Understanding Cardiovascular System Dysfunctions in Patients with Palpitations
Explore the coronary arteries, aortic arch branches, sweat-related sympathetic activation, cardiovascular abnormalities, and arrhythmia mechanisms in patients with palpitations and anxiety. Learn about WPW syndrome, ECG traces, and arrhythmia management.
Understanding Cardiovascular System Dysfunctions in Patients with Palpitations
E N D
Presentation Transcript
Name the coronary arteries Is this a left-dominant or right-dominant heart? Name the branches off the aortic arch
A patient presents with excessive sweating • Is this due to (sympathetic or parasympthetic) (activation or deactivation)? • Sympathetic activation • What abnormalities of the cardiovascular system would you expect to be associated with this? • Positive chronotropy (inc HR), positive inotropy (inc contraction force), positive dromotropy (increased AV nodal conduction velocity), positive lusitropy (increased rate of myocyte relaxation) • What neurotransmitter is associated with the post-ganglionic sympathetic synapses? • Noradrenaline
Name the parts of the conducting system of the heart Does the myocardium depolarise from left-right; right-left; inside-outside or; outside-inside
Where within the heart would you find the following change in membrane potential? Which channels open to cause the various changes in membrane potential?
A patient presents with palpitations. Give a differential diagnosis for palpitations • Probability Diagnosis • Anxiety • Premature beats (ectopics) • Sinus tachycardia • Drugs • Serious • MI/angina • Arrhythmias (VT, bradycardia, sick sinus syndrome, Torsade de pointes) • WPW syndrome • Electrolyte disturbances (hypokalaemia, hypomagnesaemia, hypoglycaemia) • Pitfalls • Fever/infection • Pregnancy • Menopause • Drugs • Mitral valve disease • Aortic incompetence • Hypoxia/hypercapnia • Tick bites • Phaeochromocytoma • Neuro • Cardiac neurosis • anxiety
What are the main mechanisms of arrhythmia • Disorders of impulse formation or automaticity • Abnormalities of impulse conduction • Re-entry • Triggered activity
What are the three abnormalities found on an ECG trace for a patient with WPW syndrome? • Short PR • Wide QRS • Delta waves
Ischaemia – lateral side (shows in I, aVR, aVL, V4, V5 and V6
What is the typical management for bradyarrhythmias • Pacemaker insertion
What is the typical management for tachyarrhythmias • Drugs • Sinus tachycardia • Metoprololtartrate • verapamil • Paroxysmal SVT • Adenosine • Verapamil • VT • Lignocaine • Amiodarone • Sotalol • Flecainide • Atenolol/metoprolol
During what arrhythmias is it suitable to shock a patient? • Sustained VT • AF • VF
What are the typical symptoms of anxiety • Cardiovascular • Palpitations • Tachycardia • Flushing • Chest discomfort • Neurological • Dizziness • Headache • Trembling • Twitching • Shaking • parasthesia • GIT • Nausea • Indigestion • Diarrhoea • Abdominal distress • Respiratory • Hyperventilation • Breathing difficulty • Air hunger • Cognitive • Fear of dying • Difficulty concentrating • ‘mind going blank’ • hypervigilance
