Palpitations Flashcards
How do you assess the haemodynamic status of a patient?
Skin warmth
BP
JVP
Conscious Level
What can be done to terminate arrhythmias?
Vagal Manoeuvres (carotid sinus massage, eyeball massage, immersing face in cold water)
IV Adenosine
ECG shows irregularly irregular heart beat
Atrial Fibrillation (AF)
ECG shows narrow complexes
Supraventricular Tachycardia
ECG shows broad complexes
Ventricular Tachycardia
A patient does not respond to vagal manoeuvers - they are most likely to have?
VT
A patient responds to vagal manoeuvres - they are most likely to have
SVT
What is important to establish in a palpitation history?
Speed of onset (instantaneous or over several minuets)
Rate
Rhythm (ask the patient to tap out the rhythm)
How can you determine if palpitations are due to anxiety?
Palpitations start and stop over several minutes (genuine tachyarrhythmias start and stop instantaneously)
Background of anxiety - work
What’re the two different types of supraventricular tachycardia (SVT)?
Atrioventricular re-enterant tachycardia (AVRT)
AV nodal re-entrant tachycardia (AVNRT)
Start during teenage years
Syncope unusual
What causes post event polyuria in SVT?
Post event polyuria is from atrial natriuretic factor release resulting from atrial stretching during the attack
Is it more common to have syncope in AF or VT?
Syncope is more common in VT (vagal manoeuvers are unhelpful)
(and is very uncommon in AF)
