Lecture 10 - Electrocardiogram

‭Electrocardiogram: ECG/EKG‬ ‭‬ T ● ‭ est to measure the natural electrical activity of the heart‬ ‭●‬ ‭One of the simplest and fastest tests used to evaluate the heart‬ ‭●‬ ‭Electrodes (small, plastic patches that stick to the skin) are placed at certain spots on the‬ ‭chest, arms, and legs‬ ‭○‬ ‭Connected to an ECG machine by lead wires‬ ‭●‬ ‭The electrical activity of the heart is measured, interpreted, and printed out‬ ‭●‬ ‭No electricity sent into the body‬ ‭What is Recorded‬ ‭‬ S ● ‭ peed of heartbeats‬ ‭●‬ ‭Rhythm of heartbeats (steady or irregular)‬ ‭●‬ ‭Timing of the electrical impulses as they move through different parts of the heart‬ ‭Electrophysiology‬ ‭‬ T ● ‭ he study of the electrical properties and activities within cells and tissues‬ ‭●‬ ‭Contraction and relaxation of any muscle is associated with electrical changes‬ ‭●‬ ‭Ions move across the cell membranes through specialized channels, generating electrical‬ ‭impulses that drive the cardiac muscle to contract and relax → heartbeat‬ ‭○‬ ‭Polarized, negative inside the cell membrane‬ ‭●‬ ‭The heart is a mechanical pump/muscle, which is stimulated to contract and relax through‬ ‭electrical conduction‬ ‭Primary Ions Involved‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ I‭ ons move in and become less negative/polarized → depolarization‬ ‭Sodium (Na‬‭+‭)‬ ‬ ‭Potassium (K‬‭+‭)‬ ‬ ‭Calcium (Ca‬‭2+‬‭)‬ ‭Electrical Impulse‬ ‭●‬ E ‭ lectrical impulse (wave of depolarization) picked up by placing‬ ‭electrodes on a patient‬ ‭●‬ ‭An EKG is only a measure of this electrical activity and does not pick‬ ‭up effective heart compressions (EF)‬ ‭Cardiac Conduction System‬ ‭Sinoatrial (SA) Node‬ ‭●‬ ‭Specialized cardiac cells that determine heart rate (60-100 bpm)‬ ‭‬ N ● ‭ atural pacemaker cells for electrical signals‬ ‭●‬ ‭Located in the RA at the entrance of the SVC‬ ‭●‬ ‭Electrical impulses from the SA node spread‬ ‭throughout both atria and stimulate contraction‬ ‭Bachman’s Bundle‬ ‭●‬ U ‭ sed to conduct impulses from the SA node to‬ ‭the AV node‬ ‭Atrioventricular (AV) Node‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ elays impulse from the atria to the ventricles, “gatekeeper”‬ D ‭Ensures the atria have ejected all blood into the ventricles before the ventricles contract‬ ‭Receives signals from the SA node and passes them onto the AV bundle‬ ‭Works in case of SA node failure (40-60 bpm)‬ ‭Located on the other side of the RA near the AV valve‬ ‭Bundle of His/AV Bundle & Bundle Branches‬ ‭‬ T ● ‭ hick fibrous tissue that divide into R&L bundle branches‬ ‭●‬ ‭Bundle branches conduct impulses to the apex of the heart then the Purkinje fibers‬ ‭Purkinje Fibers‬ ‭ ‬ I‭ mpulses travel through the fibers, heart contracts, then blood goes throughout the body‬ ● ‭●‬ ‭Electrical impulses turn upward and spread throughout the ventricular myocardium‬ ‭Overall Direction of Cardiac Impulse‬ ‭5-Lead ECG‬ ‭‬ H ● ‭ as 5 chest electrodes‬ ‭●‬ ‭Utilized in medical telemetry‬ ‭12-Lead ECG‬ ‭‬ L ● ‭ eads refer to angles/perspective snapshots of the heart‬ ‭●‬ ‭Uses 10 electrodes/lead wires:‬ ‭○‬ ‭4 limb electrodes (at the wrist and ankles)‬ ‭○‬ ‭6 chest electrodes‬ ‭●‬ ‭Shows the heart’s overall voltage‬ ‭10 Lead