Thread by @JaySavla15

Got some time to read up a bit. So here we go -

Sustained Monomorphic Ventricular Tachycardia

CF as described in my case - hypotension, syncope & some might even be able to maintain BP
Usually VT with HR > 200 - Hypotension
<150 - can be compensated unlesd LV dysfunction
1/n

https://twitter.com/JaySavla15/status/1529675114328956930

Pathophysio - usually focus is an area of fibrosis due to old infarct/inflammation or prior cardiac surgery
Rarely reentry in a diseased purkinje system.

Mechanism - Re entry circuits

DDs
1. SVT with LBBB or RBBB
2. SVT with an accessory pathway
To differentiate 👇
2/n

Presence of AV dissociation is a reliable marker for VT.

Definitive - electrophysiological study (idk where does this even happen)

Treatment
Initial Mx - ACLS

If Hypotension, Impaired consciousness or pulmonary edema present - Synchronised DC Cardioversion.

3/n

For stable tachycardia - can give Adenosine trial - will also take care of SVT with aberrancy.

TpI and CKMB even if elevated are usually secondary to ischemia due to VT.

IV Amiodarone (DOC) if heart disease present.

Other methods
Catheter ablations
ICDs for sustained

4/n

Note - Quite a few criteria have been defined based on QRS morphology to differentiate DDs but none is definite, especially in a pt with structural heart disease.

PS - Everything from Harrison's 20th edition.

#Cardiology
#MedTwitter
#residency

5/5

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