This document provides a cheat sheet on various heart dysrhythmias:
1. It describes several types of arrhythmias including sinus arrhythmia, sinus tachycardia, sinus bradycardia, sinoatrial block, wandering atrial pacemaker, premature atrial contractions, paroxysmal supraventricular tachycardia, atrial flutter, and atrial fibrillation.
2. For each arrhythmia, it lists the characteristic descriptions, common causes, and general treatment approaches.
3. The cheat sheet is intended to provide clinicians with a quick reference guide to identifying different arrhythmias based on electrocardiogram patterns and determining initial treatment strategies.
This document provides a cheat sheet on various heart dysrhythmias:
1. It describes several types of arrhythmias including sinus arrhythmia, sinus tachycardia, sinus bradycardia, sinoatrial block, wandering atrial pacemaker, premature atrial contractions, paroxysmal supraventricular tachycardia, atrial flutter, and atrial fibrillation.
2. For each arrhythmia, it lists the characteristic descriptions, common causes, and general treatment approaches.
3. The cheat sheet is intended to provide clinicians with a quick reference guide to identifying different arrhythmias based on electrocardiogram patterns and determining initial treatment strategies.
This document provides a cheat sheet on various heart dysrhythmias:
1. It describes several types of arrhythmias including sinus arrhythmia, sinus tachycardia, sinus bradycardia, sinoatrial block, wandering atrial pacemaker, premature atrial contractions, paroxysmal supraventricular tachycardia, atrial flutter, and atrial fibrillation.
2. For each arrhythmia, it lists the characteristic descriptions, common causes, and general treatment approaches.
3. The cheat sheet is intended to provide clinicians with a quick reference guide to identifying different arrhythmias based on electrocardiogram patterns and determining initial treatment strategies.
This document provides a cheat sheet on various heart dysrhythmias:
1. It describes several types of arrhythmias including sinus arrhythmia, sinus tachycardia, sinus bradycardia, sinoatrial block, wandering atrial pacemaker, premature atrial contractions, paroxysmal supraventricular tachycardia, atrial flutter, and atrial fibrillation.
2. For each arrhythmia, it lists the characteristic descriptions, common causes, and general treatment approaches.
3. The cheat sheet is intended to provide clinicians with a quick reference guide to identifying different arrhythmias based on electrocardiogram patterns and determining initial treatment strategies.
Irregular atrial and Normal variation of Atropine if rate decreases
ventricular rhythms. normal sinus rhythm in below 40bpm. Normal P wave preceding athletes, children, and the each QRS complex. elderly. Sinus Arrhythmia Can be seen in digoxin toxicity and inferior wall MI.
Atrial and ventricular Normal physiologic Correction of underlying
rhythms are regular. response to fever, cause. Rate > 100 bpm. exercise, anxiety, Beta-adrenergic blockers Normal P wave preceding dehydration, or pain. or calcium channel each QRS complex. May accompany shock, blockers for symptomatic left-sided heart failure, patients. Sinus Tachycardia cardiac tamponade, hyperthyroidism, and anemia. Atropine, epinephrine, quinidine, caffeine, nicotine, and alcohol use.
