Cardio

Question 1

ECG changes in pregnancy

Answer 1

LAD
Increased HR
Inverted / flattened T waves in leads III , V1-v3, q wave in II, III, avf
50-60% have ectopic beats in continuous ECG readings

Question 2

Most common arrhythmia in pregnancy

Answer 2

SVT

Question 3

Arrhythmia ECG changes

Answer 3

WPW - delta wave
High voltage in précordial leads with Q wave / ST changes in HOCM
Long QT - > 460ms LQTS

Question 4

Which patients need an ECHO?

Answer 4

Diagnosed arrhythmia
Audible heart murmur
Concerning features - SOB
known structural heart disease
Previous chemotherapy with cardio toxic agents
Family history inherited arrhythmia eg. Long QT syndrome, sudden cardiac death

Question 5

When is ECHO not indicated ?

Answer 5

Symptoms consistent with physiological changes in pregnancy
Isolated sinus tachycardia at time of symptoms on ambulatory ECG
Infrequent ectopic beats in the absence of other signs of structural heart disease / inherited arrhythmia

Question 6

Most common non benign arrhythmia in pregnancy

Answer 6

SVT
24/100000

Question 7

Cardiac disease associated with ventricular tachycardia

Answer 7

HOCM
Peripartum cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy
Congenital heart disease, including previous surgery
Valvular disease
Myocardial infarction

Inherited channelopathies

Long QT syndrome