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Year 3 diagnosis and management > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Symptoms and signs of AAA?

A
  • Epigastric pain
  • Radiates to back
  • Severe
  • Syncope
  • Shock

• Grey-Turner’s sign

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2
Q

Investigation for AAA?

A
  1. Aortic ultrasound (doesn’t visualise leak)

2. CT contrast to visualise leak

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3
Q

Symptoms and signs for aortic dissection?

A
  • Sudden tearing pain
  • Radiation to back, between shoulder blades
  • Symptoms of organ hypoperfusion

• Pulsus paradoxus (large decrease in SBP and pulse wave amplitude during inspiration)

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4
Q

Signs for aortic regurgitation?

A
  • Early diastolic murmur
  • Collapsing pulse
  • Wide pulse pressure
  • Displaced and heavy apex beat
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5
Q

Most common cause of aortic stenosis?

A

Worldwide - rheumatic heart disease

UK - calcification

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6
Q

Symptoms and signs of aortic stenosis?

A
  • Angina
  • Syncope
  • Heart failure symptoms (dyspnoea/orthopnoea)
  • Ejection systolic murmur
  • Narrow pulse pressure
  • Slow-rising pulse
  • Aortic thrill
  • Thrusting apex beat
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7
Q

Signs and symptoms of arterial ulcers?

A
  • Punched-out
  • Hairless
  • Nail dystrophy and absent pulses downstream
  • Night pain
  • Symptoms of acute limb ischaemia (6 Ps)
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8
Q

Investigation for arterial ulcers?

A
  1. Duplex ultrasonography

2. ABPI

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9
Q

What are the causes of AF?

A
  • Thyrotoxicosis
  • HTN
  • Pneumonia
  • Alcohol
  • IHD
  • Cardiomyopathy
  • Pericarditis
  • Atrial myxoma
  • Bronchial carcinoma
  • PE
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10
Q

Management for AF and how do you manage stroke risk (low and high risk)?

A

Rhythm control if haemodynamically unstable e.g. angina
• < 48 hours (acute) - cardioversion : DC or chemical (flecainide, or amiodarone if IHD)
• > 48 hours (chronic) - anticoagulate with DOAC for 3-4 weeks, then cardioversion

Then rate control

  1. Bisoprolol or verapamil
  2. Digoxin or amiodarone

Paroxysmal AF - pill in pocket (flecainide)

Manage stroke risk
• Low risk - aspirin
• High risk - warfarin

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11
Q

What is used to assess the risk of stroke in AF patients? What does each score mean?

A

CHADS-vasc score
0 - low
1 - moderate
> 1 - high

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12
Q

What are the 8 reversible causes of cardiac arrest?

A
  • Hypokalaemia
  • Hypothermia
  • Hypovolaemia
  • Hypoxia
  • Tamponade
  • Tension pneumothorax
  • Thromboembolic
  • Toxins
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13
Q

Management for cardiac arrest (BLS)?

A
  • pre-cordial thump

* 2 rescue breaths, 30 chest compressions

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14
Q

Management for cardiac arrest (ALS)?

A

Pulseless VT / VF (shockable)
• shock + CPR
• adrenaline
• amiodarone

Pulseless electrical activity / asystole (non-shockable)
• Above, but just adrenaline

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15
Q

Which electrolytes do you measure in AF? When is there a risk of digoxin toxicity?

A
  • Potassium
  • Magnesium
  • Calcium

Risk of digoxin toxicity if potassium/ magnesium is low, or calcium is high

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16
Q

What are the symptoms and signs of left and right cardiac failure?

A

Left heart
• dyspnoea
• orthopnoea
• paroxysmal nocturnal dyspnoea

• tachycardia, tachypnoea
• displaced apex
• bi-basal crackles
• S3 gallop
• pan-systolic murmur
(• acute: + pulsus alternans)

Right heart
• swollen ankles
• fatigue, difficulty exercising
• anorexia, nausea

  • raised JVP, kussmaul sign
  • hepatomegaly, ascites
  • ankle/sacral oedema
  • tricuspid regurgitation
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17
Q

What is used to measure pressure in vessels (cardiac failure)?

A

Swan-Ganz catheter

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18
Q

Investigation for heart failure? What is systolic and diastolic HF?

A
  1. BNP
  2. Best diagnostic - Transthoracic echocardiogram (TTE) coupled with doppler
    • EF < 40% - systolic HF
    • EF > 50% - diastolic HF
  • ECG
  • CXR
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19
Q

Management for acute LV failure?

