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54 Cards in this Set
- Front
- Back
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Dopamine |
neurotransmitter increases cardiac output improves blood flow and treats shock causes vasoconstriction |
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Atrial Fibrillation |
P wave: not present (F. waves) PR interval: unmeasurable QRS interval: typically normal Atrial rate- 350-600 **Rhythm is irregular** |
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Causes of A. Fib |
CAD HF HTN rheumatic heart disease cardiomyopathy thyrotoxicosis caffiene stress electrolyte imbalances |
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Manifestations of A. Fib |
decreased CO clots form in atria clots can be thrown causing stroke |
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Treatment for Ventricular Tachycardia |
identify those at risk Pulseless: treat as v. fib Pulse present: medications and cardioversion |
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Ventricular fibrillation |
P wave: not present PR interval: unmeasurable QRS: cannot measure
NO CARDIAC OUTPUT *ventricles contract irregular and chaotic** |
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Causes of ventricular fibrillation |
MI can happen due to cardiac cath electrical shock hyperkalemia hypoemia acidosis drug toxicity |
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Manifestations of ventricular fibrillation |
pulseless unresponsive PATIENT WILL DIE WITHOUT IMMEDIATE TX! |
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Treatment for Ventricular Fibrillation |
CPR defibrillation meds (ACLS protocol) |
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Asystole |
"flat line" occasional P wave no QRS pulseless and unresponsive |
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Causes of asystole |
advanced heart disease end stage HF |
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Treatment for asystole |
CPR ACLS protocol atropine and epinephrine |
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beta-blockers |
end in -lol reduce BP decreases HR opens up blood vessels |
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Causes of second degree heart block: Type 1 |
digoxin beta blockers CAD other heart disease common after MI |
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Treatment for second degree heart block: Type 1 |
atropine for symptomatic pts temporary pacemaker may become bradycardic |
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Second degree heart block: Type 2 |
P wave: normal PR interval: normal to prolonged QRS complex: usually longer than 0.12 atrial rate: normal and regular ventricular rate: varies and may be irregular |
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Causes of second degree heart block: Type 2 |
rheumatic heart disease CAD anterior wall MI drug toxicity |
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Treatment for second degree heart block: Type 2 |
pacemaker |
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Third degree heart block |
"complete heart block" P wave: normal PR interval: variable QRS: normal to wide atrial rate: 60-100 ventricular rate: varies on location; 20-60 |
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Causes of third degree heart block |
severe heart disease amyloidosis scleroderma meds (dig, beta blockers, Ca+2 channel blockers) |
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Clinical Manifestations of third degree heart block |
decreased CO cardiac ischemia heart failure shock syncope |
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Treatment for third degree heart block |
pacemaker Meds (atropin, dopamine, epi, isoproterenol) may need calcium chloride if due to calcium channel block |
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Premature ventricular contractions |
PVCS always has underlying rhythm will always look like underlying rhythm, but there will be extra beats and wide QRS |
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Ventricular Tachycardia |
3+ PVCs in a row P wave: buried behind QRS PR interval: unmeasureable QRS: wider than 0.12 with distorted shape; regular or irregular **LIFE THREATING** may lead to v. fib |
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Causes of Ventricular Tachycardia |
MI CAD electrolyte imbalance cardiomyopathy mitral valve prolapse drug toxicity CNS problems **can be in patients with no hx of heart disease** |
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Manifestations of Ventricular Tachycardia |
can be stable (pulse) or unstable (pulseless) decreased CO hypotension pulmonary edema decreased blood flow to brain cardiac arrest may lead to v. fib |
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Atrial Flutter |
P wave: absent (flutter waves) PR interval: unmeasurable QRS: normal atrial rate: 200-350 ventricular rate: slower *both rates are normal |
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Causes of atrial flutter |
**not usually seen in healthy heart** CAD HTN mitral valve disease PE COPD cor pulmonale hyperthyroid drugs (epi, dig, quinidine) |
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Manifestations of atrial flutter |
decreased CO can cause HF increased risk for blood clots and stroke |
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Treatment for atrial flutter |
slow ventricular rate (beta blockers adn calcium channel blockers) cardioversion cardiac ablation |
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Calcium Channel Blockers |
end in -ipine prevent calcium from entering heart relax and widen blood vessels lower BP and HR |
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Treatment for atrial fibrillation |
decrease ventricular rate (calcium channel blockers, beta blockers, digoxin, and coumadin) convert to normal sinus prevent clots and stroke cardiac ablation for retractable a. fib |
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Digoixin |
increases CO decreases HR decreases AV conduction speed |
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First degree heart block |
HR: normal and regular P wave: normal PR interval: more than 0.2 seconds QRS: normal duration and shape **duration of AV conduction is prolonged |
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Causes of first degree heart block |
MI CAD hyperthyroid vagal stimulation drugs (dig, beta blockers, calcium channel blockers, flecainide) |
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Treatment for first degree heart block |
may need med adjustments if due to meds monitor for changes to more serious heart blocks |
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Second degree heart block (Type 1) |
P wave: normal shape PR interval: progressively lengthens until QRS is completely missed QRS: normal shape/duration; will drop a complex after a PR interval **atrial rate is normal** |
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PR interval |
time it takes impulse to get through atria |
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P Wave |
atria depolarization |
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QRS Complex |
depolarization of ventricles (systole) |
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ST segment |
time between ventricular depolarization and repolarization (diastole) |
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T Wave |
ventricular repolarization |
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Normal Sinus Rhythm |
P wave: regular and present PR interval: 0.12-0.2 seconds QRS interval: less than 0.12 seconds T wave: present **rhythm is regular* |
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Sinus Bradycardia |
P wave: present and regular PR interval: 0.12-0.2 seconds regular rhythm rate less than 60 |
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Causes of sinus bradycardia |
normal for very athletic could be due to deep sleep carotid sinus massage valsalva manuever hypothermia hypoglycemia hypothyroid increased ICP MI |
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Clinical Manifestations of sinus bradycardia |
may be asymptomatic pale cool skin hypotension weakness angina dizziness/syncope confusion SOB *due to not enough blood/oxygen |
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Treatment for sinus bradycardia |
atropine (symptomatic) pacemaker if due to meds, determine if dose or med needs to be changed |
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Atropine |
antidysrhythmic/anticholinergic increases CO and HR by blocking vagal stimulation |
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Sinus Tachycardia |
P wave: regular PR interval: 0.12-0.2 seconds rhythm: regular rate 101-200 |
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Causes of sinus tachycardia |
stress hypotension hypovolemia anemia hypoxia MI HF hyperthyroidism meds (too much thyroid) |
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Clinical Manifestations of Sinus Tachycardia |
may be asymtomatic dizziness dyspnea hypotension angina |
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Treatment for sinus tachycardia |
depends on cause TREAT CAUSE bagal manuevers (stable pts) |
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SA Node Rate |
60-100 |
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AV Node Rate |
40-60 |
