<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> Acute MI - ST elevation (may occur with complete block) Hyperkalaemia - T waves abN (tall tented) then BBB, wide QRS and loss of p Myocarditis - sinus tachy, prolonged QT, ST up or down, T inversion Non ST elevation acute coronary syndrome - deep arrow T inversion (left ant descending artery), ST depression, vent arrhythmias, Pericarditis - ST elevation (saddle shape), PR depression (pathognomic) - often lots of ECG changes Acute coronary syndrome - 2-3hrs chest pain - self limiting, smoking, HT, exam normal antiplatelet (aspirin and ticagrelor), anticoag (unfractionated heparin) angiography to PCI Mx aggressively if marked Twave change / ST depression Thrombolysis - BBB, ST elevation, or MI Acute MI (may occur with AF / shock) Mx aspirin, urgent angioplasty (or thrombolysis) SVT - looks like BBB - will get broad complex if aberrant conduction - treat as ventricular if in doubt, If SVT can give Adenosine Torsades de pointes - rare VT, secondary to prolonged QT (amiodarone or electrolyte imbalance) VT (Hx severe coronary disease with chest pain) - regular broad complex tachy ?with capture / fusion beats VT Mx - resolve arrythmia and hemodynamic compromise before tackling underlying cause (usually infarction or ischaemia, may be drugs or electrolytes) sedate (midazolam) and synchronised shock Remember gastro-oesophageal reflux - pain nausea vomiting definitive test for ischaemia - exercise test, stress echo, myocardial perfusion scan Pericarditis causes - MI, post infarct (Dressler), uraemia, autoimmune, bacterial infection usually self limits - give Colchicine look out for tamponade, T>38, immunosuppressed, trauma, myopericarditis Heart block Mx - if <40 needs pacemaker no p waves - broad complex escape rhythm check electrolytes (esp hyperkalaemia) MI without ongoing Sx - needs assessment - including troponin, angiography and echo, secondary prevention and cardiac rehab