ECG > SVT + VT > Flashcards

SVT + VT Flashcards

(44 cards)

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1
Q

What causes a delta wave?

A

Early depolarisation of the ventricles

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2
Q

What are re-entry tachycardias?

A

Wolff Parkinson White syndrome
AV re-entry tachycardias
SVT

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3
Q

What are the characteristics of re-entry tachycardias?

A

Narrow QRS
Possible P waves
Non specific ST depression
They are orthodromic

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4
Q

What are the characteristics of AV re-entry tachycardias?

A 
Narrow complex tachycardia
160-250 bpm
Delta waves present on ECG
P waves present
Inverted P wave in inferior leads and lead 1
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5
Q

What is the cause of antidromic AV re-entry tachycardia?

A

Re-entry circuit from the atria to ventricles
Antegrada conduction to the ventricles via an accessory pathway with retrograde conduction to the atria via the AV node
Rare as it is pure delta waves

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6
Q

What are the characteristics of antidromic AV re-entry tachycardias?

A

Wide complex tachycardia
Regular, sinus rhythm
Delta waves with QRS morphology with normal QRS complex
Inverted P waves

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7
Q

Which tachycardia is responsible for 2/3 narrow complex tachycardias?

A

AV re-entry tachycardia

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8
Q

Which gender is AV re-entry tachycardia more commoner in?

A

Women

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9
Q

What can be distressing for pts who suffer from AV re-entry tachycardia?

A

Recurrent palpitations

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10
Q

What are the ventricular rhythms?

A 
Ventricular ectopics
Bigeminy
Idioventricular
Ventricular tachycardia
Monomorphic and polymorphic
Torsades de pointes
Ventricular fibrillation
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11
Q

What are the characteristics of ventricular arrhythmias?

A

No preceding P wave
Abnormal shape
Wide complex
Followed by a compensatory pause

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12
Q

What are the causes of ectopic beats?

A

Some are naturally occurring
IHD
Digoxin toxicity
LV dysfunction

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13
Q

What are the characteristics of ventricular ectopics / ventricular arrhythmias?

A

No P wave
Wide and bizarre QRS
Can look the same (unifocal) or different (multi focal)
Originates from a ventricular foci outside normal conduction pathways

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14
Q

What are the ventricular ectopic / ventricular arrhythmias rhythms?

A 
Unifocal
Multi focal
Bigeminy
Trigeminy
Paris Couplet
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15
Q

What is VT classed as?

A

3 or more ventricular arrhythmias rhythms

Rate = >100 bpm

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16
Q

What is a pre excitation beat?

A

It’s when the impulse bypasses the normal conduction, via the bundle of Kent
Starts in the atrium into the ventricle

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17
Q

What are the causes of ventricular arrhythmias?

A

Electrolyte imbalance
Hypoxia/ischaemia
Acidosis
Invasive equipment

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18
Q

How do you treat ventricular arrhythmias?

Study These Flashcards
A

Treat the cause

19
Q

What are the characteristics of ventricular bigeminy?

Study These Flashcards
A

Each sinus beat is followed by an ectopic beat

P waves can be seen in the T wave of the ectopic

20
Q

What does idio-ventricular rhythm look like?

21
Q

What is the cause of idio-ventricular rhythm?

Study These Flashcards
A

Reperfusion of the myocardium post MI

22
Q

How do you treat idio-ventricular rhythm?

Study These Flashcards
A

It does not require treatment

23
Q

What are the characteristics of idio-ventricular rhythm?

Study These Flashcards
A 
40-100 bpm 
Regular rhythm
P waves not present
PR interval not present
QRS wide and abnormal
T wave abnormal
24
Q

What does an abnormal T wave mean?

Study These Flashcards
A

Abnormal depolarisation = abnormal repolarisation

25
What are the characteristics of accelerated idioventricular rhythm?
Wide complex rhythm Regular P wave seen in T wave
26
What is accelerated idioventricular rhythm?
Reperfusion arrhythmia, usually seen in AMI
27
What should all wide complex tachycardias be treated as?
VT until proven otherwise
28
What are the characteristics of VT?
140-200 bpm 3+ consecutive ectopics Wide (>2.5-3.5 small squares) and bizarre QRS
29
Where does ventricular tachycardia originate?
An ectopic pacemaker
30
What are the characteristics of broad complex tachycardia?
Broad complex Tachycardia rate P wave notches present
31
What are the 3 things needed on an ECG to diagnose VT?
1. Evidence of AV dissociation (P wave in T wave) 2. Fusion beats 3. Capture beats
32
What is a fusion beat?
An impulse from 2 different foci meeting in the ventricle and depolarising simultaneously Normally and SVT impulse and ventricular ectopic impulse Similar to capture beat but merges with ventricular impulse There is evidence of AV dissociation
33
What is a capture beat?
An SVT impulse conducting into the ventricle and then conducted normally in a normal QRS Will be conducted in the middle of VT Evidence of AV dissociation
34
What is the cause of monomorphic VT?
Myocardial ischaemia
35
What does VT look like on an ECG?
Regular rhythm Chest leads are either all negative or all positive No PR interval AV dissociation of each complex slightly different
36
What is AV dissociation?
P wave in the T wave
37
What are the causes of polymorphic VT?
``` IHD (particularly MI) Impaired LV function Cardiomyopathies Long QT syndrome Electrolyte abnormalities Drugs Catecholamine sensitivity Can occur in normal hearts ```
38
What are the characteristics of polymorphic VT?
``` VT made up of multiple QRS morphologies Each beat = different shape Varying RR interval 150-300 bpm "Tornadoes de pointes" ```
39
What is Torsades do pointes?
A beat that starts with an R on T phenomenon | A ventricular premature beat that coincides with the T wave
40
What are the causes of Torsades de pointes?
``` AV block Hypokaleamia Hypomagnesia Drug induced long QT Drugs: amiodarone, sotolol, tricyclic antidepressant Congenital long QT syndrome IHD Myoedema ```
41
What are the characteristics of ventricular fibrillation?
``` Rate can't be detected Irregular rhythm P waves not present QRS not present Waves are abnormal and chaotic Can't determine onset or end of fibrillation waves Amplitude varies 3mm = coarse fibrillation ```
42
What causes the abnormal waves of VF?
Haphazard depolarisation of small individual groups of muscle
43
What are the causes of VF?
``` Digitails Quinidine Procainamide Hypoxia Acidosis Electrolyte imbalance ```
44
What does ventricular fibrillation mean for a pt?
They have no cardiac output | Use 2 leads to identify
ECG
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