Top Tweets for #TachyTalks
Links to previous #CardioBytes episodes
Episode 21 #Listen2UrHeart
(cardiac murmurs)
https://t.co/fdDJ7Br8oB
313053821212393473
Episode 22 #TachyTalks
(tacharrhythmias)
https://t.co/wWkb9OeLr6
Episode 23 #PanAndScan
(cardiac CT)
https://t.co/wWkb9OeLr6
#CardioBytes: Episode 22: #TachyTalks
Electrophysiologist @HeartRhythmMD helps me tackle the tachycardias relevant to our clinical practice. Tune in Oct 13, Tues 9:00 PM Phil time (GMT +8).
@doc_jdam Yes. Whenever you hear about a tachycardia around 150 bpm and won't terminate permanently with vagal or adenosine, think flutter! Actually one of my EP fellows has a video example of this that he took. Hope he kept it.
#CardioBytes #TachyTalks #Arrhythmias
@HeartRhythmMD For more ECG learning, visit https://t.co/2G0WTuduWG or better yet, get a copy of “My First ECG Handbook, 2nd edition" courtesy of our team at @PGHCardio
For example, this favorite tracing of mine. Persistent tachycardia with ventricular rate of 150 bpm. Adenosine unmasked the flutter waves!
#CardioBytes #TachyTalks #Arrhythmias
@HeartRhythmMD @PGHCardio #CardioBytes: Episode 22: #TachyTalks JDAM’s Parting Shots:
The best way to overdrive a fast heart is to match it with a quick mind.
A3. Clinical maneuvers. Vagal maneuvers or adenosine are helpful in any regular tachycardia, wide or narrow. If they don't terminate the tachycardia, they can offer clues as to what the tachycardia is.
#CardioBytes #TachyTalks #Arrhythmias
Q3. What are the clinical maneuvers or interventions that can help address tachyarrhythmias?
•Paroxysmal tachycardias are usually reentrant and can be terminated by maneuvers
•Know when and when not to shock a patient.
#CardioBytes #TachyTalks
Q2. How do we differentiate the various tachyarrhythmias on the ECG?
•Ask if it is wide or narrow, regular or not, supra or ventricular
•Faced with a wide QRS tachy, VT is always a logical differential.
#CardioBytes #TachyTalks
Quick Recap of #CardioBytes Episode 22: #TachyTalks
Q1. Why does the heart beat fast? Which conditions cause tachycardia?
•Remember ART of arrhythmias: automaticity, reentry, triggered activity
•Consider noncardiac and physiologic conditions
•Search for underlying cause
@doc_jdam Yes. Actually. That is why, learn the typical first. #CardioBytes #TachyTalks #Arrhythmias
@doc_jdam If it's sinus tachycardia, don't shock. It not sure and patient is unstable, shock and evaluate response. If unresponsive to multiple shocks and meds, step back and re-evaluate. Do I have the right diagnosis? #CardioBytes #TachyTalks #Arrhythmias
@doc_jdam Atypical RBBB is biphasic or monophasic (R or qR) in V1 and predominantly negative in V5, V6 (R/S ratio < 1). Atypical LBBB has a wide R in V1 or notching of the downslope of the S wave and has Q waves in V5, V6. #CardioBytes #TachyTalks #Arrhythmias
@doc_jdam Typical RBBB has terminal delay: the last parts of it are wide. In V1, wide R'. In V6, S wave is slurred. Typical LBBB has delay in the mid QRS & loss of the usual L>R activation of the septum, leading to small or absent r in V1 and loss of Q in V5, V6. #CardioBytes #TachyTalks
@doc_mikkinieves As mic mentioned, response or non-response to maneuvers can help you differentiate the paroxysmal tachy's (AVRT and AVNRT) from AT.
#CardioBytes #TachyTalks
@HeartRhythmMD When in doubt, call your electrician!
I always have a viber hotline to my EPS colleagues.
#CardioBytes #TachyTalks
A2. Differentiating between the different kinds of SVT is tricky actually. We always list several possibilities for long RP tachycardia & several possibilities for short RP tachycardia. It gets easier the more ECGs you see of AVNRT & AVRT. #CardioBytes #TachyTalks #Arrhythmias
A2. I've had trainees say to me that the morphology criteria is hard. Actually, just learn how to draw typical RBBB and typical LBBB by heart. Then learn the criteria. Learning to draw them makes it easier to digest. #CardioBytes #TachyTalks #Arrhythmias
@doc_mikkinieves @doc_jdam Yup. 80% of the time, it's VT anyway. But... as long as it's NOT obviously sinus tachycardia with bundle branch block. #CardioBytes #TachyTalks #Arrhythmias
@HeartRhythmMD Much like looking for a partner-- don't just focus on mere looks. They can deceive. The "meeting" of minds and hearts (AV association) is more crucial.
#CardioBytes #TachyTalks
@doc_jdam @doc_mikkinieves No. A wide QRS tachycardia (as long as it's NOT obviously sinus tachycardia with bundle branch block) is VT unless proven otherwise. 80% of the time, it's VT anyway. #CardioBytes #TachyTalks #Arrhythmias
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