Term
| The U wave is after the T wave and is thought to represent __ __ at the __ __ level. It is not commonly seen on the EKG. When seen it is usually in __ heart beats. |
|
Definition
- late repolarization
- Purkinje fiber level
- slower heart beats |
|
|
Term
| Pathological U waves: Hypokalemia will cause a __ U wave. A MI/CAD will cause __ U wave. |
|
Definition
|
|
Term
| Basic characteristics in Considering Dysrhythmias: |
|
Definition
What are the atrial and the ventricular rates and what is their association?
Is the rhythm regular or irregular?
Are there any AV conduction delays?
Are there any bizarre-looking QRS or P-wave complexes?
Is the rhythm dangerous or life-threatening? |
|
|
Term
| Atrial automaticity foci will make the heart beat __ to __ bpm. |
|
Definition
|
|
Term
| Junctional foci will make the heart beat __ to __ bpm. |
|
Definition
|
|
Term
| Ventricular foci will make the heart beat __ to _ bpm. |
|
Definition
|
|
Term
| Atrial foci make the P waves look different than usual but they are always __ still. |
|
Definition
|
|
Term
| Junctional foci make the QRS __ and there may or may not be a __ _. |
|
Definition
- QRS narrow
- may or may not be a P wave |
|
|
Term
| Ventricular foci cause the QRS to be __. |
|
Definition
|
|
Term
| Sinus bradycardia means the rate is less than __ bpm. The rhythm is usually regular still. May be seen in a __ __ heart, __ __ disease, or with medications like __ __. May induce __ or other dysrhythmias. Treat underlying cause if appropriate. |
|
Definition
- 60 bpm
- healthy athletic heart
- coronary artery disease
- beta blockers
- syncope |
|
|
Term
| Sinus tachycardia has a rate of greater than __ bpm. P wave to QRS ratio is 1:1. __ __ is main pacemaker. May be due to exercise, emotion, __, __, __ __, __, __ or poor physical conditioning. Usually no treatment unless there is underlying cause. |
|
Definition
- pregnancy
- pain
- endocrine disorders
- cancer
- drugs |
|
|
Term
| Sinoatrial Exit Block aka SA Block is uncommon. There are __ or __ __ but underlying rhythm is maintained. Each herat beat is initiated in the __ __, but fails to conduct to the ___. It is ___, usually __, and not consistent. May be associated with CAD or MI. |
|
Definition
- missed or drop beats
- sinus node
- atria
- asymptomatic
- benign
(see normal rhythm with dropped beat, then keeps going as normal,same intervals going across) |
|
|
Term
| With SA block there is a skipped beat but there are the same __ going across. |
|
Definition
|
|
Term
| Sinus Arrest causes and __ __ between ___ beats, and the P waves still look normal. Usually __ depending on the length of the pause. If pathological may be due to __ __ _, __, __ __, or __. |
|
Definition
- exaggerated pause between normal beats
- asymptomatic
- increased vagal tone
- MI
- digoxin toxicity
- myocarditis |
|
|
Term
| Sick Sinus Syndrome aka ___ __ or __ ___. Classicaly known as a disease of __ and __. Progressively incompetent __ __. Symptoms include __, __, __, and __ __. Many are idiopathic, associated with old age. Can be caused by post surgical scar tissue, __ __ blockers, __ blockers, CAD, HTN, and VHD. |
|
Definition
- Tachy-Brady Syndrome
- Brady-Tachy Syndrome
- wear and tear
- SA node
- dizziness, fatigue, palpitations, chest pain
- calcium channel blockers
- beta blockers
(SA NODE BECOMES INCOMPETENT AND GET LONG PAUSES WHERE NOTHING ELSE PICKS UP THE BEAT) |
|
|
Term
| Premature atrial contraction is characterized by an early beat arising from the __ but not the SA node. QRS is consistent with other complexes. Usually __ but may be caused by __ or __ disease. May be felt as palpitation. Increased frequency of ___ may be precursor to ___ __. Usually no treatment unless there is an underlying cause. You may or may not see a __ wave with this condition, it may be burried. |
|
Definition
- atria
- usually normal but may be caused by thyroid or lung disease
- PAC
- A-fib
- P wave |
|
|
Term
| Increased frequency of __ may be precursor to __ __. |