Wires‬ ‭●‬ ‭6 limb leads from 3 lead wires giving a vertical perspective‬ ‭○‬ ‭R leg lead electrode: Earth electrode, reference to understand body movement‬ ‭●‬ ‭Leads I, II, and III: Bipolar (2 limb leads)‬ ‭○‬ ‭Lead I: R arm to L arm‬ ‭○‬ ‭Lead II: Inferior L view, R arm to L leg‬ ‭○‬ ‭Lead III: Inferior R view, L arm to L leg‬ ‭●‬ ‭Augmented leads (avF, avL, avR): Unipolar‬ ‭●‬ ‭Precordial leads (V1-V6): Unipolar‬ ‭○‬ ‭Negative pole: Reference‬ ‭○‬ ‭Positive pole: View/angles of electrical impulses‬ ‭●‬ ‭Depolarization indicates contraction; repolarization indicates relaxation‬ ‭Voltage Change‬ ‭●‬ T ‭ he voltage change is sensed by measuring the‬ ‭current change across 2 electrodes‬ ‭○‬ ‭1 for unipolar‬ ‭●‬ ‭Positive deflection: Negative to positive,‬ ‭depolarization toward positive lead (up)‬ ‭●‬ ‭Negative deflection: Positive to negative,‬ ‭depolarization away from positive lead (down)‬ ‭ECG Lead Views‬ ‭‬ L ● ‭ ead: An imaginary line between two electrodes‬ ‭●‬ ‭Different leads “view” the heart from different angles‬ ‭Bipolar Leads‬ ‭‬ T ● ‭ wo electrodes used‬ ‭●‬ ‭Leads I, II, and III‬ ‭Unipolar Leads‬ ‭ ‬ 1‭ electrode used; other view is an average of leads‬ ● ‭●‬ ‭Leads aVR, aVL, and aVF‬ ‭●‬ ‭Chest/V leads: V1 - V6‬ ‭○‬ ‭Lead at angle of heart with one electrode‬ ‭6 Vertical Views‬ ‭ ‬ 3‭ limb electrodes‬ ● ‭●‬ ‭Bipolar leads: I, II, and III‬ ‭●‬ ‭Unipolar leads: aVR, aVL, and aVF‬ ‭6 Horizontal Views‬ ‭ ‬ 6‭ chest electrodes across the heart‬ ● ‭●‬ ‭Unipolar leads: V1, V2, V3, V4, V5, and V6‬ ‭Chest Leads‬ ‭‬ V ● ‭ 1 and V2: Anterior heart and R ventricle‬ ‭●‬ ‭V3 and V4: Anterior and septal‬ ‭●‬ ‭V5 and V6: Lateral and left ventricle‬ ‭Recording an ECG‬ ‭Introduction‬ ‭ ‬ I‭ dentify‬ ● ‭●‬ ‭Explain procedure‬ ‭●‬ ‭Privacy‬ ‭Procedure‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ ay patient down (does not have to be flat)‬ L ‭Expose the chest, wrists, and ankles‬ ‭Apply electrodes‬ ‭Turn on machine‬ ‭Enter patient information (name, DOB, hospital number, date/time)‬ ‭○‬ ‭EPIC usually translates the order to ECG‬ ‭ ‬ I‭ nstruct patient to lie still and to not talk during recording (otherwise, inaccurate reading)‬ ● ‭●‬ ‭Record and print‬ ‭●‬ ‭Disconnect and remove electrodes‬ ‭Wire Attachment‬ ‭Four Limb Leads‬ ‭●‬ ‭“Smoke over fire, clouds/snow over grass.”‬ ‭Six Chest Leads‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ 1: 4th intercostal space, R of sternum‬ V ‭V2: 4th intercostal space, L of sternum‬ ‭V3: Directly between leads V2 and V4‬ ‭V4: 5th intercostal space at midclavicular line‬ ‭V5: Level with V4 at L anterior axillary line‬ ‭V6: Level with V5 at midaxillary line (directly under midpoint of the armpit)‬ ‭Female Placement‬ ‭●‬ ‭Avoid breast tissue, as the ECG will not correctly pick up heart rhythms‬ ‭Interpreting ECGs‬ ‭●‬ ‭Voltage over time‬ ‭Voltage‬ ‭‬ C ● ‭ orresponds to height‬ ‭●‬ ‭1 mm = 0.1 mV‬ ‭●‬ ‭10 mm = 1 mV‬ ‭Time‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭ orresponds to length‬ C ‭1 mm = 0.04 seconds‬ ‭5 mm = 0.2 seconds‬ ‭Paper speed: 25 mm/second‬ ‭Main Components‬ ‭Rhythm‬ ‭‬ M ● ‭ easure the distance between R waves/peaks‬ ‭●‬ ‭Check for consistency‬ ‭○‬ ‭Can usually click 2 R waves to get distance and compare‬ ‭●‬ ‭Distance between