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Dysrhythmia

QuestionAnswer
Normal Sinus Rhythm Regular rhythm, rate 60-100, normal P wave before each QRS, PR 0.12-0.20s, QRS <0.12s.
Sinus Bradycardia Rate <60 bpm. Regular. Can be normal in athletes. Sx: dizziness, fatigue, syncope if symptomatic.
Sinus Tachycardia Rate >100 bpm. Regular. Response to stress, fever, pain, hypoxia. Treat underlying cause.
Atrial Fibrillation Irregularly irregular rhythm, no discernible P waves, variable ventricular rate. Risk of stroke.
A-fib Treatment Rate control (beta-blockers, CCBs), rhythm control (amiodarone), anticoagulation (warfarin/DOACs).
Atrial Flutter Regular atrial rate (~300bpm), "sawtooth" flutter waves, variable ventricular response. Can lead to A-fib.
Supraventricular Tachycardia Rate 150-250, regular, narrow QRS. Paroxysmal. Treat: vagal maneuvers, adenosine.
Ventricular Tachycardia Wide QRS, rate 100-250, no P waves. Can be pulseless (code) or with pulse (cardiovert/amiodarone).
Ventricular Fibrillation Chaotic, quivering ventricles. No CO, no pulse. Immediate defibrillation & CPR required.
Asystole Flatline. No electrical activity, no pulse. Treat with CPR, epinephrine, vasopressin. Do NOT defibrillate.
Heart Block: 1st Degree PR interval >0.20s. All impulses conducted, usually benign. No treatment needed.
Heart Block: 2nd Degree Type I Wenckebach. PR lengthens until a QRS is dropped. Usually benign, monitor.
Heart Block: 2nd Degree Type II Mobitz II. Constant PR, intermittent non-conducted P waves. Dangerous, may need pacemaker.
Heart Block: 3rd Degree Complete heart block. Atria & ventricles beat independently. Life-threatening, requires pacemaker.
Pacemaker Device that provides electrical impulses to heart muscle when natural pacemaker fails.
Defibrillation Delivery of electrical shock to depolarize myocardium & allow SA node to regain control (VF/pulseless VT).
Cardioversion Synchronized shock to convert unstable tachy dysrhythmias (A-fib, A-flutter, VT with pulse) to NSR.
Adenosine Drug for SVT. Rapid IV push, followed by flush. Causes brief asystole. Have crash cart ready.
P Wave Atrial depolarization. Should be upright in leads II, III, aVF.
QRS Complex Ventricular depolarization. Duration <0.12s. Wide indicates bundle branch block or VT.
T Wave Ventricular repolarization. Inverted can indicate ischemia. Peaked in hyperkalemia.
Created by: Wasurenboh
 

 



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