Cardiovascular Flashcards
presentations and conditions
Shockable rhythms
Ventricular tachycardia
Ventricular fibrillation
Non shockable rhythms
- pulseless electrical activity
-asystole
Narrow complex tacycardia
- QRS less than 0.12
- equal to 3 small squares on ecg
Sinus tachycardia (treatment focuses on the underlying cause)
Supraventricular tachycardia (treated with vagal manoeuvres and adenosine)
Atrial fibrillation (treated with rate control or rhythm control)
Atrial flutter (treated with rate control or rhythm control, similar to atrial fibrillation)
Management of life-threatening features of narrow complex tachycardia
- synchronised DC cardio version under sedation or GA
IV amioadrome is given if shocks are unsuccessful
Broad complex tachycardia
- QRS greater than 0.12 or 3 small squares
- VT
-polymorphic ventricular tachycardia (Rosales de pointes)
-AF with bundle branch block
-SVT with bundle branch block
Management of tornadoes de pointes
IV magnesium
Management of AF
Rate control drugs
Anticoagulant the patient to prevent clots
Ventricular tachycardia management
IV amiodarone
Atrial flutter
- re-enterant rhythm
- self perpetuating loop
-300bpm regular regular
-sawtooth appearance
-CHA2DS2VASC score
Prolonged QT number in men vs women
More than 440 milliseconds in men
More than 460 milliseconds in women
Causes of long QT syndrome
Long QT syndrome (an inherited condition)
Medications, such as antipsychotics, citalopram, flecainide, sotalol, amiodarone and macrolide antibiotics
Electrolyte imbalances, such as hypokalaemia, hypomagnesaemia and hypocalcaemia
Management of prolonged QT interval
Stopping and avoiding medications that prolong the QT interval
Correcting electrolyte disturbances
Beta blockers (not sotalol)
Pacemakers or implantable cardioverter defibrillators
Type 1 heart block
- slow conduction to the AV node.
- typically results in increased PR interval
- greater than 0.2 seconds
- regular HR
- can be asymptomatic
Manamgment
- monitoring
-identify underlying cause
Pacing