Anatomy
The four chambers of the heart.
Right Atrium
Left Atrium
Right Ventricle
Left Ventricle
When the ventricular rate reaches 150 to 180 beats/min, the P waves (if present) with ____ tend to be completely obscured by the T wave of the preceding beat.
SVT
EPI dosage in cardiac arrest
1 mg , 10 cc, 1:10000
Occurs when each impulse is delayed slightly longer than normal, resulting in a constant PRI that exceeds 0.20 second (200 ms)
First-degree AV block
Suspect STEMI if: For leads V2 and V3, the ST-segment elevation is ____ mm or more in men older than 40 years or ____ mm or more in women,
2 ; 1.5
i. The largest in diameter and shortest of the myocardial blood vessels
ii. Divides into the left anterior descending artery (LAD) and the circumflex artery (Cx)
The left main coronary artery (LMCA)
The atria no longer contract but instead fibrillate or quiver, with no organized contraction.
Atrial fibrillation (AF)
Four possible cardiac arrest rhythms
a. Pulseless VT
b. Pulseless VF
c. Asystole
d. PEA
This is also called Mobitz type I or Wenckebach.
Second-degree AV block type I
Elevation in leads II, III, AVF would in indicate what kind of STEMI?
Inferior
Cardiac cells have four important properties that help the heart function efficiently.
what are the 4 properties?
a. Automaticity
b. Excitability
c. Conductivity
d. Contractility
i. Rate of 40 to 60 beats/min; usually regular rhythm with little variation between R-R intervals
ii. The P wave inverted or absent before the QRS
junctional rhythm
After __ minutes or ____ cycles of CPR, pause resuscitation efforts and check the rhythm on the monitor.
2 ; 5
Also called complete heart block or complete AV block
Third-degree AV block
(a) Tall, peaked, asymmetric T waves develop.
(b) P waves can become flattened and disappear.
(c) In severe cases, QRS complex widens.
These are a sign of ?
Hyperkalemia
The cardiac conduction system comprises six parts:
what are the 6 parts?
The SA node, The AV node, The bundle of His, The right bundle branches, The left bundle branches, The Purkinje fibers
Characterized by:
(a) A short PRI (less than 0.12 second [120 milliseconds])
(b) Nonspecific ST-T wave changes
(c) A widened QRS complex
(d) The appearance of a delta wave on ECG
Wolff-Parkinson-White syndrome (WPW).
Two shockable rhythms in cardiac arrest
VFIB, VTACH
An intermittent block characterized by regularly occurring P waves and the abrupt appearance of at least one P wave that is not followed by a QRS complex
Second-degree AV block type II
An S1Q3T3 pattern
(1) Deep S wave in lead I
(2) Deep, narrow Q wave in lead III
(3) T-wave inversion in lead III
This is a sign of what ?
Pulmonary Embolism
The _____ supplies blood to the anterior surface of the left ventricle, part of the lateral surface of the left ventricle, and a portion of the interventricular septum in most patients.
LAD (left anterior descending artery)
i. A variety of rhythms involving a poorly functioning SA node common in older adults
ii. Patients may exhibit syncope, dizziness, and palpitations or may have no symptoms.
Sick sinus syndrome
1st Dosage and 2nd dosage of Amiodarone in Cardiac arrest ?
300 MG IV PUSH , 150 MG IV PUSH
Causes include:
(a) Ischemic heart disease
(b) Acute inferior wall or right ventricular MI
(c) Increased vagal tone
(d) Digoxin toxicity
(e) Certain electrolyte imbalances
(f) Administration of certain medicines
Second-degree AV block type I
Genetic disorder involving sodium channels in the heart
ii. Characterized by:
(a) Incomplete RBBB
(b) ST-segment elevation that aggressively returns to baseline
(c) Changes in leads V1 to V2 (and possibly in V3)
Symptoms may include syncope, seizures, difficulty breathing
Brugada Syndrome