A 
1. Treat pulmonary oedema
• Sit up
• 60-100% O2
• IV furosemide
• Diamorphine
• GTN infusion
  1. Treat cardiogenic shock (SBP < 90)
    • inotropes e.g. dobutamine
  2. Monitor essential stats
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20
Q

Management for chronic LV failure? What should you avoid?

A
  1. Lifestyle changes
  2. ACEi (ARB if contraindicated) + beta blocker + furosemide
  3. Hydrazaline + isosorbide dinitrate, if 1. contraindicated
  4. Severe symptoms or EF <35%, consider cardiac resynchronisation

Avoid NSAIDs and non-dihydropiridine CCB

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21
Q

Causes of dilated, hypertrophic and restrictive cardiomyopathy?

A

Dilated - alcohol, drugs, post-viral, thyrotoxicosis
Hypertrophic - genetic
Restrictive - amyloidosis, sarcoidosis

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22
Q

Symptoms/presentation of dilated, hypertrophic and restrictive cardiomyopathy?

A

Dilated - HF symptoms, arrhythmias, FHx sudden death
Hypertrophic - asymptomatic, syncope, FHx sudden death
Restrictive - Kussmaul sign (paradoxical JVP rise), S3

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23
Q

Investigations for cardiomyopathy?

A

Diagnostic: echo
• CXR
• ECG

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24
Q

Symptoms and signs of constrictive pericarditis?

A
  • Gradual onset
  • Advanced - jaundice, cachexia, muscle wasting
  • RHF signs e.g. dyspnoea, peripheral oedema, Kussmaul’s sign S3
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25
Q

Causes of constrictive pericarditis?

A
  • TB
  • Virus
  • Post-surgical
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26
Q

What is the diagnostic investigation for constrictive pericarditis and what would you would you see in other investigations?

A

Diagnostic: echo (distinguish from restrictive cardiomyopathy)
• CXR (calcification)
• CT / MRI (thickness)
• Pericardial biopsy

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27
Q

Management for constrictive or normal pericarditis? Management if acute/purulent?

A
  1. NSAIDs + PPI (consider colchicine if idiopathic/viral)
  2. Corticosteroids
  3. Immunosuppression e.g. azathioprine
  4. Surgical pericardiectomy

acute: pericardiocentesis - ABx if purulent

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28
Q

How the risk for DVT is calculated?

A

Wells criteria

• 2 or more = high risk

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29
Q

Investigations for DVT?

A

Wells score < 2

  1. D-dimer
  2. if normal: DVT excluded. if elevated: do duplex USS (gold standard)

Wells score 2 or more
1. duplex USS

Pregnant
1. duplex USS

PE suspected - also do ECG, CXR, ABG

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30
Q

Management for DVT?

A
  1. Anticoagulation
    • Warfarin
    • LMWH whilst waiting for Warfarin to get to INR target (2-3), as it’s prothrombotic for first 48 hours

Below knee DVT - 3 months of anti-coag + obs
Above knee DVT - 6 months of anti-coag + obs

  1. IVC filter - if anti-coag contraindicated / high risk of PE
  2. Prevention
    • Graduated compression stockings
    • Mobilisation
    • Prophylactic heparin in high risk patients
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31
Q

Management for dyslipidaemia?

A
  1. Lifestyle advice
  2. Medication
    … 1. Statins
    … 2. Cholesterol absorption inhibitors e.g. ezetimibe, or fibrates (best for hypertriglyceridaemia)
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32
Q

Is gangrene and necrotising fasciitis common or rare?

A

Gangrene - common

• Necrotising Fasciitis - rare

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33
Q

Investigation for gangrene and necrotising fasciitis?

A

Diagnostic: MC+S tissue swab
• Blood test for infection (FBC, CRP)
• Blood culture
• X-ray (gas gangrene)

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34
Q

Compare the different types of gangrene + NF

A
  • Dry gangrene - necrosis, no infection
  • Wet gangrene - necrosis and infection, pus and strong odour
  • Gas gangrene - necrosis, crepitus, oedema
  • NF - erythema, oedema, haemorrhagic blisters, signs of sepsis
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35
Q

Describe the different types of heart block on ECG

A
  • 1st degree - prolonged PR interval
  • 2nd degree MT1 - PR gradually increases, then no QRS after p wave, repeats
  • 2nd degree MT2 - PR fixed in duration, not every p wave has a QRS after
  • 3rd degree / complete - no relationship between p wave and QRS complexes
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36
Q

Presentation of heart block? Which ones actually have symptoms?

