Arrythmias

Question 1

Holiday heart syndrome

Answer 1

Binge-drinking and MJ can cause AF or SVT (resolved by abstinence)

Question 2

Wenckebach phenomenon

Answer 2

Mobitz I (2nd degree)

AV block, PR gets longer until QRS is dropped

Question 3

What is AVN-RT?

Answer 3

AVN reentry tachycardia (most common type of SVT)

• early contraction makes electrical impulse enter circuit & circle back around, sudden sustained tachy

Question 4

CHA2DS2-VASc score

Answer 4

Risk of AF patient having
- stroke/TIA
- VTE
NICE recommends anticoags for score >2
(MDCalc)

Question 5

ORBIT Score

Answer 5

AF - bleeding risk with anticoags

Question 6

What does a monomorphic VT look like on an ECG?

Answer 6

Same shape, fast QRS

Question 7

How does pulseless electrical activity (PEA) present?

Answer 7

No palpable pulse, still sinus

Question 8

SVT management

Answer 8

Attempt vagal manoeuvres:
- Valsalva’s manoeuvre
- carotid sinus massage

IV Adenosine (horrible, feels like going to die) don’t give to asthmatics (6mg)

Transcutaneous pacing
Transvenous pacing

Question 9

How is AF treated?

Answer 9

Haemodynamically unstable:
- emergency synchronised DC shock (cardioversion)

Stable: