3091507
Descripción
Fichas por Karin Heeney, actualizado hace más de 1 año
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Creado por Karin Heeney
hace más de 9 años
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| Pregunta | Respuesta |
| premature atrial contraction (PAC) causes / associations | fatigue COPD digoxin toxicity EtOH / tobacco coronary artery disease |
| premature atrial contractions (PAC) ECG characteristics | Ectopic P wave 1. sooner than expected 2. different shape and direction 3. may or may not be conducted through AV node (normal or aberrant QRS) |
| premature atrial contractions (PAC) DEM care / disposition | ** can be symptomatic ++ or cause sustained tachycardias 1. discontinue precipitating drugs 2. treat underlying disorder (stress / fatigue) 3. commence B-adrenergic antagonist (e.g. metoprolol) |
| Sinus Bradycardia (supraventricular bradyarrhythmias) ECG characteristics | 1. atrial rate slower than 60bpm 2. normal sinus p wave, PR intervals 3. 1:1 AV conduction |
| Sinus Bradycardia (supraventricular bradyarrhythmias) causes | suppression of sinus node disharge in response to 3 categories of stimuli 1. PHYSIOLOGIC (vagal tone) 2. PHARMACOLOGIC (e.g. Ca channel blockers, B blockers, digoxin) 3. PATHOLOGIC (acute MI, increased ICP, carotid sinus hypersensitivity, sick sinus, hypothyroidism) |
| Sinus Bradycardia (supraventricular bradyarrhythmias) DEM treatment / disposition | Class I evidence; transcutaneous cardiac pacing class II evidence atropine 0.5mg IV every 3-5 min (max 3g) adrenaline 2-10mcg min IV dopamine 3-10 mcg/kg/min isoproterenol 2-10mcg/min IV infusion (but increases myocardial oxygen demand) pacemaker |
| steps required for transcutaneous cardiac pacing (external pacing) | 1. attach monitor leads 2. place pacing pads on left lateral precordial and left infrascapular 3. slowly increase pacing output from 0mA to lowest point where capture is observed (widened QRS after each pacing spike) ** if Required give sedative / analgesia |
| sinus tachycardia (supraventricular tachyarrythmia) causes | response to 3 categories of stimuli 1. PHYSIOLOGIC (pain / exertion) 2. PHARMACOLOGIC (sympathomimetics, caffeine, bronchodilators) 3. PATHOLOGIC (fever, hypoxia, anaemia, hypovoluemia, PE, hyperthyroidism) ** often due to effort for increased CO / meet circulatory demand |
| SVT (supraventicular tacycardia) definition | describes any tachycardia arising above bundle of His includes; sinus tachy, AF, atrial flutter, WPW, PSVT, AVRT, ** often used synonymously for accessory conduction - reentrant AVnRT in normal heart |
| SVT (PSVT / AVnRT / AVRT / WPW) (supraventicular tacycardia) associated conditions | rheumatic heart disease MI mitral valve prolapse acute pericarditis preexcitation syndromes |
| SVT (supraventicular tacycardia) DEM treatment / disposition | in unstable pt; 1. synchronised cardioversion in stable pt; 1. vagal manouvers 1st (supine with legs lifted for increased venous return) 2. diving reflex 3. carotid sinus massage 4. adenosine 6mg IV rapid with flush if no effect within 2 min further 12mg IV rapid calcium channel blocker diltiazem 20mg IV over 2 min verapamil 0.01mg/kg IV over 15-60 sec digoxin 0.4-0.6mg IV b-blocker metoprolol 5mg IV |
| AVnRT (supraventicular tacycardia) ECG http://lifeinthefastlane.com/ecg-library/svt/ | regular tachycardia 140-280bpm QRS usually narrow ST segment depression possible QRS alternans with normal amplitude p-wave retrograde conduction / p-wave inversion in leads Ii, III, aVF p-wave may be burried in QRS |
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