Chapter 12 - Resusc & SCD Flashcards
What are the risk factors for SCD?
Advancing age
Male
CAD present
Cardiomegaly
CHF
Long QT
Ventricular arrthymias.
What are the causes of VT/VF?
MI/ischemia
LVH
Pre-excitation with sufficient conduciton
Brugada
Long QT
What factors are associated with increased survival from arrest?
Younger age
Early CPR
Defibrillation
Witnessed Arrest
What vessel supplies the AV node?
What vessel supplies the SA node?
- RCA in 55%
- RCA in 90%
What is the Bezold-Jurisch reflex?
What is the clincal significance?
Ischemia leading to sympathetic inhibition which results in vasodilation, bradycardia, hypotension.
It is common with inferior MI (due to receptors on the posterior left ventricle). This offers and explanation for increased rates of nausea with inferior MI.
What is sick sinus syndrome?
What are some underlying disease processes that cause it?
SSS is diffuse degeneration of the electrical and conduction systems of the heart.
Idiopathic sclerodegeneration of the AV node and the bundle branches (Lenègre disease) or invasion of the conduction system by fibrosis or calcification spreading from adjacent cardiac structures (Lev disease).
Invasive disease from systemic illness, vascular compromise, or tumors can also be implicated.
What are the H’s, T’s, and P’s?
H:
Hypovolemia, hypoglycemia, acidosis, hypothermia, hyper/hypokalemia, hypercarbia, hypoxia.
T:
Trauma, MI, PE, Tamponade, Toxin, Tension Pneumo
P:
Pseudo PEA, Post defib pulselessness, profound shock
What classes of antiarrhythmics are benefical for prevention of SCD? Which are harmful?
Beneficial: Class II (BB), Class III (sotalol, amio)
Harmful: Class I (lidocaine, procainamide)
How does each minute of delayed defibrillaiton affect mortality?
7% decrease per minute without defibrillation.
Shock within 30 seconds results in near 100% survival.
