Congestive Heart Failure and Cardiac Arrhythmias Flashcards

Vocabulary flashcards covering Congestive Heart Failure (CHF) classifications, pathophysiology, diagnostic criteria, and management, alongside cardiac conduction, basic EKG interpretation, and key atrial/ventricular dysrhythmias.

HFrEF

Heart failure with reduced ejection fraction, a classification associated with systolic dysfunction in heart failure.

HFpEF

Heart failure with preserved ejection fraction, a classification associated with diastolic dysfunction in heart failure.

Pulsus Alternans

An arterial pulse characterized by alternating strong and weak beats, identified as a clinical finding in congestive heart failure.

Paroxysmal Nocturnal Dyspnea (PND)

A symptom of left-sided heart failure characterized by sudden, severe shortness of breath occurring at night that awakens the patient.

NYHA Functional Classification

A four-class system rating heart failure severity based on physical activity limitations, ranging from Class I (no limitation) to Class IV (severe limitation with symptoms present at rest).

ACC/AHA Heart Failure Staging

A four-stage heart failure continuum ranging from Stage A (high risk without structural disease or symptoms) to Stage D (refractory heart failure requiring specialized interventions).

Digitalis

A heart failure medication that exhibits positive ($+$) inotropic and negative ($-$) chronotropic effects on cardiac performance.

Hydralazine and Isosorbide Dinitrate

A combination therapy used as an alternative to ACE inhibitors or ARBs, particularly in African American patients; hydralazine acts as a direct centrally acting vasodilator and isosorbide dinitrate acts as a venodilator to reduce afterload.

Normal Sinus Rhythm (NSR)

A normal cardiac rhythm originating in the sinus node with a regular rate of $60\,\text{bpm}$ to $100\,\text{bpm}$, normal consistent P waves preceding every QRS complex, a PR interval of $0.12\,\text{sec}$ to $0.20\,\text{sec}$, and a $1:1$ P to QRS ratio.

Sinus Bradycardia

A cardiac rhythm originating from the SA node with a regular rhythm and a rate of less than $60\,\text{bpm}$, treated with Atropine Sulfate or pacing when symptomatic or unstable.

Sinus Tachycardia

A cardiac rhythm originating from the SA node with a regular rhythm and a heart rate exceeding $100\,\text{bpm}$.

Atrial Fibrillation (AF)

Rapid, disorganized, and uncoordinated twitching of the atrial musculature characterized by an atrial rate of $300\,\text{bpm}$ to $600\,\text{bpm}$, an irregular ventricular rhythm, and absence of distinct P waves, which are replaced by fibrillatory f waves.

Holiday Heart Syndrome

Atrial fibrillation caused by acute alcohol ingestion.

First-Degree AV Block

A conduction delay where impulses from the SA node are delayed at the AV node, resulting in a prolonged PR interval greater than $0.20\,\text{sec}$ with a regular rhythm and a $1:1$ P to QRS ratio.

Second-Degree AV Block Type 1 (Wenckebach / Mobitz I)

An AV block characterized by a progressive lengthening of the PR interval with each consecutive beat until one P wave is completely blocked (dropped), leading to grouped beating.

Second-Degree AV Block Type 2 (Mobitz II)

An AV block characterized by punctual, constant P waves and PR intervals followed by intermittent, suddenly dropped QRS complexes without preceding PR lengthening.

Third-Degree AV Block

Complete heart block occurring when no atrial impulses are conducted through the AV node to the ventricles, resulting in complete AV dissociation where atria and ventricles depolarize independently.

Premature Ventricular Contraction (PVC)

An ectopic beat originating from an irritable focus in the ventricles, characterized on an EKG as a wide, bizarre QRS complex.

Idioventricular Rhythm

A ventricular escape rhythm originating in the conduction system below the AV node, typically with a rate of $20\,\text{bpm}$ to $40\,\text{bpm}$.

Agonal Rhythm

A dying idioventricular rhythm characterized by a heart rate below $20\,\text{beats/min}$ that occurs immediately prior to asystole.

Ventricular Tachycardia (VT)

A ventricular dysrhythmia defined as $3$ or more consecutive PVCs with a ventricular rate usually between $100\,\text{bpm}$ and $200\,\text{bpm}$ and a wide, bizarre QRS duration greater than $0.12\,\text{sec}$.

Ventricular Fibrillation (VF)

A chaotic, uncoordinated ventricular rhythm without identifiable waves or cardiac output, requiring immediate CPR and emergency defibrillation.

Pulseless Electrical Activity (PEA)

A clinical condition characterized by the presence of an organized electrical rhythm on a monitor in the absence of a palpable pulse.

H's and T's

A diagnostic framework of reversible causes for pulseless electrical activity (PEA) and cardiac arrest, encompassing Hypovolemia, Hypoxia, Hydrogen ions (acidosis), Hypothermia, Toxins, Cardiac tamponade, Tension pneumothorax, Trauma, and Thrombus.

Synchronized Cardioversion

A timed electrical procedure used for tachydysrhythmias (such as VT with a pulse, atrial flutter, or AF) where shocks are synchronized with the R wave of the QRS complex.

Defibrillation

An asynchronous electrical shock delivered to the myocardium to stop chaotic electrical activity and restore a perfusing rhythm, indicated specifically for VF and pulseless VT.