Cardiac arrhythmia pearls

Discussion in '医療フォーラム' started by dr.k, Apr 11, 2020.

  1. dr.k

    dr.k Famous Member

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    Atrial Flutter vs. Atrial Fibrillation:

    Both are tachyarrhythmia, almost with same symptoms of palpitation, dizziness or fainting, shortness of breath, and chest pain or tightness, both increase the chance of blood clots and stroke
    The main difference is that atrial fibrillation is always irregular whereas atrial flutter usually regular rhythm


    Multifocal Atrial Tachycardia (MAT) is more common in elderly patients with chronic lung disease (e.g COPD)


    Cardioversion and digoxin are not useful in the management of Multifocal Atrial Tachycardia (MAT)



    Features suggesting ventricular tachycardia (VT) rather than supra ventricular tachycardia (SVT) with aberrant conduction are:
    Atrioventricular (AV) dissociation
    Fusion or capture beats
    Positive QRS concordance in chest leads
    Marked left axis deviation
    History of ischemic heart disease (IHD)
    Lack of response to adenosine or carotid sinus massage
    QRS > 160 ms


    Verapamil is contraindication in wide complex tachycardia as it may causes ventricular fibrillation in patients with ventricular tachycardia


    In case of V Tach in case of digoxin toxicity:
    Treat with lidocaine and phenytoin; avoid Amiodarone and Procainamide because they increase digoxin toxicity
    Use DC shock when medical treatment failed


    For more medical pearls please visit:
    https://bestmedicalpearls.blogspot.com/
     

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