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Cardiac Conduction Disorders

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Cardiology | Physician Assistant (PA) School Study Aid

Cardiac Conduction Disorders
13 Picmonics to Learn | 30 mins
Parts of an ECG
PQRST
P Wave
Atrial Depolarization
QRS Complex
Ventricular Depolarization
T Wave
Ventricular Repolarization
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2 mins
ECG Interpretation
Rate
Rhythm
P Waves
Upright, Rounded, Before Every QRS
PR Interval (< 0.20 seconds)
Normal QRS (< 0.12 seconds)
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2 mins
ECG: Sinus Bradycardia
Rate
< 60 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Atropine
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1 min
ECG: Sinus Tachycardia
Rate
> 100 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Treat Underlying Cause
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2 mins
ECG: Atrial Flutter
Rate
Variable
Rhythm
Regular or Irregular
P Wave
Saw Tooth, Multiple Before Every QRS
PR Interval
Non-measurable
QRS Interval
< 0.12 seconds
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2 mins
ECG: Atrial Fibrillation
Rate
Variable Rate
Rhythm
Irregular Rhythm
P Wave
No P Wave
PR Interval
No PR Interval
QRS Interval
QRS < 0.12 Seconds
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1 min
CHA2DS2-VASc for Stroke Risk in Atrial Fibrillation
CHF (+1)
Hypertension (+1)
Age 75 + (+2)
Diabetes (+1)
Stroke or TIA or Thromboembolism History (+2)
Vascular Disease (+1)
Age 65-75 Years (+1)
Sex Female (+1)
Interpretation
0 = No Anticoagulation
1 = Consider Anticoagulation
2 = Anticoagulation
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3 mins
Torsades de Pointes
Characteristics
Polymorphic Ventricular Tachycardia
Prolonged QT Interval
QRS Twist Around Isoelectric Line
Causes
Congenital
Antibiotics
Antiarrhythmics
Antipsychotics
Antidepressants
Electrolyte Deficiencies
Complications
Ventricular Fibrillation
Treatment
Stable: Magnesium Sulfate
Unstable: Defibrillation
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3 mins
Wolff-Parkinson-White Syndrome
WPW Pattern vs. WPW Syndrome
Pathophysiology
Ventricular Pre-excitation Syndrome
Accessory Conduction Pathway
Signs & Symptoms
Supraventricular Tachycardia
Atrial Fibrillation
Diagnosis
Shortened PR Interval
Delta Wave
Widened QRS
Treatment
No Treatment if Asymptomatic
Treat Arrhythmia
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3 mins
Brugada Syndrome
Defective Myocardial Sodium Channels
Predominance in Asian Males
Autosomal Dominant
Pseudo-Right Bundle Branch Block Pattern
Persistent ST Elevations in Leads V1-V2
Risk of VTACH and Sudden Cardiac Death
Syncope
Management
ICD
Antiarrhythmics
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3 mins
Atrioventricular Block Types
First Degree
First Degree
PR Interval > 200ms
No Treatment Needed
Second Degree
Second Degree
Mobitz I (Wenckebach)
Progressive PR Interval Lengthening with Nonconducted QRS Complex
Mobitz II
Constant PR Interval with Nonconducted QRS Complex
Third Degree
Third Degree
Atrioventricular Dissociation
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3 mins
Congenital Long QT Syndrome
PATHOGENESIS
Inherited Disorder of Myocardial Repolarization
Potassium (K+) Channel Mutations
SYMPTOMS
Prolonged QT Interval
Torsades de Pointes
Increased Risk of Sudden Cardiac Death (SCD)
TYPES OF SYNDROMES
Romano-Ward Syndrome
Autosomal Dominant
Pure Cardiac Phenotype (No Deafness)
Jervell and Lange-Nielsen Syndrome
Autosomal Recessive
Sensorineural Deafness
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4 mins
Atrioventricular Nodal Reentrant Tachycardia
Rate
140-280 bpm
Rhythm
Regular
P Wave
P Wave Hidden
PR Interval
No PR Interval
QRS Interval
QRS <0.12 Seconds
Management
Vagal Maneuvers
Adenosine
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2 mins

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