Ventricular Tachycardias - Ventricular Ectopic

Question 1

Aetiology

Answer 1

Random electrical discharges from outside the atria.

Question 2

Definition

Answer 2

Premature ventricular beats caused by electrical discharges from outside the atria
Following a premature beat, there is usually a complete compensatory pause because the AV node or ventricle is refractory to the next sinus impulse - resulting in a missed beat

Question 3

Epidemiology

Answer 3

All ages
More common in patients with pre-existing heart conditions (e.g., ischaemic heart disease or heart failure)

Question 4

Diagnosis

Answer 4

ECG - Individual random, abnormal, board QRS complexes on a background of a normal ECG
Check bloods for anaemia, electrolyte disturbances and thyroid abnormalities

Question 5

Management

Answer 5

Bloods for anaemia, electrolyte disturbances and thyroid abnormalities
Reassurance and no treatment in otherwise healthy people
Seek expert advice in patients with background heart conditions or other concerning features or findings (e.g., chest pain, syncope, murmur, family history of sudden death)

Question 6

Bigeminy

Answer 6

This is where the ventricular ectopic are occurring so frequently that they happen after every sinus beat. The ECG looks like a normal sinus beath followed immediately by an ectopic, then a normal beat, then ectopic and so on.

Question 7

Signs and Symptoms

Answer 7

Palpitations
Faint or dizzy

Question 8

Complications

Answer 8

Left ventricular dysfunction
VF = fatal