Makindo Medical Notes"One small step for man, one large step for Makindo" |
![]() |
---|---|
Download all this content in the Apps now Android App and Apple iPhone/Pad App | |
MEDICAL DISCLAIMER: The contents are under continuing development and improvements and despite all efforts may contain errors of omission or fact. This is not to be used for the assessment, diagnosis, or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. Use the BNF for drug information. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website. Makindo Ltd. |
Related Subjects: |Ventricular Fibrillation |Classical Ventricular Tachycardia |Idiopathic Ventricular Tachycardia |Resuscitation - Adult Tachycardia Algorithm |Resuscitation - Advanced Life Support |Automatic Implantable Cardioverter Defibrillator (AICD) |Brugada Syndrome |Long QT syndrome (LQTS) Acquired |Long QT syndrome (LQTS) Congenital |Torsades de Pointes |Wolff-Parkinson White syndrome (WPW) |Supraventricular Tachycardia (SVT) |Atrial Flutter |Atrial Fibrillation
โก Ensure that a defibrillator is nearby, switched on, and ready for use. Follow the Adult Tachycardia Algorithm as outlined.
๐ Management Summary: IV Access and Obtain Defibrillator |
---|
|
Examples of VT strips:
โ ๏ธ Classical VT is the most common cause of wide complex tachycardia. If unsure โ treat as VT and follow algorithm.
A 65-year-old man with a history of previous anterior MI presents with palpitations and dizziness. BP is 110/70 mmHg, pulse 160 bpm, and ECG shows a broad-complex regular tachycardia consistent with monomorphic VT. Management: ๐ IV amiodarone (or procainamide if available) with close monitoring; treat reversible causes (e.g. hypokalaemia, ischaemia). Electrophysiology review for ICD consideration. Avoid: โ Giving adenosine or verapamil โ can cause haemodynamic collapse in VT.
A 72-year-old woman with dilated cardiomyopathy presents with palpitations, chest pain, and confusion. BP is 70/40 mmHg and she has cool peripheries. ECG shows a regular wide-complex tachycardia at 180 bpm. Management: โก Immediate synchronised DC cardioversion (ALS protocol); IV amiodarone after cardioversion; urgent cardiology review for ICD if recurrent. Avoid: โ Delaying cardioversion while trying antiarrhythmic drugs โ shock is lifesaving here.
A 48-year-old woman with a history of prolonged QT (on sotalol and with recent electrolyte disturbance) presents with syncope. ECG shows polymorphic VT with twisting QRS complexes around the baseline โ torsades de pointes. Management: ๐ IV magnesium sulphate is first-line; correct electrolytes (Kโบ, Mgยฒโบ, Caยฒโบ); stop QT-prolonging drugs; temporary pacing if recurrent. Avoid: โ Avoid giving amiodarone or other QT-prolonging agents as they worsen torsades.