Term
| What is the P-wave on ECG? |
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Definition
| -atrial depolarization adn precedes QRS-complex |
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Term
| What is the QRS complex on ECG? |
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Definition
| -electrical depolarization of the ventricles |
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Term
| What is the T wave on ECG? |
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Definition
| -ventricular repolarization |
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Term
| Which animals should have an ECG? |
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Definition
-pre-anesthesia
-geriatric
-breeds at risk of cardiomyopathy: Doberman, Maine Coon, etc
-animals w/ CHF
-animals w/ arrhythmias
-symptoms of collapse or syncope |
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Term
| What info do we get from an ECG? |
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Definition
-HR
-amplitude and duration chagnes of P wave & QRS deflection
-T wave changes
-mean electrical axis (MEA)
-detection and classification of ectopic beats
-detection and classify the etiology of bradyarrhythmias and tachyarrhythmias |
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Term
| What are the 4 different methods of obtaining an ECG? |
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Definition
-in hospital routine ECG
-telemetry
-24 hr ambulatory ECG: Holter
-event monitors |
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Term
|
Definition
-patient ECG info sent to central computer and will be stored for 24-48h
-print all data or parts |
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Term
| What kind of patients do we use to telemetry ECG? |
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Definition
| -will use for post surgical patient, monitoring, response to anti-arrhthmics, and metabolic/endocrine dz |
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Term
| What is the major drawback to event monitors? |
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Definition
| -must reapply electrodes weekly |
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Term
| What vantage point is lead 1, 2, and 3 on an eCG? |
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Definition
-Lead 1: right arm to left arm
-Lead 2: right arm to left leg
-Lead 3: left arm to left leg |
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Term
| What are augmented leads? What are they? |
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Definition
-takes the average of the other two
-AVF: average of right arm and left arm to left leg
-AVR:average left ar, & left leg looking at right arm
-AVL: average right arm & left leg looking at left arm |
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Term
| In which position should the patient be in for ECG recording? |
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Definition
-patient should be in right lateral recumbecy on rubber mat or towel
-have a ground lead
-wet the skin w/ alcohol or ECG paste
-make sure all leads are on correct leg or chest area |
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Term
| True or False: Can use alligator clips in emergency or electrode patches. |
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Definition
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Term
| Where do we place ECG electrodes on the limbs? |
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Definition
| -back of elbows and front of stifles |
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Term
| Why is restraint is important w/ ECG? |
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Definition
| -movement can cause huge artifacts |
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Term
| What is 60 cycle interference? |
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Definition
| -electrical equipment interference |
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Term
| What do we make sure to do when recording ECG? |
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Definition
-fastest paper speed possible
-record multiple leads not jsut lead 2
-usue highest voltage possible that allows the entire complex to be on paper |
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Term
| What do you do if you are having difficulty seeing P waves while recording? |
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Definition
-inc amplitude (even if R wave are too big to fit on paper/screen)
-make augmented chest leads: take R and L front legs and put on chest then read lead 1 |
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Term
| Where do we often see arrhythmias on ECG? |
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Definition
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Term
| What does the AV node do? |
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Definition
| -acs as he gate keeper and is the only normal way electrical impusles go from atrium to ventricle |
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Term
| How do we count HR on an ECG? |
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Definition
-count 25 or 50mm for 1 sec. Count 3 sec and X 20
-instantaneus rate: count small boxes b/n beaths HR = 1500/#smallboxes (use 3000 if 50 mm/sec paper speed) |
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Term
| Which lead do we use to measure waves? |
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Definition
| -use Lead 2 in right lateral recumbency |
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Term
| What is sinus bradycardia? |
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Definition
| -sinus node slowing discharge rate |
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Term
| What are some common causes of sinus bradycardia? |
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Definition
-GI dz: inc para tone
-resp dz
-ocular dz
-neuro dz |
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Term
| If under anesthesia, what drugs can we use to correct sinus bradycardia? |
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Definition
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Term
| What are common causes of sinus tachycardia? |
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Definition
| -underlying causes such as pain, anemia, dehydration |
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Term
| What do we need to differentiate sinus tachycardia from? |
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Definition
| -supraventricular tachycardia |
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Term
| What is a 1st degree AV block? What causes it? |
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Definition
-prolonged PR interval
-can be normal or high vagal tone
-can be secondary to drugs: digoxin, diltiazem, beta blockers |
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Term
| What is a 2nd degree AV block? |
|
Definition
|
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Term
|
Definition
-progressive lengthen of PR prior to 2nd degree block
-often benign |
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Term
|
Definition
-PR remains unchanged w/ 2nd degree AV block
-more pahtologic |
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Term
| What is a positive response of 2nd degree AV block to an Atropine response test? |
