Arrhythmias

Question 1

What is AF?

Answer 1

Arrhythmia due to atrial spasm from erratic signaling.

Question 2

Symptoms of AF

Answer 2

Asymptomatic (most common), chest pain, palpitations + dyspnoea

Question 3

Investigations for AF?

Answer 3

1) ECG - irregularly irregular, no P waves
2) FBC, U&E, TFTs + cardiac enzymes
3) Echo - structural abnormalities

Question 4

Managing Unstable AF?

Answer 4

1) ABCDE
2) Call help
3) Defibrillate
4) Amiodorane

Question 5

Managing stable AF (<48h)

Answer 5

1) Flecaninide/Amiodarone

2) LMWH

Question 6

Managing stable AF (>48h)

Answer 6

1) DOAC/Warfarin for 3 weeks

2) Bisoprolol + dilitiazem (rate control)

Question 7

Managing Chronic AF?

Answer 7

1) Beta or rate limiting Ca blocker
2) Calculate CHA2DS2-VASc-C score
3) DOAC + Warfarin (Life)

Question 8

What is a Broad Complex Tachycardia?

Answer 8

HR >100 bpm, QRS > 0.12 secs; ventricular origin

Question 9

Signs of VF?

Answer 9

Medical emergency: Cardiac Arrest, syncope + no pulse

Question 10

Investigation of BCT?

Answer 10

1) Connect to Cardiac Monitor
2) Give O2 if <90% sats
3) Obs + Bloods (FBC, U&Es)

Question 11

Managing BCT?

Answer 11

1) Sedate patient
2) Up to 3 synchronized DC shocks
3) Correct electrolyte abnormalities
4) IV amiodarone 300mg

Question 12

Examples of BCT?

Answer 12

VF, Ventricular tachycardia, Torsade de pointes

Question 13

What is VF?

Answer 13

Ventricles do not pump normally, chaotic electric conduction.