CABS Cardiac Syncope

Question 1

The coronary sinus drains into

Answer 1

the right atrium

Question 2

What is syncope?

Answer 2

transient loss of consciousness secondary to lack of cerebral blood flow

Question 3

How does syncope differ from seizures

Answer 3

there is no postictal period, and the pts will return fully to baseline when awaking

Question 4

Presyncope is

Answer 4

the period before the pt might pass out
feels lightheaded, dizzy, tunnel vision, etc

Question 5

Syncope is m/c d/t

Answer 5

vasovagal event - this is reflex induced and not associated with cardiac or neurologic pathology

Question 6

no matter the cause, syncope will lead to

Answer 6

decreased cerebral blood flow

Question 7

What can present with syncope

Answer 7

Acute coronary syndrome (includes unstable angina, NSTEMI, STEMI)
Prolonged QT

Question 8

Long QT = (for men and women)

Answer 8

if greater than 440ms in men
if greater than 460ms in women
over 500ms increased risk of torsades

Question 9

Long QT = (for men and women)

Answer 9

if greater than 440ms in men
if greater than 460ms in women
over 500ms increased risk of torsades
(measure in 2 or V5-6)

Question 10

Long QT syndrome can be either

Answer 10

congenital (increased risk of SCD) or acquired

Question 11

Wolf Parkinson White syndrome is

Answer 11

abnormal conduction pathway along the bundle of kent directly connecting atria to ventricles and bypasses the AV node, doesn’t allow for ventricles to fill

Question 12

Wolf Parkinson White syndrome makes the pt prone to

Answer 12

supraventricular tachydysrhythmias

Question 13

Wolf Parkinson White syndrome presents with

Answer 13

palpitations, dizzy, syncope, CP, SCD, commonly associated with afib

Question 14

WPW syndrome on ECG

Answer 14

ECG triad:
Delta wave
- slurred upstroke of QRS
short PR <0.12 seconds

Question 15

Brugada (channelopathy) is

Answer 15

repolarization issue associated with sodium ion channels which can lead to ventricular strain

Question 16

Brugada on ECG

Answer 16

RBBB with RSR’
down sloping ST depression in V1 and V2

Question 17

Brugada syndrome presents with

Answer 17

palpitations, syncope, dyspnea

Question 18

HOCM on ECG

Answer 18

‘dagger-like’ Q wave in lateral leads (1, aVL, V5-6)

Question 19

Hypertrophic Obstructive Cardiomyopathy (HCOM) is

Answer 19

leads to increased LV thickness which reduces filling and ultimately decreases CO
increased risk of arrhythmias and SCD

Question 20

Tamponade is

Answer 20

acute or chronic increase in fluid around the heart that can cause pressure on the heart leading to decreased size of chambers of the heart

Question 21

In tamponade the increased pressure will lead to ______ systemic venous return, _______ CO leading to syncope

Answer 21

decreased
decreased

Question 22

What is Beck’s Triad

Answer 22

Tamponade (muffled heart sounds, elevated JVP, Hypotension)

Question 23

Tamponade on ECG

Answer 23

tachycardia
low voltage
electrical alternans (from too much fluid the heart is swinging around)

Question 24

TX of tamponade

Answer 24

pericardiocentesis or can cut a window for it to drain into the cavity and will be reabsorbed

Question 25

What is Virchows Triad

Answer 25

stasis hypercoagulability endothelial injury

Question 26

severe pulm HTN increases pulmonary vascular resistance which leads to

Answer 26

right sided HF and decreased CO

Question 27

Aortic dissection is

Answer 27

separation between layers of the aorta with a false lumen that spreads secondary to pulse and BP - can occlude blood flow to other organs

Question 28

Cardioversion is

Answer 28

shocking the pt at correct time - synchronized

Question 29

Defibrillate is

Answer 29

increased J count, not synchronized like cardioversion

Question 30

Lethal tachyarrhythmias include

Answer 30

Ventricular tachycardia - when the heart is pumping so fast that it can't fill correctly and will decrease CO Ventricular fibrillation - nothing being ejected out (low CO)