A

Only MB2 and 3rd degree usually have symptoms
• Stokes-Adams attack - syncope from ventricular asystole
• Dizziness, palpitations, chest pain, HF
• Large volume pulse
• Cannon A waves

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37
Q

Investigations for heart block?

A
  1. ECG (gold standard)
  2. Bloods - troponin, potassium, calcium, digoxin, cardiac enzymes
  3. Echo
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38
Q

Management for heart block?

A

Asymptomatic (1st degree, MT1?)
1. monitor

Symptomatic

  1. discontinue AV nodal blocking meds e.g. beta blockers
  2. consider permanent pacemaker or cardiac resynchronisation

(atropine no longer indicated?)

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39
Q

What causes isolated systolic hypertension?

A

Stiffening of large arteries

most common form in UK

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40
Q

What is malignant hypertension?

A

Rapid rise in BP leading to vascular damage

Bilateral retinal haemorrhages + exudates

Hallmark: fibrinoid necrosis

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41
Q

Outline the Keith-Wagner classification of hypertensive retinopathy?

A

Grade I - Silver wiring
Grade II - Silver wiring + AV nipping
Grade III - flame haemorrhage, cotton wool spots
Grade IV - papilloedema - requires admission

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42
Q

Diagnosis and investigations for hypertension?

A

Diagnosis: if BP 140/90 - 180/120, ABPM used to confirm
• ECG - left ventricular hypertrophy
• Bloods - U&Es, cholesterol, blood glucose
• Urinalysis

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43
Q

Management for hypertension?

A

Conservative
Medical if symptomatic with end organ damage, or BP over 160/100

  1. Type 2 diabetes/under 55 - ACEi or ARB
  2. Afrocaribbean/over 55 - CCB
  3. (ACEi or ARB) + (CCB or thiazide)
  4. (ACEi or ARB) + CCB + thiazide
  5. Consider low-dose spirinolactone if K+ ≤ 4.5, consider α/β-blocker if K+ > 4.5
44
Q

Management for severe hypertension (Diastolic >140)

A
  • Atenolol

* Nifedipine

45
Q

Management for acute malignant hypertension?

A
  1. IV beta blocker - labetolol
  2. Dihydropyridine CCB - nicardipine
  3. Fenoldopam

(nitroprusside restricted due to thiocynate poisoning risk)

46
Q

Hypertension targets (age 80, diabetes)

A

under age 80 - 135/85
over age 80 - 145/85

Diabetes without proteinuria = < 130/80
Diabetes with proteinuria = < 125/75

47
Q

Why do you have to be careful of rapidly lowering BP?

A

Brain ischaemia - constriction from HTN before

48
Q

Symptoms and signs of infective endocarditis?

A
  • Fever with sweats/chills/rigors (can be remitting)
  • Malaise
  • Weight loss
  • Skin lesions
  • Confusion
  • Pyrexias
  • Tachycardia
  • Clubbing
  • Murmur: M > A > T > P
  • Vasculitic lesions (Roth spots, Osler’s nodes, petechiae, splinter hameorrhage)
  • Janeway lesions - painless macules
49
Q

Investigation for infective endocarditis?

A

Duke’s criteria (based on investigations + symptoms/signs)

50
Q

Management for infective endocarditis?

A

4-6 weeks of ABx

  • Blind therapy of native valve: amoxicillin +/- gentamicin
  • Blind therapy of prosthetic valve: vancomycin + gentamycin + rifampicin

• Surgery if poor response to antibiotics (valve replacement)

Fatal if untreated, quite high mortality even with treatment

51
Q

4 different types of angina?

A
  • Stable - induced by effort
  • Unstable - occurs during rest or minimal exercise
  • Decubitus - induced by lying flat
  • Prinzmetal’s - coronary artery spasm, increased myocardial work when lying down
52
Q

Symptoms and signs of angina?

A
  • Chest tightness
  • Radiation to one/both arms, neck, jaw, teeth
  • Dyspnoea
  • Tachycardia
53
Q

Investigation for stable angina?

A
  1. Resting ECG
  2. Stress ECG (gold standard)

TSH, stress echo, coronary angiogram

54
Q

What does IHD comprise?

