39. Arrhythmias Flashcards
What are the signs and symptoms of arrthymias/ presentation? (9)
- can be asymptomatic
- palpitations
- dyspnoea
- chest pain
- fatigue
- embolism
- syncope/pre-syncope
- pulmonary oedema
- hypotension
What investigations should be done for arrhythmias? (3)
- ECG; 12 lead, 24 hour recording, event recorder
- blood tests (esp. thyroid function, U+Es, FBC, glucose, Ca, Mg)
- Echo
What should be looked for an an ECG?
- long QT interval (metabolic imbalance, drugs, congenital)
- short PR interval (WPW syndrome)
- atrial fibrillation
- ischaemic heart disease signs
What should be looked for in an echo?
-any structural heart disease e.g. mitral stenosis
What 2 things are targeted in treatment of arrhythmias?
- rate control
2. rhythm control
What drugs are used to treat arrhythmias? (3)
- digoxin
- beta blockers
- ca antagonist plus Warfarin (or aspirin if low risk)
What electrical approaches are used to treat arrhythmias? (2)
- pace and ablation of AV node
2 substrate modification e.g. pulmonary vein ablation maze procedures
What is supraventricular tachycardia?
- abnormally fast heart rate from upper part of the heart
- they start from either atria or AV node
- regular
What are symptoms of supraventricular tachycardia? (4)
- palpitations
- dyspnoea
3 dizziness/syncope - chest pain
What can be used as treatment for supraventricular tachycardia? (4)
- for acute cases; valsalva manoeuvre (vagotonic manoeuvres)
- IV adenosine, Verapail or beta blockers
Does supraventricular tachycardia have good prognosis?
Yes; low recurrence rate (5%), 1 in 1500 mortality
What is atrial flutter?
- regular
- starts in atrial chamber
- type of supraventricular tachycardia
- re-entrant rhythm in either right or left atrium
- premature impulses arising in the atria
What is atrial flutter treated with?
- beta blockers or verapamil (for control of heart rate)
- digoxin is alternative
(control ventricular rate and thromboembolic risk)
What is ventricular fibrillation?
- irregular
- heart quivers due to disorganised electrical activity
What is ventricular tachycardia?
- regular
- very fast heart rate that arises from electrical activity in the ventricles of the heart