Arrhythmias- Broad Complex Tachycardias Flashcards
1
Q
define broad complex tachycardias
A
HR > 100bpm & QRS width >0.12seconds
2
Q
outline the types of broad complex tachycardias?
A
- Ventricular tachycardia
- Torsades de Pointes
- SVT w BBB
3
Q
what is sustained VT?
A
VT that lasts > 30 seconds / causes haemodyanmic compromise
4
Q
aetiology of VT? mnemonic
A
IMQVICK
Infarction
Myocarditis
QT interval prolonged
Valve abnormality
Iatrogenic
Cardiomyopathy (esp dilated)
K down, Mg down, oxygen down
5
Q
symptoms of VT?
A
- chest pain
- palpitations
- syncope
6
Q
VT on ECG?
A
- no P waves
- regular, wide QRS complex
- no T waves
7
Q
Rx of VT?
A
- no pulse–> CPR
- unstable
- sedate + DC cardioversion
- stable
- anti-arrhythmic
- if recurrent
- ICD
8
Q
complication of VT?
A
V Fib
9
Q
what is Torsades de Pointes?
A
- a type of polymorphic ventricular tachycardia
- name - twisting of hips- reflects the ECG characteristics
- height of QRS complexes progressively gets smaller, then larger and so on
10
Q
aetiology of torsades de pointes?
A
Prolonged QT interval
- muscle cells take longer to repolarise after contraction –>some myocytes randomly depolarise and this spreads throughout the ventricle –> causing the ventricle to contract prior to proper repolarisation occurring
11
Q
outcomes of TDP?
A
- terminate spontaneously & revert back to sinus rhythm
- VT
12
Q
causes of prolonged QT?
A
- long QT syndrome (inherited)
- Medications
- antipsychotics
- citalopram
- flecianide
- sotalol
- amiodarone
- macrolide Abx
- Electrolyte disturbances
- hypokalaemia
- hypocalcaemia
- hypomagnasaemia
13
Q
Mx of long QT syndrome?
A
- avoid QT prolonging drugs
- correct electrolyte abnormalities
- beta blockers (not sotalol)
- pacemaker or ICD
14
Q
Mx of TDP?
A
- correct cause (electrolyte/drugs)
- magnesium infusion
- even if serum magnesum normal
- defibrillation if VT occurs
