THANK YOU TO CAROLINE FOR A TRULY HEART WARMING M&M THIS MORNING ABOUT PROLONGED QT AND ALL THE DISASTERS THAT IT CAN CAUSE...
SO LETS TALK ABOUT SOME MORE CARDIOLOGY STUFF AND SYNCOPE, BECAUSE WE ALL LOVE IT RIGHT? AND THAT WE ALSO LOVE CAPS LOCKS!
Also a heart stopping condition (....yeah I went there), causing syncope, not commonly seen in the ED, but when you see it you HAVE TO recognize it.
SO, when you get an EKG and see this...... you'll know what to do.
WHAT IS IT?????
- GENETIC DISORDER, CAUSING CONDUCTION PROBLEMS IN THE HEART
HOW TO DIAGNOSE IT?
- In the ED, the only way is by EKG. There are 3 types of Brugada so for every patient who syncopizes you need to make sure you check for all of them. There are genetic tests to confirm, but for our sakes, EKG EKG EKG
SO WHAT? THEY HAVE INTERESTING EKG AND THIS RARE DISEASE (OR MAYBE NOT SO RARE). DISCHARGE WITH NSAIDS AND PMD FOLLOWUP RIGHT?
- It actually is thought to be THE most common cause of sudden unexplained death
- These people are at EXTREMELY high risk of ventricular arrhythmias (VF, VT), and the first presentation is usually SYNCOPE
THESE PEOPLE NEED AICD's and PRONTO. LIKLEY CARDS ADMISSION VS ACUTE CARDS F/U WITH ED CONSULTATION
- No medication has shown to really effectively prevent the arrhythmias.
- STILL, average age of death of these peeps is 41.
Lesson of the Day??? With Syncope, BE AFRAID, BE VERRRRRY AFRAID