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MS4 - CVS > Brady and Tachy > Flashcards

Brady and Tachy Flashcards

1
Q

Mx of bradycardia

A

Asymptomatic or HR >40 : No rx

Symptomatic or HR < 40 : atropine

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2
Q

Sick sinus syndrome definition

A

Sinus node dysfunction

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3
Q

Presentations of sick sinus syndrome

A

Bradycardia +/- arrest

Sinoatrial block

SVT alternating with bradycardia

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4
Q

Mx of sick sinus syndrome

A

Pace if symptomatic

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5
Q

Indications to shock pt with arrhythmia

A

BP < 90

Chest pain

Signs of heart failure

Reduced GCS

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6
Q

Mx of AF / atrial flutter

A

Shock if indicated

Rate / Rhythm control

Anticoagulation

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7
Q

When to us Rhythm control rather than Rate control for AF

A

Atrial structure normal

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8
Q

Rate control medication

A

Beta blocker / verapamil or diltiazem
Digoxin
Amiodarone

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9
Q

Rhythm control medication

A

Amiodarone
Flecanide

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10
Q

How to determine to give anticoagulation for AF

A

CHADS2 VASc

HAS-BLED

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11
Q

Use of CHADS2 VASc

A

Risk of clots

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12
Q

Use of AA HAS-BLED

A

Risk of bleeding

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13
Q

Components of CHADS2 VASc

A

CCF

HTN

Age > 75

DM

Stroke (2 points)

Vascular disease

Age > 65

Sex category (female)

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14
Q

Interpretation of CHADS2 VASc

A

0 - no rx

1 - consider anti-platelet / anti-coagulation

2 - should be on anti-coagulation

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15
Q

Components of AA HAS-BLED

A

Abnormal liver funcion

Abnormal renal funtion

HTN

Alcohol

Stroke

Bleeding

Labile INR

Elderly > 65

Drugs

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16
Q

Interpretation of AA HAS-BLED

A

1 - Low risk

2 - medium risk (can use anti-coag if needed)

3 - high risk (look for alternatives to anti-coag)

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17
Q

SVT ECG changes

A

Narrow complex

Regular tachy

No p waves

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18
Q

Acute mx of SVT

A

Vagal manoeuvres

IV adenosine or verapamil

Shock

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19
Q

CI to verapamil use in acute SVT

A

If pt already on beta blocker

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20
Q

CI to adenosine

A

Asthma

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21
Q

Maintenance Rx for SVT

A

Beta blocker or verapamil

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22
Q

Examples of vagal manoeuvres

A

Breath holding

Valsalva manoeuvre

Carotid massage

23
Q

VT ECG changes

A

Broad complex

Regular tachy

24
Q

Types of VT

A

Pulseless VT

Pulsed VT

25
Q

Mx of pulseless VT

A

Shock

26
Q

Mx of pulsed VT

A

Amiodarone

27
Q

Prophylaxis of VT

A

Sotalol

Amiodarone

28
Q

VF ECG changes

A

Broad complex

Irregular tachy

29
Q

Mx VF

A

Shock

30
Q

Types of heart block

A

Type 1
Type 2 : Mobitz 1, Mobitz 2
Type 3

31
Q

Type 1 heart block ECG changes

A

Long PR

32
Q

Type 2 Mobitz 1 Heart block ECG changes

A

Gradually increasing PR until drop beat

33
Q

Type 2 Mobitz 2 Heart block ECG changes

A

Beats dropped every set number of beats

34
Q

Type 3 Heart block ECG changes

A

No relationship between P waves and QRS

35
Q

Mx of Type 1 heart block

A

No Rx

36
Q

Mx of Type 2 Mobitz 1 heart block

A

No Rx

Atropine if symptomatic

37
Q

Mx of Type 2 Mobitz 2 heart block

A

Atropine

Pacing

38
Q

Mx of Type 3 heart block

A

Permanent pacemaker

39
Q

Causes of AF

A

IHD
Rheumatic heart disease
Thyrotoxicosis
HTN

40
Q

Sx of AF?

A

Asymptomatic but also

  • chest pain/ palpitations
  • SOB
  • Fainting
41
Q

Sign of AF?

A
  • Irregularly irregular pulse
  • signs of LVF
42
Q

4 types of AF?

A

Acute
Paroxysmal
Persistant
Permanent

43
Q

Acute AF definition

A

< 48 hrs

44
Q

Paroxysmal AF definition

A

< 7 days

May recur

45
Q

Persistant AF definition

A

> 7 days

46
Q

Permanent AF definition

A

> 1 yr

47
Q

Acute AF mx?

A

Emergency cardioversion if indicated
Control ventricular rate
Start LMWH

48
Q

Paroxysmal AF mx?

A
  • Anticoagulate (chadsvasc)
  • PRN: flecainide, propafenone
49
Q

Prevention of AF

A

B blocker or
Sotalol or
Amiodarone

50
Q

Antiarrhythmics for persistent AF

A
  • Not needed if successfully treated precipitant
  • 1st line: beta blockers
  • 2nd line: amiodarone
51
Q

Aim of rate for persistent AF rate control

A

< 90 bpm at rest

52
Q

Rate control for persistent AF?

A

1st: b-blocker or CCB (not both)
2nd: add digoxin
3rd: consider amiodarone

53
Q

Mx of permanent AF?

A

Rate control

54
Q

Mx of persistent AF?

A

Rate control + antiarrhythmics

MS4 - CVS (8 decks)

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