Marwah Medicine

Medicine, NEET PG

Ventricular Tachycardia

2min read #NEETPG #INICET #FMGE #MCISCREENINGEXAM #medicinelectures #drmarwah #marwahtestseries Identify and Treat Underlying Causes – Assess and treat any reversible causes, such as electrolyte imbalances, ischemia, or structural heart disease. In-case of TCA toxicity, metabolic acidosis needs to be treated with soda bicarbonate. Stable VT (BP > 90 /60 mm Hg) – In cases of stable monomorphic VT, medications may be used to control the heart rate and rhythm. Antiarrhythmic drugs like amiodarone, procainamide, or sotalol may be considered. In structural heart disease Amiodarone is preferred. Unstable VT/ pulseless VT – If the patient is unstable with signs of poor perfusion, immediate Defibrillation may be necessary to restore a normal heart rhythm. ICD (Implantable Cardioverter-Defibrillator) for recurrent VT – In some cases, especially if there is a high risk of recurrent VT or sudden cardiac death, an implantable cardioverter-defibrillator (ICD) may be recommended. An ICD can detect and treat life-threatening arrhythmias by delivering shocks to restore a normal rhythm. Catheter Ablation Therapy– Catheter ablation is a procedure where a catheter is used to deliver energy to the heart tissue responsible for the abnormal rhythm. This can be a curative option, especially if the VT is originating from a specific location in the heart.

Medicine, NEET PG

Paroxysmal Supraventricular Tachycardia

2min read #NEETPG #INICET #FMG #MCISCREENINGEXAM Paroxysmal Supraventricular Tachycardia (PSVT) is a type of abnormal heart rhythm characterized by a rapid heartbeat originating above the heart’s ventricles in the AV node due to re-entry phenomenon. The management of PSVT involves both acute treatment to terminate ongoing episodes and long-term strategies to prevent future occurrences. Notice the narrow qRS complexes (Blue arrow) with Heart rate of 250 bpm. ST depression (red arrow) is due to sudden increase in oxygen demand of heart. Hidden P waves are noticed (black Star mark). Interventions Vagal Maneuvers – The first-line approach for terminating an acute episode of PSVT involves vagal maneuvers. These include techniques such as: Valsalva maneuver (bearing down as if having a bowel movement) Carotid sinus massage (Contraindicated in Carotid artery Stenosis due to the risk of stroke) Don’t answer from this algorithm BP is crashing where Synchronized DC shock is the treatment of choice. Adenosine – Administer intravenous adenosine, that slows down re-entry phenomenon in the heart and restore normal rhythm. Calcium Channel Blockers or Beta-Blockers – Medications such as verapamil or diltiazem (calcium channel blockers) or metoprolol (beta-blocker) may be prescribed for long-term management to prevent recurrent episodes. Antiarrhythmic Medications – In some cases, antiarrhythmic medications like flecainide or propafenone may be prescribed to help maintain a normal heart rhythm. Catheter Ablation – For individuals with recurrent or poorly controlled PSVT, catheter ablation may be recommended. This procedure involves the use of radiofrequency energy to destroy the abnormal pathway causing the rapid heart rate. Lifestyle Modifications: – Avoiding triggers such as excessive caffeine or stimulant intake. – Managing stress through relaxation techniques. – Staying well-hydrated. Regular Follow-Up: – Regular follow-up appointments with a cardiologist are essential to monitor the effectiveness of the chosen treatment plan and adjust as needed. When to seek Emergency Medical Attention:   – Inform patient that if PSVT is associated with severe symptoms, such as chest pain, shortness of breath, or loss of consciousness #Keep Hammering  

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