Cs - Cardiology - Arrythmias

Front 1

Atrial Fibrillation

Back 1

Epi: 1% of pop over 60, 6% of pop over 70, more common in men
Eti: Ischemic Heart Disease, Acute Inflammation (pericarditis, pneumonia), Chronic Inflammation (connective tissue disorders), Valvular Heart Disease, Hypertension, Cardiotoxins, Thyrotoxicosis, Cardiomyopathy, "Lone"
RF:
Path: Irregular rhythm with no discernable p-waves, Usually caused by ectopic pacemakers in the heart firing faster than the SA node
Sx: Irregular rhythms, Varying intensity of first heart sound, Occasional pulse deficit,
Px:
Tx: Conversion (Electrical, Medical), Thrombus prevention, Interventional therapy
Note:

Front 2

Types of Atrial Fibrillation

Back 2

Recurrent: More than 2 episodes

Paroxysmal: Spontaneous conversion to sinus rhythm (comes and goes)

Persistent: Lasting longer than 7 days

Permanent: Lasting over a year or more with failed attempts to cardiovert

"Lone": No underlying heart dysfunction or risk factors, under age 60

Front 3

Atrial Fibrillation
(Therapeutic Approach)

Back 3

Control rate while patient remains in fibrillation

Convert rhythm to sinus

Prevent thromboembolism

Front 4

Premature Atrial Contractions

Back 4

Epi:
Eti: Normal variant, Stimulants, Atrial enlargement, Hypertension, Valvular disease, Ischemia, Irritants
RF:
Path: Ectopic beats sneaking into regular rhythms
Sx: ECG (early occurring QRS identical to sinus beats preceded by a P wave)
Px:
Tx: Consider B-blockers
Note:

Front 5

Paroxysmal Atrial Tachycardia

Back 5

Epi:
Eti: Hyperthyroidism, Toxins (especially ETOH), Hypertension, Digoxin toxicity
RF:
Path: Sudden rapid Atrial firing usually do to toxins
Sx: Regular tachycardic rate (150-250), ECG (P waves evident before each QRS, Narrow QRS), Sudden onset and cessation
Px: Immediate intervention to ablate, Cardioversion, Ca+ or B-blockers (for long term treatment)
Tx:
Note:

Front 6

Atrial Flutter

Back 6

Epi:
Eti: Irritants, Toxins, Stimulants, Atrial Enlargement, Valvular Disease
RF:
Path: Atrial firing due to ectopic pacemakers in atria going off
Sx: ECG (Regular atrial waves at rate 250-350, QRS rate regular, Atrial waves have biphasic configuration)
Px:
Tx: Vagal maneuver, Rx, Anticoagulation, Ablation
Note:

Front 7

Multifocal Atrial Rhythm

Back 7

Epi:
Eti: Decompensated pulmonary disease
RF:
Path:
Sx:
Px:
Tx: Anticoagulation, Fix underlying issues
Note:

Front 8

Supraventricular Tachycardia

Back 8

Epi:
Eti:
RF:
Path: Nodal re-entry rhythm
Sx:
Px:
Tx: Nodal ablation
Note: Looks, Acts, Smells, Treated like PAT

Front 9

Ventricular Ectopy

Back 9

Epi:
Eti: Ischemia, Cardiomyopathy, Scarring, Toxins, Drugs, Pre-excitation, Dysplasia
RF:
Path:
Sx: Asymptomatic, Palpitations, Syncope
Px:
Tx: B-blocker, Avoidance of stimulants
Note:

Front 10

Ventricular Tachycardia

Back 10

Epi:
Eti: Ischemia, Cardiomyopathy, Scarring, Toxins, Drugs, Pre-excitation, Dysplasia
RF:
Path:
Sx: ECG (Regular rate of 120-180, Wide QRS, No P waves), Asymptomatic, Syncope, Angina, Dyspnea
Px:
Tx: Nonsustained- no antiarrythmics, Sustained- Cardioversion, Implantable defibrillator, Ablation
Note:

Front 11

Ventricular Fibrillation

Back 11

Epi:
Eti: Ischemia, Cardiomyopathy, Scarring, Toxins, Drugs, Pre-excitiation, Dysplasia
RF:
Path:
Sx: ECG (Grossly irregular waves, variable and rapid rate, no distinct QRS), Syncope, Pulselessness
Px:
Tx: Cardioversion, Precordial thump, Implantable Defibrillator
Note: