Ventricular ectopics

Question 1

What is another name for a VE?

Answer 1

A PVC (premature ventricular complex)

Question 2

What is the criteria for a VE?

Answer 2

-premature
-compensatory pause
-broad
-normal atrial activity appears after complex

Question 3

How do you decide if a VE is monomorphic or polymorphic?

Answer 3

Need rhythm strip to see multiple beats and their morphology

Question 4

What are the causes of VEs?

Answer 4

-MI
-ischaemia
-hypertension
-cardiomyopathies
-stimulants
-sympathetic activity

Question 5

What are the symptoms of VEs?

Answer 5

-palps
-some have none

Question 6

What does the atrial activity depend on?

Answer 6

Whether the AV junction transmits the impulse to the atria

Question 7

What is seen when the impulse is transmitted to the atria?

Answer 7

Inverted P wave seen (either superimposed or concealed by VE)

Question 8

What is seen when the impulse is not transmitted to the atria?

Answer 8

Atrial activity continues independently of ventricular (in these cases- VE followed by compensatory pause)

Question 9

What is seen when the impulse partially penetrated the AV junction (still partially in refractory)?

Answer 9

Prolonged PR interval

Question 10

What are the features of an end-diastolic VE?

Answer 10

-comes in late or just slightly early in cardiac cycle
-will fall immediately after the sinus P wave (can see the P wave)
-P wave won’t be premature
-PR shorter compared to sinus

Question 11

What is ventricular bigeminy?

Answer 11

Normal, VE, normal, VE (1:1)

Question 12

What are the features of an interpolated VE?

Answer 12

-no compensatory pause
-ectopic beat sandwiched between 2 normal beats

Question 13

What are the features of R on T ectopics?

Answer 13

-close to the peak of the T wave
-triggers polymorphic VT (torsades)
-long QT (longer period of vulnerability and R on T)