Symptomatic Bradycardia Flashcards Preview

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Flashcards in Symptomatic Bradycardia Deck (9)
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1
Q

A bradycardia is symptomatic if these 3 criteria are present

A
  1. The heart rate is slow
  2. The patient has symptoms
  3. The symptoms are due to the slow heart rate
2
Q

Bradycardic symptoms include…

A
Chest discomfort or pain
Shortness of breath
Decreased level of consciousness
Fatigue
Light-headedness
Dizziness
Presyncope or syncope
3
Q

Bradycardic signs include…

A
Hypotension
Orthostatic hypotension
Diaphoresis
Pulmonary congestion
Frank congestive heart failure
Pulmonary edema
Frequent bradycardia-related PVCs or VT
4
Q

Primary decision point in bradycardia algorithm is…

A

Determination of adequate perfusion

5
Q

Ask: Is persistent bradycardia causing… (5)

A
Hypotension?
Acutely altered mental status?
Signs of shock?
Ischemic chest discomfort?
Acute heart failure?

If no to all, monitor an observe

6
Q

If persistent bradycardia is causing poor perfusion, the first drug of choice is… (dose, frequency, maximum)

A

Atropine

First dose: 0.5 mg bolus
Repeat every 3-5 minutes
Maximum 3 mg

7
Q

Drug choices other than Atropine include… (and dose)

A

Dopamine: 2-10 mcg/kg per minute
Epinephrine: 2-10 mcg per minute

8
Q

Do not rely on Atropine in…

A

Mobitz type II second- or third-degree AV block or in third-degree AV block with a new wide QRS complex

9
Q

Consider transcutaneous pacing…

A

…in unstable patients with high degree heart block when IV access is not available and when patients do not respond to atropine