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Questions and Answers
What is the most significant implication of diagnosing cardiac arrhythmias in children?
What is the most significant implication of diagnosing cardiac arrhythmias in children?
- It can be lifesaving in cases of serious rhythm disturbances. (correct)
- It can lead to unnecessary procedures.
- It reduces the need for regular health check-ups.
- It can prevent the progression of minor health issues.
In which part of the heart do most significant childhood arrhythmias originate?
In which part of the heart do most significant childhood arrhythmias originate?
- Atrioventricular (AV) node
- Ventricles
- Sinoatrial (SA) node (correct)
- Pericardium
What condition is characterized by SA nodal dysfunction in children?
What condition is characterized by SA nodal dysfunction in children?
- Premature ventricular contractions
- Ventricular tachycardia
- Sick sinus syndrome (correct)
- Atrial fibrillation
Who is most likely to be affected by sick sinus syndrome?
Who is most likely to be affected by sick sinus syndrome?
Which of the following statements is true regarding childhood arrhythmias?
Which of the following statements is true regarding childhood arrhythmias?
What distinguishes sick sinus syndrome from other arrhythmias?
What distinguishes sick sinus syndrome from other arrhythmias?
What general characteristic of arrhythmias in children can be inferred?
What general characteristic of arrhythmias in children can be inferred?
What is a common feature of significant arrhythmias in children?
What is a common feature of significant arrhythmias in children?
What is a common clinical manifestation of SSS?
What is a common clinical manifestation of SSS?
Which arrhythmia is characterized by a rhythm disturbance originating from the SA node?
Which arrhythmia is characterized by a rhythm disturbance originating from the SA node?
When should patients suspected of having SSS be referred?
When should patients suspected of having SSS be referred?
What indicates normal heart rhythm controlled by the sinoatrial node?
What indicates normal heart rhythm controlled by the sinoatrial node?
Which ECG finding is typically associated with atrial fibrillation?
Which ECG finding is typically associated with atrial fibrillation?
Which term describes a disturbance in heart rhythm that does not originate from the sinoatrial node?
Which term describes a disturbance in heart rhythm that does not originate from the sinoatrial node?
Which factor can characterize the rhythm of sinus arrhythmia?
Which factor can characterize the rhythm of sinus arrhythmia?
What does the term 'Sinoatrial Node' refer to?
What does the term 'Sinoatrial Node' refer to?
What does an ECG showing absent or very low-voltage P waves and an irregular R-R interval indicate?
What does an ECG showing absent or very low-voltage P waves and an irregular R-R interval indicate?
What condition is characterized by an irregularly irregular pulse and may cause palpitations, chest pain, or syncope?
What condition is characterized by an irregularly irregular pulse and may cause palpitations, chest pain, or syncope?
What should be done if atrial fibrillation is suspected but the ECG is normal?
What should be done if atrial fibrillation is suspected but the ECG is normal?
Which of the following arrhythmias does NOT require additional evaluation if the initial findings are diagnostic?
Which of the following arrhythmias does NOT require additional evaluation if the initial findings are diagnostic?
What does a premature atrial complex (PAC) do to the sinoatrial node?
What does a premature atrial complex (PAC) do to the sinoatrial node?
Which of the following is primarily concerned with understanding the etiology and diagnosis of cardiac arrhythmias?
Which of the following is primarily concerned with understanding the etiology and diagnosis of cardiac arrhythmias?
What type of heart condition involves causing an irregular rhythm that can be detected through careful examination of a patient’s pulse?
What type of heart condition involves causing an irregular rhythm that can be detected through careful examination of a patient’s pulse?
What is the role of recognizing inciting events in relation to premature atrial complexes (PACs)?
What is the role of recognizing inciting events in relation to premature atrial complexes (PACs)?
What heart rate is defined as tachycardia in the context of SVT?
What heart rate is defined as tachycardia in the context of SVT?
