Nichols Arrhthymias

Question 1

Most common cause of V-Tach in adults?

Answer 1

Ischemic heart disease

Question 2

Mechanism of arrhythima most commonly seen in CAD induced arrhythmias?

Answer 2

Reentry around the edge of a scar in the left ventricle

Question 3

Type of channelopathy causing early after-depolarization?

Answer 3

Long QT syndrome

Question 4

Chamber of the heart affected by Long QT?

Answer 4

Left Ventricle

Question 5

Chamber of the heart affected by Brugada Syndrome?

Answer 5

Right Ventricle

Question 6

Chamber of the heart affected by Catecholaminergic Polymorphic V-tach?

Answer 6

Left Ventricle

Question 7

Mechanism of catecholaminergic polymorphic v-tach?

Answer 7

Delayed after-depolarization (phase 4)

Question 8

Mechanism of Long QT syndrome?

Answer 8

Early after-depolarization (phase 2)

Question 9

Electrolyte abrnomalities causing Long QT?

Answer 9

hypokalemia, hypomagnesemia, hypocalcemia

Question 10

Clinical presentations of Long QT?

Answer 10

syncope, sudden cardiac death

Question 11

Prototypical polymorphic v-tach seen with congenital long QT?

Answer 11

Torsades de Pointe

Question 12

Treatment AFTER resuscitating someone that experiences a ventricular arrhythmia

Answer 12

surgery to insert an ICD

Question 13

What channel does Brugada Syndrome affect?

Answer 13

Sodium channels

Question 14

Epidemiology of Brugada Syndrome?

Answer 14

young Asian males, usually presents in 40s

Question 15

EKG features of Brugada Syndrome?

Answer 15

Persisently elevated ST segments (>2mm) in leads V1-V3; abnormal EKG at REST

Question 16

Mechanism of Brugada Syndrome?

Answer 16

Half ass sodium channel response fails to produce a full action potential and causes a localized conduction block in the RIGHT VENTRICLE–> predispose to phase 2 reentry V-Tach

Question 17

Epidemiology of catecholaminergic polymorphic v-Tach?

Answer 17

presents at the average age of 8 with syncope or sudden cardiac death during emotional duress or physical stress

Question 18

Mutation in catecholaminergic polymorphic v-tach?

Answer 18

Ryanodine receptor mutation–> excessive cytosolic calcium–> polymorphic v-tach with high levels of catecholamines (exercise/emotional distress)

Question 19

Cardiomyopathy(ies) associated with impaired compliance?and diastolic function?

Answer 19

Hypertrophic and Restrictive

Question 20

Cardiomyopathy(ies) associated with impaired contractility and systolic function?

Answer 20

Dilated

Question 21

2 most common causes associated with idiopathic cardiomyopathy?

Answer 21

Alcoholism and viral myocarditis

Question 22

Mutation seen in arrhythmogenic right ventricular cardiomyopathy?

Answer 22

mutation in desmosomal proteins–> reentrant v-tach in the RIGHT VENTRICLE

Question 23

Structural changes seen in the arrhythmogenic right ventricular cardiomyopathy?

Answer 23

fatty replacement of myoctyes, frequently with lymphocytic infiltration, later fibrosis

Question 24

EKG manifestations of arrhythmogenic right ventricular cardiomyopathy?

Answer 24

Epsilon waves (notch in terminal portion of the QRS) that are most prominent in V1

Question 25

Epidemiology of arrhythomogenic right ventricular cardiomyopathy?

Answer 25

Italian/Medditernean descent, 20s-30s