HAMAD AT THE COOPERATIVE

demographics
1. Hamad, male, early 70s, retired for 10 years
  1. presenting complaint: syncope
causes of syncope
1. cardiovascular causes
  1. electrical causes
    1. arrhythmia
  2. mechanical causes
    1. aortic stenosis
    2. hypertrophic cardiomyopathy
2. non cardiovascular causes
  1. orthostatic hypotension
  2. untreated diabetes
  3. severe dehydration
  4. medication/alcohol
  5. neurologic
  6. carotid sinus syndrome
Glasgow coma scale
cardiac conduction system
1. 1. CPR
Electrocardiogram
1. components
  1. monitor
  2. ECG graph
  3. electrodes
    1. locations of electrodes
    2. leads
      1. limb leads
      2. chest leads
      3. augmented leads
    3. axis of the leads
2. consider the following to analyse
  1. rhythm
  2. rate
  3. conduction
3. normal ECG
4. abnormal ECG
  1. sinus tachycardia, sinus bradycardia, paroxysmal supraventricular tachycardia, paroxysmal ventricular tachycardia, first degree block, second degree block, third degree block, atrial fibrillation, ventricular fibrillation, etc.
SICK SINUS SYNDROME
1. SA node is affected
  1. found in 1 in 600 CVD patients
2. cause
  1. idiopathic age-related fibrosis and cell atrophy or ischemia leading to changes in the electrophysiology of the SAN, known as electrical remodeling
    1. manifested as bradycardia or asystolic pause
3. pathophysiology
  1. The Na+ channels normally present at the periphery of the SA node has been shown to decrease which could potentially lead to SAN exit block
4. diagnosis
  1. Holter monitor
  2. exercise tests
  3. intracardiac electrophysiologic tests
5. asymptomatic but may show
  1. fatigue
  2. dizziness
  3. weakness
  4. short breath
  5. faint
6. risk factors
  1. controllable factors
    1. high cholesterol
    2. high BP
    3. diabetes
    4. smoking
    5. alcohol abuse
    6. stress
    7. certain medications
  2. non controllable factors
    1. family history
    2. congenital heart disorders
    3. advancing age
    4. gender
7. prognosis
  1. having it with only bradycardia is a good prognosis
8. treatment:
  1. antiarrhythmic drugs
  2. pacemakers
    3. risks of procedure
      1. bleeding, damage to vessels, infection at incision, pneumothorax
    4. precautions

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HAMAD AT THE COOPERATIVE

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	Created by Huwaida Fazel over 7 years ago