Cardiac and ECG

Question 1

What ECG changes do you see in myocarditis?

Answer 1

Generalised ST elevation (most leads)
PR segment depression (most leads, except V1)

Note:
No simultaneous T wave inversions
No reciprocal ST depression (very common in STEMI)

Question 2

How long can it take for ST elevation to normalise after myocarditis? What abnormality can you see then?

Answer 2

Weeks

Then T wave inversions (but never simultaneously)

Question 3

Which psychotropic drugs are most likely to cause QT prolongation?

Answer 3

Typical antipsyhotics (haloperidol, thioridazine)
Tricyclic antidepressants (almost all)
Some atypical antipsychotics (ziprasidone, quetiapine)
Some SSRIs (escitalopram)

Question 4

What is considered prolonged QTc?

Answer 4

> 440ms in males

>460ms in females

Question 5

What are some risk factors for prolonged QTc?

Answer 5

Older age
Pre-existing heart problems
Female
Multiple medications
Hypokaelemia

Question 6

What is the most serious cardiac consequence of prolonged QTc?

Answer 6

Torsades de Points (ventricular arrhythmia)