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 complexes, rapid rate (usually >100 bpm), monomorphic or polymorphic appearance. | Palpitations, hypotension, syncope, can progress to ventricular fibrillation. | Cardioversion if unstable; IV antiarrhythmics (e.g., amiodarone) if stable; consider ICD placement for recurrent VT. |
Ventricular Fibrillation (VF) | Chaotic, irregular rhythm without identifiable QRS complexes. | Cardiac arrest, loss of consciousness, no palpable pulse. | Immediate defibrillation; CPR; advanced cardiac life support (ACLS) protocols; consider ICD for survivors. |
Atrial Fibrillation (AF) | Irregularly irregular rhythm, no distinct P waves, variable ventricular response. | Palpitations, fatigue, dyspnoea; may cause haemodynamic instability in post-MI patients. | Rate control (beta-blockers, calcium channel blockers), anticoagulation, possible rhythm control (electrical cardioversion, antiarrhythmic drugs). |
Sinus Bradycardia | Slow heart rate (<60 bpm), normal P waves and QRS complexes. | Often asymptomatic but can cause fatigue, dizziness, hypotension, especially in inferior MI. | Atropine if symptomatic; pacing if refractory or associated with haemodynamic compromise. |
Second-Degree AV Block (Mobitz II) | Intermittent non-conducted P waves, with a constant PR interval on conducted beats. | Bradycardia, possible progression to complete heart block; usually symptomatic with syncope or near-syncope. | Temporary pacing; consideration for permanent pacemaker if persistent. |
Third-Degree (Complete) AV Block | Atrium and ventricles beat independently (no association between P waves and QRS complexes). | Severe bradycardia, hypotension, syncope, heart failure symptoms. | Immediate temporary pacing; permanent pacemaker placement. |
Premature Ventricular Contractions (PVCs) | Early, wide QRS complex not preceded by a P wave; compensatory pause follows. | Usually asymptomatic but may cause palpitations; can be a precursor to more serious arrhythmias. | Generally no treatment if isolated; beta-blockers if symptomatic or frequent; correct underlying electrolytes. |