3
Tachyarrhythmia Question 1 A 40%year%old woman presents to ED with palpitations. She has a history of recurrent SVT. She is awake and haemodynamically stable. She has no other medical problems and no allergies. Her ECG is attached (ECG 1) 1. What is your approach to this patient? 2. Discuss the use of Adenosine vs Verapamil in this patient

Tachyarrhythmia! - GCS 16 · Question!3! A!75!year!old!man!is!brought!to!ED!after!a!conscious!collapse!whilst!shopping.!He! describes!feeling!lightheaded!prior!to!his!collapse!but!no!pain.!He!has

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Tachyarrhythmia! - GCS 16 · Question!3! A!75!year!old!man!is!brought!to!ED!after!a!conscious!collapse!whilst!shopping.!He! describes!feeling!lightheaded!prior!to!his!collapse!but!no!pain.!He!has

!

!

!Tachyarrhythmia!

!

Question!1!

A!40%year%old!woman!presents!to!ED!with!palpitations.!She!has!a!history!of!recurrent!SVT.!She!is!awake!and!haemodynamically!stable.!She!has!no!other!medical!problems!and!no!allergies.!Her!ECG!is!attached!(ECG!1)!

1. What!is!your!approach!to!this!patient?!2. !Discuss!the!use!of!Adenosine!vs!Verapamil!in!this!patient!

!

!

!

!

!

!

Page 2: Tachyarrhythmia! - GCS 16 · Question!3! A!75!year!old!man!is!brought!to!ED!after!a!conscious!collapse!whilst!shopping.!He! describes!feeling!lightheaded!prior!to!his!collapse!but!no!pain.!He!has

!

!

!

!

Question!2!

A!65%year%old!man!present!to!the!ED!with!palpitations,!which!he!has!never!before.!He!has!no!chest!pain.!He!is!awake!and!oriented.!He!has!a!history!of!hyperlipidaemia!and!hypertension!(but!has!left!his!medications!at!home).!!

His!vital!signs!are:!HR!130!irreg,!BP!95/65,!RR!18,!O2!sats!96%!RA,!afebrile.!

His!ECG!is!attached!(ECG!2).!

1. What!is!your!approach!to!this!patient?!2. Discuss!the!concept!of!‘Rhythm!Control!vs!Rate!Control’!3. When!would!you!consider!anticoagulation!for!this!patient?!

Despite!treatment,!the!patient!remains!in!AF,!with!a!rate!of!105!

4. What!factors!will!determine!whether!this!patient!is!safe!for!Discharge?!!!!!!!

!

!

!

Page 3: Tachyarrhythmia! - GCS 16 · Question!3! A!75!year!old!man!is!brought!to!ED!after!a!conscious!collapse!whilst!shopping.!He! describes!feeling!lightheaded!prior!to!his!collapse!but!no!pain.!He!has

!

!

!

Question!3!

A!75!year!old!man!is!brought!to!ED!after!a!conscious!collapse!whilst!shopping.!He!describes!feeling!lightheaded!prior!to!his!collapse!but!no!pain.!He!has!a!history!of!CABG,!diabetes!and!hypertension.!

His!ECG!is!attached!(ECG3).!The!patient!is!awake!and!talking,!has!a!BP!80/50!and!cool!peripheries.!

1. Describe!your!management!

You!elect!to!DC!cardiovert!this!patient!

2. Discuss!your!options!for!sedation!for!this!procedure!

!

!

!

!

!

!

!

!

!

Author:!Monash!Emergency!Education!group,!2015!