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What is PR Interval?
- Time needed for:
- SA Node stimulation,
- Atrial depolarization,
- Conduction thru AV Node (before Ventricles depolarize)
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How Long is the PR Interval?
- 0.12 - 0.20 Seconds
- 3-5 small boxes
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Causes of a Longer PR Interval Include?
- 1st degree block
- Hypothyroidism
- Digitalis
- Beta-Blockers
- Calcium Channel Blockers
- Aging
- Conduction Disease
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What is the ST Segment?
Early Ventricular Repolarization.
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Where is the ST Segment Located?
End of the QRS Complex to the Beginning of the T wave
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What does and ELEVATED ST Segment Represent?
- Myocardial Injury
- Coronary Vasospasm
- pericardiditis
- Ventricular Aneurysium
- HyperKalemia
- Early Repolarization
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What Does DEPRESSED ST Segment Represent?
- Myocadial Ishemia
- Left or Right Ventricular Hypertrophy
- Left of Right Ventricula Bundle Branch Blocks
- HypoKalemia
- Digitalis
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What is a P Wave?
- Sinus Node spreading thru the Atria
- Atrial Depolarization
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What is the Normal Amplitude of the P Wave?
2.5mm
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How Long is the P Wave?
Less than 0.11 seconds
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What is the QRS Complex?
Ventricular Depolarization
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What is the Amplitude of the QRS Complex?
- less than 5mm represented by qrs
- Greater than 5mm represented by QRS
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What is the Duration of the QRS Complex?
- less than 0.12 seconds
- 3 small boxes
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Where is Atrial Repolarization?
Hidden behind QRS Complex
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What is the T wave Represent?
- Ventricular repolarization
- regaining negative charge
- Resting state
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What is the U Wave represent?
Thought to be repolarizaion of Purkinje Fibers
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What is the Physiological meaning behind the U Wave?
- Hypokalemia
- Hypertension
- Heart Disease
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What are causes of Abnormally wide QRS Complex?
- Left or Right Conduction impulses thru Bundle Branch
- Early Electrical impulses (premature beats)
- Conduction of impulses from Abnormal Accessory Conduction pathy that bypasses AV Node
- Electrical Impulses that orginiate in an ectopic site in the ventricles
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What Are the H's of H&T's?
- Hypovolemia
- Hypoxia
- Hydrogen ions (acidosis)
- Hypokalemia/Hyperkalemia
- Hypoglycemia
- Hypothermia
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What are the T's of H&T's?
- Toxins
- Tamonade
- Tension pneumothorax
- Thrombosis (coronary pulmonary)
- Trauma (hypovolemia, Increase Cranial Pressure ICP)
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What is Sinus Bradycardia?
- Ventricular Rate or Atrial Rate less than 60pbm
- Regular Rhythm
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Medication Treatment of Sinus Bradycardia includes?
- *Atropine 0.5mg q3-5min max 3mg
- **Rarely Catecholamines (Epinephrine, Norepinephrine, dopamine, metanephrine)
- **Emergency Transcutaneous Pacing
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What are Hypo (lower) Metabolic Needs?
- Sleep
- Hypothyroidism
- Athletic Training
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What are Hypermetabolic Needs?
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What are Vagal Stimulations?
- Vomiting
- Bareing Down
- Suctioning
- Severe Pain
- Extreme Emotions
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What is Sinus Tachycardia?
- Faster than normal impulse rate.
- greater than 100 bpm but less than 120 bpm
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What are Causes of Sinus Tachycardia?
- Physiologica/Psychologica Stress
- Medications
- Autonomic Dysfunction
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Medications Causing Sinus Tachycardia Include:
- Catecholamines(Dopamine, Norepinephrine, Epinephrine, Metanephrine)
- Aminophylline
- Atropine
- Stimulants (Caffiene, alcohol, nicotine)
- Illicit drugs (amphetamines, Cocaine, Ecstasy)
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Treatment of Tachycardia Include
- Identify and stop cause
- RARELY: Beta Blockers & Calcium Channel Blockers
- Catheter ablation of SA Node
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What is POTS?
Postural Orthostatic Tachycardia Syndrome
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What is the Treatment for POTS?
- Increased Fluids and sodium
- Use of Anti-embolism stocking to prevent pooling of blood in the lower extremities.
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What is a Sinus Arrythmia?
- Sinus Node Creates irregular rhythm (atrial & ventricular)
- Rate Increase on Inspiration Decreases on Expiration
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What is the usual treatment for Sinus Arrythmias?
Not usually trated because rarely causes any significant hemodynamic effect.
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