R waves is same = regular‬ ‭●‬ ‭Distance between R waves varies = irregular‬ ‭Rate‬ ‭300 Rule for Regular Rhythms‬ ‭●‬ C ‭ ount the number of large squares between‬ ‭two R waves‬ ‭●‬ ‭Rate is 300 divided by number of large‬ ‭squares counted‬ ‭●‬ ‭Ex. 300/4 = 75 bpm, 300/8 = 37.5 bpm‬ ‭x6 Rule for Irregular Rhythms‬ ‭‬ T ● ‭ he ECG strip is usually 250 mm long (10 seconds)‬ ‭●‬ ‭Count the number of R waves on that strip and multiply by 6 (to get 60 seconds)‬ ‭PQRST Wave‬ ‭P Wave‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ trial depolarization; starts electrical impulse‬ A ‭Always positive in leads I and II‬ ‭Always negative in lead aVR‬ ‭Height: < 0.25 mV (2.5 small squares) in amplitude‬ ‭Length: < 0.08 seconds (2 small squares) in duration‬ ‭Irregular P Waves‬ ‭●‬ ‭Tall P wave:‬ ‭○‬ ‭RA hypertrophy (atrial muscle enlargement)‬ ‭○‬ O ‭ ften due to pulmonary hypertension (high pressure blood from the lungs goes to‬ ‭the right atrium)‬ ‭ ‬ ‭Long P wave:‬ ● ‭○‬ ‭LA hypertrophy and delayed LA depolarization/contraction‬ ‭○‬ ‭Often due to mitral valve disease or LV hypertrophy‬ ‭○‬ ‭Long since impulse must travel across large left atrium‬ ‭PR Interval‬ ‭●‬ T ‭ ime between atrial depolarization/contraction (P) and ventricular‬ ‭depolarization/contraction (R)‬ ‭●‬ ‭Length: Usually between 0.12 and 0.2 seconds (3-5 small squares)‬ ‭Irregular PR Intervals‬ ‭●‬ ‭Shorter: Wolff-Parkinson-White Syndrome‬ ‭●‬ ‭Longer: 1st, 2nd, or 3rd degree heart block‬ ‭○‬ ‭More time taken to reach AV node from SA node‬ ‭QRS Complex‬ ‭‬ V ● ‭ entricular depolarization/contraction‬ ‭●‬ ‭Height: Varies by lead (> 0.5 - 1 mV)‬ ‭●‬ ‭Width: Less than 0.12 seconds (3 small squares); should be thin‬ ‭Irregular QRS Complexes‬ ‭●‬ ‭Tall in lead II (2 mV): LV hypertrophy‬ ‭○‬ ‭Enlargement/thickening of heart walls in LV‬ ‭●‬ ‭Wide QRS: R or L bundle branch block (RBBB/LBBB)‬ ‭○‬ ‭Does not squeeze as quickly‬ ‭ST Segment‬ ‭●‬ T ‭ ime between the end of ventricular depolarization/contraction‬ ‭(S) and beginning of ventricular repolarization/relaxation (T)‬ ‭●‬ ‭Deflection: Usually isoelectric (no electrical impulse flow)‬ ‭○‬ ‭Should be flat, but may vary from -0.5 to +1 mm‬ ‭Irregular ST Segments‬ ‭●‬ ‭Depression/elevation: Myocardial ischemia or infarction‬ ‭T Wave‬ ‭‬ V ● ‭ entricular repolarization/relaxation‬ ‭●‬ ‭Affected heavily by potassium‬ ‭●‬ ‭Height: No definite rule, but should not be taller than half the size of the QRS‬ ‭Irregular T Waves‬ ‭●‬ ‭Too tall: Hyperkalemia or acute MI‬ ‭●‬ ‭Too flat: Hypokalemia‬ ‭●‬ ‭Inverted: MI‬ ‭Various Rhythms‬ ‭Normal Sinus Rhythm‬ ‭Sinus Bradycardia‬ ‭‬ H ● ‭ eart beats slower than normal; under 60 bpm for adults‬ ‭●‬ ‭Common for adults over 65 and people who exercise regularly‬ ‭●‬ ‭Typically harmless with no symptoms‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭ typically causes lack of O‬‭2‬ ‭in the brain/body due to insufficient blood pumping‬ A ‭S/S: SOB, fatigue, memory issues, confusion, chest pain, fainting‬ ‭Causes: Lack of electrolytes, Lyme disease, rheumatic fever, radiation tx, heart surgery‬ ‭Tx: Electrical pacing, atropine (stimulation of cardiac muscle)‬ ‭Sinus Tachycardia‬ ‭●‬ A ‭ ssociated with a regular rhythm, abnormally fast heart rate (> 100 