Arrhythmias - Torsades de Pointes Flashcards
1
Q
ESSENCE
A
Polymorphic ventricular tachycardia characterised by sinusoidal and cyclic alterations on ECG
2
Q
AETIOLOGY
Risk factors
A
- Low magnesium
- Low potassium
3
Q
AETIOLOGY
Common causes
A
- Familial
- Drugs (remember ABCDE)
- Class 1A antiarrhythmics
- Class III antiarrhythmics
- antiBiotics
- antipsyChotics
- antiDepressants
- antiEmnetics
- Diuretics
4
Q
PROGNOSIS
Long term
A
Typically resolves spontaneously but may degenerate into ventricular fibrillation and death
5
Q
CLINICAL FEATURES
Symptoms
A
- Palpitations
- Dizziness
- Syncope
- Symptoms may be triggered by stress
- Sudden cardiac death
6
Q
CLINICAL FEATURES
Signs
A
- Tachycardia
- Pallor
7
Q
INVESTIGATIONS
First choice
A
- Labs
- U&Es
- ECG
8
Q
ECG findings
A
- If in sinus rhythm
- Prolonged QT interval
- Pathological U waves
- If in episode
- Change in polarity of QRS around the isoelectric line
- Sinusoidal waveform
9
Q
MANAGEMENT
Options
A
- Conservative
- Discontinue all QT prolonging drugs
- Medical
- Magnesium sulfate
- B-antagonists
- Operative
- Pacing
10
Q
Discontinue all QT prolonging drugs indication
A
All patients
11
Q
Magnesium sulfate indicates
A
All patients
12
Q
B-antagonist indication
A
Long term therapy for patients with congenital long QT syndrome
13
Q
Pacing indications
A
- Medical failure
- Typically for patients with congenital long QT syndrome
