Cardiology

Question 1

What is a poor prognostic indicator in ACS?

Answer 1

Cardiogenic shock

Question 2

An ECG is performed which shows ST elevation and bradycardia with a 1st-degree heart block.

Given the ECG findings, which leads will most likely show the ST elevation?

Answer 2

Leads II, III and aVF

Right coronary infarct supplies the AV node so can cause arrhythmias after infarction

Question 3

What are some adverse effects from adenosine?

Answer 3

Chest pain
Bronchospasm (avoid in asthmatics)
Transient flushing
Can enhance conduction down accessory pathways, resulting in increased ventricular rate (e.g. WPW syndrome)

(most commonly used to terminate supraventricular tachycardias)

Question 4

How to approach tachyarrhythmias?

Answer 4

1. Is it regular Y/N?
   - irregular = AF
2. Narrow or broad?
   - narrow = atrial flutter, atrial tachy, AVNRT, AVRT, sinus tachy
   - broad = VT, SVT with accessory pathway

Question 5

What % of all broad complex tachycardias are VT?

Answer 5

80%

Question 6

In IHD/LV dysfunction, what % of all broad complex tachycardias are VT?

Answer 6

95%