Let's Go Back to the Basics
Cardiac Etiologies
Moktar
Do you know your Arrythmias?
Sexy Ventricles
100
The typical rhythm rate from this structure runs a modest 40-60 BPM
AV node
100
These 6 risk factors are the primary causes of arrythmias
Hypoxia, Ischemia & Irritability, Sympathetic Stimulation, Drugs, Electrolyte Disturbances, and Enlargement & Hypertrophy
*Team must get all six correct, if not - the opposing team has the ability to steal by obtaining the rest of the unsaid etiologies. Opposing team recv's 2x points!
100
Dysfunction of the SA node that fails to meet the needs of the heart can create this syndrome that is often the cause of cardiac pathologies like profound bradycardia, sinus pauses, arrests, AVNRT, etc.
Sick Sinus Syndrome
Bonus ?: How does Sick Sinus Syndrome lead to faulty escape beats?
100
These 4 criteria are needed to classify SVT
1. No P-wave (mostly)
2. Narrow Complex
3. Regular Rhythm
4. Rapid Rate
*Bonus ?: How do we differentiate between SVT and Afib?
100
*Send photo in gc*
What is this rhythm?
Ventricular tachycardia
Bonus ?: What is the rate? How does the initiation usually form?
200
Lead II, III, & AVF view this region of the heart
Inferior Region of the Heart
200
The most common pathologies associated with sinus tachycardia
Hyperthyroidism & PE
200
The absence of an atrial focal response will cause automaticity in this region assuming all other aspects of the heart are healthy.
Junctional Escape Beat
*Bonus ?: What is the BPM? What about ventricular escape beats - BPM?
200
This is the most common kind of SVT
AVNRT
*LOL YOU THOUGHT YOU HAD IT EASY HUH*
**** D E A T H ROUND ******
Bonus ? (if the original team does not answer this question, they lose all points thus far and will be given to the opposing team. If both teams provide incorrect answers, all points will return to zero): (1) What is the full name of AVNRT? (2) What is the alternative full name to AVNRT? (3) Describe to me the physiological mechanism of AVNRT.
200
Send photo in gc
What is this rhythm?
Ventricular Fibrillation
Bonus ?: (1) How do we stop it? (2) What arrhythmia degenerates into it? (3) List me common causes of Vfib
300
Positive inward leaking of ions allows for this cell's automaticity within the SA node
Pacemaker Cell
300
Vasovagal syncope is a pathological etiology for this arrhythmia
Sinus Bradycardia
*Bonus ?: What is an example of a medication That causes sinus bradycardia from the lecture?
300
What kind of rhythm
Junctional Escape Beat
300
This is the most common kind of AVRT characterized by a narrow QRS
Orthodromic AVRT
Bonus ?: Describe to me the physiological mechanism of this cardiac pathology
Bonus ?: This will most likely look like this heart pathology
300
This is the most common ventricular arrythmia
Premature Ventricular Contraction (PVC)
*LMAO PSYCH MWHAHAHA YOU KNOW WHAT TIME IT ISSSSSSSS??????*********
*********D E A T H ROUNDDDDD ************
Bonus ?: (You must get all 3 to survive, if not, you lose all points with possible donation to the other team):
(1) How long (in seconds) are the QRS complexes in PVC?
(2) T or F: Isolated PVCs are abnormal
(3) T or F: PVC's will have an irregular rhythm
(4) Explain to me the pathopys behind why a PVC occurs
400
This heart pathology exhibits a wide P wave that is often notched in Lead II and wide biphasic wave in V1
Left Atrial Enlargement
400
You have a 65 yr old Male patient who enters your clinic for his yearly physical. His BP is 160/100, BPM of 100, and pulse of of 89%. Despite statin intervention, you are worried about his cardiac health. After conducting a CMP + TSH/T4, you find him to have low TSH and abnormally high T4. What cardiac condition would you most be concerned for in this patient?
Atrial Fibrillation
*Bonus ?: If I told you the patient had a PMHx of rheumatic fever with continuing bouts of chest pain and dyspnea years after his sickness, what cardiac condition could also contribute to his Afib?
400
What rhythm is this?
Ventricular Escape Beat
400
A type of AVRT that is narrow and resembles Afib and is rare in occurrence
Antidromic AVRT
*Bonus ?: Describe to me the pathophys of this disease
400
You have a 24 yr old male patient with a hx of MDD. He is coming into your clinic to refill his 40mg PO Citalopram and 150 mg. Haloperidol. He complains of chest pain, rapid heart palpitations, and general feeling of lightheadedness. What cardiac condition would you most likely be concerned for?
The following EKG was performed on the patient:
Torsades de Points
Bonus Question: How do we distinguish between Torsades and Afib?
500
T-wave inversion typically coincides with this heart pathology
ST depression - T-wave depression is usually okay, but could help to dx ischemia in severe cases
500
You have a 55 yr old Female patient who comes into your clinic for persistent dyspnea and unresolved tachycardia that has been persistent for the last month. She has tried to massage her carotid artery because she saw on "Homeopathicremedies.com" that it could stop her excessive heart palpitations but has not helped the issue. She has a PMHx of asthma and chronic tobacco use that she says "it don't count if I'm drunk *winks* " On physical exam, she demonstrates cough and foul smelling sputum. She also appears to be blue and bloated, yet also slightly pink. Vitals show BP 145/96, HR of 160, and pulse ox of 85%. What cardiac arrhythmia would you MOST be concerned about given this patient's physical examination and symptoms?
Multifocal Atrial Tachycardia
The patient has COPD - if you remember from patho, COPD is essentially chronic bronchitis (blue bloaters) and emphysema (pink puffers) combined into one single disease. In the PP, Dr. Kelley refers to MAT as being "Common in patients with severe lung disease." More specifically though, COPD is often seen with MAT.
*Bonus ?: T or F: MAT has an irregular rhythm and rapid rate.
500
This cardiac phenomenon occurs due to the SA node firing towards both ventricles and atria.
Retrograde P-waves
*Bonus ?: Where do these primarily depolarize from?
500
Send photo into group chat**
What arrhythmia is this?
Wandering Atrial Pacemaker
500
What is the pathophysiology behind accelerated idioventricular rhythm?
Ventricular escape focus that is temporarily driving the heart.