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34 Cards in this Set
- Front
- Back
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what will a premature atrial contraction look like on EKG?
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simply a p wave followed by QRS that occurs earlier than it is supposed to
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what 4 things can stimulate an arrhythmia?
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caffeine
ETOH cocaine catecholamines |
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how do you treat premature atrial contractions?
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no therapy indicated unless significantly symptomatic
consider a beta blocker, rarely antiarrhythmic |
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what will paroxysmal atrial tach look like on EKG? (4)
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regular tachycardia rate of 150-250
P waves evident before each QRS usually narrow QRS sudden onset and cessation |
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what additional thing may stimulate paroxysmal atrial tach?
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hyperthyroidism
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what are you looking for when you do an echo on paroxysmal atrial tach?
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to see if atria are enlarged, valvular stenosis
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what is the immediate therapy for paroxysmal atrial tach? (4)
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cardioversion if hypotensive or in CHF
adenosine calcium channel blockers beta blockers |
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what is the long term therapy for paroxysmal atrial tach? (3)
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beta blockers
calcium channel blockers antiarrhythmics if above is unsuccessful |
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what type of rhythm is atrial flutter?
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reentrant rhythm
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how do you know atrial flutter is not a sinus rhythm?
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because sinus will never exceed 150bpm
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what will atrial flutter look like on EKG? (3)
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regular waves at 250-350bpm
QRS generally regular but may be irregular atrial waves often biphasic |
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what is the classic presentation of atrial flutter on EKG?
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2:1 block where QRS are going at 150 and P waves are going at 300
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what is the acute intervention for atrial flutter? (3)
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pharm
vagal maneuvers cardioversion if needed |
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what are long term therapies for atrial flutter? (3)
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pharm
ablation pacemaker |
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what will atrial fibrillation look like on EKG? (3)
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no pattern; irregular rhythm with no P waves
may have coarse or fine baseline deflections rate is widely variable |
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what is the most common atrial rhythm seen?
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atrial fibrillation
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what is a special predisposition for a fib?
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post operative cardiac patients, especially post valvular
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what are 2 therapeutic options for a fib?
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control ventricular response (keep the rate liveable)
conversion to sinus rhythm |
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what can you give patients to control ventricular response to a fib? (3)
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digoxin
beta blockers calcium channel blockers |
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what limits digoxins effectiveness?
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limited to resting heart rate; poor control of exercise response
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what type of drugs will you use to medically cardiovert? (2)
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type 1A, type 1C
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what will you always have to give a fib patients?
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antithrombolytics
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what will have a 75% chance of reversion after cardioversion?
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large atria (5cm or greater)
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what will have a 50% chance of reversion after cardioversion?
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severe LV dysfunction
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when are invasive therapies indicated?
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in a fib when the patient has refractory arrhythmia of high risk patients unable to tolerate medical therapy
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what will a multifocal atrial rhythm look like on EKG? (2)
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irregular rhythm with P waves before each QRS but at least 3 different morphologies
difficult to distinguish from a fib |
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what is multifocal atrial rhythm associated with?
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decompensated pulmonary disease
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why is it important to distinguish multifocal atrial rhythm from a fib?
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because MAR will not responsd to the same treatment as a fib
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what will SVT look like on EKG? (2)
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rate 200-250
regular rhythm with no p wave or retrograde p waves |
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what type of rhtyhm is SVT?
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junctional re-entry
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when will paroxysmal atrial tach and SVT not be considered the same?
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when SVT has P waves
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what will pre-excitation look like on EKG? (3)
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PR interval less than 120msec
with or without delta waves may have a wide or narrow QRS |
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how will you treat narrow QRS pre-excitation?
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same as all others
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how will you treat wide QRS pre-excitation? (2)
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antiarrhythmics
no beta blockers |
