Exam (elaborations)
cardiac dysrhythmias Questions and Answers
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cardiac dysrhythmias
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Types of dysrhythmiasSinus bradycardia - answer-ECG: HR <60 bpm, rhythm regular
-S/sx: pale, cool skin; hypotension, weakness, angina, dizziness or syncope; confusion
or disorientation; and shortness of breath
Treat: atropine. if that's ineffective, transcutaneous pacing, or a dopamine or epi
infusion
Sinus tachycardia - answer-ECG: HR 101-200 bpm, rhythm regular
-Treat: depends on underlying cause (treat pain if caused by pain)
-S/sx: dizziness, dyspnea, hypotension
-Associations: exercise, fever, pain, hypotension, hypovolemia, anemia, hypoxia,
hypoglycemia, myocardia ischemia, heart failure, hyperthyrodism, anxiety, and fear
Premature atrial contraction (PAC) - answer-Contraction starting from an ectopic focus
in the atrium and coming sooner than the next expected sinus beat
-ECG: HR varies, rhythm irregular. P wave has a different shape, or it may be hidden in
the T wave
-S/sx: may report palpations or that heart "skipped a beat"
-Treat: b-blockers
-Associations: emotional stress, physical fatigue, tobacco, caffeine, or alcohol. Hypoxia,
electrolyte imbalances, hyperthyroidism, COPD, heart disease
Paroxysmal supraventricular tachycardia (PSVT) - answera dysrhythmia starting in an
ectopic focus anywhere above the split of the bundle of His
-S/sx: prolonged episode and HR >180 bpm will cause decreased CO b/c of reduced
stroke volume. Hypotension, palpations, dyspnea, and angina
Treat: vagal stimulation and drugs
-Associations: overexertion, emotional stress, deep inspiration, caffeine, and tobacco.
Rheumatic heart disease, CAD, cor pulmonale
Atrial flutter - answer-Atrial tachydysrhythmia identified by recurring, regular, sawtooth-
shaped flutter waves that originate from a single ectopic focus in teh right atrium
-ECG: atrial rate 200-300 bpm, regular. Ventricular rate ~150, regular
-Treat: b blockers and Ca channel blockers. radiofrequency catheter ablation.
-Associations: CAD, HTN, mitral valve disorders, pulmonary embolus, chronic lung
disease, cor pulmonale, cardiomyopathy, hyperthyroidism, and the use of drugs like
digoxin, quinidine, and epi
** these pts have increased risk for stroke
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