sudden death Flashcards

Question

what are antiarrhythmic drugs

Answer 1

usually affect ion channel activity or sympathetic drive eg amiodarone, beta blockers, digoxin for AF mostly for supraventricular arrhythmias (atria or AV node)

Answer 2

tissue damage caused when blood supply returns to the tissue after a period of ischaemia or hypoxia can lead to electrical irregularities & risk

Answer 3

the restoration of circulation results in inflammation and oxidative damage

Answer 4

cooling immunosuppression oxygen radical scavengers

Answer 5

both loss of consciousness may have no symptoms when not occurring Syncope registered by Holter monitor (24 hr ECG) Seizure registered by EEG (brain imaging is also important) seizures associated with stiffness/unusual posture seizures tip and syncope crumple convulsive syncope can feature both

Answer 6

``` Vagal increase (& symp decrease) - vasodilatation and low heart rate Triggered centrally (ie brain) not at level of heart most common form of syncope, common in young adults and is recurrent ```

Answer 7

Neurocardiogenic origin | Benign

Answer 8

the initial patient in the population of an epidemiological investigation

Answer 9

In medical genetics, the index case is the case of the original patient that stimulates investigation of other members of the family

Answer 10

Statistical measurement of the impact of a medicine or therapy Average number of patients who need to be treated to prevent one additional bad outcome

Answer 11

genetic screening

Answer 12

proportion of individuals carrying a particular variant (or allele) of a gene that also expresses an associated trait (the phenotype)

Answer 13

do not express trait even though they carry the allele channelopathies can vary from patient to patient phenotypes of disease can differ most diseases are polygenic

Answer 14

50% all cardiac death more male peak 45-75y/o majority related to coronary disease

Answer 15

``` substrate (structure or elec) ectopic activity (early after depolarisation, short coupling interval, delayed after depolarisation) re-entry wave break ```

Answer 16

reconduction through an area of unidirectional conduction block circuit larger, refractory period abnormal, zone of slow conduction - allow for repolarisation

Answer 17

acute ischaemia | ventricular remodelling - scar formation, myocardial fibrous, coupling, dilatation, poor function

Answer 18

zone of infarction to injury to ischaemia which spreads

Answer 19

``` idiopathic viral alcohol drugs autoimmune ```

Answer 20

``` myocardial fibrosis neurohumoral activation increased sympathetic tone electrolyte disturbances = ectopy, re-entry, VT/VF ```

Answer 21

most common cause of SCD in young athletes autosomal dominant, incomplete penetrance mutation of cardiac muscle sarcomere genes commonly beta-myosin or troponin-T LV outflow obstruction, anterior motion of mitral valve, asymmetrical septal hypertrophy

Answer 22

``` asymptomatic exertion chest pain/dyspnoea exertion syncope palpitations mechanism of SCD unclear ```

Answer 23

30-50% familial multi-genomic replace RV myocardium with fibro-fatty tissue RV hypertrophy and dilation VT/VF due to re-entry around interstitial fibrosis

Answer 24

asymptomatic exertional syncope atrial arrhythmias common epsilon wave on ECG

Answer 25

aortic stenosis mitral stenosis mitral valve prolapse congenital heart disease (anomalous coronary arteries, Epstein's anomaly, complex like tetralogy)

Answer 26

non ischaemic structurally normal heart syndromes include - long QT, WPW, Brugada, primary VT/VF

Answer 27

``` Wolff-Parkinson-White accessory pathway from atria to ventricle atrial arrhythmia ventricular pre-excitation VTVF clues on resting ECG ```

Answer 28

``` channelopathy mostly SCN5A - fast-type sodium channel reduce conduction velocities particularly affects RVOT prone to VT arising from RVOT ```

Answer 29

identify those at risk preventative treatment - underlying cause, avoid precipitants, anti-arrhythmic meds, ICDs family screening if appropriate

Answer 30

S-ICD - subcutaneous, on breastbone | Transverse ICD - intravascular, tip of lead in contact with right V

Answer 31

``` Cardiac arrest survivors VT with haemodynamic compromise high risk - CAD, poor LV function, broad QRS Some HCM, long QT, Brugada, ARVC Congenital HD ```

Answer 32

``` survived cardiac arrest one or more of VF/spontaneous sustained VT Unexplained syncope LV wall thickness over 30mm spontaneous NSVT abnormal exercise BP family history of premature sudden death ```

sudden death Flashcards

(56 cards)