Condition- Ventricular fibrillation Flashcards
Define Ventricular Fibrillation
Irregular broad complex tachycardia
Can cause cardiac arrest and sudden death
What happens to the cardiac muscle in VF?
- Ventricular fibres contract randomly causing complete failure of ventricular function
List some risk factors leading to the development of VF
- Thrombus (coronary artery syndrome)
- Toxins (drugs)
- Hypoxia
- Hyper/hypokalaemia
- Cardiomyopathy
- Congenital Heart Disease (WPW, long QT, valvular disease)
- AF
List some of the symptoms of VF
- Chest pain
- Fatigue
- Palpitations
List some pre-existing conditions a patient with VF may have
- Coronary artery disease
- Cardiomyopathy
- Valvular heart disease
- Long QT syndrome
- Wolff-Parkinson-White syndrome
What does this ECG show and why?
VF = very fucked up
- chaotic irregular defections
- No p waves, QRS complexes or T waves
Other than ECG which investigations might you need to conduct on someone with VF?
- Cardiac enzymes (trops)
- TFTs
- Electrolyte levels
- Drugs + Tox screen
- Coronary angiography to check myocardial perfusion
How would you manage a patient acutely presenting with VF?
- VF requires urgent defibrillation and cardioversion à non-synchronised DC shock
What will VF survivors need as part of their long-term management?
- Full assessment of heart function and perfusion and bloods
- Most survivors will need an implantable cardioverter defibrillator (ICD)
- Empirical beta-blockers
- Some may be treated with radiofrequency ablation (RFA)
What is the main complication seen in survivors of VF? List two other complications
- Anoxic encephalopathy due to loss of CO
- Post-defib arrhythmias
- Myocardial injury
- Skin burns
- Sudden cardiac death
For a patient with VF to survive, how quickly must they be defibrillated?
Within 4-6mins of onset