1 / 23

Dirty Laundry

Dirty Laundry. UNEXPLAINED SYNCOPE Arrhythmic Causes Sinus node dysfunction Tachyarrhythmias AV Block Cause of syncope undetected in 50% of patients 1 year mortality is 6%! (unknown cause) 1 year morbidity is 12% (non-cardiovascular)

terrel
Download Presentation

Dirty Laundry

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Dirty Laundry

  2. UNEXPLAINED SYNCOPE • Arrhythmic Causes • Sinus node dysfunction • Tachyarrhythmias • AV Block • Cause of syncope undetected in 50% of patients • 1 year mortality is 6%! (unknown cause) • 1 year morbidity is 12% (non-cardiovascular) • 1 year mortality is 20-30% (cardiovascular) (untreated) • Mortality & incidence of sudden cardiac death are determined by the presence of underlying heart disease

  3. NATURAL HISTORY OF H.O.C.M Annual mortality 3% in adults, 6% in children Symptoms my be unrelated to the gradient, but my relate to the onset of atrial fibrillation Death is most often sudden & difficult to predict Young age of diagnosis (<30) Malignant family history Hypertensive response to exercise Genetic abnormalities associated with SCD Ominous history of syncope (childhood) NSVT

  4. MANAGEMENT OF H.O.C. M. • Symptoms • Diuretics for pulmonary congestions only • Beta Blockers-mainstay of treatment for angina, • dyspnea, presyncope • Not known if BB prevents SCD • Verapamil can be tried if BB not tolerated • Amiodarone ? improves prognosis • Sotalol experience is limited • Avoidance of Strenuous Exercise • Conversion of Atrial Fibrillation • Defibrillator Implantation • Septal Ablation • Myomectomy & mitral valve repair • Transplantation.

  5. PAIN IN AORTIC DISSECTION Pain is often morbidly appropriate to the actual event ( tearing, ripping, stabbing ) Pain tends to migrate from point of origin to other sites along the path of the dissection When pain is anterior, 90% +had involvement of the ascending aorta Pain in the neck, throat, jaw or face predicted aortic root involvement

  6. Graphic Credits The Cardiology Intensive Board Review Question Book Cho,Griffin,Topol Heart Disease Braunwald,Zipes,Libby Manual of Cardiovascular Medicine Griffin, Topol Early Medical Photography in America Burns

More Related