Podcast
Questions and Answers
Which of the following best describes dysrhythmias?
Which of the following best describes dysrhythmias?
How are dysrhythmias diagnosed?
How are dysrhythmias diagnosed?
What is a possible cause of sinus bradycardia?
What is a possible cause of sinus bradycardia?
Which medication can cause sinus bradycardia?
Which medication can cause sinus bradycardia?
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What is the main site of origin of the electrical impulse in sinus bradycardia?
What is the main site of origin of the electrical impulse in sinus bradycardia?
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Which condition is associated with increased intracranial pressure?
Which condition is associated with increased intracranial pressure?
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What is the treatment of choice for sinus tachycardia if vagal maneuvers and adenosine are unsuccessful or not feasible?
What is the treatment of choice for sinus tachycardia if vagal maneuvers and adenosine are unsuccessful or not feasible?
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In cases of persistent inappropriate sinus tachycardia unresponsive to other treatments, what treatment may be used?
In cases of persistent inappropriate sinus tachycardia unresponsive to other treatments, what treatment may be used?
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What is the usual rate range for ventricular and atrial rate in adult sinus arrhythmia?
What is the usual rate range for ventricular and atrial rate in adult sinus arrhythmia?
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What is the ventricular and atrial rhythm in sinus arrhythmia?
What is the ventricular and atrial rhythm in sinus arrhythmia?
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What is the characteristic QRS shape and duration in sinus arrhythmia?
What is the characteristic QRS shape and duration in sinus arrhythmia?
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What is the PR interval range in sinus arrhythmia?
What is the PR interval range in sinus arrhythmia?
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What is the P:QRS ratio in sinus arrhythmia?
What is the P:QRS ratio in sinus arrhythmia?
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Under what circumstances is sinus arrhythmia typically treated?
Under what circumstances is sinus arrhythmia typically treated?
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What are some of the approaches involved in the treatment for POTS?
What are some of the approaches involved in the treatment for POTS?
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If synchronized cardioversion is unsuccessful, which treatment may be considered for sinus tachycardia?
If synchronized cardioversion is unsuccessful, which treatment may be considered for sinus tachycardia?
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What is the usual ventricular and atrial rate range for sinus bradycardia in adults?
What is the usual ventricular and atrial rate range for sinus bradycardia in adults?
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What is a possible cause of sinus bradycardia?
What is a possible cause of sinus bradycardia?
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What is the characteristic QRS shape and duration in sinus bradycardia?
What is the characteristic QRS shape and duration in sinus bradycardia?
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What is the characteristic PR interval range in sinus bradycardia?
What is the characteristic PR interval range in sinus bradycardia?
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What is the usual ventricular and atrial rate range for sinus tachycardia in adults?
What is the usual ventricular and atrial rate range for sinus tachycardia in adults?
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What is a possible cause of sinus tachycardia?
What is a possible cause of sinus tachycardia?
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What is the characteristic QRS shape and duration in sinus tachycardia?
What is the characteristic QRS shape and duration in sinus tachycardia?
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What is the characteristic PR interval range in sinus tachycardia?
What is the characteristic PR interval range in sinus tachycardia?
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Study Notes
- Bradycardia, specifically sinus bradycardia, can be caused by hypoxemia, acute altered mental status, and acute decompensated heart failure.
- Sinus bradycardia has a slow ventricular and atrial rate (less than 60 bpm), regular QRS shape and duration, a normal P wave shape in front of the QRS, and a consistent PR interval between 0.12 and 0.20 seconds. All characteristics are the same as normal sinus rhythm, except for the rate.
- If bradycardia is caused by vagal nerve stimulation or medication, attempts are made to prevent further stimulation or withhold the medication. Treatment is directed toward increasing heart rate if it causes significant hemodynamic changes, such as shortness of breath, altered mental status, angina, hypotension, ST-segment changes, or PVCs.
- Risk factors for sinus node dysfunction include increased body mass index, presence of right and left bundle branch block, history of major cardiovascular events, increased age, and hypertension.
- Tachy-brady syndrome is a condition where bradycardia alternates with tachycardia.
- Medical management for bradycardia depends on the cause and symptoms. Resolving causative factors may be the only treatment needed. If bradycardia causes clinical instability or is unresponsive to atropine, emergency transcutaneous pacing or medications like dopamine, isoproterenol, or epinephrine may be used.
- Sinus tachycardia occurs when the sinus node creates an impulse at a faster-than-normal rate. Causes include physiologic or psychological stress, medications, enhanced automaticity of the SA node, and autonomic dysfunction.
- Sinus tachycardia has a greater than 100 bpm ventricular and atrial rate (usually less than 120 bpm), regular QRS shape and duration, a normal P wave shape in front of the QRS, and a consistent PR interval between 0.12 and 0.20 seconds. Sinus tachycardia is nonparoxysmal and can result in reduced cardiac output, syncope, and acute pulmonary edema if the rapid rate persists and the heart cannot compensate for decreased ventricular filling.
- Medical management for sinus tachycardia is determined by the severity of symptoms and aimed at identifying and abolishing its cause. Vagal maneuvers, such as carotid sinus massage, gagging, bearing down against a closed glottis, forceful and sustained coughing, and applying a cold stimulus to the face, or administration of adenosine can be considered to interrupt the tachycardia. If the tachycardia is persistent and causing hemodynamic instability, synchronized cardioversion may be used.
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Description
Test your knowledge of dysrhythmias, which are disorders of the formation, conduction, or both the formation and conduction of the electrical impulse within the heart. This quiz covers the causes, effects, and characteristics of dysrhythmias.