Sudden Cardiac Death Flashcards
sudden cardiac death is most often a/w?
- structural heart dz
- abnormal cardiac rhythms or conduction
- HF
- WPW
- Brugada syndrome
- long QT syndrome
risk factors for acquired long QT syndrome
- female
- hypokalemia
- hypomagnesemia
- structural heart dz
- meds
- drug interactions
meds that can cause long QT syndrome
- macrolides
- fluoroquinolones (especially MOXIFLOXACIN)
- antipsychotics
- antidepressants
- METHADONE
- antifungals
- class 1a and 3 antiarrhythmics
r/o long QT syndrome is greatest w/ a QTc interval of?
> 500 ms
what is Brugada syndrome?
- structurally normal heart
- ABNORMAL electrical conduction
- a/w sudden cardiac death
classic Brugada syndrome on ECG
- incomplete RBBB
- coved STE in leads V1 and V2
other risk factors of sudden cardiac death
- pts taking antiarrhythmics
- excessive alcohol use
- illicit drug use
next test for survivors of sudden cardiac death
echocardiogram
what are looking for on echocardiogram in survivors of sudden cardiac death?
- anatomic abnormalities
- impaired ventricular function
- myopathic processes
in which pts are EP studies indicated?
- suspected ventricular arrhythmias
- episodes of impaired consciousness
- structural heart abnormality
2 things that need to be done in pts taking antiarrhythmics w/ possible long QT syndrome
- serum drug level
- ECG
tx for sudden cardiac death survivors
- tx of underlying CAD
- revascularization if possible
tx for inherited long QT syndrome
BB
placement of ICD in which scenarios
- cardiac arrest survivors d/t VF or VT NOT explained by reversible cause
- sustained VT w/ structural heart dz
- syncope and sustained VT/VF on EP study
- ICM and NICM w/ EF < 35%
- Brugada syndrome
- inherited long QT syndrome not responding to BBs
- MI w/ EF < 30%
- high-risk HCM
inherited arrhythmia syndromes:
characteristic findings of long QT syndrome
- syncope
- QTc > 460 ms
- TdP
