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Bradycardia Diagnostic and Management Algorithm

CONSIDER ETIOLOGY (not inclusive): 
 - STRUCTURAL: sick sinus, AV block, ischemia,
Bradycardia Diagnostic ... STRUCTURAL: sick sinus, AV ... Hypothyroidism - TOX: beta-blockers ... LIFE THREATENING CAUSES ... TREATMENT - Drugs (beta-blockers
Bradycardia - Differential Diagnosis Framework

BRADI Mnemonic
 • BRASH/Hyperkalemia
 • Reduced oxygen/Glucose/Temp
 • ACS
 • Drugs
 •
Hyperkalemia + AV ... Renal failure • AV ... Medications: • Beta ... differential #diagnosis #causes ... #cardiology #BRADI
Approach to ECGs - Tachy/Bradyarrhythmias
Tachyarrhythmias - HR > 100
Wide
  (1) VT - DANGER
  (2)
- treat with beta-agonist ... 200ms from longer pause ... block (lower AV ... EKG #diagnosis #electrocardiogram ... #cardiology #differential
Non-lschemic Causes of Cardiogenic Shock:

Beta-Blockers, Calcium Channel Blockers, Digoxin 

Myocarditis 

Cardiomyopathies (sarcoidosis, amyloidosis, Takatsubo, 
hemochromatosis) 

Valvular
Non-lschemic Causes ... Cardiogenic Shock: Beta-Blockers ... Calcium Channel Blockers ... Fibrillation AV ... Differential #Diagnosis #Cardiology
Antiarrhythmics - Vaughan Williams Classification:
CLASS 1 - Sodium Channel Blockers:
 • MOA: Block fast Na+ channels
duration CLASS 2 - Beta ... alpha & beta adrenergic ... inotropy) ACCP Cardiology ... Classification #Classes ... pathophysiology #cardiology
Mobitz Type I (Wenckebach Phenomenon) 2nd Degree AV Block on EKG
 • P-R interval gradually increases
Phenomenon) 2nd Degree AV ... Block on EKG ... till a dropped beat ... #diagnosis #cardiology ... #EKG #ECG #Electrocardiogram
Anatomical Differential Diagnosis for Arrhythmias
 • SA node: Sinus bradycardia, Sick Sinus Syndrome (SSS)
 • AV
SA node: Sinus bradycardia ... rhythm, Conduction blocks ... system: Conduction blocks ... Differential #Diagnosis #Causes ... #cardiology
Summary of Heart Blocks
1st Degree Heart Block:
 • Prolonged PR >200ms (5 small squares).
 • Narrow
before dropped beat ... • Block in AV ... beyond AV node) ... Diagnosis #EKG #electrocardiogram ... #ecg #cardiology
Intraoperative  Bradycardia - Guidelines for Crises in Anaesthesia
Bradycardia in theatre should not be treated as
Consider known drug causes ... toxicity (→ 3-10); beta-blocker ... calcium channel blocker ... #Anesthesiology ... Management #Workup #Cardiology
Antiarrhythmics Pharmacology Summary
Cardiac Conduction Phases:
Phase 0 - Ventricular Depolarization:
 • Na+ channels open leading to a
duration CLASS 2 - Beta ... alpha & beta adrenergic ... inotropy) ACCP Cardiology ... Classification #Classes ... pathophysiology #phases #cardiology