Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: |Atherosclerosis |Ischaemic heart disease |Assessing Chest Pain |ACS - General |ACS - STEMI |ACS - NSTEMI |ACS - GRACE Score |ACS - ECG Changes |ACS -Cardiac Troponins |ACS - Post MI arrhythmias |ACS: Right Ventricular Infarction
⚡ Arrhythmia | 📈 ECG Appearance | 🧑⚕️ Clinical Findings | 💊 Treatment |
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Ventricular Tachycardia (VT) | Wide QRS (>120 ms), rapid rate >100 bpm. Monomorphic (same shape) or polymorphic (variable). | Palpitations, hypotension, chest pain, syncope. 🚨 Risk of degeneration to VF. | Unstable → immediate DC cardioversion.
Stable → IV amiodarone/lidocaine. Recurrent → ICD consideration. |
Ventricular Fibrillation (VF) | Chaotic baseline, no organised QRS complexes, no output. | Cardiac arrest, unconscious, pulseless. | Immediate CPR + defibrillation.
ACLS drugs (adrenaline, amiodarone). ICD in survivors. |
Atrial Fibrillation (AF) | Irregularly irregular rhythm, absent P waves, fibrillatory baseline. | Palpitations, breathlessness, fatigue. May cause hypotension post-MI. ⚠️ Stroke risk. | Rate control (β-blocker, diltiazem).
Anticoagulation (CHA₂DS₂-VASc). Rhythm control (cardioversion, antiarrhythmic). |
Sinus Bradycardia | Regular rhythm, P wave before each QRS, rate <60 bpm. | Often asymptomatic. May cause fatigue, dizziness, hypotension, inferior MI. | If symptomatic → atropine 500 mcg IV.
Pacing if unresponsive or severe compromise. |
Second-Degree AV Block (Mobitz II) | Some P waves not followed by QRS. PR interval constant on conducted beats. | Bradycardia, syncope/near syncope. 🚨 High risk of progression to complete heart block. | Temporary pacing.
Permanent pacemaker required in most. |
Third-Degree (Complete) AV Block | Atria + ventricles beat independently (no relation between P waves & QRS). | Severe bradycardia, hypotension, syncope (Stokes–Adams attacks). | Immediate pacing (temporary).
Permanent pacemaker definitive. |
Premature Ventricular Contractions (PVCs) | Wide, early QRS not preceded by P wave. Followed by compensatory pause. | Often asymptomatic. Palpitations if frequent. May precede VT in diseased hearts. | Usually no treatment if isolated.
Correct electrolytes, stop stimulants. β-blockers if symptomatic/frequent. |