bpm), present P‬ ‭wave, and normal QRS complex‬ ‭●‬ ‭May be a response to daily activities such as exercise, caffeine intake, and stress‬ ‭●‬ ‭Normally does not cause negative health effects or cause symptoms‬ ‭●‬ ‭If a patient does feel continuous symptoms, they may manifest as a fluttering feeling in‬ ‭the chest, chest pain, dizziness, fainting, or breathing difficulties‬ ‭Treatments‬ ‭●‬ T ‭ he body should be able to self-regulate to a normal rhythm, but if symptomatic or‬ ‭unnaturally persistent:‬ ‭Lifestyle Changes‬ ‭●‬ ‭If the cause is stress/exercise, stop/reduce contributing activities‬ ‭●‬ ‭Avoiding stimulants (ex. Caffeine, nicotine)‬ ‭●‬ ‭Hydration (PO or IV)‬ ‭Medications‬ ‭●‬ ‭Beta-blockers or calcium channel blockers may be needed‬ ‭Cardiac Ablation‬ ‭●‬ ‭Destroys the heart tissue causing tachycardia‬ ‭●‬ ‭A catheter is used to deliver energy to a small area of the heart and “burn” the abnormal‬ ‭conduction area triggering a faster heart rate; extra impulse is burned‬ ‭Normal Sinus Rhythm with PVC‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ VC: Premature ventricular contraction‬ P ‭Extra heartbeats that begin in one of the heart’s ventricles‬ ‭Disrupt the heart’s regular rhythm, resulting in a fluttering or skipped beat sensation‬ ‭Often harmless and sporadic‬ ‭May be a result of high caffeine consumption, anxiety/stress, poor sleep, abnormal serum‬ ‭electrolyte levels, smoking, alcohol use, certain medications, or heart valve issues‬ ‭Treatment‬ ‭‬ M ● ‭ edication‬ ‭●‬ ‭Catheter ablation‬ ‭●‬ ‭Treatment of underlying conditions (ex. HTN)‬ ‭Types of PVCs‬ ‭Within every other beat‬ ‭Every third beat‬ ‭Irregular occurrence intervals‬ ‭One after the other‬ ‭Normal Sinus Rhythm with PAC‬ ‭‬ P ● ‭ AC: Premature atrial contraction‬ ‭●‬ ‭Extra heartbeat when the atrium contracts before it should; feels like a skipped beat‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ /S: Heart palpitations, dizziness, or chest pains‬ S ‭Common in patients who are older, tall, inactive or have COPD, diabetes, congestive HF‬ ‭Causes: Less blood to the heart, heart injury, stress, excessive tobacco/caffeine/alcohol‬ ‭Tests: Electrocardiogram (if normal, other tests may not be needed), heart monitor‬ ‭Tx: Only needed when symptoms are frequent but usually go away; beta-blockers‬ ‭Management: Regular exercise, reduced alcohol/caffeine, hydration, adequate sleep,‬ ‭sufficient electrolyte intake‬ ‭1st Degree Heart Block‬ ‭●‬ D ‭ isease in which impulses from the atria to the ventricles through‬ ‭the AV node are slower than normal; signals are still transmitted‬ ‭●‬ ‭Seen as a prolonged PR interval‬ ‭●‬ ‭Causes/risk factors: Aging, damage to the heart, low thyroid levels,‬ ‭electrolyte abnormalities, inflammatory/infectious heart disease,‬ ‭certain medications (ex. Beta-blockers)‬ ‭●‬ ‭S/S: Mostly asymptomatic; fatigue or unusual awareness of‬ ‭heartbeat‬ ‭●‬ ‭Tx: Monitoring and medication adjustment‬ ‭2nd Degree Heart Block‬ ‭●‬ D ‭ isease in which the electrical impulse through the AV node and/or His bundle is delayed‬ ‭or blocked‬ ‭●‬ ‭Also known as incomplete heart block; impulses are only able to travel from the atria to‬ ‭the ventricles some of the time‬ ‭Type 1‬ ‭‬ M ● ‭ obitz Type 1 or Wenckebach’s