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Definition
| -double original rate or > 140 bpm |
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Term
| What do we do when we seea high grade 2nd degree AV block? Therapy? |
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Definition
-atropine response test
-pacemaker PLUS
-iff atropine responseibe: parasymatholytics and sympathomimetics |
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Term
| What do we do with a third degree AV block? |
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Definition
-atropine response test
-don't usually respond |
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Term
| What is the therapy for third degree AV block? |
|
Definition
-pacemaker
-sometimes parasympatholytics and sympahtomimetics |
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Term
| What is sick sinus syndrome? |
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Definition
| -atrium does not polarize and the backup takes too long to kick in and there is a time of sinus arrest |
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Term
| What is the therapy for sick sinus syndrome? |
|
Definition
-pacemaker
-sometimes parasympatholytics and sympathomimetics |
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Term
| What can sick sinus syndrome be associated w/? |
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Definition
| -atrial tachycardia = tachybrady sinus syndrome |
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Term
| What is the criteria for VPC treatment? |
|
Definition
-number
-complexity (multiforcal)
-runs (# length)
-rate of runs |
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Term
| What is the at home therapy for VPCs? |
|
Definition
-Sotalol
-Procainamide
-Atenolol
-Ammiodarone
-Mexiletine |
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Term
| What is wide ventricular tachycardia? |
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Definition
| -R on T: trying to beat on top of T wave thus trying to depolarize at the same time as repolarization |
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Term
| What is the in hospital tx for ventricular techycardia? |
|
Definition
-Lidocaine: follow w/ CRI if bolus works
-Procainamide
-Esmolol
-Electrical cardioversion |
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Term
| Side effects of lidocaine? |
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Definition
|
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Term
| What is electrical cardioversion? Defibrillation? |
|
Definition
-Cardioversion: timed shock
-Defibrillation: random shock |
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Term
| What are supraventricular ectopics (SVE)? |
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Definition
-premature QRS w/out visible P-wave b/ buried in T wave
-aka Atrial premature complexes (APC) |
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Term
| Whatdo supraventricular ectopics suggest? |
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Definition
-structural heart dz: MV dz, DCM, neoplasia etc
-could be precursor to worsening arrhythmia (Afib) |
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Term
| What is atrial tachycardia? |
|
Definition
-aka supraventricular tachycardia
-sudden huge jump in HR and sudden stop back to normal |
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Term
| What is the thought behind treating atrial/supraventricular tachycardia? Which drugs do this? |
|
Definition
-rate control: block AV node
-Digoxin, Atenolol, Diltiazem |
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Term
| What is the other method of treating atrial/supraventricular tachycardia? |
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Definition
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Term
| What is atrial fibrillation? |
|
Definition
-lack of consistent P waves + irregular R to R
-often tachycardic |
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Term
| How do we control rate w/ atrial fibrillation? |
|
Definition
-Digoxin
-Diltiazem
-Atenolol |
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Term
| How do we control atrial fibrillation s/ atrial fibrillation? |
|
Definition
| -chemical cardioversion: Quinidine (horse), Sotalol, Amiodarone, Procainamide, Diltiazem |
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Term
| What is the typical cause of atrial fibrillation? exceptions? |
|
Definition
-due to structural heart dz
-Lone Afib: purely electrical disturbance |
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Term
| Is atrial fibrillation more common in dog or cat? |
|
Definition
|
|
Term
|
Definition
| -one p wave after the other w/ occassional regular beats |
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Term
| How do we treat atrial flutter? |
|
Definition
-diltiazem: slightly depresses contractility
-digoxin: best
-atenolol: avoid w/ dec contractility and/or CHF |
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|
Term
| What is idioventriclar rhythm? |
|
Definition
| -slow vtach: wide bizarre complexes but slow |
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Term
| WHat diseases is idioventricular rhythm seen with? |
|
Definition
| -GDV, splenic dz, septic conditions |
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Term
| How do we treat idioventricular rhythm? |
|
Definition
-pain control
-check Potassium
-anti-arrhythmics |
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Term
| What is a bundle brach block? Cause? |
|
Definition
-wide and bizarre QRS w/ consistent P-R interval that eventually looks normal
-one side of bundle branches blocked or anesthesia |
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Term
| What is the possible major concern with bundle branch block? |
|
Definition
| -progression to complete block |
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Term
| How do you tell the difference b/n right and left bundle branch block? |
|
Definition
-if negative in lead 2 and wide/bizarre= right bundle branch block = RH dz
-positive in lead 2 = LH dz |
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|
Term
| What is ventricular fibrillation? Treatment? |
|
Definition
-absolutely no coordinated electrical activity
-defibrillation |
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|
Term
| What is atrial standstill? |
|
Definition
-regualr QRS but no P wave
-aka sinoventricular rhythm |
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|
Term
| What causes sinoventricular rhythm? |
|
Definition
-hyperkalemia
-if normal K+ then atrial m dz or silent atrium |
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|
Term
| How do you treat hyperkalemia? |
|
Definition
-calcium gluconate: protect myocardium
-dextrose
-insulin
-fluids |
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|
Term
| HOw do you treat atrial standstill? |
|
Definition
|
|
Term
| What si difference b/n sick sinus syndrome and atrial standstill? |
|
Definition
-SSS: inconsistent presence of P waves
-AS: consistently lacks P waves |
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|
Term
| What is electrical alternancs? |
|
Definition
| -higher and lower Q peaks w/ double T wave |
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|
Term
| What usually causes electrical alternans? |
|
Definition
-secondary to pericardial effusion
-also w/ supraventricular arrhythmia: less dramatic |
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