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Arrhythmias (Aetiology (Inflammation Pericarditis Myocarditis Pneumonia…
Arrhythmias
Aetiology
Inflammation
Pericarditis
Myocarditis
Pneumonia
Sepsis
Congenital/genetic
Cardiomyopathy
Abherrant conduction pathways
Vascular
IHD, MI, aneurysm,
valve disease, PE
Degenderative
Valvular disease
Endocrine
Thyrotoxicosis
Phaeochromocytoma
Drugs
Nicotine, caffeine, B-blockers/agonists,
TCAs, SSRIs
Metabolic
Electrolyte disturbance
Hypoxia
Hypercapnia
Types
Narrow complex
tachycardias (SVT)
AV (junctional) tachycardia
Atrial fibrillation/flutter
Sinus tachycardia
Atrial ectopics
WPW
Heart block
AV block
First degree
Second degree
1) Mobitz 1 (Wenkebach)
2) Mobitz II
Third degree
BB block
RBBB
LBBB
Fasicular block
Sinus rhythms
Sinus arrhythmia
(fluctuations of SNS tone
with inspiration/expiration)
Sinus bradycardia
Sinus rhythm
Ventricular
tachycardias
Vetricular ectopics
Ventricular tachycardia
Ventricular fibrillation
Long QT syndrome
Asystole
(cardiac arrest)
Clinical
presentation
Palpitations
SOB
Chest pain
Syncope
Asymptomatic
Diagnosis
Examination
Cardio exam
Pallor, puse (rate/rhythm),
apex, heart sounds, crackles, oedema
Investigations
Bloods
FBC (anaemia, infection), CRP, U+E (electrolytes),
LFTs, TFTs, troponins, D-dimer, amylase, blood cultures,
lipids, glucose
Imaging
CXR (pericarditis/tamponade, pneumonia)
ECHO (structural defects e.g. valve)
Catheterisation studies
Bedside
Obs (tachy/bradycardia, tachypnoea, BP, fever)
ECG (arrhythmia, BBB, MI changes)
Special tests
Ambulatory ECG (paroxysymal)
Exercise ECG (induced)
History
FH
Heart disease
SH
Living arrangements, occupation,
smoking, alcohol, drugs, diet
DH
Current meds, allergies
PMH
Known CVD, endocrine disease,
infections, acute illness
PC/HPC
Chest pain, SOB, syncope,
palpitations, collapse
Epidemiology
Common
Acute illness
Management
Initial ABCDE
Definitive
Per specific arrhythmia
Definition
Abnormality of cardiac rhythm,
other than sinus rhythm