In this article, we will discuss various Causes of Ventricular Fibrillation. So, let’s get started.

Causes

Myocardial Ischemia/infarction

Electrolyte disturbance e.g. hypomagnesemia, hypokalemia

Electric Shock

Atrial fibrillation with rapid ventricular rate may degenerate to ventricular fibrillation

Congenital prolonged QT syndrome

Severe hypothermia

Cardiomyopathy

Drugs e.g. proarrhytmics, digitalis

Failure to proper synchronisation of cardioversion

As a terminal cardiac event in a dying heart.

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In this article, we will discuss the Clinical Features of Cardiac Tamponade. So, let’s get started.

Clinical Features

Symptoms

  • Progressive dyspnea, tachypnea
  • Fullness, tightness of chest
  • Altered sensorium, confusion, dizziness, vertigo, syncope
  • Chest pain

Signs

  • Tachycardia, low blood pressure with low pulse rate
  • Elevated JVP with prominent ‘x’ descent and absent ‘y’ descent
  • Kussmaul sign (paradoxical rise in JVP during inspiration) is less common.
  • Pulsus paradoxus
  • An increased area of dullness over the anterior chest on percussion
  • Feeble heart sounds
  • Congestive hepatomegaly
  • Dry lung fields on auscultation
  • Occasional Pericardial knock

In this article, we will discuss various Causes of Ventricular Tachycardia. So, let’s get started.

Ventricular Tachycardia is a wide QRS (>0.12 sec) tachycardia consisting of 3 or more consecutive ventricular premature beats at a rate of >100 bpm. The sudden onset of a wide QRS tachycardia usually rings an alarm bell if the patient is symptomatic. If left untreated, VT may degenerate into a fatal ventricular flutter. VT may be sustained (persists for >30 seconds) or nonsustained (does not persist beyond 30 seconds). The sustained VT requires termination because of hemodynamic consequences. Repeated episodes (>2 in 24 hours) of VT require external cardioversion/defibrillation or DC shock therapy.

Causes

  • Acute myocardial infarction or ischemia
  • Cardiomyopathy (ischemic or idiopathic)
  • Electrolyte disturbance (e.g. hypokalemia, hypomagnesemia)
  • Drugs (e.g. digitalis and other proarrhythmics)
  • Myocarditis, mitral valve prolapse
  • Reperfusion
  • Ventricular aneurysm
  • Pacemaker mediated (e.g. DDD pacemaker)
  • Mechanically induced by a pacing catheter or flow-directed pulmonary artery catheter.
  • Idiopathic
  • Miscellaneous such as right ventricular dysplasia, Bergada syndrome, sarcoidosis.

In this article, we will discuss the Framingham Criteria for Diagnosis of Congestive Heart Failure. So, let’s get started.

Framingham Criteria for Diagnosis of Congestive Heart Failure

Major Criteria include:

  • Paroxysmal nocturnal dyspnea
  • Distended neck veins
  • Rales
  • Cardiomegaly
  • Acute pulmonary edema
  • S3 gallop
  • Increased venous pressure (>16 cmH2O)
  • Positive hepatojugular reflux

Minor criteria include:

  • Peripheral edema
  • Nocturnal cough
  • Exertional dyspnea
  • Congestive hepatomegaly
  • Pleural effusion
  • Reduced vital capacity by one third
  • Tachycardia (HR>120/min)
  • Weight loss

For diagnosis: At least one major and two minor criteria are required.

In this article, we will discuss various Causes of Cardiac Tamponade. So, let’s get started.

It is defined as clinical syndrome occurring due to the rapid accumulation of fluid in the pericardial sac in a quantity sufficient to cause obstruction to the inflow of blood to the ventricles. It is a life-threatening emergency where cure can be achieved by pericardiocentesis (removal of pericardial fluid).

Causes

Acute Cardiac Tamponade

Trauma

  • Penetrating or blunt thoracic injury
  • Iatrogenic e.g. pacing, catheterization, pericardial tapping, post-resuscitation, anticoagulant therapy.

Cardiac rupture

  • Acute MI-free wall rupture
  • Aortic aneurysm rupturing into the pericardium.

Subacute or Chronic Cardiac Tamponade

  • Infection such as Tuberculosis, bacterial, viral, fungal, parasitic, etc.
  • Malignancy
  • Uremic pericarditis
  • Systemic disorders such as SLE, myxoedema, Dressler’s syndrome (post-MI or postcardiotomy), amyloidosis
  • Radiation
  • Idiopathic
  • Drugs e.g. anticoagulants, procainamide, isoniazid, hydralazine, daunorubicin, etc.