Bradyarrythmias

Question 1

How should you assess someone with this?

Answer 1

Look for adverse features

1) Shock
2) Syncope
3) Features of myocardial ischaemia
4) Symptoms of HF
5) Risk factors for asystole
- recent asystole
- Mobitz type 2
- complete HB
- Ventricular pause >3 seconds

Question 2

What is the management of unstable bradycardia?

Answer 2

1) IV atropine 500mcg
2) Repeat every 3-5 mins up till 3mg atropine
3) Consider transcutaenous pacing or second line meds e.g. isoprenaline/adrenaline
4) If all fails then transvenous pacing

Question 3

What is this?

Answer 3

1st degree heart block
PR >200ms

Question 4

What is this

Answer 4

Mobitz I- Wenkebach
Prolonged PR until dropped QRS

Question 5

What is this?

Answer 5

Mobitz II
Prolonged PR with dropped QRS complex
- interval is constant
High risk of developing complete heartblock

Question 6

What is this?

Answer 6

Complete Heartblock

Will have wide pulse pressure