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45 Cards in this Set
- Front
- Back
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S/S of Abnormal atrial rhythms |
palpitations, angina, fatigue -may be asymptomatic |
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describe the rate and morphology of PAC |
-regular rhythm w/ exception of premature beats -rate 60-100 -P wave looks different than all the other P waves -unable to determine PR interval which is important for AV blocks -P before every QRS and QRS after every P
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what causes PACs? |
Caffeine, cocaine |
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does PAC alone constitute a heart disease? |
no |
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what's a wandering pacemaker? rate? morphology? |
Rate <100 Irregular ventricular rhythm (measure R to R) different P wave than a PAC or sinus rhythm |
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what's a multifocal atrial tachycardia (MAT)? |
rate >100 at least 3 different foci irregular P-P interval
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what causes a MAT? |
DECOMPENSATED CHRONIC LUNG DISEASE hypoxia-COPD hypokalemia hypomagnsemia heart failure valvular heart disease diabetes PE |
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what is the atrial rate for atrial flutter? |
250-350 rhythm regular or irregular |
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characteristics of atrial flutter |
-continuous SAW-TOOTH sequence of atrial complexes from a single rapid-firing atrial focus -no P waves (flutter waves) -unable to determine PR interval -can't see T waves |
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who is likely to have atrial flutter? |
COPD, CHF, ASD, CAD |
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what kind of rhythm does atrial fibrillation have? |
irregular-irregular rhythm |
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what is the atrial rate for atrial fibrillation? |
350-450 |
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what is the morphology of atrial fibrillation? |
-jagged baseline -QRS response is irregular -no distinct P waves |
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what is most common chronic arrhythmia? |
Atrial Fibrillation |
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what is "holiday heart"? To which rhythm does it apply to? |
holiday heart is caused by excessive alcohol use or withdrawal
applies to A-Fib |
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what are you at risk for if you have A-FIB? |
CVA, PE |
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how do you treat atrial flutter? |
-electric cardioversion -amiodarone for chronic disease -radiofrequency ablation for recurrent conditions |
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how do you treat A-fib? |
electric cardioversion tx underlying cause tx w/ DIGOXIN
**warfarin for chronic disease** |
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what is the rate for a junctional rhythm? |
40-60 |
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what is the morphology of a junctional rhyhtm? |
-P wave absent, inverted w/ short PR interval, or inverted after QRS -PR interval constant when present -P absent, if present, will have P before every QRS and QRS after every P |
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name 4 types of junctional dysrhythmias |
1. premature junctional contractions 2. accelerated junctional rhythm 3. supraventricular tachycardia 4.V-tach |
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what is a premature junctional rhythm? |
regular rhythm w/ exception of premature beats |
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what is the rate for premature junctional rhythm? |
rate 60-100 (may be brady or tachycardia) |
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what is the morphology of premature junctional rhythm? |
-absent or inverted P waves w/ short PR -narrow QRS <0.12
compensatory pause- the pause that "resets" the SA node to go back to the original rhythm |
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What is an accelerated junctional rhythm? |
-regular rhythm -rate 60-100 -P abset, inverted w/ short PR interval, or inverted after QRS |
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what is junctional tachycardia? |
if >100 |
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what is suprventricular tachycardia (SVT)? rate? |
-junctional or atrial focus -regular rhythm -rate >100 -usually no P waves (if visible, atrial tachycardia) -unable to determine PR interval -NORMAL DURATION QRS COMPLEX |
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what is paroxysmal SVT? |
very brief |
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what is sustained SVT? |
prolonged; >30 sec |
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morphology of ventricular rhythms |
-QRS is wide (>0.12) -no visible P waves -SVT can become Vtach
-multifocal PVC has a different morphology than Vtach |
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what is the rhythm like in PVCs? rate? |
regular rhythm w/ premature beats rate 60-100 compensatory pause
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what is the P wave like in PVC? what is the PR interval? |
P wave and PR interval absent.
if P wave is present, it is a PAC or PJC w/ aberrancy. |
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what is considered a run of Vtach? |
a run of >3 or more PVCs |
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what is a trigeminy PVC? |
every 3rd beat is a PVC
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what is the rhythm and rate of Vtach? |
regular rhythm rate 150-250
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morphology of Vtach |
-no p waves -discordent T waves -QRS >0.12 -a run of 3 or more PVCs -may be sustained or unsustained |
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S/S of Vtach and what causes it |
Acute MI or dilated cardiomyopathy asymptomatic or dizziness or syncope pulse may be present |
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what is Torsades de Pointes? |
Vtach where the QRS complex twists around the baseline -sine wave pattern rate 250-350 -no p waves -discordent T waves -QRS >0.12 |
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what causes Torsades de pointes? |
-hypokalemia -hypomagensemia -Long QT syndrome -spontaneous |
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what is ventricular flutter? Rate? morphology? |
-a rapid series of SMOOTH SINE WAVES from a single rapid-firing ventricular focus (usually leading to V-Fib) -Rate 250-350 -no P waves -QRS complex is indistinguishable from T wave -can lead to sudden cardiac death |
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what is VFIB? rate? rhythm? morphology? |
-multiple ventricular foci rapidly discharging producing a totally erratic ventricular rhythm without identifiable waves -irregular rhythm -no P, QRS, or T - may be fine or course
EMERGENCY |
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Brugada Syndrome |
genetic disease due to a loss of function of sodium channels
-RBBB -Persistent ST elevation in V1,V2, V3 -prolonged PR interval
sudden death by onset of ventricular dysrhythmia |
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work up and treatment for Brugada Syndrome |
Work up: genetic studies Tx: A.I.C.D. |
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Wellen's syndrome |
high grade occlusion of proximal LAD
if not identified and treated, onset of symtpoms to extensive anterior wall MI is 8.5 days |
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morphology of Wellen's syndrome |
-progressive, symmetrical, deep T wave inversion in V2 and V3 -slope of T waves are generally 60-90 degrees OR tall, biphasic, T waves -little or no enzyme elevation -little or NO ST segment elevation -no loss of precordial R waves -anginal chest pain |