What is a common symptom reported by patients with SVT?
What is a common symptom reported by patients with SVT?
Why is it important to identify SVT in children?
Why is it important to identify SVT in children?
Which monitoring device is useful for diagnosing SVT in pediatric patients?
Which monitoring device is useful for diagnosing SVT in pediatric patients?
What ECG characteristic is commonly associated with SVT?
What ECG characteristic is commonly associated with SVT?
What is a common finding on the ECG of a patient suspected to have PVCs?
What is a common finding on the ECG of a patient suspected to have PVCs?
How is ventricular tachycardia defined in children?
How is ventricular tachycardia defined in children?
In cases of AP-mediated reentry tachycardia, what might be difficult to see on an ECG?
In cases of AP-mediated reentry tachycardia, what might be difficult to see on an ECG?
What is a common clinical presentation of atrial flutter in infants?
What is a common clinical presentation of atrial flutter in infants?
What characteristic finding is commonly seen on an ECG for atrial flutter?
What characteristic finding is commonly seen on an ECG for atrial flutter?
What is the typical heart rate associated with atrial flutter in older children?
What is the typical heart rate associated with atrial flutter in older children?
What complication can arise from prolonged atrial fibrillation or flutter?
What complication can arise from prolonged atrial fibrillation or flutter?
What defines Supraventricular Tachycardia (SVT)?
What defines Supraventricular Tachycardia (SVT)?
What effect does a blocked PAC have on the QRS complex?
What effect does a blocked PAC have on the QRS complex?
Which of the following is NOT a common symptom of atrial flutter in older children?
Which of the following is NOT a common symptom of atrial flutter in older children?
What is the primary reason to refer a new diagnosis of atrial flutter in children to a pediatric cardiologist?
What is the primary reason to refer a new diagnosis of atrial flutter in children to a pediatric cardiologist?
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Study Notes
Sick Sinus Syndrome
- Sick sinus syndrome (SSS) is a rhythm disturbance originating from the SA node.
- SSS is most common in patients with prior cardiac surgery or cardiomyopathy
- SSS can manifest as brady- and tachyarrhythmias
- ECG may show SA block, atrial fibrillation (AF), or supraventricular tachycardia (SVT)
- Refer patients suspected of having SSS to a cardiologist
The Atria
- Atrial arrhythmias involve changes on the ECG in the P wave or P-R interval
- Premature Atrial Complexes (PACs) are a common atrial arrhythmia
- PACs can reset the SA node, causing a prolonged pause before the next beat
- PACs are usually benign, but can cause palpitations, chest pain or syncope
- If diagnosis is confirmed by ECG, additional evaluation is usually not needed
- Atrial flutter is caused by a reentrant circuit confined to the right atrium
- Atrial flutter may manifest in infants with congestive heart failure and older children with chest pain, dizziness or shortness of breath
- Atrial flutter has a characteristic heart rate greater than 300 beats/min with a 1:1 ventricular conduction
- Atrial fibrillation (AF) can cause an irregularly irregular rhythm
- AF presents with absent or low-voltage P waves on ECG
- Refer any patient with new AF diagnosis to a pediatric cardiologist
- Prolonged AF can cause clots in the left atrium, increasing the risk of stroke, myocardial damage or other end-organ infarctions
The Atrioventricular Node and Supraventricular Tachycardias
- Supraventricular Tachycardia (SVT) is a rapid tachycardia originating above the bundle of His
- SVT usually presents with a narrow complex tachycardia at a heart rate greater than 220 beats/min
- P waves are often difficult to see, but may be observed as sharp deflections within the T waves
- Refer patients with suspected SVT to a cardiologist for additional evaluation
- Ambulatory ECG monitoring devices (Holter monitors) are recommended for patients with sporadic SVT episodes
Ventricular Tachycardia
- Ventricular tachycardia (VT) is a tachycardia of at least three successive ventricular beats.
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