Bradyarrhythmias Flashcards
1
Q
What is a bradyarrhythmia?
A
Abn slow heart rate below 60 bpm
2
Q
What are the differential diagnosis of Bradyarrythmias? (4 things)
A
- 1st degree HB
- 2nd degree HB
- 3rd degree (complete) HB
- Sick Sinus Syndrome (Sinus Node Dysfunction)
3
Q
What are the Cardiac causes of Bradyarrhythmia? (3 things)
A
- AV block
- Sinus node disease
- Post MI
4
Q
What are the Non-cardiac causes of Bradyarrhythmia? (4 things)
A
- Vasovagal
- Hypothermia
- Hypothyroidism
- Raised intracranial pressure in assoc w HTN
5
Q
What are the Drug-induced causes of Bradyarrhythia? (4 things)
A
- Amiodarone
- Beta blockers
- Calcium channel blockers
- Digoxin
6
Q
What are the clinical features of bradycardia? (4 things)
A
- Syncope
- HF like: SOB / Orthopnoea / PND / Bibasal crepitations / raised JVP // NO peripheral oedema, only in HF)
- Shock: Hypotensive / Sweating / Pale / Increased CRT
- Chest Pain
7
Q
What investigations should you do for bradycardia? (4 things)
A
- 12 lead ECG
- Echo
- CXR
- Bloods (FBC, UnE, Mg, Bone profile, Thyroid, LFT, coag)
8
Q
What are the management steps for Bradyarrhythmias? (6 steps)
A
- ABCDE
- IV fluids if needed
- Identify + treat reversible causes (e.g electrolyte imbalance in VBG)
- Atropine 0.5mg IV (if showing clinical features)
- If atropine not working, do Transcutaneous Pacing (less srs version of cardioversion)
- Arrange for permanent pacemaker if needed
9
Q
How does Atropine work in Bradyarrhythmias? (4 things)
A
- Atropine = Antimuscarinic
- Blocks vagus nerve action on SAN + AVN
- Increased SAN activity + conduction thru AVN
- Increases HR
10
Q
What is pacing?
A
Delivering electrical stimuli to heart via pacing leads
11
Q
What are the different types of Pacing? (2 things)
A
- Temporary = Transcutaneous pacing (uses defibrillator + chest pads)
- Permanent = Pacemaker
