Dysrhythmia

Dysrhythmia | What it is… | Associated with… | Manifested by… | Treatment | What it looks like… |

Sinus Bradycardia | SA <60bpm, normal in sleep and athletes | Carotid sinus massage, hypothermia, increased vagal tone, parasympathomimetic Rx, hypothyroidism, increased intracranial pressure, obstructive jaundice, <3 diseases, hyperkalemia | Hypotension, pale cool skin, weakness, chest pain, dizziness/syncope, blurred vision, confusion or disorientation, SOB | Atropine, pacemaker may be required | |

Sinus Tachycardia | Vagal inhibition increase SA >100bpm | (physiologic stressors) Pain, anxiety, exercise, fever, stress, hypovolemia, myocardial ischemia, HF, meds, anemia, hemorrhage | Dizziness/syncope, hypotension, anxiety, chest pain, nervousness, palpitations | (Underlying cause) Beta-blockers, Ca+ channel blockers, antipyretics for fever, analgesics for pain | |

Premature Atrial Contraction | Ectopic focus in atrium other than SA, travels abnormal pathway across atria=distorted P-wave, may be stopped, delayed or conducted normally at AV | Emotional stress, caffeine, tobacco, alcohol, hypoxia, electrolyte imbalance, COPD, valvular disease, CAD, HF | Isolated PACs not significant in healthy hearts, warning of more serious dysrhythmia in diseased hearts | (depends on symptoms) b-adrenergic blockers to decrease PACs, reduce/eliminate caffeine, tobacco, alcohol | |

Atrial Flutter | Atrial tachydysrhythmia with recurring, regular, sawtooth-shaped flutter waves; orginates from single ectopic focus | CAD, hypertension, mitral valve disorders, PE/edema, chronic lung disease, cardiomyopathy, hyperthyroidism, Digoxin, Quinidine, Epinephrine | High ventricular rates >100 with loss of atrial kick decreasing CO and precipitate HF, angina; risk for stroke b/c risk of atrial thrombus formation | Goal: slow ventricular response by increasing AV block; Ca+ channel blockers, b-adrenergic blockers, cardioversion, anticoagulation therapy, antidysrhythmia drugs...