11.2 MTB Step 3 - Arrhythmias (MAT, SVT, & WPW) Flashcards

Cards Complete:

1
Q

MULTIFOCAL ATRIAL TACHYCARDIA (MAT)

What is the Presentation for MAT?

A

MAT presents like Atrial Arrhythmia in a patient with

COPD/Emphysema

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2
Q

MULTIFOCAL ATRIAL TACHYCARDIA (MAT)

What are (3) Findings on ECG for MAT?

A
  1. Polymorphic P-waves (different Atrial Foci for the QRS complexes)
  2. Tachycardia (HR > 100bpm)
  3. Irregular “Chaotic” Rhythm
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3
Q

MULTIFOCAL ATRIAL TACHYCARDIA (MAT)

What is the 2-Step Treatment for MAT?

A

Step 1: Oxygen

Step 2: Diltiazem

Do NOT use Beta-Blockers!

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4
Q

SUPRAVENTRICULAR TACHYCARDIA (SVT)

What are (3) Common Presenting Signs/Symptoms of SVT?

A
  1. Palpitations
  2. Tachycardia (Ventricular Rate = 160 - 180)
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5
Q

SUPRAVENTRICULAR TACHYCARDIA (SVT)

What are the Best Inpatient & Outpatient Diagnostic Tests for SVT?

A

Inpatient = Telemetry

Outpatient = Holter Monitor

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6
Q

SUPRAVENTRICULAR TACHYCARDIA (SVT)

What is the Best INITIAL Management for Stable patients with SVT?

A

Vagal Maneuvers

(Carotid Sinus Massage, Ice Immersion of Face, Valsalva)

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7
Q

SUPRAVENTRICULAR TACHYCARDIA (SVT)

What is the Next BEST Step in Management for Stable patients with SVT who don’t respond to initial treatment?

A

Adenosine (IV)

Most Frequently asked SVT question

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8
Q

SUPRAVENTRICULAR TACHYCARDIA (SVT)

What is the Best INITIAL Management for Unstable patients with SVT?

A

Synchronized Cardioversion

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9
Q

SUPRAVENTRICULAR TACHYCARDIA (SVT)

What is the Best Long-Term Management for SVT?

A

Radiofrequency Catheter Ablation

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10
Q

WOLFF-PARKINSON-WHITE SYNDROME (WPW)

Hows does WPW Present?

A

WPW presents like SVT that can Alternate with Ventricular Tachycardia (VT)

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11
Q

WOLFF-PARKINSON-WHITE SYNDROME (WPW)

What is a Unique Clue to the Diagnosis of WPW?

A

Worsening of SVT after the use of:

Calcium-Channel Blockers

or

Digoxin

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12
Q

WOLFF-PARKINSON-WHITE SYNDROME (WPW)

  1. What is the Best INITIAL Test for WPW?
  2. What is the Most ACCURATE Test for WPW?
A
  1. ECG showing Delta-wave
  2. Electrophysiologic Studies
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13
Q

WOLFF-PARKINSON-WHITE SYNDROME (WPW)

  1. What is the Best INITIAL Therapy if the patient is described as being in SVT or VT from WPW?
  2. What is the Best Long-Term Therapy for WPW?
A
  1. Procainamide
  2. Radiofrequency Catheter Ablation
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14
Q

WOLFF-PARKINSON-WHITE SYNDROME (WPW)

What is the Mechanism of WPW?

A
  • There is an abnormal piece of neutralized cardiac muscle going around the AV node in WPW.
  • This can result in either Atrial or Ventricular arrhythmia.
  • The slowest conduction in the heart is the AV node.
  • Conduction in the aberrant tract is faster; that is why the PR is short (< 120 msec) and there is a Delta-wave of ECG.
  • Calcium Channel Blockers and Digoxin block conduction more in the normal AV and force the conduction down the abnormal conduction tract.
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