Term
| What is another name for the brady-tachy syndrome? |
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Definition
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Term
| What is the underlying problem in sick sinus syndrome? |
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Definition
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Term
| What are the common symptoms of sick-sinus syndrome? |
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Definition
| palpitation, light-headness, fatique, confusion, syncope |
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Term
| How do you treat sick sinus syndrome? |
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Definition
treat the tachy with anti-arrhythmics
treat the brady with pacemaker |
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Term
| How can you enduce sinus arrest? |
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Definition
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Term
| What are 7 causes of Third Degree Heart block? |
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Definition
amyloidosis
medications
sarcoidosis
Acute Rheumatic Fever
Lyme Disease
degeneration
Acute MI |
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Term
| What happens to the QRS height in AV node reentry tachycardia? |
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Definition
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Term
| Why is the QRS height larger than normal on AV node reentry? |
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Definition
| b/c the p wave is often superimposed |
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Term
| Are the QRS complexes wide in AV Node Reentry Tachycardia? |
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Definition
| No b/c the ventricles are normally contracted |
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Term
| What will tend to aggrevate a rhythum into AV Node Re-entry Tachycardia? |
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Definition
| ETOH, caffine, hyperthyroidism |
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Term
| What are six options for treatment of AV Node Re-entry Tachycardia? |
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Definition
cardioversion
B-blocker
Ca channel blockers
Digitalis
Carotid massage
Adenosine |
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Term
| If the P wave is present in AV node re-entry Tachycardia, what will its direction of deflection be in I, II, and aVF and why? |
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Definition
| it will abnormally be deflected down b/d the atria is being activated in a retrograde direction from the AV node |
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Term
| What is the cause of atrial flutter? |
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Definition
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Term
| Why does the saw tooth appearence occur in Atrial Flutter? |
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Definition
| b/c there are multiple P waves in a fast rhythum due ot the fast intra atrial reentry loop |
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Term
| What is the most likely ratio of atrial contractions to ventricular contractions in atrial flutter? What can make this ratio larger? |
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Definition
2:1
a diseased AV node can make it larger |
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Term
| What is a necessary treatment you have to impose in A. Fib and A. Flutter? |
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Definition
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Term
| What type of reentry is Wolff-Parkinson-White? |
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Definition
| atrioventricular macro re-entry |
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Term
| What causes Wolff-Parkinson-White Syndrome? |
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Definition
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Term
| What makes an accessory pathway faster than the AV pathway? |
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Definition
| it does not have the delay that the AV node has |
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Term
| What are the two directions that the current can travel in Wolff-Parkinson-White Syndrome? |
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Definition
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Term
| What is the orthodromic direction imply in Wolff-Parkinson-White Syndrome? |
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Definition
| that the conduction goes down the AV node and up the accessory path |
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Term
| What is the QRS interval like in orthodromic Wolff-Parkinson-White Syndrome? |
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Definition
| it is normal b/c the conduction goes down the AV node and it has its usual delay |
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Term
| What is the direction of conduction in antidromic Wolff-Parkinson-White Syndrome? |
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Definition
| It is down the accessory path and up the AV node |
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Term
| What type of waves are seen in Wolff-Parkinson-White Syndrome? |
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Definition
| delta waves if the flow is down the accessory pathway |
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Term
| What is the definative treatment of Wolff-Parkinson-White Syndrome? |
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Definition
| ablation of the accessory pathway |
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Term
| What is true of the PR interval in Wolff-Parkinson-White Syndrome? |
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Definition
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Term
| Where do you see the p waves and how are they deflected in orthodromic Wolff-Parkinson-White Syndrome in leads I, II, aVF? |
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Definition
| right after the QRS and inverted |
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Term
| What is the defining criteria for a long QT syndrome in normal rate? |
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Definition
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Term
| What are the two general categories of long QT syndrome etiology? |
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Definition
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Term
| What is an important thing to keep in mind when seeing a patient for long QT syndrome with regards to the congenital type? |
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Definition
| that family should be screened |
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Term
| Why should families of Long QT syndrome patients be screened besides the fact that it can be abruptly fatal? |
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Definition
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Term
| What two channels were discussed in class that can be mutated in long QT syndrome? |
