Cardiovascular disorder

Cardiac Dysrhythmias

Route Rate Rhythm

Rhythm P Wave PR Interval QRS Rate Regularity Life Causes
threatening
Normal sinus Normal 0.12-0.20 <0.12 60-100 Regular No Normal finding
Sinus Normal 0.12-0.20 <0.12 <60 Regular Dependant Sleep,
bradycardia on cause inactivity,
athletic, vagal
tone, drugs,
MI, K+,
respiratory
arrest
Sinus Normal 0.12-0.20 <0.12 >100, Regular No Caffeine,
tachycardia usually exercise, fever,
100-150 anxiety, heart
failure, drugs,
pain, hypoxia,
hypotension,
volume
depletion
Atrial Pause Looks like SR but drops a complex Normal or Irregular Depends Elderly,
slow on length digoxin
and toxicity, MI,
frequency rheumatic
fever
Atrial Flutter Saw tooth None <0.12 Atrial rate Regular or Dependant Valvular heart
250-400 irregular on disease, MI,
ventricular CHF,
rate pericarditis
Atrial Fibrilation Wavy None <0.12 Atrial rate Irregular Dependant Heart disease,
 unidentifiable >400 on pulmonary
ventricular disease,
rate emotional
stress,
excessive
alcohol or
caffeine
Junctional INVERTED <0.12 <0.12 40-60 Regular Dependant Electrical
rhtym before or on impulse not
after QRS or ventricular arriving from
absent rate SA node, AV
node fires at
inherent rate
Accelerated INVERTED <0.12 <0.12 60-100 Regular dependant Digoxin
junctional before or on toxicity,
rhythm after QRS or ventricular damage to AV
absent rate node
Junctional INVERTED <0.12 <0.12 >100 Regular Dependant Same as SVT
tachycardia before or on
after QRS or ventricular
absent rate
Superventricula Pointed or Immeasurable <0.12 150-250 Regular Dependant Caffeine, chf,
r tachycardia hidden in T on rate and fatigue,
patient hypoxia, mitral
ability to valve disease,
tolerate altered
pacemaker in
heart
Idioventricular None None >0.11 20-40 Regular Yes, may Digoxin
Rhythm wide have pulse toxicity, acute
and MI
bizzare
Ventricular None None >0.11 150-250 Regular Yes, may MI, ischemia,
tachycardia wide have pulse digoxin
 and toxicity,
bizzare hypoxia,
acidosis, low
K+,
hypothermia,
drug overdose
Ventricular None None None None Irregular Yes, no Follow pvc, vt,
fibliration vary in site, pulse most common
shape and cause of
height sudden death
Asystole Possible None None None No QRS Yes Follows
VT/VFib,
acidosis,
hhypoxia, low
K+,
hypothermia,
drug overdose
1 degree AV Normal >0.20 <0.12 Varies Regular or Usually not First sign of
block irregular increasing AV
block
2 degree AV Normal Varies: <0.12 Varies Regularly Usually not Acute inferior
block type I progressively irregular: MI, digoxin
prolonged QRS toxicity, vagal
dropped stimulation,
after conduction
progressivel system disease
y prolonged
PRI
2 degree AV Normal Consistent Norma Usually Regular or Dependant BBB, anterior
block type II normal or l or slow irregular; on overall MI, lesion of
prolonged wide occasionally ventricular conduction
dropped rate, may system
QRS progress to
3rd degree
 AV block
rd
3 degree AV Normal No relations Wide Slow regular Yes, Atria and
block between PR & pacemaker ventricles beat
QRS needed independently,
digoxin or K+
toxicity, acute
MI, ischemic
heart disease
Premature atrial Yes, PAC P May differ <0.12 Rate of PAC No Coffee, tea,
contractions wave shaped from underlying complexes alcohol, CHF,
different underlying rhythm come early emotions,
rhythm fatigue, fever,
hypoxia, mitral
valve disease
Premature Inverted <0.12 <0.12 Rate of PJC make it No Vagal tone,
junctional before or underlying irregular stress,
contractions after QRS or rhythm caffeine,
absent alcohol, heart
failure, digoxin
toxicity, low
K+
Premature None N/A >0.11 Dependant Irregular due Depends Ventricular
ventricular wide on to on irritability,
contractions and underlying premature frequency hypoxia, low
bizarre rhythm beat and how K+, Ca, MI,
close to T digoxin
wave toxicity,
anxiety

Adakah - Asystole
QRS
- ventricular asystole
kompleks?
- VF: kasar dan halus
 Tidak

Ya

Frekuensi

<2 ktk sedang = taki QRS lebar (>3 ktk)=berasal dari ventricle VT

>6 ktk sedang = bradi

QRS sempit (<3 ktk)=berasal dari
supraventricle diatas bunle of his

Apakah p
mendahului QRS
QRS regular = Atrial
kompleks?
flutter
QRS iregular = Atrial fibrilazation

Tidak Irama sinus Apakah P-QRS

berdampingan?
- PR memanjang = AVB dr. I Konstan
Ya
- PR memanjang = AVB dr II progresif + dropbeat
- P defleksi = irama junctional lead II Tidak
- PR normal = AVB dr II konstan + dropbeat tipe II
- p dibelakang = irama junctional QRS complex
- PR tidak = AVB dr. III / berdampingan dengan total
- p ga ada = sinus arrest / AF AV block