A
  • Stable angina
  • ACS
  • unstable angina
  • NSTEMI or STEMI
55
Q

Management for stable angina?

A
  • Manage modifiable risk factors
  • Acute attack - sublingual GTN
  1. beta blockers (CCB in PM)
  2. add CCB (nitrates in PM)
  3. PCI
  4. CABG

Syndrome X - CCBs

56
Q

Troponin in unstable angina and STEMI/NSTEMI?

A

Elevated in STEMI/NSTEMI but not unstable angina

57
Q

ECG in unstable angina and STEMI/NSTEMI?

A
  • Unstable angina + NSTEMI - ST depression or T wave inversion
  • STEMI - ST elevation, T wave inversion, Q waves
58
Q

Relationship between ECG leads and side of heart

A
  • Anterior (LADA) - V1-V4
  • Posterior (PDA) - V1-3 (TALL R WAVE and ST depression)
  • Lateral (left circumflex) - I, aVL, V5/6
  • Inferior (RCA) - II, III, aVF

If V1-V3 ST depression without tall R wave = anterior NSTEMI

59
Q

Investigation for ACS?

A
  1. ECG , bloods (troponin, glucose etc.)
  2. Consider CXR and TTE

(angiography if positive troponin high risk stress test)

60
Q

Management for unstable angina/NSTEMI?

A
  1. O2
  2. IV GTN
  3. IV morphine
  4. Aspirin + clopidogrel (300mg immediately, 75mg a day after)
  5. LMWH e.g. enoxaparin
  6. Beta blockers (verapamil if contraindicated)
  7. GPIIb/IIIa inhibitor - at risk of MI or death
  8. Abciximab/eptifibatide - undergoing PCI

statins and nitrates?

61
Q

Management for STEMI?

A

Same as unstable angina + NSTEMI but…

Clopidogrel - slight change in dose

Primary PCI - goal < 90min

Thrombolysis - fibrinolytics a.g. alteplase (within 12 hours). Rescue PCI if it doesn’t work.

62
Q

What is the most common cause of mitral regurgitation (and in young women)?

A
  • Most common - rheumatic heart disease

* Young women - mitral valve prolapse

63
Q

Presentation of mitral regurgitation on examination?

A
  • AF pulse
  • Laterally displaced apex beat
  • Pan-systolic murmur
  • Signs of LV failure
64
Q

Investigation for mitral regurgitation?

A 
Diagnostic: TTE (with doppler?)
• ECG - normal, may show p mitrale or AF
• CXR - acute: LVF, chronic: cardiomegaly, calcification, PO, left atrial enlargement
• Doppler echo
• Cardiac catheterisation
65
Q

Main cause of mitral stenosis?

A

Rheumatic heart disease

66
Q

Presenting signs of mitral stenosis?

A
  • Peripheral cyanosis
  • Malar flush
  • AF pulse
  • Parasternal heaves
  • Mid-diastolic murmur
  • Loud S1
67
Q

Investigation for mitral stenosis?

A

Diagnostic: TOE (better view than TTE)
• ECG - normal, may show p mitrale or AF
• CXR - left atrial enlargement, calcification, PO
• Cardiac catheterisation

68
Q

Most common pathogenic cause of myocarditis in EU and USA?

A

Coxsackie B virus

Most commonly idiopathic though

69
Q

Symptoms and signs of myocarditis

A
  • Flu like
  • Breathlessness
  • Palpitation
  • Sharp chest pain (pericarditis suggestion)
  • Tachycardia
  • Soft S1
  • S4 gallop
70
Q

Investigation for myocarditis?

A
  • Bloods - +ve troponin I or T, antimyosin scintigraphy
  • ECG - non-specific T/ST changes, pericarditis signs
  • CXR - may show cardiomegaly
  • Echo
71
Q

Most common cause of pericarditis?

A

Idiopathic

72
Q

What is pericarditis occuring weeks/months after acute MI called?

A

Dressler’s syndrome

73
Q

Symptoms and signs of pericarditis?

A
  • Sharp and central chest pain
  • Pleuritic
  • Radiation to neck/shoulder
  • Relieved by sitting forwards
  • Worse when lying flat
• Pericardial friction rub
• Cardiac tamponade signs - Beck's triad
- Raised JVP
- Low BP
- Muffled heart sounds
• Pulsus paradoxus (>10 drop in SBP and drop in pulse wave amplitude on inspiration)
74
Q

Investigation for pericarditis?

