Beta-blocker or Ca2+ channel blocker, aspirin or
antiocoagulation medication, external cardioversion, see text for
stroke evaluation
Atrial Fibrillation Correct Answer No discernible P waves or T
waves with normal QRS complex
Atrial Flutter Correct Answer Incisions or scars in the atria s/p
open heart surgery, failed surgical procedures for A-fib
Adenosine, rate control or cardioversion, transesophogeal
echocardiogram (TEE)
Atrial Flutter Correct Answer R2R may be normal or irregular.
First Degree AV Block Correct Answer Enhanced
parasympathetic tone (overstimulation of vagus nerve), AV
nodal disease, CAD, medications (chronic use of cardiac drugs),
and electrolyte imbalances (hypokalemia and hypomagnesemia)
Usually does not require treatment, monitor patient if needed,
give atropine if presenting with bradycardia
, First Degree AV Block Correct Answer PR interval greater
than .20 sec
No missed beats
HR can be within normal limits unless there is atrial
enlargement.
Left Atrial Enlargement Correct Answer (Wide notched
prolonged P wave with duration greater than or equal to .12 sec -
3 small boxes, Biphasic P wave in V1 with negative terminal
component greater than the initial positive component)
The negative portion of the p wave in V1 is greater than 1mm
wide and 1 mm deep
If the P wave in V1 is completely negative this usually reflects
left atrial abnormalities.
Left Atrial Enlargement Correct Answer Chronic HTN, mitral
valve insufficiencies, heart failure, A-fib. preceded by LVH
Treat according to cause. Stabilize HTN, prevent further
enlargement
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