Sunday, October 2, 2022. Cardiology: Tachyarrhythmias (Abnormal Fast Heart Rate or Greater than 100 Beats Per Minute). Pathology is Abnormal Conduction System. SSx: 1)Palpitations, 2) Lightheadedness, 3) Dizziness, and 4) Syncope is Possible, and 5) Dyspnea/Shortness of Breath (SOB). Dx: Electrocardiography/Electrocardiogram with Clinicopathological Correlation. Tachyarrhythmias: 1) Supraventricular Tachycardia (SVT), 2) Paroxysmal Supraventricular Tachycardia (PSVT) and Tx involves IV Adenosine; 3) Multifocal Atrial Tachycardia (MAT) has Multiple P Wave Morphology (EKG Diagnosis); Tx: 1) Stabilization of Patient, 2) Face Mask 100% Oxygen (or Intubation if Necessary for COPD Cases); 4) Wolff-Parkinson-White Syndrome (WPWS). Aetiology is Congenital Developmental Disease (Therefore Pediatric, Infant and Young Adult Patients) creating an Accessory Conduction Site (Multiple Conduction Sites Possible) Between Atria And Ventricles; SSx: 1) Asymptomatic (Incidental Finding Usually), 2) Palpitations, 3) Lightheadedness, or 4) Episodic Syncope; Px: 1) EKG will show 1) Tachycardia (Abnormal Elevated Heart Rate), 2) Wide QRS Complexes with Sloping "Delta Wave" (Pathognomonic Morphology) Between Q and R Wave; Dx: Electrocardiography (EKG); Tx: 1) If Symptomatic with Carotid Maneuvers (Carotid Massage), or First Line Medial Treatment is IV Adenosine ( Adenosine Receptor Agnoist Antiarrythmic) or if Refractory IV Procainamide (Antiarrhythmic Class 1A with a Mechanism of Action [MOA] by Sodium Channel Antagonism of Cardiomyocytes); Long-term Treatment involves Radiofrequency Ablation can be Curative of WPWS (Oral Therapy is Possible); 5) Ventricular Tachycardia (VT) is a Medical Emergency; Cx: Ventricular Fibrillation (VF); VT has bizarre QRS Complexes with no discernible P or T Waves. SSx: 1) Palpitations, 2) Lightheadedness, 3) Syncope, and 4) Chest Pain; Pathology (Sinoatrial or Atrioventricular Nodal Paresis) is the Rapid Depolarization of the Ventricles without Atrial Depolarizations causing a Drastic Reduction of Cardiac Output (CO) and thereby Cardiac Shock; Dx: Electrocardiography/Electrocardiogram; and Tx will involve Cardioversion (IV Antiarrhythmics will usually be Ineffective); Standard Of Care follows: 1) Oxygen Supplementation; 2) If Stable IV Amiodarone (In Critical Care Guidelines known as ACLS Protocol [Advanced Cardiovascular (or Cardiac) Life Support]) and if Refractory (IV Lidocaine or IV Procainamide); 3) When Patient is Unstable (Unconscious or Pulseless) Cardioversion is Indicated STAT (Sedation with a Sedative-Hypnotic Agent (Propofol) is possible or Without); 6) Torsade De Pointes (TdP) is a Medical Emergency which can Complicate to Ventricular Fibrillation (Death). The Pathology is Ventricular Tachycardia (Accessory Ventricular Conduction Site[s]) with Oscillating Amplitudes; SSx: 1)Palpitations, 2) Lightheadedness, 3) Dizziness, and 4) Syncope is Possible, and 5) Dyspnea/Shortness of Breath (SOB). Aetiology: 1) Hypomagnesemia (Most Common Cause), 2) Congenital Long QT Syndrome, 3) Drug (Multiple Number of Medications are known to Prolong the QT Interval: 1) Methadone (Heroin Withdrawal), 2) Lithium for Bipolar, 3) TCA Antidepressants 4) Antipsychotics (Psychosis), 5) Macrolide Antibiotics, 6) Cisapride (Gastroparesis), Odansatron (Anti-emetic) and others; Dx is via EKG and Tx may be via Cardioversion. Tx: 1) Acute TdP and Stable: IV Magnesium Sulfate and 2) If Unstable Cardioversion; Long-term Treatment is with Beta Blockers (BBs) and Implantable Cardiac Defibrillator (ICD); BBs are Contraindicated in Congenital Long QT Syndrome. By MD Paul Bolin.
