Various Cardiology Syndromes Flashcards
What is Brugada’s syndrome?
An inheritable condition.
It is predominantly autosomal dominant and causes loss of sodium-channel function.
Calcium-channel dysfunction has also been described in some forms of Brugada’s.
Sympoms and signs of Brugada’s syndrome.
It is usually asymptomatic.
It can also present with sudden death during sleep, resuscitated cardiac arrest and also with syncope.
It is usually diagnosed incidentally or during familial assessment if a family member died inexplicably at a young age etc…
In what population is Brugada’s syndrome more common?
Young males
South-east asia
Diagnosis of Brugada’s syndrome.
By ECG
ECG findings in Brugada’s syndrome.
Right bundle branch block
With
Coved ST elevation in leads V1-V3
Treatment of Brugada’s syndrome.
ICD
Beta-blocers have proved to be dangerous
What is long QT syndrome?
An ECG where the ventricular repolarisation is greatly prolonged.
Causes (broad) of long QT syndrome.
Congenital
Acquired
Causes of acquired long QT syndrome.
Electrolyte imbalances like hypo-K+,Mg2+,Ca2+
Drugs
Poisons
Bradycardia
Mitral valve prolapse
Acute MI
Diabetes
CNS disease
Drugs that can cause long QT syndrome.
Anti-arrhythmics - Quinidine, Sotalol and Amiodarone, Procainamide
Tricyclic antidepressants like amitriptyline
Chlorpromazine
Antipsychotics like haloperidol and olanzapine
Macrolides like erythromycin
Quinolones like ciprofloxacin
Methadone
Clinical features of long QT syndrome.
Syncope and palpitations as a result of polymorphic ventricular tachycardia (torsades de pointes).
They usually terminate spontaneously but may degenerate to ventricular fibrillation resulting in sudden death.
What do torsades de pointes look like on an ECG?
RApid irregular sharp complexes that continuously change from an upright to an inverted position.
Treatment of long QT syndrome.
Treat any underlying cause or stop medication which causes the syndrome.
Beta-blockers are usually given, not to treat the long QTs themselves but to combat any arrhythmia that may follow.
ICDs may be implanted as well if long QT persists.
What is WPW Wolff-Parkinson-White syndrome?
WPW is a congenital accessory conduction pathway between atria and ventricles (bundle of Kent).
Clinical features of WPW.
Rapid regular palpitations
Anxiety
Dizziness
Dyspnoea
neck pulsation
Central chest pain
Weakness
ECG findings in WPW.
Short PR interval
Wide QRS complex - this is due to slurred upstroke (delta-wave)
ST-T changes as well.
Tachycardia due to AF can also be present
