm

ddx:

26

treatment of MAT

- CCB
- flecainide or propafenone

27

describe sustained vtach

- fast, wide complex rhythm
- >30s duration
- with structural heart disease
- syncope
- 3+ consecutive ventricular premature beats
- 160-240bpm, moderately regular
- frequent complication of MI & dilated cardiomyopathy

28

symptoms of vtach

- asx (rare)
- palpitations
- sense of impending doom
- chest discomfort
- SOB, diaphoresis, syncope
- LOC

29

treatment of vtach

- w/pulse = DC cardioversion, amiodarone, implantable cardioverter-defibrillator (ICD)
- w/o pulse = ACLS

30

describe NSVT

- 3+ consecutive ventricular beats
- rate > 120bpm
-