26 Questions
What is the primary system affected by Ventricular Fibrillation (V-fib)?
Cardiovascular
Which of the following is a risk factor for Ventricular Fibrillation (V-fib)?
CAD
What is the primary symptom of Ventricular Fibrillation (V-fib)?
Syncope/Collapse
What is the primary investigation for Ventricular Fibrillation (V-fib)?
ECG
What is the primary treatment for Ventricular Fibrillation (V-fib)?
CPR + Defibrillator
What is the primary complication of untreated Ventricular Fibrillation (V-fib)?
Sudden Cardiac Death
What is the primary system affected by Dilated Cardiomyopathy?
Cardiovascular
Which of the following is a risk factor for Dilated Cardiomyopathy?
Alcoholism
What is the most common cardiac arrhythmia?
Atrial Fibrillation
What is the primary treatment for asymptomatic Atrial Fibrillation?
No treatment
What is the diagnostic test for Atrial Fibrillation?
ECG
What is the classification of Heart Block that involves a delay in conduction between the SA node and ventricles?
First Degree
What is the treatment for Third Degree Heart Block?
Pacemaker
What is the complication of left untreated Atrial Fibrillation?
V-tachycardia
What is the risk factor for Atrial Fibrillation?
All of the above
What is the symptom of Second Degree Heart Block (Mobitz 2)?
Syncope
What is the diagnostic test for Heart Block?
ECG
What is the complication of left untreated Heart Block?
All of the above
What is the primary system associated with Sinus Bradycardia?
Cardiovascular
What is the typical heart rate in Sinus Bradycardia?
<60 BPM
Which of the following is a risk factor for Supraventricular Tachyarrhythmia (SVT)?
Alcohol
What is the primary goal of vagal stimulation in the treatment of SVT?
Block AV conduction
What is the typical ECG finding in SVT?
Narrow QRS complex
What is the potential complication of untreated SVT?
Heart failure
What is the primary treatment for symptomatic Sinus Bradycardia?
B-blocker
What is the primary indication for Holter monitor in Sinus Bradycardia?
Assess for 72 hours
Study Notes
Cardiovascular Conditions
Ventricular Fibrillation (V-fib)
- Loss of regular heartbeat, causing ventricular quivering and inefficient pumping
- Risk factors: CAD, stress, M>F, ischemic heart disease, cardiomyopathy, myocarditis, acidosis
- Symptoms: palpitations, fatigue, weakness, syncope/collapse, hypotension, chest discomfort
- Investigation: ECG shows erratic readings, no identifiable waves
- Treatment: CPR + Defibrillator
- Red flag: MEDICAL EMERGENCY – call EMS
Dilated Cardiomyopathy
- Non-inflammatory enlargement of the heart muscles, four-chamber hypertrophy, unexplained dilation, and impaired systolic function
- Risk factors: alcoholism, thiamine deficiency, genetics, myocarditis, drugs, peripartum (within 6 months postpartum)
- Symptoms: SOB, weakness, palpitations
- Progressions/Sequela: life-threatening, tissue and function loss, amputation, septic shock & toxemia, wet gangrene = poor prognosis
- Treatment: antibiotics, surgery, proper wound care
- Red flag: EMERGENT – surgical consult
Atrial Fibrillation
- Loss of regular atrial contractile rhythm out of sync with ventricular contraction
- Risk factors: HTN, AV valve disorder, hyperthyroidism, cardiomyopathy, M>F, white, elderly, previous heart pathology, FHx
- Symptoms: asymptomatic, possible palpitations, SOB, dizziness
- Investigation: ECG shows QRS width >120ms, abnormal shape, diagnostic; Holter monitor for monitoring heart rhythm, noting arrhythmias
- Progressions/Sequela: V-tachycardia if left untreated
- Treatment: no treatment if asymptomatic, b-blockers, CCB if symptomatic, electrolyte replacement/ magnesium, potassium, lifestyle modifications
Heart Block
- Problem affecting the electrical impulses of the heart
- Risk factors: elderly
- Classification:
- First degree: delay in conduction between SA node and ventricles
- Second degree (Mobitz 1 = Wenckebach’s): PR interval gets progressively more extended
- Second degree (Mobitz 2): QRS not following each P wave, PR internal stays constant
- Third degree: no electrical signals reach the ventricles
- Symptoms: 1st = asymptomatic, 2nd = asymptomatic or syncope, 3rd degree = syncope, dizziness, acute HA, hypotension, fainting
- Investigation: ECG/EKG shows classification results
- Progressions/Sequela: anterior wall MI, arrhythmias, asystole if left untreated
- Treatment: pacemaker, removal of any medications responsible
Sinus Bradycardia
- Heartbeat <100BPM
- Investigation: ECG/EKG shows regular rhythm; Holter monitor for 72hrs
- Progressions/Sequela: ischemic heart disease, valvular disease if left untreated
- Treatment: no treatment if physiological, b-blocker/CCB if symptomatic
Supraventricular Tachyarrhythmia (SVT)
- Sudden burst of elevated heart rate that originates from the AV node or within atria
- Risk factors: alcohol, tobacco, caffeine, anxiety, SA/AV ischemia, meds (digoxin), COPD, pneumonia, Wolff-Parkinson White Syndrome
- Symptoms: palpitations, presyncope/syncope, dizziness, SOB, chest discomfort
- Investigation: pulse shows pounding, >100bpm; ECG shows narrow QRS complex
- Progressions/Sequela: heart disease, cardiomyopathy, CHF, hypotension if left untreated
- Treatment: vagal stimulation, adenosine IV push (6mg-12mg)
This quiz covers the risk factors, symptoms, investigation, and treatment of ventricular fibrillation, a medical emergency that requires immediate attention.
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