Cardiac emergencies

Question 1

Which lesions are PDA dependent?

Answer 1

PA
TA
Critical PS
Ebstein’s anomaly

Question 2

How do you diagnose a myocarditis?

Answer 2

High sensitivity trop T
CK MB
Viral studies
ECG
Echo/CT/MRI

Question 3

How do you manage cardiac tamponade?

Answer 3

Oxygen
Fluid bolus
Inotropes
Pericardiocentesis

Question 4

How do you manage an SVT?

Answer 4

Stabilise patient
Vagal maneuvers (cough, ice on forehead, face in cold water)
Carotid massage
Adenosine rapid bolus
Synchronized cardioversion
Overdrive pacing

Question 5

What is the dose of adenosine in SVT management?

Answer 5

100 -> 200 -> 300mcg/kg via CVP

Question 6

How do you classify a ventricular tachycardia?

Answer 6

Monomorphic vs polymorphic
Sustained vs non-sustained
Pulseless vs stable

Question 7

How do you manage a ventricular tachycardia?

Answer 7

Pulseless - cardioversion

Stable - amiodarone then cardioversion

Question 8

Name causes of a complete heart block

Answer 8

Congenital

• isolated (maternal autoimmune)
• complex (heterotaxy syndrome, AVSD, corrected TGA)

Acquired

• myocarditis
• postcardiac surgery

Question 9

How do patients with a complete heart block appear clinically?

Answer 9

Bradycardia
Syncope
Hypotension

Question 10

Discuss management of a complete heart block

Answer 10

Unstable - pacing pads and defib
Stable - cath lab
Temporary pacemaker vs permanent pacemaker

Question 11

What are the criteria for Kawasaki disease?

Answer 11

Warm CREAM
Fever>5d
4/5
Conjunctivitis (bilateral, non-purulent)
Rash (maculopapular, erythematous)
Erythema (hands and soles)
Adenopathy (unilateral, cervical)
Mucous membranes (red mouth and tongue)

OR 3/5 if proven coronary aa disease