Sudden cardiac death

Question 1

7 common causes of sudden cardiac death

Answer 1

-long QT syndrome
-brugada syndrome
-hypertrophic cardiomyopathy
-arrhythmogenic right ventricular cardiomyopathy
-dilated cardiomyopathy
-wolf parkinson white syndrome
-myocarditis

Question 2

Arrhythmogenic right ventricular cardiomyopathy (ARVC)
1. what is it
2. symptoms
3. ECG criteria

Answer 2

1. fatty and fibrous tissue replaces healthy cardiac tissue disrupting conduction system, primarily in R ventricle
2. palpitations, dizzy, syncope, SOB, chest pain, fatigue, oedema, cough
3. T wave inversion in inferior leads without RBBB, epsilon wave in V1 (slur at end of QRS), QRS broadening in V1/V2

Question 3

Brugada syndrome
1. what is it
2. symptoms
3. ECG changes

Answer 3

1. sodium ion channel defect causing abnormal electrical activity in the heart
   2.dizzy, syncope, laboured breathing, palpitations, tachycardia, seizures
2. broad QRS, coved ST elevation in V1-3 followed by T wave inversion (type 1) or saddleback ST elevation where ST elevation rises, falls then rises again ( type 2 and 3)

Question 4

Hypertrophic cardiomyopathy
1. what is it
2.symptoms
3. ECG criteria

Answer 4

1. heart muscle thickened which interferes with the hearts ability to pump efficiently as the walls thickening shrinks the chambers
2. SOB, chest pain, dizzy, syncope, palpitations
3. dagger like Q waves, arrhythmias eg AF, SVT

Question 5

Long QT syndrome
1. what is it
2.symptoms
3.ECG changes

Answer 5

1. genetic condition causing prolonged QT interval
2. palpitations, syncope, seizure
3. QT interval longer than 440ms usually in 2 or V5/V6

Question 6

Myocarditis
1. what is it
2.symptoms
3. ECG changes

Answer 6

1.inflammation of myocardium causes necrosis of myocytes, this effects the efficiency of the hearts pump
2. chest pain, discomfort, SOB, fatigue, palpitations, possible HF
3. HR greater than 100bpm, ST segment elevation or depression or T wave inversion mimics MI, PR depression (pericarditis and myocarditis), small amplitude QRS

Question 7

Wolff parkinson white syndrome
1. what is it
2. symptoms
3. ECG changes

Answer 7

1. congenital heart condition caused by an extra electrical pathway in the heart that can lead to a rapid heart rate
2. palpitations, dizzy, SOB, chest pain, syncope
3. sinus rhythm with short PR interval (less than 120ms), broad QRS with slurred upstroke, dominant R wave in V1, tall R wave and inverted T in V1-3 mimicking R ventricular hypertrophy