Cardiology Flashcards
(14 cards)
Cause of Torsade de Pointes
congenital
- Jervell-Lange-Nielsen syndrome
- Romano-Ward syndrome
antiarrhythmics: amiodarone, sotalol, class 1a antiarrhythmic drugs
tricyclic antidepressants
antipsychotics
chloroquine
terfenadine
erythromycin
electrolyte: hypocalcaemia, hypokalaemia, hypomagnesaemia
myocarditis
hypothermia
subarachnoid haemorrhage
Treatment of Torsades de pointes
IV magnesium sulphate
Arrhythmia life threatening signs
Shock
Syncope
Heart failure
MI
Treatment of life threatening bradycardia
Atropine 500 mcg IV
Up to 3 mg
After, adrenaline 2-10 mcg/min
Transcutaneous pacing
Transvenous pacing
Asystole risk in bradycardia
Recent
Mobitz type II
Complete heart block
Ventricular pause >3s
Life threatening tachycardia treatment
Up to 3 synchronised DC cardioversion shocks
No success
AMiodarone 300 mg IV over 10-20 mins
VT treatment
Amiodarone 300 mg IV over 10-60 min
if ineffective synchronised dc cardioversion
Type of arrhythmia: Torsades de Pointes
broad irregular
Type of arrhythmia: VT
broad regular
Type of arrhythmia: AF
irregular narrow
or broad if bundle branch block
Regular narrow tachy treatment
Vagal manoeuvres
Carotid massage
Adenosine 6 mg rapid IV bolus
then 12 mg
then 18 mg
unsuccessful verapamil or beta blocker
ineffective then synchronised DC cardioversion
Fluids in children <10 kg
100 ml/kg
Fluids in children 10-20 kg
100 ml/kg for first 10 kg
then 50 ml/kg
Fluids in children >20 kg
