arrythmias- pathophysiology, presentation and investigation

Question 1

how do arrythmias present?

Answer 1

asymptomatic
palpatations
dyspnoea
chest pain
fatigie
embolism

Question 2

investigations of arrythmias

Answer 2

ECG
blood tests esp thyroid funtion
echocardiogram

Question 3

what are the therapeutic options?

Answer 3

rate control versus rhythm control
digoxin, betat blockers, ca-antagonist plus warfarin

electrical approaches

consider anticoagulation

Question 4

what is Supraventricular Tachycardia

Answer 4

is an abnormally fast heart rhythm arising from improper electrical activity in the upper part of the heart

Question 5

symptoms of supra ventricular tachycardia?

Answer 5

palpatations
dyspnoae
diziness

Question 6

what treatment would you give for supra ventricular tachycardia

Answer 6

control ventricular rate and thrombotic risk

usually cardiovert

prevent with AA drugs or RFA of cavotricuspid isthmus

Question 7

what are symptooms of ventricular tachycardia?

Answer 7

palpatations
CP
dyspnoea
dizziness
syncope

Question 8

what device would you use for correcting arrhythmias?

Answer 8

ICD

implantable cardioverter defibrillator

Question 9

what are indications for ICD therapay?

Answer 9

secondary prevention:
cardiac arrest due to VF/VT not due to transient or reversible cause

sustained VT causing syncope or significant compromise

sustained VT with poor LV function

Question 10

indications for pacing: temporary

Answer 10

Temporary:
intermittent or sustained symptomatic bradycardia, particularly syncope
prophylactic when patient at high risk for development of severe bradycardia

Question 11

indications for pacing: permanent

Answer 11

symptomatic or profound 2nd/3rd degree AV block,
particularly when cause (?) unlikely to disappear

probably Mobitz type II 2nd/3rd degree AV block even if asymptomatic

AV block associated with neuromuscular diseases 
after (or in preparation for) AV-node ablation

alternating RBBB/LBBB

 syncope when bifascicular/trifascicular block and no other explanation

 sinus node disease associated with symptoms

carotid sinus hypersensitivity/malignant vasovagal syncope