artery involved in complete heart block following MI
Rt Coronary artery ( AV node supplied by post interventricular artery, which rises from rt coronry in majority of pts, in other pts in arises from left circumflex artery)
Drugs in AF fro rate control
Beta blockers ( avoid in asthma)
Ca channel blockers
Digoxin ( esp qif HF )
Drugs to maintain sinus rhythm in pts with AF
Beta Blockers
Dronederone ( after cardioversion)
Amiodarone ( esp if HF)
catheter ablation for AF
SE
Pulmonary vein stenosis
cardiac tamponade
Stroke
( pt still needs anticoag after coming in sinus rhythm based on CHAD VASC
if 1 : lifelong
0: 2 months
xanthelasma
familial hypercholesterolemia
remnant hyperlipidemia
HF mx
-ACE inhibitors
-Beta blockers
-SGLT2 inhibitor
-Mineralocorticoid receptor antagonist
Adenosine
Used in supraventricular tachycardias
SE
Chest pain
Intense flushing
Bronchospasm
Mitral stenosis
Features:
Loud S1
AF
Diastolic murmur
Loud opening snap
Peri arrest bradycardia
IV atropine 500mcg upto 5 times max 3mg
Transcutaneous pacing
IV adenosis
Transvenous pacing
Drug for cardioversion in AF
1) amiodarone
2) flecainide( if no structural heart defects)
ALS for shockable rhythm
Shockable rhythm: VF,VT
Adrenaline 1mg after third shock, repeat every 3-5 minutes
Amiodarone: 300mg after 3 shocks
ALS for non shockable rhythm
1mg adrenaline IV asap
If IV not possible, IO route
Most common after MI
Cardiac arrest due to VF
SVT management
Vagal maneouvres
Adenosine 6mg, 12 then 18
Verapamil or beta blockers if unsuccessul
(Adenosine CI in asthmatics, use verapamil)
HF acute Mx
1) furosemide IV or bumetanide
2) O2 ( aim sats 94-98%)
3) IV GTN or Na nitroprusside infusion
(Considered if systolic BP above 100)
Pts with Resp Failurw
CPAP
HOCM
- syncope following exercise
MR SAM ASH on echo
Mitral regurg, Systolic anterior motion, asymmetric hypertrophy
ECG
progressive T wave inversion, left ventricular hypertrophy
Signs:
Jerky pulse, Double apex beat,
Ejectio systolic murmmur, decreases on squatting increases on valsalva