|
Definition
|
|
Term
| PAC are not __, just note it in chart. |
|
Definition
|
|
Term
|
Definition
- irregular rhythm
- premature and abnormal or hidden P waves
- PR interval: normal
- QRS complex: normal time period |
|
|
Term
| With Junctional Rhythm, electrical impulses are generated at the __ __ and conducted ___. There are __ or __ P waves or the P wave could follow the QRS. Rate is usually __ to __ bpm, if it is above 60 bpm it is called __ __ __. The PR inteval if present is __. The rhythm is usually __. |
|
Definition
- AV node and conducted retrograde
- retrograde or no P waves
- 40-60 bpm
- Accelerated Junctional Rhythm
- shorter
- regular |
|
|
Term
| Causes of Junctional Rhythm: |
|
Definition
- CAD
- cardiomyopathies
- digitalis toxicity
- Hypertensive heart disease
- Congenital heart disease
- Rheumatic heart disease |
|
|
Term
| With Junctional Rhythm, in many cases you do not __. If the rate is too slow with symptoms treat with __ or __. If the rate is too fast treat with __ __. |
|
Definition
- do not treat
- atropine or pacing
- cardiac ablation |
|
|
Term
|
Definition
100 – 180 b/m
Normal physiology
Due to exercise, anxiety
Fever
Hypotension – reflex response |
|
|
Term
| SVT (supraventricular tachycardia) is any ___ involving ___ and/or ___ nodal tissue for its initiation and maintenance. This is usually a narrow __ tachycardia that has a __ __ rhythm |
|
Definition
- tachyarythmia
- atrial and/or atrioventricular (AV) nodal tissue
- narrow complex
- regular rapid |
|
|
Term
| SVT is a __ whose origin occurs above the ___ _ __. Usually due to reentry at the __ __ (rarely the SA node). __ __is not always discernible and may be somewhere in the QRS complex. Rate is usually greater than __ bpm and may be greater than __ bpm. May prsent suddenly (paroxysmal or chronic). May include __ __, __ __ _, __ __, and __ __. |
|
Definition
- tachydysrhythmia
- above the Bundle of His
- AV node
- P wave is not always discernbile and may be somewhere in the QRS complex
- 140
- 200
- Atrial Tachycardia
- Wolf-Parkinson-White
- A-fib
- A-flutter |
|
|
Term
|
Definition
- Atrial Tachycardia
- Wolf-Parkinson-White
- A-fib
- A-flutter |
|
|
Term
| SVT may be __ or due to ___. Causes in include __, __, __ and/or __ __ disturbance. |
|
Definition
- benign or due to pathology
- COPD
- CHF
- electrolyte and/or acid-base disturbance |
|
|
Term
|
Definition
- syncope
- dizziness
- chest tightness
- sweating
- nausea |
|
|
Term
| SVT common treatment approaches: |
|
Definition
- many times no treatment
- Vasotonic maneuvers
- Adenosine
- Beta blockers
- Calcium channel blockers |
|
|
Term
|
Definition
- atrial or junctional tachycarida (supraventricular)
- AV nodal reentry tachycardia
- AV reentrant tachycardia such as WPW |
|
|
Term
|
Definition
Paroxysmal
140-250 b/m
Junctional tachycardia in the same heart rate range
3 or more beats
most examples involve an ectopic (nonsinus) pacemaker |
|
|
Term
| AV Nodal Reentry Tachycardia (AVNRT) is a common cause of __ __ __. More common in __. 50-60% of patients with this have a __ QRS tachyarrhythmia. Most people have one conducting pathway in AV node, a few have 2. |
|
Definition
- Paroxysmal Supraventricular Tachycardia (PSVT)
- women
- narrow |
|
|
Term
| Atrial Fibrillation has an __ __ rate. There is no definitive __ __. Atrial contractions are greater than __ bpm. QRS are usually __ and __. May be paroxysmal or chronic. |
|
Definition
- irregular irregular
- no definitive p wave
- 300 bpm
- narrow and similar |
|
|
Term
|
Definition
- mature individuals
- HTN
- cardiomyopathy
- CHF
- coronary heart disease
- valvular heart disease
- hyperthyroidism |
|
|
Term
| Main risk associated with A fib: |
|
Definition
|
|
Term
| Common treatment approaches for A-fib: |
|
Definition
- beta blockers
- digoxin
- Ablation or Suppression
- Cardioversion
- Stroke prevention |
|
|
Term
| With A-fib there is an __ __ rhythm and __ __ __. May be fast or slow rate. |
|
Definition
- irregular irregular rhythm
