Snapshot A 57-year-old man presents to the emergency department after fainting. He was accompanied by his wife who witnessed the event. Prior to the event, he experienced lightheadedness and palpitations. When he fainted, cardiopulmonary resuscitation was performed. Defibrillator pads were placed on the patient, which demonstrates pulseless ventricular tachycardia. He is defibrillated with 200 Joules (biphasic.) Introduction A group of ventricular arrhythmias that include ventricular premature beats (premature ventricular contractions) action potentials are ectopically generated within the ventricles typically benign and asymptomatic but can signify underlying pathology ischemia electrolyte derangements (most commonly Mg2+ and K+) ventricular tachycardia if sustained ventricular tachycardia is not managed, it can result in ventricular fibrillation can occur secondary to blunt chest trauma consider commotio cordis (blunt trauma during ventricular repolarization) with focal trauma to the chest over the heart followed by ventricular tachycardia ventricular fibrillation life-threatening, if not immediately managed most common cause of cardiac arrest after a STEMI Epidemiology risk factors myocardial ischemia and infarction ventricular hypertrophy long QT syndromes valvular heart disease congenital cardiac abnormalities short QT syndrome Symptoms palpitations symptoms of heart failure, which include shortness of breath chest discomfort syncope cardiac arrest Ventricular Arrhythmias Type Electrocardiogram Findings Treatment Ventricular premature beats (VPBs) Widened QRS complex with abnormal morphology Typically with reassurance or a β-blocker in healthy patients Ventricular tachycardia 3 or more consecutive VPBs, displaying a broad QRS complex tachyarrhythmia Stable amiodarone lidocaine procainamide Unstable synchronized cardioversion Pulseless ventricular tachycardia defibrillation Ventricular fibrillation Erratic rhythm with no discernable waves (P, QRS, or T waves) Defibrillation for all patients
QUESTIONS 1 of 5 1 2 3 4 5 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M2.CV.15.114) A 75-year-old man presents to the emergency department with a sensation of a flutter in his chest. He has a past medical history of diabetes and hypertension but is generally not compliant with his medications. His temperature is 98.0°F (36.7°C), blood pressure is 122/78 mm Hg, pulse is 130/min, respirations are 17/min, and oxygen saturation is 98% on room air. Physical exam is notable for an obese man who is not confused, moving all extremities spontaneously, and has a rapid heart rate. An ECG is obtained as seen in Figure A. The patient is asked to bear down while he is laid flat and his legs are elevated resulting in no change in his symptoms or rhythm strip. Which of the following is the best next step in management? QID: 104120 FIGURES: A Type & Select Correct Answer 1 Adenosine 0% (0/4) 2 Amiodarone 75% (3/4) 3 Aspirin and cardiac catheterization 0% (0/4) 4 Cardioversion 25% (1/4) 5 Defibrillation 0% (0/4) M 7 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK