Arrhythmia

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Arrhythmia by Mind Map: Arrhythmia

1. Associated Disease

1.1. Hyperthyroid, PE, Infection/Sepsis/Inflammation, drugs (cocaine)/alcohol

1.2. CAD, Rheumatic HD, HTN, Valvular HD, Hypertrophic cardiomyopathy

2. Definition

2.1. anything other then NSR

3. Atrial Fibrillation

3.1. Epidemiology

3.1.1. incidence: 5 mil/year, M>F, >age

3.2. Definition

3.2.1. Irregularly Irregular RR intervals, Narrow QRS complex, No distinct P waves

3.3. Types

3.3.1. Paroxsymal

3.3.1.1. <7 days w/ or w/o Rx, recur

3.3.2. Persistent

3.3.2.1. >7 days usually need Rx

3.3.3. Long-Standing

3.3.3.1. >1 YEAR

3.3.4. Permenant

3.3.4.1. Refractory

4. Sx

4.1. Palpitations, light headedness, awareness of HR, dizzy, chest pain, SOB, fatigue, pre-syncope

4.2. Signs

4.2.1. HTN, pulse, change in BP readings

5. DDx: Atrial Flutter (sawtooth), WPW, ectopic PVC/PAC, MAT, sinus arrythmia

6. Investigations

6.1. ECG

6.1.1. 24 hr, event (30 days), implantable, stress test

6.2. Bloods

6.2.1. FBC, U/E, ESR/CRP, Troponin, BNP, TFT, tox screen, septic screen, glucose

6.3. Imaging

6.3.1. CXR, Echo, Cor angio

7. Management

7.1. ECG, TE risk, Rate/Rhythm, CV disease risk

7.1.1. Rate control @ 80-100 bpm: BB or CCB

7.1.1.1. Stable

7.1.1.1.1. ORAL

7.1.1.2. Unstable

7.1.1.2.1. IV

7.2. CHADS2-VASC score

7.2.1. CCF/LVD, HTN, Age, DM, Stroke/TIA, Sex F, Vascular disease (stroke and age = 2)

7.2.1.1. >2 = oral anticoagulant

7.3. Cardioversion

7.3.1. When: shock, rate controlled but symptomatic, MI

7.3.2. How: if >48 hrs after AF onset, 3 week OAC then cardioversion OR <48hrs heparin, cardiovert THEN on stroke risk long term OAC after (except if <48hr onset + no RFs)

8. Complications

8.1. Emboli: peripheral, stroke, MI, HF from tachy, haemodynamic instability