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Definition
the Na channel responsible for phase 0
the K channels Kr and Ks for phase 3 |
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Term
| What gene is the mutation in that prolongs the Na current in one form of congenital Long QT syndrome? |
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Definition
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Term
| What type of channels are the Kr and Ks channels? |
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Definition
| they are delayed outward rectifiers |
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Term
| What are two genes responsible for the problems with the Kr and Ks channels in Long QT syndrome? |
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Definition
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Term
| What are some things that can increase chance of death from Long QT syndrome with LQT3? |
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Definition
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Term
| What are some things that can increase chance of death from Long QT syndrome with LQT1 or LQT2? |
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Definition
| exercise, emotional stress, swimming |
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Term
| What will happen to the rhythum after prolonged long QT prior to V. Fib? |
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Definition
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Term
| What syndrome is Torsades de Points associated with? |
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Definition
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Term
| What do you recommend long QT syndrome people to not participate in to lower chances of episodes? |
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Definition
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Term
| What are three drug types and two electrolyte conditions that can lead to acquired Long QT intervals? |
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Definition
antidepresents
antiarrhythmics that block K channel
erythromycin
hypomagnesius
hypokalemia |
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Term
| How can you tell where a preventricular contraction (PVC) originates? |
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Definition
if it is wide then it is in the ventricle
if it is narrow then it is above the bifurcation of the HIS bundle |
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Term
| What is the defintion of ventricular bigeminy? |
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Definition
| when you have a PVC every other beat |
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Term
| What is a junctional escape rhythum? |
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Definition
| one that is coming from the AV node or HIS bundle when SA fails |
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Term
| In a junctional escape rhythum, what is true of the QRS complex? |
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Definition
| it is narrow b/c it comes from above the HIS bifurcation |
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Term
| What is a ventricular escape rhythum (idioventricular)? |
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Definition
| a beat from below the bifurcation of the HIS bundle |
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Term
| What is true of the QRS in a ventricular escape rhythum (idioventricular beat)? |
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Definition
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Term
| Are there p waves present in junctional escape beats or ventricular escape beats? |
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Definition
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Term
| What is true of the R' wave in leads V1 and V2 in RBBB? |
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Definition
| they will be wide and deflected up |
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Term
| What is true of the S wave in V6 of a RBBB? |
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Definition
| it is deflected down and wide |
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Term
| What is the normal conduction time from the SA node to the AV node? |
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Definition
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Term
| What is the normal conduction time form the HIS to ventricular muscle? |
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Definition
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Term
| When should you be more concerned about a first degree heart block, when it is in the AV node or below the AV node? Why? |
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Definition
| when it is below the AV node b/c it can quickly progress to third degree heart block and be fatal |
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Term
| What is the definative treatment of heart block? |
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Definition
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Term
| What conditions are Right BBB and Left BBB more common in? (7) |
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Definition
HTN
CAD
myocarditis
cardiomyopathy
Congenital heart disease
tumors
degneration |
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Term
| What is concealed Wolff Parkinson White Syndrome? |
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Definition
| when the accessory pathway is blocked |
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Term
| What is manifest Wolff Parkinson White Syndrome? |
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Definition
| when the conduction goes down both the AV node and the acessory pathway? |
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Term
| WHen the heart rate increases what is the natural response of the AV node? |
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Definition
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Term
| What is an orthodromic SVT? |
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Definition
| when the conduction goes down the AV node, keeps the impulse delayed, keeps a normal ventricular (QRS) contraction, comes back up the accessory pathway causing a inverted P wave due to retrograde conduction right after QRS |
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Term
| What is more common orthodromic or antidromic SVT? |
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Definition
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Term
| What is true of the PR interval in antidromic vs. orthodromic SVT? |
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Definition
it is shortened in antidromic
normal in orthodromic |
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Term
| What are four options for treatment in Wolff Parkinson White Syndrome? |
|
Definition
ablation
anti-arrhytmics
anti-tachy device
surgery (old method) |
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|
Term
| What is the normal PR interval? |
|
Definition
|
|
Term
| What is the normal QRS interval? |
|
Definition
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