1 / 35

Recognizing Cardiac arrhythmias

Recognizing Cardiac arrhythmias. Normal anatomy. Normal ECG. Normal ECG. Broad Complex. Classification - tachys. Atrial. Junctional. Ventricular. AF Atrial Flutter PAC. Paroxysmal SVT (PSVT) Junctional Tachycardia. VT VF PVC. Mark Henderson. Classification - bradys. Atrial.

phila
Télécharger la présentation

Recognizing Cardiac arrhythmias

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Recognizing Cardiac arrhythmias

  2. Normal anatomy

  3. Normal ECG

  4. Normal ECG

  5. Broad Complex Classification - tachys Atrial Junctional Ventricular • AF • Atrial Flutter • PAC • Paroxysmal SVT (PSVT) • Junctional Tachycardia • VT • VF • PVC Mark Henderson

  6. Classification - bradys Atrial Junctional Ventricular • Sinus brady • Sick sinus syndrome • Junctional Escape • Ventricular Escape Mark Henderson

  7. Atrial Fibrillation • Atrial dilation & decreased CO • RAAS activation • Protease stimulation • Progressive atrial fibrosis • Fragmented, asynchronous depolarizations Mark Henderson

  8. Atrial Fibrillation Mark Henderson

  9. AF - Classification • Valvular AF? • Lone AF? • Secondary AF? • Symptomatic AF? Mark Henderson

  10. AF - Causes Mark Henderson

  11. symptoms DDX • Tachyarrhythmias • Flutter • Panic attack/anxiety • Drugs • Caffeine/alcohol • Symp. Agents • Stimulants • Palpitations • Breathlessness • Lightheaded • Fatigue • Chest pain • Exercise intolerance Mark Henderson

  12. Diagnosis • Heart failure • Echo evidence of stroke risk • Alcohol • Regurg/stenosis • Thyroid Mark Henderson

  13. Atrial flutter Ectopic loop (reentrant pathway) of atrial electrical activity, usually precipitated by a PAC Mark Henderson

  14. Differences to AF • P waves clearly visible in characteristic ‘sawtooth’ pattern • Comment on degree of block 2:1, 3:1, 4:1 etc • More sensitive to electrical CV • Less sensitive to chemical CV. • RFA useful because of the reentrant nature.

  15. PAC • Premature Atrial Contractions • Common, not necessarily pathological • P wave is abnormal due to ectopic focus • P wave may be isolated or may have resulting QRS.

  16. FP SP FP SP FP SP Junctional tachys PSVT • Paroxysmal Supra-Ventricular Tachycardia • AVNRT and AVRT (nodal or accessory pathway) AVNRT

  17. AVRT • Atrioventricular Reentrant Tachycardia • (Wolf Parkinson White (WPW) Syndrome) • Narrow complex • P wave may be inverted and straight after T wave.

  18. VT • Monomorphic • Usually due to MI scarring causing an aberrant focal automaticity or a reentrant pathway like flutter • Polymorphic • Usually abnormality of repolarization - prolonged QT eg. • Needs electrical cardioversion if pulseless, or progresses to VF • If < 30 seconds = non-sustained VT

  19. VF • Causes: Trauma (physical or electrical), CAD, MI, cardiomyopathies, sudden cardiac death, congenital heart disease etc... • Most have no hx of heart disease • Though often have many risk factors - smoking, hyperlipidaemia, DM. • Episodes outwith hospital have 2-25% long term survival • many survivors are comatose/permanently brain damaged. Seemingly random pattern No identifiable P or QRS rhythm Wandering baseline

  20. Heart block • 1st degree AV block (prolonged PR) • 2nd degree AV block • Mobitz I (lengthening PR til dropped QRS) • Mobitz II (intermittently dropped P waves) • 3rd degree AV block (complete) • Infranodal block • Left BBB • Left Anterior Fascicular Block • Left Posterior Fascicular Block • Right BBB

  21. mobitz ii

  22. lBBB

  23. AF

  24. PSVT - AVRT

  25. Atrial flutter

  26. 1st degree AV Block

  27. RBBB

  28. Polymorphic vt - ecgTORSADES

  29. mobitz 1

  30. Premature Atrial Complexes

  31. 3rd degree

  32. Monomorphic vt

  33. PSVT - AVNRT

  34. VF

  35. ECG simulator http://www.skillstat.com/tools/ecg-simulator

More Related