cardiac- dys part 2.pptx - Cardiac Part 2 Dysrhythmias Shock Normal EKG Problems seen with EKG Rate Problems Rhythm Problems Conduction Problems \u25e6

cardiac- dys part 2.pptx - Cardiac Part 2 Dysrhythmias...

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Cardiac Part 2Dysrhythmias Shock
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Normal EKG
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Rate ProblemsRhythm ProblemsConduction ProblemsHeart BlocksOrigin of Electrical ActivityProblems seen with EKG
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TachycardiaBradycardiaAsystoleRate Problems
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Atrial Fibrillation:Characterized by a total disorganization of atrial electrical activity resulting in loss of effective atrial contraction.May be paroxysmal (begins and ends spotaneously), or persistent (lasting more than 7 days)Most common,clinically significant with respect to morbidity and mortality rate, as well as economic impact.Atrial Flutter:Atrial tachydysrhythmia, characterized by recurring, regular, sawtooth-shapeflutter waves, originates most common in the right atriumAtrial Dysrhythmias
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Atrial fibrillationLoss of effective atrial contractionMay come and go or be constantMost common dysrhythmiaManifestationsHypotension (30% loss of CO)TachycardiaIrregular HRPalpitations ECG pg 827Atrial rate 350-600 beats/minChaotic fibrillatory F wavesbetween the QRS complesControlled < 100Uncontrolled > 100May alternate with A-flutterCommonly occurs with CADCardiomyopathyHypertensive heart diseaseHFPericarditis –ST elevation in every leadCardiac surgery (acute)
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Decrease in Cardiac Output up to 30% - loss of ‘atrial kick’Blood clot formation due to blood stasis, an embolized clot that may travel to the brain which results in a stroke.Stroke – accounts for 20% of all strokesClinical Significance with A-Fib
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Decrease HR to < 100Prevention of clot formationVentricular rate control is priority Conversion back to sinus rhythmCardioversion Amiodarone – most commonfor conversion and maintenanceAblation Beta blockersCalcium channel blockersTreatment goal of A-Fib
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Atrial Flutter
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Saw-tooth shaped flutter wavesRarely occurs in a healthy heartIs associated with CAD, hypertension, mitral valve disorders, cardiomyopathy, and the use of drugs such as digoxin, quinidine and epinephrineECG characteristicsAtrial rate is 200-350 beats/minAtrial and ventricular rhythm is regularQRS complex is normalAtrial Flutter
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High ventricular rates and loss of the atrial ‘kick’ decrease CO and cause serious consequences such as HF, increased risk of stroke (thrombus formation)Coumadin is given to prevent the possibility of stroke.Clinical Significance of Atrial Flutter
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Primary – to slow the ventricular response by increasing AV blockMedications: calcium channel blockers, beta-blockers, antidysrhythmias to convert to sinus rhythmCardioversion to covert flutter to sinus rhythm in an emergencyRadiofrequency catheter ablation is the treatment of choice for atrial flutterTreatment Goal of Atrial Flutter
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Premature Ventricular Contraction (PVCs)- premature occurrence of a QRS complexV-tach – occurs when there are three or more consecutive PVC’sV-fib – severe derangement of the heart rhythm characterized by irregular waveforms of various shapes and amplitude.
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