AV Block‬ ‭●‬ ‭PR interval progressively increases until a beat is dropped‬ ‭●‬ ‭Less serious form in which the impulse gets slower and slower until the heart skips a beat‬ ‭Type 2‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ obitz Type 2‬ M ‭PR intervals are normal but there is a dropped beat‬ ‭More serious form that may warrant a pacemaker‬ ‭Most electrical signals reach the ventricles, but every so often, some do not‬ ‭The heartbeat becomes irregular and slower than normal‬ ‭S/S‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭ ary depending on severity of heartblock; may be asymptomatic‬ V ‭Light-headedness, dizziness, fainting, fatigue‬ ‭Chest pain if related to myocarditis or ischemia‬ ‭A regularly irregular heartbeat and heart palpitations with bradycardia‬ ‭‬ S ● ‭ igns of hypoperfusion, such as hypotension‬ ‭●‬ ‭SOB and tachypnea‬ ‭Causes‬ ‭‬ D ● ‭ iseases that damage the heart‬ ‭●‬ ‭Adverse effects of certain medications‬ ‭●‬ ‭Some autoimmune diseases‬ ‭Prognosis‬ ‭‬ W ● ‭ ithout treatment, severe heart blocks can cause sudden cardiac arrest‬ ‭●‬ ‭Most commonly, untreated blocks cause lightheadedness and fainting spells‬ ‭3rd Degree Heart Block‬ ‭●‬ ‭Complete blockage of electrical signals between the atria and ventricles‬ ‭●‬ W ‭ hen the impulse cannot travel from the SA node to the ventricles, ventricle‬ ‭contraction/relaxation become out of sync with atrial contraction/relaxation‬ ‭●‬ ‭Ventricle contraction is instead stimulated through an escape rhythm‬ ‭○‬ ‭AV node: Junctional escape‬ ‭○‬ ‭Fascicles: Fascicular escape‬ ‭○‬ ‭Ventricular myocytes: Ventricular escape‬ ‭●‬ ‭Clinical manifestations: Chest pain, fatigue, SOB,‬ ‭tachypnea, palpitations, nausea, dizziness, faintinge‬ ‭●‬ ‭Causes: MI, CAD, cardiomyopathy, heart valve‬ ‭diseases, scarring of conduction system, heart‬ ‭structure anomaly, surgery, meds, toxins, obstructive‬ ‭sleep apnea, thyroid disease, Lyme disease,‬ ‭autoimmune disorders, genetic‬ ‭●‬ ‭Risk factors: Hx of other CV conditions/diseases,‬ ‭overactive vagus nerve (causes bradycardia), certain medications that affect BP/HR‬ ‭●‬ ‭Diagnosis: Irregular placement of P wave r/t QRS complex‬ ‭●‬ ‭Tx: Permanent artificial pacemaker‬ ‭Memorization Tool:‬ ‭●‬ ‭If the R is far from P, then you have 1st degree (consistent)‬ ‭●‬ ‭PR gets longer, longer, drops, then you have a Wenckebach‬ ‭●‬ ‭If some Rs don’t get through, then you have a Mobitz II‬ ‭●‬ ‭If the Ps and Qs don’t agree, then you have 3rd degree‬ ‭Atrial Fibrillation‬ ‭●‬ O ‭ ccurs when the atria beat rapidly and‬‭irregularly‬‭out-of-sync‬ ‭with ventricles‬ ‭●‬ ‭Atria contract instead of pumping blood to the ventricles, leading‬ ‭to arrythmias and clots‬ ‭●‬ ‭Episodes are usually occasional but may be persistent‬ ‭●‬ ‭S/S: Heart palpitations, chest pain, SOB, dizziness‬ ‭●‬ ‭Causes: Congenital heart defect, heart disease, sick sinuses‬ ‭syndrome, ehart attack, heart valve disease, CAD, sleep apnea,‬ ‭lung disease, overactive thyroid, abuse of alcohol/drugs‬ ‭●‬ ‭Diagnosed by ECG:‬‭Absence of P wave and irregular‬ ‭●‬ ‭Tx: Medication, heart procedures, and lifestyle changes‬ ‭Atrial Flutter‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ I‭ rregular rhythm where the atria fires at a rapid rate (atrial bpm of ~300 bpm)‬ ‭Results in poor blood flow, increasing risk of clots and stroke‬ ‭Causes: Heart valve problems (ex. Overactive thyroid), heart attacks, heart surgeries‬ ‭EKG:‬‭No P-waves, sawtooth flutter waves‬‭, narrow and‬‭regular QRS complex,‬ ‭tachycardic,‬‭regular‬ ‭ ‬ ‭S/S: Chest pain, heart palpitations, SOB, fatigue‬ ● ‭●‬ ‭Tx: Rate control with calcium channel blockers or beta blockers, rhythm control with‬ ‭antiarrhythmics, anticoagulation therapy to prevent CVA‬ ‭STEMI‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ T-segment elevation MI; life-threatening heart attack‬ S ‭Coronary artery is completely blocked‬ ‭Blood supply to the heart is completely cut off‬ ‭More dangerous than other types of heart attack; cardiogenic shock‬ ‭Causes: Plaque, on which a blood clot forms, closing up the artery‬ ‭S/S: Angina, anxiety, sweating, dizziness, palpitations‬ ‭EKG: Abnormal elevation of ST segment (should be flat)‬ ‭○‬ ‭Sign that ventricle muscles are dying (ischemia)‬ ‭○‬ ‭Indicates total blockage of the affected coronary artery‬ ‭ ‬ ‭Triggers ventricular tachycardia/fibrillation, leading to sudden death‬ ● ‭●‬ ‭Lab testing: Increased troponin, released by damaged heart cells‬ ‭●‬ ‭Tx: Anticoagulants, beta blockers (raise HR), nitroglycerin‬ ‭(vasodilator), aspirin, statins‬ ‭Ventricular Fibrillation‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ I‭ rregular heart rhythm where the ventricles quiver, causing inadequate CO‬ ‭Must be treated right away; not life-sustaining‬ ‭S/S: Chest pain, dizziness, SOB, racing pulse‬ ‭Causes: Heart attack, heart disease, cardiomyopathy, electrolyte imbalances, electrocution‬ ‭Tx: Defibrillator shock, implanted cardioverter-defibrillator, amiodarone‬ ‭Dx: Chaotic ECG, cardiac telemetry, AED‬ ‭Ventricular Tachycardia‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭ -Tach/VT; type of arrhythmia present in the ventricle myocardium‬ V ‭Muscle contracts too often, leading to inadequate filling and blood supply to the body‬ ‭Occurs due to irregular electrical impulses sent to the myocardium‬ ‭S/S: Lightheadedness, SOB, heart palpitations, angina, dizziness, fainting, no pulse‬ ‭HR: > 100 bpm up to 250 bpm‬ ‭ECG: Regular pattern, wide QRS complex, no P waves‬ ‭Causes/risk factors: Previous heart disease, muscle‬ ‭scarring, adverse effects of meds, electrolyte imbalances‬ ‭(K), illegal stimulant drug use (ex. Cocaine, meth)‬ ‭Lifestyle changes: Balanced, nutrient-dense diet‬ ‭Regular exercise, sleep, and stress management‬ ‭Managing BP and cholesterol‬ ‭Limiting alcohol and tobacco use‬ ‭ECG Readings for V-Tachs‬ ‭●‬ ‭All no pulse and require defibrillation‬ ‭Asystole‬ ‭●‬ C ‭ ardiac arrest that occurs when the‬ ‭electrical system of the heart fails; long‬ ‭pause/flat-line‬ ‭●‬ ‭The heart stops pumping; no heartbeat or‬ ‭bloodflow‬ ‭●‬ ‭Asystole is the most serious form of‬ ‭cardiac arrest and is considered non-shockable‬ ‭●‬ ‭The survival rate is very low and requires immediate treatment with CPR and epinephrine‬ ‭administration, as death/brain damage occur within minutes‬ ‭●‬ ‭Prompt, high quality CPR and effective treatment of underlying conditions increase‬ ‭chances of survival‬ ‭Artifact‬ ‭●‬ ‭Fix leads or check if patient is moving‬