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Line 13: − * [[Bradyarrhythmias]] and Conduction Abnormalities+ − **H&P: syncope, nausea, vomiting, blurred vision, dizziness+ − + − **Tx: correct electrolytes/hypothermia, atropine/dopamine, transcutaneous pacing, transvenous pacing, leadless pacing, permanent pacemaker+ − * [[Tachyarrhythmias]]+ − **H&P: palpitations, syncope+ − + − **Tx: Stable vs. Unstable. Synchronized cardioversion vs DCCV. Vagal maneuvers (blowing into a 20 ml syringe), atropine, [[beta blockers]], [[amiodarone]] '''(Decrease Warfarin by 25% when starting amiodarone)''', digoxin, diltiazem. Rate control superior to rhythm control most of the time. Calculate a CHA2DS2-VASc for Afib patients. Consider cardioablation vs. Watchman. Always get a TEE/cardioversion for chronic Afib. The most effective [[AC]] is warfarin. Best AC is usually DOAC because of once daily oral dosing. LMWH is an alternative if they can't have a DOAC. Aflutter can be 2:1, 3:1, or 4:1 with fixed rates of 150, 100, and 75 respectively. Do NOT shock sinus tach. '''Treatment for WPW syndrome (ECG findings plus symptoms) is catheter ablation to avoid sudden cardiac death, due to AFib or VFib.'''+
→Arrhythmias
=Arrhythmias=
=Arrhythmias=
SA node -> AV node -> bundle of His -> left/right bundles -> Purkinje fibers
SA node -> AV node -> bundle of His -> left/right bundles -> Purkinje fibers
==[[Bradyarrhythmias]] and Conduction Abnormalities==
*H&P: syncope, nausea, vomiting, blurred vision, dizziness. '''Inferior MI''' can be complicated by symptomatic bradycardia and cardiogenic shock due to ischemia of the SA node leading to an increase in vagal tone.
**DDx: [[sinus brady]], [[SSS]], [[1st degree AV block]], [[2nd degree AV block (Mobitz 1)]], [[2nd degree AV block (Mobitz 2)]], [[3rd degree AV block]]
*Dx: [[sinus brady]], [[SSS]], [[1st degree AV block]], [[2nd degree AV block (Mobitz 1)]], [[2nd degree AV block (Mobitz 2)]], [[3rd degree AV block]]
*Tx: correct electrolytes/hypothermia, '''atropine/dopamine''', transcutaneous pacing, transvenous pacing, leadless pacing, permanent pacemaker
==[[Tachyarrhythmias]]==
*H&P: palpitations, syncope
**DDx: [[Sinus tach]], [[Multifocal Atrial Tachycardia]], [[Afib]], [[Aflutter]], [[AVNRT]], [[AVRT]], [[WPW]], [[Vtach]], [[Vfib]], [[Torsades de Pointes]]
*Dx: [[Sinus tach]], [[Multifocal Atrial Tachycardia]], [[Afib]], [[Aflutter]], [[AVNRT]], [[AVRT]], [[WPW]], [[Vtach]], [[Vfib]], [[Torsades de Pointes]]
*Tx: Stable vs. Unstable. Synchronized cardioversion vs DCCV. Vagal maneuvers (blowing into a 20 ml syringe), atropine, [[beta blockers]], [[amiodarone]] '''(Decrease Warfarin by 25% when starting amiodarone)''', digoxin, diltiazem. Rate control superior to rhythm control most of the time. Calculate a CHA2DS2-VASc for Afib patients. Consider cardioablation vs. Watchman. Always get a TEE/cardioversion for chronic Afib. The most effective [[AC]] is warfarin. Best AC is usually DOAC because of once daily oral dosing. LMWH is an alternative if they can't have a DOAC. Aflutter can be 2:1, 3:1, or 4:1 with fixed rates of 150, 100, and 75 respectively. Do NOT shock sinus tach. '''Treatment for WPW syndrome (ECG findings plus symptoms) is catheter ablation to avoid sudden cardiac death, due to AFib or VFib.'''
=Congestive Heart Failure=
=Congestive Heart Failure=