Term
| What does Atrial Flutter look like on ECG? What are we most concerned with in this situation? |
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Definition
Sawtooth pattern; lots of p-waves between a few ventricular waves.
Mostly concerned w/ ventricular rate, and the resulting C.O. |
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Term
| If a patient has atrial fibrillation, is it appropriate to exercise? |
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Definition
| It's conditional. If the patient has chronic A-Fib and has adequate C.O., it's ok for them to exercise. If this is a sudden change - no exercise. |
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Term
| Ventricular flutter looks like what pattern on ECG? |
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Definition
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Term
| What does ventricular fibrillation look like? |
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Definition
| Totally irratic - no visible pattern or identifiable complexes. |
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Term
| What does atrial fibrillation look like? |
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Definition
| A wavy baseline. no distinct p-waves, just kind of bumpy along whole strip. QRS are not regular, and may be rapid OR slow. Atia and ventricles are dissociated - so the atrial and ventricular patterns do not coincide with one another. They each do their own thing. |
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Term
| Is C.O. necessarily comprimised when the patient is in atrial fibrullation? |
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Definition
| No. It is possible to have adequate C.O. if ventricle is filling and pacing properly. |
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Term
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Definition
| Electrical blocks that prevent pacing for at least one cycle before pacing resumes at previous rate. They may or may not provoke an escape beat. |
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Term
| What does sinus block look like? |
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Definition
| SA node fails to pace for at least one cycle, leaving either a flat line until the next beat, or provoking an escape beat that will have a different p wave from the previous beats. |
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Term
| Are Sinus Blocks harmful? |
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Definition
| No, they're not usually a big deal. |
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Term
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Definition
| From the beginning of the P-wave so the beginning of the QRS complex. |
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Term
| What is a normal P-R interval, and how do you measure it? |
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Definition
| Normal P-R Interval = < .2 sec. 5 small blocks on the EKG = .2 sec. |
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Term
| What does it mean if a patient has a P-R interval of >.2 sec? |
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Definition
| There is a first degree ventricular block |
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Term
| What characterizes a first degree ventricular block? |
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Definition
| Delayed polarization - inhibition of depolarization from reaching the ventricle. |
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Term
| What are the two types of second degree ventricular blocks? |
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Definition
| Type 1 = Wenckebach ("Winkeybock") and Type 2 = Mobitz. |
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Term
| What does a type 1 (Wenckebach) ventricular block look like? |
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Definition
| The P-R interval gets progressively longer, then there is a missing QRS. It is a very regular, consistent cycle that will repeat over and over again. It often doesn't deteriorate, and can disappear on its own. |
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Term
| Do we worry a whole lot about type 1 ventricular blocks? |
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Definition
| No. They are very regular and rarely deteriorate into anything worse. |
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Term
| What is the primary cause of type 1 ventricular block? |
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Definition
| occlusion/narrowing of the R coronary artery +/or MI of R inferior wall. |
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Term
| What does a Type 2 (Mobitz) ventricular block look like? |
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Definition
| Sudden drop of QRS without warning. |
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Term
| Are type 2 (Mobitz) ventricular blocks particularly worrysome? |
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Definition
| Yes. They're often a sign of more serious conduction problems, and frequently deteriorate into complete blocks. |
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Term
| How do you tell the difference between type 2 (mobitz) ventricular blocks and an escape beat? (Someone in class asked it and she explained. may or may not be important) |
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Definition
| In an escape beat, the p-wave will look different. In a block, the p-wave is the same as all the others. |
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Term
| What is a third degree ventricular block? What does it look like? |
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Definition
| Nothing gets through the A-V node, so the atria pace themselves, and the ventricles pace themselves, with no communication between the two. So atria contract at the normal rate of 60-100, and ventricles pace at their rate. The ventriclar waveform will have a wide QRS. |
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