A

Diagnostic: ECG - saddle ST elevation
• Echo
• Bloods (cardiac enzymes normal|)
• CXR (usually normal)

75
Q

What are the 4 types of peripheral vascular disease? Compare them.

A
  • Intermittent claudication - calf pain on exercise
  • Critical limb ischaemia - pain at rest (develops from inter. claudication - most severe PVD)
  • Acute limb ischaemia - sudden deterioration due to thrombotic/embolic causes
  • Arterial ulcers + gangrene

Fontaine classification: asymptomatic, i. claud, rest pain, ulceration/gangrene

76
Q

What (arterial) disease causes calf and buttock claudication?

A
  • Calf claudication - femoral disease

* Buttock claudication - iliac disease

77
Q

What is Leriche syndrome?

A

Arterioiliac occlusive disease
• Buttock claudication - build up of plaque in iliac arteries
• Importence
• Absent/weak distal pulses

78
Q

What are the investigations for peripheral vascular disease?

A

History + vascular exam

  1. ABPI
  2. Colour duplex ultrasound (shows site and degree)
  3. MRI/CT angiogram (gold standard)
  4. Full cardiovascular risk assessment (BP, FBC, ECG, etc.)
79
Q

How do you calculate ABPI and what do the results mean?

A
  • Ankle SBP/Brachial SBP
  • Normal: 1-1.2
  • PAD: 0.5-0.9
  • Critical limb ischaemia: <0.5 (< 0.2 with tissue loss)
  • < 0.8, don’t apply pressure bandage
80
Q

Investigation for PE?

A

Wells’ score ≤ 4

  1. D-dimer
  2. if normal: PE excluded. if elevated: do CTPA (gold standard)

Wells’ score > 4
1. CTPA and start on LMWH (or V/Q scanning if CT contradindicated e.g. pregnancy)

Additional: bloods, ECG, CXR

(Get result of D-dimer within 4 hours, or offer interim anticoagulaiton)

81
Q

Management for PE?

A

Compression stockings, heparin prophylaxis for high risk
ABCDE if h. unstable

  1. LMWH, NOAC/heparin (h. unstable)
  2. IVC filter or embolectomy if recurrent or anti-coagulant contraindicated

High risk - thrombolysis

Long-term - NOAC or warfarin for 6 months post. LMWH if malignancy present.

82
Q

Signs of pulmonary hypertension?

A
  • Right ventricular heave
  • Loud pulmonary second heart sound
  • Tricuspid regurgitation
  • Raised JVP
  • Peripheral oedema
83
Q

Investigations for pulmonary hypertension?

A 
Diagnostic - right heart catheterisation
• Echo
• ECG
• CXR (exclusion)
• LFTs (liver damage from portal hypertension)
84
Q

Define rheumatic fever (causative infection)?

A

Inflammatory multisystem disorder following group A beta-haemolytic strep. (GAS) infection

Pharyngeal infection

85
Q

Diagnosis and investigations for rheumatic fever?

A

Revised Jones criteria - evidence of recent strep infection + 2 major, or 1 major + 2 minor

Evidence of infection
• Positive throat culture
• Rapid strep antigen test
• Elevated strep antibody titre
• Recent scarlet fever
Major criteria (CASES)
• Carditis (tachycardia, murmurs etc.)
• Arthritis
• Subcutaneous nodules
• Erythema marginatum (mainly on trunk and proximal limbs)
• Sydenham's chorea
Minor criteria (PRAPP)
• Pyrexia
• Raised ESR/CRP
• Arthralgia
• Prolonged PR interval
• Previous rheumatic fever
86
Q

Describe the 2 types of SVT?

A
  • AVNRT - localised re-entry around AV node - conducts to ventricles faster
  • AVRT - normal AV conduction, but accessory pathway. Can conduct anteretrograde (towards) or retrograde (both directions) impulses
87
Q

What is Wolff-Parkinson-White Syndrome?

A
  • An AVRT

* Accessory pathway = bundle of Kent

88
Q

Symptoms and signs of SVT?

A

• Syncope
• Palpitations
• Polyuria
(most common in females, risk factors include nicotine, alcohol, caffeine)

  • AVNRT - normal except tachycardia
  • WPW - tachycardia, secondary cardiomyopathy (S3 gallop, RV heave, displaced apex)
89
Q

Investigations and findings for SVT?