Excellent presentation. On Congenital long QT don’t give B1 selective B Blocker like Metoprolol or Atenolol. You can give non selective B blocker like Propranolol, Carvedolol, or Nadolol. Thank you for your efforts
You can give Non selective B Blockers like Propranolol or Carvidolol for Long QT syndrome. You can’t give selective B blockers like Metoprolol or Atenolol
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Sunday, October 2, 2022. Cardiology: Tachyarrhythmias (Abnormal Fast Heart Rate or Greater than 100 Beats Per Minute). Pathology is Abnormal Conduction System. SSx: 1)Palpitations, 2) Lightheadedness, 3) Dizziness, and 4) Syncope is Possible, and 5) Dyspnea/Shortness of Breath (SOB). Dx: Electrocardiography/Electrocardiogram with Clinicopathological Correlation. Tachyarrhythmias: 1) Supraventricular Tachycardia (SVT), 2) Paroxysmal Supraventricular Tachycardia (PSVT) and Tx involves IV Adenosine; 3) Multifocal Atrial Tachycardia (MAT) has Multiple P Wave Morphology (EKG Diagnosis); Tx: 1) Stabilization of Patient, 2) Face Mask 100% Oxygen (or Intubation if Necessary for COPD Cases); 4) Wolff-Parkinson-White Syndrome (WPWS). Aetiology is Congenital Developmental Disease (Therefore Pediatric, Infant and Young Adult Patients) creating an Accessory Conduction Site (Multiple Conduction Sites Possible) Between Atria And Ventricles; SSx: 1) Asymptomatic (Incidental Finding Usually), 2) Palpitations, 3) Lightheadedness, or 4) Episodic Syncope; Px: 1) EKG will show 1) Tachycardia (Abnormal Elevated Heart Rate), 2) Wide QRS Complexes with Sloping "Delta Wave" (Pathognomonic Morphology) Between Q and R Wave; Dx: Electrocardiography (EKG); Tx: 1) If Symptomatic with Carotid Maneuvers (Carotid Massage), or First Line Medial Treatment is IV Adenosine ( Adenosine Receptor Agnoist Antiarrythmic) or if Refractory IV Procainamide (Antiarrhythmic Class 1A with a Mechanism of Action [MOA] by Sodium Channel Antagonism of Cardiomyocytes); Long-term Treatment involves Radiofrequency Ablation can be Curative of WPWS (Oral Therapy is Possible); 5) Ventricular Tachycardia (VT) is a Medical Emergency; Cx: Ventricular Fibrillation (VF); VT has bizarre QRS Complexes with no discernible P or T Waves. SSx: 1) Palpitations, 2) Lightheadedness, 3) Syncope, and 4) Chest Pain; Pathology (Sinoatrial or Atrioventricular Nodal Paresis) is the Rapid Depolarization of the Ventricles without Atrial Depolarizations causing a Drastic Reduction of Cardiac Output (CO) and thereby Cardiac Shock; Dx: Electrocardiography/Electrocardiogram; and Tx will involve Cardioversion (IV Antiarrhythmics will usually be Ineffective); Standard Of Care follows: 1) Oxygen Supplementation; 2) If Stable IV Amiodarone (In Critical Care Guidelines known as ACLS Protocol [Advanced Cardiovascular (or Cardiac) Life Support]) and if Refractory (IV Lidocaine or IV Procainamide); 3) When Patient is Unstable (Unconscious or Pulseless) Cardioversion is Indicated STAT (Sedation with a Sedative-Hypnotic Agent (Propofol) is possible or Without); 6) Torsade De Pointes (TdP) is a Medical Emergency which can Complicate to Ventricular Fibrillation (Death). The Pathology is Ventricular Tachycardia (Accessory Ventricular Conduction Site[s]) with Oscillating Amplitudes; SSx: 1)Palpitations, 2) Lightheadedness, 3) Dizziness, and 4) Syncope is Possible, and 5) Dyspnea/Shortness of Breath (SOB). Aetiology: 1) Hypomagnesemia (Most Common Cause), 2) Congenital Long QT Syndrome, 3) Drug (Multiple Number of Medications are known to Prolong the QT Interval: 1) Methadone (Heroin Withdrawal), 2) Lithium for Bipolar, 3) TCA Antidepressants 4) Antipsychotics (Psychosis), 5) Macrolide Antibiotics, 6) Cisapride (Gastroparesis), Odansatron (Anti-emetic) and others; Dx is via EKG and Tx may be via Cardioversion. Tx: 1) Acute TdP and Stable: IV Magnesium Sulfate and 2) If Unstable Cardioversion; Long-term Treatment is with Beta Blockers (BBs) and Implantable Cardiac Defibrillator (ICD); BBs are Contraindicated in Congenital Long QT Syndrome. By MD Paul Bolin.
Excellent presentation. On Congenital long QT don’t give B1 selective B Blocker like Metoprolol or Atenolol. You can give non selective B blocker like Propranolol, Carvedolol, or Nadolol. Thank you for your efforts
I love your work! Very useful, pure gold. Thank you!
Please reupload valvular disease video.. thanks
Great lecture but isn´t Adenosine contraindicated in WPW-Syndrome because it could lead to ventricular fibrillation
Clear, concise. Very helpful . Thank you
You are a blessing indeed!
thank you for the wonderful lecture
Great help ... bless you and thank you
Aren't you supposed to avoid AV node blockers with WPW? So you would not want to use adenosine and would use procainamide as the TOC
You are correct
thank you
Thaaaank you 🙏🏻🙏🏻🙏🏻
Thank you
Thank you 👍👍👍
Amazing, thank you
Thank you!
gracias
Hello dr paul, how can i find the ppt versions, are they for sell ?
Thk you very much ...love ur videos :)
torsades de pointes slide you said can use beta blocker, but you said its for long QT syndrome is it? or is it not?
You can give Non selective B Blockers like Propranolol or Carvidolol for Long QT syndrome. You can’t give selective B blockers like Metoprolol or Atenolol
wow great , very much helpful👍
Dome of ur videos have become soundless... kindly upload them again. Thanks
Some*