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y4 acute care > Ventricular Tachycardia > Flashcards

Ventricular Tachycardia Flashcards

1
Q

Why does VT occur? (2 points)

A
  1. Rapid ventricular depolarisation originating from within ventricles
  2. Commonly bc scarring of ventricles after MI
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2
Q

How is a VT seen on an ECG?

A
  1. 100+ BPM
  2. Broad QRS complex (120+ ms)
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3
Q

What are the 2 types of VT?

A
  1. Monomorphic VT
  2. Polymorphic VT
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4
Q

What are the characteristics of Monomorphic VT? (2 things)

A
  1. Wide QRS complexes (200+ ms)
  2. Uniform QRS morphology
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5
Q

What are the characteristics of Polymorphic VT? (2 things)

A
  1. Wide QRS complexes (120+ ms)
  2. Variable QRS morphology
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6
Q

What is Torsades de pointes? (3 things)

A
  1. A subtype of Polymorphic VT
  2. QRS complexes “twist” around isolecetric baseline
  3. QT prolongation
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7
Q

Why does Monomorphic VT have UNIFORM QRS morphology?

A

Bc ventricular contractions all uniform shape bc all depolarizations beginning from same spot in ventricle

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8
Q

Why does Polymorphic VT have VARIABLE QRS morphology?

A

Ventricular contractions change shape each beat bc signal begins in different areas of ventricle

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9
Q

What are the risk factors of VT? (4 things)

A
  1. Ventricular muscle ischaemia (we said ventricular scarring from MI)
  2. Structural heart disease
  3. Coronary artery disease
  4. Electrolyte abnormalities
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10
Q

What are the clinical features of VT? (5 things)

A
  1. Syncope / Dizziness
  2. SOB
  3. Chest pain
  4. Palpitations (cah is tachy)
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11
Q

How is the diagnosis of VT made?

A

ECG / cardiac monitoring

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12
Q

What investigations should you do for VT? (3 things)

A
  1. ECG
  2. Serum electrolytes
  3. Toxicology studies (therapeutic / recreational drug use)
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13
Q

What does the management option for VT depend on?

A

Whether there is a pulse or not

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14
Q

How should you a manage VT WITH a pulse but haemodynamically UNSTABLE?

A

Direct current cardioversion

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15
Q

How should a deteriorating VT patient who is haemodynamically UNSTABLE be managed? (2 things)

A
  1. Direct current cardioversion
  2. If fails –> IV amiodarone hydrochloride + repeat cardioversion
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16
Q

How should you manage a PULSELESS VT / VT?

A

Resuscitation

17
Q

How should a VT patient who is haemodynamically STABLE be managed? (3 things)

A
  1. IV amiodarone hydrochloride
  2. If fails –> direct current cardioversion / pacing
  3. Catheter ablation (if not urgent)
18
Q

How should Non-Sustained VT (NSVT) be managed?

A

Beta blocker

19
Q

What are most patients with VT treated?

A

Implantable Cardioverter Defibrillator (ICD)

20
Q

What can be used in addition to the Implantable cardioverter defibrillator in VT? (2 things)

A
  1. Amiodarone
  2. Beta blockers
21
Q

What is the complication of VT? (2 things)

A

Sudden cardiac death bc:

  1. Insufficient blood perfusion
  2. Ventricular fibrillation

y4 acute care (31 decks)

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