Cardiology - Atrial flutter and WCT

Question 1

Typical atrial flutter is caused by reentry around? (Direction and anatomy)

Answer 1

counterclockwise rotation around the tricuspid annulus.

Question 2

Atrial Flutter - rate or rhythm control?

Answer 2

Rate control often difficult (requires large amount of Nodal blockers)

#rhythm control
#ablation

Question 3

Typical atrial flutter appearance on ECG (directions of complexes)?

Answer 3

#Negative in inferior leads
#Positive in V1

Question 4

ECG features of wide complex tachycardia that suggest VT?

Answer 4

#positive in lead aVR
#QRS concordant in the precordial leads
#Exhibit extreme axis deviation (−90° to ±180°, sometimes called a northwest axis)
#AV dissociation
#fusion beats (QRS complex created by fusion between a sinus capture beat and a VT beat), 
#capture beats (sinus beat that captures the myocardium in between VT beat

Question 5

Forceful palpitations with PVCs are usually caused by?

Answer 5

exaggerated cardiac filling during the pause after the PVC

Question 6

PVCs care commonly seen in patients with?

Answer 6

#HTN
#LVH
#prior MI

Question 7

Test for PVC?

If fails to detect?

Answer 7

ECG

24 to 48 hour ambulatory monitoring

Question 8

Over 10,000 PVCs in a day can lead to?

If found, or should undergo?

Answer 8

Tachycardia-related myopathy

ECHO or cMRI to evaluate for structural heart disease

Question 9

Treatment for patients with low-risk bigemony or trigemony?

Answer 9

#β-blocker or nondihydropyridine  CCB
#Antiarrhythmic if PVCs persist #Catheter ablation if patient unable to tolerate medical therapy or if medical therapy fails

Question 10

High risk features in patients with PVCs include?

Answer 10

syncope
#a family history of premature SCD
#coronary artery disease,
#structural heart disease

Question 11

VT with structural heart disease

Answer 11

VT with structural heart disease