University:
Michigan State University
Course:
MED 611 | Cardiology Clerkship
Academic year:

2021
Views:

73

Pages:

3
Author:

omiliar74be

Arrhythmia Sinus Tachycardia Sinus Bradycardia Sinus Arrhythmia (benign) Normally; heart rate increases with inspiration & decreases with expiration Phenomenon of Re-entry Causes increased sympathetic tone Fever, Pain, Dehydration, Hypovolemia, Anemia normally in athletes at rest Vagal stimulation R-R interval variation (deviation exceeds 0.12 sec) Atrial fibrillation dilated hearts (prolonged pathway) blockage of the Purkinje system, ischemia of the muscle or high blood potassium levels (Decreased rate of conduction) Drugs (shortened refractory period) Sudden electrical shock of the heart Ischemia of the heart or conduction system or both arrhythmia Reentry phenomenon atrial enlargement Atrial flutter re-entry circuit within the right atrium Atrioventricular (AV) Block Ischemia Compression by scar tissue or by calcified portions Inflammation Extreme stimulation of the heart by the vagus nerves Ventricular Fibrillation Ventricular Fibrillation ECG Normal but high HR Normal but high HR R-R interval variation Bizarre no regular rhythm of any type either no P waves are seen or only a fine, high frequency, very low voltage wavy record QRS-T complexes are normal in shape but are irregular P waves are strong (saw tooth appearance) QRS-T complex follows an atrial P wave only once for everytwo to three beats of the atria, giving a 2:1 or 3:1 rhythm First Degree Heart Block Type I (Wenckebach periodicity) coronary artery disease, acute rheumatic carditis, digoxin toxicity or electrolyte disturbances abnormality of the A-V node Type II (Fixed ratio blocks) abnormality of the bundle of His-Purk system Third degree block acute phenomenon in patients with myocardial infarction or it may be chronic, usually due to fibrosis around the bundle of His the PR interval increases to greater than 0.22 second Pattern: Progressive lengthening of the PR interval and then failure of conduction of an atrial beat, followed by a conducted beat with a shorter PR interval and then a repetition of this cycle fixed number of non-conducted P waves for every QRS complex beats(2:1) ,or one conducted atrial beat and then two (3:1) or three (4:1) non-conducted beats 1. Regular P-P interval 2. Regular R-R interval 3. Lack of an apparent relationship between the P waves and QRS complexes 4. Atrial rate is higher than ventricular rate Stokes- Adams Syndrome Axis Deviation The total block comes and goes Holter monitor left angulation of the heart and left axis deviation: 1. Deep expiration 2. Lying down 3. Obesity Conditions that cause right angulation of the heart and leright axis deviation: 1. Deep inspiration 2. Standing up Pathology Hypertrophy of One Ventricle the axis of the heart shifts toward the hypertrophied ventricle Prolonged QRS + high voltage QRS (HYPERTROPHY) Left bundle branch block Branch block Right bundle branch block Branch block MI Angina Pathological Q wave ongoing or prior myocardial infarction left axis deviation and widening of the QRS complex right axis deviation and widening of the QRS complex ST segment changes not permanent ST segment changes may be induced by making the patient exercise Q waves: >.04 sec >2 mm deep >25% of depth of QRS complex

Causes of Arrhythmia

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