Regular atrial and Normal in a well- Follow ACLS protocol for
ventricular rhythms. conditioned heart (e.g., administration of atropine Rate < 60 bpm. athletes). for symptoms of low Normal P wave preceding Increased intracranial cardiac output, dizziness, Sinus Bradycardia each QRS complex. pressure; increased vagal weakness, altered LOC, or tone due to straining low blood pressure. during defecation, Pacemaker vomiting, intubation, mechanical ventilation. Atrial and ventricular Infection Treat symptoms with rhythms normal except for Coronary artery disease, atropine I.V. missing complex. degenerative heart Temporary pacemaker or Sinoatrial (SA) Normal P wave preceding disease, acute inferior wall permanent pacemaker if arrest or block each QRS complex. MI. considered for repeated Pause not equal to Vagal stimulation, episodes. multiple of the previous Valsalva’s a euver, rhythm. carotid sinus massage. Atrial and ventricular Rheumatic carditis due to No treatment if patient is Wandering atrial rhythms vary slightly. inflammation involving asymptomatic pacemaker Irregular PR interval. the SA node. Digoxin toxicity P waves irregular with Sick sinus syndrome Treatment of underlying changing configurations cause if patient is i dicati g that they are ’t symptomatic. all from SA node or single atrial focus; may appear after the QRS complex. QRS complexes uniform in shape but irregular in rhythm. Premature, abnormal- May prelude Usually no treatment is looking P waves that differ supraventricular needed. in configuration from tachycardia. Treatment of underlying normal P waves. Stimulants, cause if patient is QRS complexes after P hyperthyroidism, COPD, symptomatic. Premature atrial waves except in very early infection and other heart Carotid sinus massage. contraction (PAC) or blocked PACs. diseases. P wave often buried in the preceding T wave or identified in the preceding T wave. Atrial and ventricular Physical exertion, If patient is unstable rhythms are regular. emotion, stimulants, prepare for immediate Heart rate > 160 bpm; rheumatic heart diseases. cardioversion. rarely exceeds 250 bpm. Intrinsic abnormality of AV If patient is stable, vagal P waves regular but conduction system. stimulation, or Valsalva’s aberrant; difficult to Digoxin toxicity. maneuver, carotid sinus differentiate from Use of caffeine, massage. preceding T wave. marijuana, or central Adenosine by rapid I.V. P wave preceding each nervous system bolus injection to rapidly Paroxysmal QRS complex. stimulants. convert arrhythmia. Supraventricular Sudden onset and If patient has normal Tachycardia termination of arrhythmia ejection fraction, consider When a normal P wave is calcium channel blockers, prese t, it’s called beta-adrenergic blocks or paroxysmal atrial amiodarone. tachycardia; when a If patient has an ejection normal P wave is ’t fraction less than 40%, prese t, it’s called consider amiodarone. paroxysmal junctional tachycardia. Atrial rhythm regular, Heart failure, tricuspid or If patient is unstable with rate, 250 to 400 bpm mitral valve disease, ventricular rate > 150bpm, Ventricular rate variable, pulmonary embolism, cor prepare for immediate depending on degree of pulmonale, inferior wall cardioversion. AV block MI, carditis. If patient is stable, drug Atrial flutter Saw-tooth shape P wave Digoxin toxicity. therapy may include configuration. calcium channel blockers, QRS complexes uniform in beta-adrenergic blocks, or shape but often irregular antiarrhythmics. in rate. Anticoagulation therapy may be necessary. Atrial rhythm grossly Heart failure, COPD, If patient is unstable with irregular rate > 300 to 600 thyrotoxicosis, constrictive ventricular rate > 150bpm, bpm. pericarditis, ischemic prepare for immediate Ventricular rhythm grossly heart disease, sepsis, cardioversion. irregular, rate 160 to 180 pulmonary embolus, If stable, drug therapy bpm. rheumatic heart disease, may include calcium PR interval indiscernible. hypertension, mitral channel blockers, beta- No P waves, or P waves stenosis, atrial irritation, adrenergic blockers, that appear as erratic, complication of coronary digoxin, procainamide, Atrial Fibrillation irregular base-line bypass or valve quinidine, ibutilide, or fibrillatory waves replacement surgery amiodarone. Anticoagulation therapy to prevent emboli. Dual chamber atrial pacing, implantable atrial pacemaker, or surgical maze procedure may also be used. Atrial and ventricular Inferior wall MI, or Correction of underlying rhythms are regular. ischemia, hypoxia, vagal cause. Atrial rate 40 to 60 bpm. stimulation, sick sinus Atropine for symptomatic Ventricular rate usually 40 syndrome. slow rate to 60 bpm. Acute rheumatic fever. Pacemaker insertion if P waves preceding, hidden Valve surgery patient is refractory to within (absent), or after Digoxin toxicity drugs Junctional Rhythm QRS complex; usually Discontinuation of digoxin inverted if visible. if appropriate. PR interval (when present) < 0.12 second QRS complex configuration and duration normal, except in aberrant conduction. Atrial and ventricular MI or ischemia Correction of underlying rhythms are irregular. Digoxin toxicity and cause. P waves inverted; may excessive caffeine or Discontinuation of digoxin Premature precede be hidden within, amphetamine use if appropriate. Junctional or follow QRS complex. Conjunctions QRS complex configuration and duration normal. Atrial and ventricular Inferior wall MI or Correction of the rhythms regular ischemia or infarction, underlying cause. First-degree AV PR interval > 0.20 second. hypothyroidism, Possibly atropine if PR block P wave preceding each hypokalemia, interval exceeds 0.26 QRS complex. hyperkalemia. second or symptomatic QRS complex normal. Digoxin toxicity. bradycardia develops. Use of quinidine, Cautious use of digoxin, procamide, beta- calcium channel blockers, adrenergic blocks, calcium and beta-adrenergic blockers.
