1.27.2012
VENTRICULAR TACHYCARDIA
Posted on 1:34 AM by know about heart
 |
| VENTRICULAR TACHYCARDIA |
An ECG tracing of ventricular tachycardia: Shows
*A very broad QRS complex
*Absence of p wave (Dissociated p wave may seen)
* Heart rate: 140-220 beats/min.
*Occasional sinus capture beat (Normal P, QRS, T complex between ventricular)
*Occasional fusion (Dressler) beat present.
* A bifid, upright QRS with a taller first peak in VI & A deep S wave in V6. * A concordant (same polarity) QRS direction in all chest leads (V1-V6).
Causes of VT:
§Acute MI
§Chronic ischemic heart disease (specially poor left ventricular function) §Myocarditis
§Cardiomyopathy
§Ventricular aneurysm
§Electrolyte imbalance: Hypokalaemia hypomagnesaemia
Mx of ventricular tachycardia:
Clinical feature:
Symptoms:
§History of myocardial infarction,
§Palpitation
§Symptoms of low cardiac output: dizziness, dyspnoea or Syncope.
Signs:
i) Atrioventricutar dissociation (pathognomonic)
ii) Capture/fusion beats (pathognomonic)
iii) Extreme left axis deviation
IV) Very broad ORS complexes (>140ms)
 |
| ECG of VT |
v) No response to carotid sinus massage or iv adenosine.
Investigation:
ECG:
Rx:
a) When pt is haemodynamically unstable (systolic BP< 90mm of dinus rhythm is restored by DC cardioversion
b) When pt is haemodynamically stable-sinus rhythm is restored by pharmacological cardioversion such as
- Amiodarone IV 300mg bolus within 30 min. followed 600mg over 24hours
-Lignocaine IV also used
c) To prevent recurrence- Beta-blockers & Amiodarone
d) Corection of Hypokalaenia, hypomagneswemia, acidosis and hypoxaemia e) VT is associated with haemodynamic compromise; the use of an implantable cardiac defibrillator is recommended
f) Rarely surgery of catheter ablation can be used to interrupt the arrhythmia focus or circuit.
Subscribe to:
Post Comments (Atom)
No Response to "VENTRICULAR TACHYCARDIA"
Leave A Reply