Cardiac sudden death Flashcards
(59 cards)
1
Q
What are the 4 H’s of cardiac arrest
A
- hypoxia
- hypovolaemia
- hypo/hyperkalaemia
- hypothermia
2
Q
Wischnewski ulcers are found _____ and are associated with___
A
- gastric
- hypothermia
3
Q
What are the 4 T’s of cardiac arrest
A
- thrombosis
- tamponade
- toxins
- tension pneumothorax
4
Q
When might a cardiac tamponade be seen?
A
- after MI
- increased fluid
5
Q
Name 2 complications of MI’s?
A
- pericarditis
- cardiac aneurysm
6
Q
Define shock
A
- condition of inadequate perfusion to sustain normal organ function
7
Q
Name different types of shock
A
- cardiogenic
- hypovolaemic
- obstructive
- distrubtive
- cytotoxic
8
Q
Describe hypovolaemic shock
A
- loss of circulating volume
- reduced preload and cardiac output
9
Q
Define preload
A
- volume in ventricles before systole
10
Q
Define cardiac output
A
- amount of blood pumped by the heart per minute
11
Q
Define cardiogenic shock
A
- myocardial dysfunction causing reduction in systolic function and cardiac output
12
Q
Define obstructive shock
A
- physical obstruction to filling of the heart
13
Q
Causes of obstructive shock?
A
- PE
- cardiac tamponade
- tension pneumothorax
14
Q
Define distributive shock
A
- significant reduction in SVR
15
Q
Define cytotoxic shock
A
- uncoupling of tissue oxygen delivery and mitochondrial oxygen uptake
16
Q
What moves the frank starling curve up?
A
- inotropes
17
Q
What moves the frank starling curve down
A
- decreased contractility
- failing heart
18
Q
Rising lactate levels are due to what and what is it a sign of?
A
- due to hypoperfusion
- septic shock
19
Q
Neurogenic shock often follows_____
A
- spinal cord or central trauma
20
Q
Name 2 shockable cardiac arrest rhythms?
A
- ventricular fibrillation
- pulseless ventricular tachycardia
21
Q
Name 2 non-shockable cardiac arrest rhythms?
A
- pulseless electrical activity
- asystole
22
Q
What is the CPR ratio advised?
A
- 30:2
23
Q
What does transthoracic impedance mean?
A
- body’s resistance to current flow
24
Q
How might ventricular fibrillation look on ECG?
A
- bizarre irregular waveform
- no recognisable QRS complexes
25
Pulsless ventricular tachycardia has 2 subtypes?
- monomorphic
| - polymorphic = torsade de pointes
26
After 3 shocks and no improvement what should be given?
- adrenaline 1mg IV
| - Amiodarone 300mg IV
27
How should aystole be treated?
- adrenaline 1mg every 3-5mins
28
Treatment of hyperkalaemia?
- calcium chloride
| - insulin/dextrose solution
29
Treatment of hypokalaemia
- electrolyte infusion
30
Treatment of cardiac tamponade
- needle pericardiocentesis
31
How long should CPR be continued after fibrinolytic treatment in a thrombosis?
- 60-90mins
32
How can the heart increase its cardiac output?
- increase heart rate (tachycardia)
| - increase stroke volume (isotropy)
33
What is the cranial nerve involved in the baroreceptor reflex in the carotid sinus?
- CN IX
| - glossopharyngeal
34
What is the cranial nerve involved in the baroreceptor reflex in the aortic arch?
- CN X
| - vagus
35
What are the 2 categories of cardiac arrhythmias
- cardiomyopathies
| - channelopathies
36
Explain what is meant by a cardiomyopathy?
- related to scar/electrical barrier formation
37
Explain what is meant by a channelopathie?
- ion current imbalances
38
Name some cardiomyopathies?
- hypertrophic cardiomyopathy
- dilated cardiomyopathy
- arrthymogenic right ventricular cardiomyopathy
39
Name some channelopathies?
- long QT syndrome
| - brugada
40
3 divisions of arrhythmia generation?
- automaticity
- trigger
- re-entry
41
Early afterdepolarisations occur in what phase of the cardiac cycle?
- phase 2 or 3
42
What is at risk of developing in an early afterdepolarisation?
- torsardes de pointes
43
Delayed afterdepolarisations occur in what phase of the cardiac cycle?
- phase 4
44
What can potentiate a early afterdepolarisation?
- hypokalaemia
| - amiodarone
45
Amiodarone does what to the QT interval?
- increased QT interval
46
Commonest mutation in long QT syndrome effects what channel?
- potassium channel
47
Diagnosis of long QT syndrome?
- QT >480ms
| - mutation
48
Management of long QT syndrome?
- beta blockers
| - avoid triggers
49
KCNQ1 mutation is associated with?
- Long QT syndrome
50
Short QT syndrome is mutations to the ____ channel
- potassium
51
Brugada syndrome has a high risk of ______
- polymorphic VT, VF
52
What may trigger polymorphic VT in Brugada syndrome?
- rest
- sleep
- excessive alcohol
53
Treatment of Brugada syndrome?
- ICD
54
Catecholaminergic polymorphic ventricular tachycardia is autosomal___
- dominant
55
Explain ECG appearance of Wolff-parkinson white syndrome
- delta wave
| - short PR interval
56
Name the accessory pathway in Wolff-parkinson white syndrome?
- bundle of Kent
57
hypertrophic cardiomyopathy is associated with mutations in what genes?
= sarcomere
58
HCM 5-year risk score of greater than ____% indicates the need for a ICD in hypertrophic cardiomyopathy?
- >4%
59
Genetic mutations account for ___% of dilated cardiomyopathies, other causes include___
- 20%
| - viral, alcohol, diet