A 
1. ECG
• Tachycardia
• Narrow complex
• P waves buried
• Shortened PR interval
(after correcting tachycardia, delta wave in AVRT, but not AVNRT)
• WPW - delta wave (slurred upstroke in QRS)
2. 24 hour ECG monitor
  • Cardiac enzymes - features of MI
  • Electrolytes, digoxin
  • Echo
90
Q

Immediate management for SVT?

A

H. stable

  1. Vagal maneouvres e.g. valsava or carotid massage
  2. Adenosine - chemical cardioversion
  3. No change => IV beta-blocker/amiodorone (verapamil if asthmatic)
  4. DC cardioversion

H. unstable
1. DC cardioversion

91
Q

Ongoing management for SVT (AVRT, AVNRT, Sinus Tachycardia)?

A
  • AVRT - Catheter ablation
  • AVNRT - Catheter ablation + BB (CCB if asthma)
  • Sinus tachycardia - exclude secondary cause, BB or rate-limiting CCB
92
Q

Most common cause of tricuspid regurgitation?

A

Infective endocarditis

93
Q

Signs of tricuspid regurgitation?

A
  • Pan-systolic murmur
  • Louder on inspiration (Carvallo sign)
  • AF signs
  • Raised JVP with giant V waves
  • Giant A waves
  • Parasternal heave
  • Ascites, jaundice, palpable liver
  • Pitting oedema, pleural effusion, PH
94
Q

Investigations for tricuspid regurgitation? (3)

A

Diagnostic - TTE with doppler USS
• ECG - p pulmonale
• CXR - right sided enlargment

95
Q

What is the difference between primary and secondary varicose veins?

A

Primary
• Genetic/developmental weakness
• Congenital valve absence

Secondary
•  Venous outflow obstruction - pregnancy, DVT, ovarian tumour, ascites etc.
• Valve damage
•  High flow
•  Constipation
96
Q

Signs/tests of varicose veins?

A
  • Oedema, eczema, ulcers, atrophie blanche, lipodermatosclerosis
  • Cough impulse over saphenofemoral junction
  • Tap test - sf junction - impulse felt distally
  • Trendelenburg test allows localisation of site
97
Q

Investigation for varicose veins?

A

Duplex USS

allows exclusion of DVT too

98
Q

Management for varicose veins (superficial vs deep)?

A

Symptomatic superficial vein insufficiency
1. Graduated compression stockings
2.
• If effective: ablative prodecures +/- phlebectomy/sclerotherapy.
• If ineffective: phlebectomy/sclerotherapy

Deep vein insufficiency
1. phlebectomy + compression stockings

99
Q

Investigations for vasovagal syncope?

A

Usually for checking other causes of syncope
• ECG - arrhythmia
• Echo - outflow obstruction
• Lying/standing BP - orthostatic hypotension
• Fasting blood glucose - DM

100
Q

Presentation of venous ulcers?

A
  • Large, shallow, painless
  • Irregular margin
  • Above medial malleoli
101
Q

Investigations for venous ulcers?

A
  • ABPI (exclude arterial)
  • Measure surface area and monitor
  • Swab
  • Biopsy - possibility of Marjolin’s ulcer
102
Q

Management for venous ulcers?

A
  • Graduated compression
  • Debridement and cleaning
  • ABx and topical steroids
103
Q

VF investigations?

A
  1. ECG, electrolytes, troponin

2. Drug levels and toxicology

104
Q

VF management? (Acute and sub-acute)

A

Acute
• defibrillation and cardioversion

Sub-acute
• ICD (implantable cardioverter defibrillator)
• beta blockers
• RFA (radiofrequency ablation)

105
Q

Difference between VF and VT?

A
  • VF - irregular, broad-complex tachycardia (can cause cardiac arrest and death)
  • VT - regular, broad-complex tachycardia (usually >120bpm)
106
Q

VT investigations?

A
  • ECG - > 100bpm, broad QRS, AV dissociation

* Electrolytes, drug levels

107
Q

Management for VT?

A 
• Pulseless VT - ALS (CPR/shock=>adrenaline=>amiodarone)
•  Unstable VT (reduced CO)
1. synchronised DC cardioversion
2. correct electrolytes
3. amiodarone
•  Stable VT
1. correct electrolytes
2. amiodarone
3. synchronised DC cardioversion (if above unsuccessful)

Year 3 diagnosis and management (9 decks)

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