Ventricular rhythm disease, anterior wall MI, and dopamine for irregular. acute myocarditis. symptomatic bradycardia. Atrial rate exceeds Digoxin toxicity Temporary or permanent Second-degree AV ventricular rate. pacemaker for block Mobitz I PR interval progressively, symptomatic bradycardia. (Wenckebach) but only slightly, longer Discontinuation of digoxin with each cycle until QRS if appropriate. complex disappears. PR interval shorter after dropped beat. Atrial rhythm regular. Inferior or anterior wall Atropine, epinephrine, Ventricular rhythm regular MI, congenital and dopamine for and rate slower than atrial abnormality, rheumatic symptomatic bradycardia. rate. fever. Temporary or permanent No relation between P pacemaker for Third-degree AV waves and QRS symptomatic bradycardia. block (complex complexes. heart block) No constant PR interval. QRS interval normal (nodal pacemaker) or wide and bizarre (ventricular pacemaker). Atrial rhythm regular Heart failure; old or acute If warranted, Ventricular rhythm myocardial ischemia, procainamide, lidocaine, irregular infarction, or contusion. or amiodarone I.V. QRS complex premature, Myocardial irritation by Treatment of underlying usually followed by a ventricular catheters such cause. complete compensatory as a pacemaker. Discontinuation of drug pause Hypercapnia, causing toxicity. QRS complex wide and hypokalemia, Potassium chloride IV if Premature distorted, usually >0.14 hypocalcemia. PVC induced by ventricular second. Drug toxicity by cardiac hypokalemia. contraction (PVC) Premature QRS complexes glycosides, aminophylline, Magnesium sulfate IV if occurring singly, in pairs, tricyclic antidepressants, PVC induced by or in threes; alternating beta-adrenergic. hypomagnesaemia. with normal beats; focus Caffeine, tobacco, or from one or more sites. alcohol use. Ominous when clustered, Psychological stress, multifocal, with R wave on anxiety, pain T pattern. Ventricular rate 140 to Myocardial ischemia, If pulseless: initiate CPR; Ventricular 220 bpm, regular or infarction, or aneurysm follow ACLS protocol for Tachycardia irregular. Coronary artery disease defibrillation. QRS complexes wide, Rheumatic heart disease If with pulse: If bizarre, and independent Mitral valve prolapse, hemodynamically stable, of P waves heart failure, follow ACLS protocol for P waves no discernible cardiomyopathy administration of May start and stop Ventricular catheters. amiodarone; if ineffective suddenly Hypokalemia, initiate synchronized Hypercalcemia. cardioversion. Pulmonary embolism. Digoxin, procainamide, epinephrine, quinidine toxicity, anxiety. Ventricular rhythm and Myocardial ischemia or If pulseless: start CPR, rate are rapid and chaotic. infarction, R-on-T follow ACLS protocol for QRS complexes wide and phenomenon, untreated defibrillation, ET irregular, no visible P ventricular tachycardia, intubation, and waves Hypokalemia, administration f Ventricular hyperkalemia, epinephrine or Fibrillation Hypercalcemia, alkalosis, vasopressin, lidocaine, or electric shock, amiodarone; ineffective hypothermia. consider magnesium Digoxin, epinephrine, or sulfate. quinidine toxicity. No atrial or ventricular Myocardial ischemia or Start CPR. rate or rhythm. infarction, aortic valve No discernible P waves, disease, heart failure, QRS complexes, or T hypoxemia, hypokalemia, waves severe acidosis, electric shock, ventricular arrhythmias, AV block, Asystole pulmonary embolism, heart rupture, cardiac tamponade, hyperkalemia, electromechanical dissociation. Cocaine overdose.