Y4 Acute Care > Heart Block > Flashcards

Heart Block Flashcards

(31 cards)

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1
Q

What is heart block?

A

HB = bradyarrhythmia caused by delay / interruption in electrical conduction between Atria + Ventricles

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2
Q

What are the Cardiac causes of HB? (5 things)

A
  1. Post MI
  2. AV block
  3. SA node dysf
  4. Inf End
  5. Fibrosis w age
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3
Q

What are the Non-Cardiac causes of HB? (4 things)

A
  1. Vasovagal
  2. Hypothermia
  3. Hypothyroidism
  4. Raised ICP (bc HTN)
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4
Q

What are the Meds causes of HB? (4 things)

A
  1. Amiodarone
  2. Beta blockers
  3. Calcium Ch blockers
  4. Digoxin

(All HF meds)

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5
Q

How can a MI cause Heart Block?

A

AV node supplied by RCA

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6
Q

What is 1st Degree HB in simple terms?

A

Delayed conduction thru AV node

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7
Q

What is 2nd Degree HB in simple terms?

A

Progressive delayed conduction / intermittently blocked conduction

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8
Q

What is 3rd Degree HB in simple terms?

A

TOTAL interruption of conduction between Atria + Ventricles –> complete AV dissociation

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9
Q

What is seen on an ECG for 1st Degree HB?

A

CONSTANT PR prolongation (200+ ms)

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10
Q

What more srs conditions can 1st Degree HB be a sign of? (3 things)

A
  1. Inf End
  2. BBB
  3. Aortic Root Abscess
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11
Q

What are the 2 types of 2nd Degree HB?

A
  1. Mobitz Type 1 (Wenckebach)
  2. Mobitz Type 2
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12
Q

What is seen on an ECG of Mobitz Type 1 (Wenckebach)? (4 steps)

A
  1. Progressive lengthening of PR interval
  2. Followed by dropped beat (Wencke Wencke Wencke BACH)
  3. Followed by a normal conducted beat w shorter PR interval
  4. Cycle continues
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13
Q

What is seen on an ECG of Mobitz Type 2? (2 things)

A
  1. Constant PR interval
  2. Occasional missing QRS complex after P wave (naked P wave lol)
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14
Q

Why are there occasional missing QRS complexes after P waves in Mobitz Type 2?

A

Occasionally atrial conduction NOT transmitted to ventricles

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15
Q

What is a Fixed Ratio Block in Mobitz Type 2?

A

Fixed number of P waves each time before you get a QRS complex

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16
Q

How do you calculate the ratio of the Fixed Ratio Block in Mobitz Type 2?

Study These Flashcards
A

Count number of P waves before QRS complex
e.g 2 P waves before every QRS complex = 2:1 Block

17
Q

What is seen on an ECG of 3rd Degree Heart Block?

Study These Flashcards
A
  1. Normal constant P waves
  2. Less + broad QRS complexes happening randomly (not linked w P waves bc complete AV dissociation)
18
Q

Why are the QRS complexes not linked with P waves in 3rd Degree HB?

Study These Flashcards
A

The atria and ventricles are not communicatin with each other

19
Q

Which HB’s are asymptomatic? (2 things)

Study These Flashcards
A
  1. 1st Degree HB
  2. Mobitz Type 1 (Wenckebach)
20
Q

Which HB’s are symptomatic? (2 things)

Study These Flashcards
A
  1. Mobitz Type 2
  2. 3rd Degree HB
21
Q

What are the symptoms of HB? (4 things)

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A
  1. Syncope
  2. Shock: Hypotension, Sweating, Pale, Increased CRT
  3. SOB
  4. Chest Pain

(1st Degree + Mobitz 1 = asymptomatic)

22
Q

How is the diagnosis of HB made?

23
Q

What are the management options for ALL HBs?

Study These Flashcards
A

Identify reversible causes aka Elec imb / Meds induced causes

24
Q

What HB’s don’t need treatment? (2 things)

Study These Flashcards
A
  1. 1st Degree
  2. Asymptomatic Mobitz 1 Wenckebach
25
What is the management options for ASYMPTOMATIC 1st Degree HB?
No treatment
26
What is the management options for SYMPTOMATIC 1st Degree HB?
Pacemaker
27
What is the management options for ASYMPTOMATIC Mobitz Type 1 (Wenckebach)?
No treatment
28
What is the management options for SYMPTOMATIC Mobitz Type 1 (Wenckebach)? (3 things)
1. Atropine 2. Transcutaneous Pacing (if atropine doesn’t work) 3. Pacemaker (if persistent + NO reversible causes)
29
What is the management options for Mobitz Type 2? (4 things)
1. Atropine 2. Transcutaneous Pacing (if atropine doesn’t work) 3. Pacemaker (if persistent + NO reversible causes) 4. Continuous monitoring bc can progress to 3rd Degree HB
30
What is the management options for 3rd Degree HB? (3 things)
1. Atropine 2. Transcutaneous Pacing (if atropine doesn’t work) 3. Pacemaker (if persistent + NO reversible causes)
31
What poem lets you remember HB ECG?
Y4 Acute Care
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