- No P waves |
|
|
Term
| Atrial flutter characteristics: |
|
Definition
- saw toothed P waves
- 2-3 P waves per 1 QRS complex
- atrial contractions 150-250 bpm
- rhythm can be irregular |
|
|
Term
| Causes of Atrial Flutter: |
|
Definition
- CAD
- COPD
- Valvular Heart Disease
- Hyperthyroidism
- immediate post-op open heart surgery
- Tachycardic rate may preceede syncope and palpitations |
|
|
Term
| Common treatment approaches to Atrial Flutter: |
|
Definition
- Cardioversion
- Meds similar to A. fib
- Stroke prevention |
|
|
Term
| Treatment for Supraventricular Tachycardia due to AV Nodal Reentry: |
|
Definition
- increase vagal tone
- digoxin
- adenosine
- beta blockers |
|
|
Term
| Wolff-Parkinson White Syndrome is caused by an __ pathway. Characteristics include an ___ PR interval and a __ wave, a __ QRS, and secondary sT and T wave changes. |
|
Definition
- accessory pathway
- short PR interval(less than 3 small squares)
- delta (slurred upstroke to QRS indicating pre-excitation) |
|
|
Term
| 3 main characteristics of WPW: |
|
Definition
- short PR interval
- QRS prolongation (wide)
- Delta wave |
|
|
Term
| PVC has wide QRS and inverted T waves. These occur more with increased __ tone. |
|
Definition
| increased sympathetic tone |
|
|
Term
|
Definition
- ischemic heart disease
- MI
- anxiety and stress
- EtOH
- electrolyte imbalance
- excessive caffeine
- fatigue
- may cause palpitations, chest pain, dizziness |
|
|
Term
|
Definition
- beta blockers
- rarely ablation |
|
|
Term
| One normal contraction followed by one PVC is called: |
|
Definition
|
|
Term
| 2 normal contractions followed by one PVC: |
|
Definition
|
|
Term
| 3 normal contractions followed by 1 pvc: |
|
Definition
|
|
Term
| Triplet PVCs are called a __. |
|
Definition
|
|
Term
| Ventricular tachycardia characteristics: |
|
Definition
Rapid, ventricular impulses,
three or more beats of ventricular origin in succession at a rate greater than 100 beats/minute |
|
|
Term
| Ventricular tachycardia is __ ___ and may progress to __ __. |
|
Definition
- life-threatening
- Ventricular fibrillation |
|
|
Term
| Common causes of Ventricular Tachycardia: |
|
Definition
- MI
- ischemic heart disease
- cardiomyopathy
- PMH of sudden cardiac arrest
- myocarditis
- hypokalemia
- may presnet with dizziness, syncope, SOB, chest pain, palpitations |
|
|
Term
| Common tmt approaches to Vent. Tachycardia: |
|
Definition
- antiarrhythmics such as lidocaine
- cardioversion
- Implantable Cardioverter Defibrillator (ICD) |
|
|
Term
| Ventricular Fib characteristics: |
|
Definition
Persistent, multiple (>350) ventricular impulses
Bizarre wave form without distinct complexes |
|
|
Term
| Associated risks of Vent-Fib: |
|
Definition
- life-threatening
- cardiac arrest |
|
|
Term
| Common causes of Vent Fib: |
|
Definition
| myocardial infarction, ischemic heart disease, cardiomyopathy, PMH of sudden cardiac arrest, myocarditis, electrolyte disorder |
|
|
Term
|
Definition
|
|
Term
| Torsades de Pointes characteristics: |
|
Definition
Polymorphic VT
Usually results after an early PVC with a pause |
|
|
Term
| Torsades de Pointes associated risks and causes: |
|
Definition
May occur with or without presence of heart disease
A side effect of most antiarrhythmic agents but can be caused by other medications (famous example is the combination of Erythromycin and Seldane) |
|
|
Term
| Common treatment approaches to Torsades: |
|
Definition
- cardioversion and magnesium
- treat underlyiing disease |
|
|
Term
| Accelerated Idioventricular Rhythm definition: |
|
Definition
Usually defined as an ectopic rhythm generated from the ventricles with 3 or more consecutive premature ventricular beats and a rate faster than the normal ventricular intrinsic escape rate of 30-40 bpm but slower than VT.
Usually asymptomatic, usually very brief when observed.
Ventricular rate of 100-120 bpm
Pathology
Reperfusion syndrome
CAD
MI |
|
|
Term
| How do you treat pulseless electrical activity? |
|
Definition
|
|
