Scenario 4 - SVT Flashcards
Recall 4 differentials for palpitations
- Sinus tachycardia
- SVT
- AF
- Ventricular tachycardia
Recall 2 situations where sinus tachycardia may be a physiological response in a hospital patient?
- Sepsis
2. Hypovolaemia
Recall 3 possible causes of sinus tachycardia
- Physiological response
- Thyrotoxicosis
- Phaeochromocytoma
What are the characteristic findings on ECG in SVT?
At rest: short PR/delta wave
In SVT: absent p waves
Recall 3 non-cardiac causes of AF
- Any lung pathology
- Thyrotoxicosis
- Alcohol
Which type of valve disease is most likely to cause AF?
Mitral stenosis
Recall 3 causes of ventricular tachycardia
- IHD
- Electrolyte imbalance
- Long QT syndrome
What are the 2 types of SVT?
AVRT; AVNRT
Recall the 2 possible causes of absent p waves on ECG and how to differentiate them
- AF
- SVT
AF is irregular, SVT is regular
What is the first line in management of SVT, and what should be done if this fails?
Vagal manoevres
If fails –> 6mg adenosine and then increasing doses
Recall 2 vagal manoevres
- Valsalva manoevre (forced expiration against closed airway)
- Carotid massage
What is always the first line of management if an arrhythmia causes haemodynamic compromise?
DC cardioversion/ defibrillation
How can you tell if an arrhythmia is causing haemodynamic compromise?
The patient is hypotensive
Differentiate the appearance of the different stages of heart block on ECG
- Prolonged PR
- Some p waves do not have QRS
- AV dissociation, bradycardia and BROAD QRS
How does left ventricular hypertrophy appear on ECG?
Deep S in V1/2
Tall R waves in V5/6 (tall = >7 small squares)
