Ventricular Tachycardia Flashcards Preview

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Flashcards in Ventricular Tachycardia Deck (33)
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1

What is ventricular tachycardia (VT).

Sustained VT is VT that lasts >30seconds or causes haemodynamic compromise.

2

What causes VT. (5)

Most commonly due to ischaemic heart disease (and a myocardial infarction).
Cardiomyopathy.
Metabolic abnormalities.
Drug toxicity.
Long QT syndrome.

3

What are the symptoms of VT. (3)

Palpitations.
Chest pain.
Syncope.

4

What are the clinical signs of VT. (4)

Tachycardia with hypotension.
Varying 1st heart sound.
Occasional cannon waves (giant 'a' waves in JVP).

5

What is the most appropriate investigation for VT.

ECG.

6

What can be seen in the ECG in VT.

Wide complex tachycardia.

7

What is the most appropriate treatment for VT. (3)

Anti-arrhythmics.
DC cardioversion.
Implantable cardiac defibrillator to treat recurrence.

8

What anti-arrhythmics can be used in VT. (2)

Amiodarone.
Lidocaine.

9

What is the main complication of VT.

Ventricular fibrillation (VF).

10

What are the ECG changes that indicate VT. (2)

Rate >100 BPM.
QRS >120ms.

11

What is included in VT.

Torsade de pointes.

12

What is the differential diagnosis for a broad complex tachycardia. (2)

VT (includes torsade de pointes).
Supraventricular tachycardia.

13

What are the main ECG findings that will indicate VT. (5)

Positive QRS concordance in chest leads.
Marked left axis deviation.
AV dissociation (occurs in 25%) or 2:1 or 3:1 AV block.
Fusion beats or capture beats.
QRS Brugada criteria.

14

What does concordance mean.

Means that the QRS complexes are all positive or all negative.

15

What is a fusion beat.

It is when a normal beat fuses with a VT complex to create an unusual complex.

16

What is a captured beat.

A normal QRS between abnormal beats.

17

How do you manage pulseless or unstable VT.

Use asynchronized DC shock.

18

How do you manage stable VT. (7)

High flow oxygen by face maskl.
IV access (UandEs, cardiac enzymes, calcium, magnesium).
Correct low potassium or magnesium.
12 lead ECG.
ABG (if evidence of pulmonary oedema, reduced consciousness or sepsis).
Amiodarone.
ICD to prevent further recurrence.

19

How do you treat torsade de pointes.

Magnesium sulphate.

20

What is torsade de pointes.

Looks like VF, but is VT with a varying axis.

21

What is the commonest post MI arrhythmia.

Ventricular extrasystoles (ectopics).

22

What does the R on T pattern of ectopics indicate post MI.

Risk of VF.

23

What is the brugada criteria used for.

To help differentiate SVT from VT.

24

What does the presence of Q waves in V6 favour.

VT.

25

What does no Q wave in V6 favour.

SVT.

26

What does this pattern in V1 or V2 favour:
R>30ms.
>60ms to nadir S.
Notches S.

VT.

27

What does a triphasic R in V6 favour.

SVT..

28

What does a R to S ratio of

VT.

29

What does a QS or QR in V6 favour.

VT.

30

What does a monophasic R in V6 favour.

VT.