The p waves of the complex are hidden in the t wave

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the p waves of the complex are hidden in the T wave of the precedingbeats-We manage it with the use of medication-Can do vagal maneuvers, carotid massage, drug of choice is adenosine we want to makesure the patient doesn’t have asthma, given push and then saline right afterAtrial flutterHow do I recognize?-Atrial flutter is an ectopic atrial rhythm in which an irritable site fires regularly at anextremely rapid rate-The extremely rapid atrial rate results in waveforms that resemble the teeth of a saw or apicket fence-Flutter wavesAtrial flutter with 2:1 conduction and atrial flutter with 4:1 conductionDownloaded by teddy bear ([email protected])lOMoARcPSD|9070136
-P waves: no identifiable P waves, saw toothed, flutter waves are present-PR intervalnot measurable-QRS <0.10 sec but may be widened if flutter waves are buried in QRS complex or anintraventricular conduction delay existsWhat causes it:-Atrial flutter is usually a paroxysmal rhythm precipitated by a PAC- may last for secondsto hours and occasionally lasts 24 hrs-Chronic atrial flutter is unusual rhythm usually converts to sinus rhythm or atrialfibrillation on its own or with treatmentCondition associated with atrial flutter-Hypoxia, pulmonary edema, chronic lung disease, mitral or tricuspid valve stenosis orregurgitation, pneumonia, complication of myocardial infarction, ischemic heart disease,cardiomyopathy, hyperthyroidism, digitals or quinidine toxicity, cardiac surgery,pericarditisAtrial flutterwhat do to about it?-Severity of signs and symptoms very depending on: ventricular rate, duration of rhythm,patients cardiovascular status-Vagal maneuvers may help differentiate atrial flutter from other dysrhythmias-If rapid ventricular rate, control ventricular response-If rapid ventricular rate and serious signs and symptoms, synchronized cardioversionAtrial fibrillation-AF occurs because of altered automaticity or re-entry-Irritable sites in the atria fire at a rate of 400-600 times/min- cause muscle of atria toquiver (fibrillate)-Results in: ineffectual atrial contraction, decreased stroke volume, subsequent decrease incardio output, loss of atrial kickPRnot measurableQRS - <0.10 sec but may be widened if an intraventricular conduction delay existsWhat causes it?-Can occur in patients with or without detectable heart disease or related symptomsDownloaded by teddy bear ([email protected])lOMoARcPSD|9070136
-Lone atrial fibrillationAF that occurs in young person without clinical orechocardiographic evidence of cardiopulmonary disease-Increased stroke risk-Atria do not contract effectively-Blood pools within atria forming clots-Clots dislodge and moves to artery in the brainConditions associated with atrial fibrillation-Idiopathic, hypertension, ischemic heart disease, advanced age, rheumatic heart disease,cardiomyopathy, congestive heart failure, congenital heart disease, sick sinus syndrome,WPW syndrome,pericarditis’s, pulmonary embolism-Chronic lung disease, after surgery, diabetes, stress, sympathomimetic, excessive

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Term
Fall
Professor
Sue Coffey (P)
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