Unstable Bradycardia With Shock

Question 1

List differential diagnoses for bradycardia.

Answer 1

THE Q&A lies in the Hs and Ts

QT prolongation,
Acidosis

Hypoxia,
hypervagal,
hyper/hypokalemia,
hypovolemia,
hypothermia/hyperthermia (malignant),
hypoglycemia,
Hypertension (pulmonary)
tamponade,
tension pneumothorax,
trauma,
Toxins
thrombosis (coronary/pulmonary)/ embolus,

Question 2

Compare atropine, dopamine, epinephrine, isoproterenol, and electrical therapy use in the management of bradycardia.

Answer 2

CO = HR x SV

Atropine - blocks the effects of acetylcholine (neurotransmitter) that slows down heart rate.
Dopamine - stimulate the heart rate and increase blood pressure.
Epinephrine - stimulate the heart rate and increase contractility of the heart.
Isoproterenol - synthetic catecholamine that acts on beta-adrenergic receptors to increase heart rate. Electrical therapy (ie TVP, TCP) - used to deliver an electrical current to the heart to increase its rate. VV, VA,dual chamber, single chamber