70 yr old with lethargy and presyncope type ii av block – mobitz ii
TRANSCRIPT
- Slide 1
- 70 yr old with lethargy and presyncope Type II AV block Mobitz II
- Slide 2
- Same patient few minutes later Type II block Wenkebach/Mobitz I
- Slide 3
- Same patient yet again Complete heart block Third degree block
- Slide 4
- 70 yr old with lethargy and syncope Trifascicular block 1 st degree HB, RBBB and LAD (L anterior hemiblock)
- Slide 5
- Fusion beat Capture beats Monomorphic VT 50 yr old with palpitations
- Slide 6
- R on T causing polymorphic VT = Torsade's du pointe
- Slide 7
- Ventricular Fibrillation You dont want this for your patient
- Slide 8
- 30 yr old male with syncope Brugada Syndrome
- Slide 9
- ECG Findings Three types ST elevation v1 v3 > 2mm Complete or incomplete RBBB T-wave types 1. Inverted 2. Biphasic 3. Upright
- Slide 10
- Brugada Why do we care? Predisposition to polymorphic ventricular tachycardia Identification and treatment with AICD may prevent a young sudden cardiac death
- Slide 11
- Arrthymogenic RV cardiomyopathy/dysplasia - inverted T waves in leads V 1 through V 5. Arrowheads point to late RV activation, called an epsilon wave 25 year old with syncope on exercising
- Slide 12
- When to refer cardiac syncope to ED All 2 nd degree and 3 rd degree heart blocks All trifascicular blocks All rapid AF >120 All SVTs in not terminated by Valsalva manouvre funny looking ST/T segments discuss/fax Asymptomatic patients with WPW, ST changes can be referred to cardiology OPA
- Slide 13
- Important contact details for Northern Hospital Nov 2013 Clinical ED Consultant 8405 2610/8405 8610 ED Fax 8405 8633 EMET/General enquiries 8405 8013 (Kim Tarzia ED secretary) EMET queries to Dr Cynthia Lim, Dr Peter Jordan, Dr Megan Robb ED Director Dr Shyaman Menon EMET presentations : www.nhedventures.comwww.nhedventures.com Adult Outpatients 8405 8850/8405 8335 Fax 8405 8761 Cardiology 8405 8859 Fax 8405 8405 (currently 3 month wait for Chest pain clinic) Paediatric/Paed Surgery OPA 8405 8417 Fax 8405 8449 (current 4-6 week)(apmt sent 1 week) Paediatric Surg Fax 8405 8449 (within a week)
- Slide 14
- www.nhedventures.com Click on EMET on left to access presentations provided. Registrar education sessions and interesting education links
- Slide 15
- 70 yr old with lethargy and presyncope Type II AV block Mobitz II
- Slide 16
- Same patient few minutes later Type II block Wenkebach/Mobitz I
- Slide 17
- Same patient yet again Complete heart block Third degree block
- Slide 18
- 70 yr old with lethargy and syncope Trifascicular block 1 st degree HB, RBBB and LAD (L anterior hemiblock)
- Slide 19
- Fusion beat Capture beats Monomorphic VT 50 yr old with palpitations
- Slide 20
- R on T causing polymorphic VT = Torsade's du pointe
- Slide 21
- Ventricular Fibrillation You dont want this for your patient
- Slide 22
- 30 yr old male with syncope Brugada Syndrome
- Slide 23
- ECG Findings Three types ST elevation v1 v3 > 2mm Complete or incomplete RBBB T-wave types 1. Inverted 2. Biphasic 3. Upright
- Slide 24
- Brugada Why do we care? Predisposition to polymorphic ventricular tachycardia Identification and treatment with AICD may prevent a young sudden cardiac death
- Slide 25
- Arrthymogenic RV cardiomyopathy/dysplasia - inverted T waves in leads V 1 through V 5. Arrowheads point to late RV activation, called an epsilon wave 25 year old with syncope on exercising
- Slide 26
- When to refer cardiac syncope to ED All 2 nd degree and 3 rd degree heart blocks All trifascicular blocks All rapid AF >120 All SVTs in not terminated by Valsalva manouvre funny looking ST/T segments discuss/fax Asymptomatic patients with WPW, ST changes can be referred to cardiology OPA
- Slide 27
- Important contact details for Northern Hospital Nov 2013 Clinical ED Consultant 8405 2610/8405 8610 ED Fax 8405 8633 EMET/General enquiries 8405 8013 (Kim Tarzia ED secretary) EMET queries to Dr Cynthia Lim, Dr Peter Jordan, Dr Megan Robb ED Director Dr Shyaman Menon EMET presentations : www.nhedventures.comwww.nhedventures.com Adult Outpatients 8405 8850/8405 8335 Fax 8405 8761 Cardiology 8405 8859 Fax 8405 8405 (currently 3 month wait for Chest pain clinic) Paediatric/Paed Surgery OPA 8405 8417 Fax 8405 8449 (current 4-6 week)(apmt sent 1 week) Paediatric Surg Fax 8405 8449 (within a week)
- Slide 28
- www.nhedventures.com Click on EMET on left to access presentations provided. Registrar education sessions and interesting education links