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Sudden death - CLASP > Cardiac sudden death > Flashcards

Cardiac sudden death Flashcards

1
Q

What are the 4 H’s of cardiac arrest

A
  • hypoxia
  • hypovolaemia
  • hypo/hyperkalaemia
  • hypothermia
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2
Q

Wischnewski ulcers are found _____ and are associated with___

A
  • gastric

- hypothermia

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3
Q

What are the 4 T’s of cardiac arrest

A
  • thrombosis
  • tamponade
  • toxins
  • tension pneumothorax
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4
Q

When might a cardiac tamponade be seen?

A
  • after MI

- increased fluid

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5
Q

Name 2 complications of MI’s?

A
  • pericarditis

- cardiac aneurysm

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6
Q

Define shock

A
  • condition of inadequate perfusion to sustain normal organ function
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7
Q

Name different types of shock

A
  • cardiogenic
  • hypovolaemic
  • obstructive
  • distrubtive
  • cytotoxic
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8
Q

Describe hypovolaemic shock

A
  • loss of circulating volume

- reduced preload and cardiac output

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9
Q

Define preload

A
  • volume in ventricles before systole
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10
Q

Define cardiac output

A
  • amount of blood pumped by the heart per minute
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11
Q

Define cardiogenic shock

A
  • myocardial dysfunction causing reduction in systolic function and cardiac output
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12
Q

Define obstructive shock

A
  • physical obstruction to filling of the heart
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13
Q

Causes of obstructive shock?

A
  • PE
  • cardiac tamponade
  • tension pneumothorax
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14
Q

Define distributive shock

A
  • significant reduction in SVR
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15
Q

Define cytotoxic shock

A
  • uncoupling of tissue oxygen delivery and mitochondrial oxygen uptake
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16
Q

What moves the frank starling curve up?

A
  • inotropes
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17
Q

What moves the frank starling curve down

A
  • decreased contractility

- failing heart

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18
Q

Rising lactate levels are due to what and what is it a sign of?

A
  • due to hypoperfusion

- septic shock

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19
Q

Neurogenic shock often follows_____

A
  • spinal cord or central trauma
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20
Q

Name 2 shockable cardiac arrest rhythms?

A
  • ventricular fibrillation

- pulseless ventricular tachycardia

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21
Q

Name 2 non-shockable cardiac arrest rhythms?

A
  • pulseless electrical activity

- asystole

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22
Q

What is the CPR ratio advised?

A
  • 30:2
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23
Q

What does transthoracic impedance mean?

A
  • body’s resistance to current flow
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24
Q

How might ventricular fibrillation look on ECG?

A
  • bizarre irregular waveform

- no recognisable QRS complexes

25
Q

Pulsless ventricular tachycardia has 2 subtypes?

A
  • monomorphic

- polymorphic = torsade de pointes

26
Q

After 3 shocks and no improvement what should be given?

A
  • adrenaline 1mg IV

- Amiodarone 300mg IV

27
Q

How should aystole be treated?

A
  • adrenaline 1mg every 3-5mins
28
Q

Treatment of hyperkalaemia?

A
  • calcium chloride

- insulin/dextrose solution

29
Q

Treatment of hypokalaemia

A
  • electrolyte infusion
30
Q

Treatment of cardiac tamponade

A
  • needle pericardiocentesis
31
Q

How long should CPR be continued after fibrinolytic treatment in a thrombosis?

A
  • 60-90mins
32
Q

How can the heart increase its cardiac output?

A
  • increase heart rate (tachycardia)

- increase stroke volume (isotropy)

33
Q

What is the cranial nerve involved in the baroreceptor reflex in the carotid sinus?

A
  • CN IX

- glossopharyngeal

34
Q

What is the cranial nerve involved in the baroreceptor reflex in the aortic arch?

A
  • CN X

- vagus

35
Q

What are the 2 categories of cardiac arrhythmias

A
  • cardiomyopathies

- channelopathies

36
Q

Explain what is meant by a cardiomyopathy?

A
  • related to scar/electrical barrier formation
37
Q

Explain what is meant by a channelopathie?

A
  • ion current imbalances
38
Q

Name some cardiomyopathies?

A
  • hypertrophic cardiomyopathy
  • dilated cardiomyopathy
  • arrthymogenic right ventricular cardiomyopathy
39
Q

Name some channelopathies?

A
  • long QT syndrome

- brugada

40
Q

3 divisions of arrhythmia generation?

A
  • automaticity
  • trigger
  • re-entry
41
Q

Early afterdepolarisations occur in what phase of the cardiac cycle?

A
  • phase 2 or 3
42
Q

What is at risk of developing in an early afterdepolarisation?

A
  • torsardes de pointes
43
Q

Delayed afterdepolarisations occur in what phase of the cardiac cycle?

A
  • phase 4
44
Q

What can potentiate a early afterdepolarisation?

A
  • hypokalaemia

- amiodarone

45
Q

Amiodarone does what to the QT interval?

A
  • increased QT interval
46
Q

Commonest mutation in long QT syndrome effects what channel?

A
  • potassium channel
47
Q

Diagnosis of long QT syndrome?

A
  • QT >480ms

- mutation

48
Q

Management of long QT syndrome?

A
  • beta blockers

- avoid triggers

49
Q

KCNQ1 mutation is associated with?

A
  • Long QT syndrome
50
Q

Short QT syndrome is mutations to the ____ channel

A
  • potassium
51
Q

Brugada syndrome has a high risk of ______

A
  • polymorphic VT, VF
52
Q

What may trigger polymorphic VT in Brugada syndrome?

A
  • rest
  • sleep
  • excessive alcohol
53
Q

Treatment of Brugada syndrome?

A
  • ICD
54
Q

Catecholaminergic polymorphic ventricular tachycardia is autosomal___

A
  • dominant
55
Q

Explain ECG appearance of Wolff-parkinson white syndrome

A
  • delta wave

- short PR interval

56
Q

Name the accessory pathway in Wolff-parkinson white syndrome?

A
  • bundle of Kent
57
Q

hypertrophic cardiomyopathy is associated with mutations in what genes?

A

= sarcomere

58
Q

HCM 5-year risk score of greater than ____% indicates the need for a ICD in hypertrophic cardiomyopathy?

A
  • > 4%
59
Q

Genetic mutations account for ___% of dilated cardiomyopathies, other causes include___

A
  • 20%

- viral, alcohol, diet

Sudden death - CLASP (4 decks)

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