Evaluation of underlying conditions

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Evaluation of underlying conditions

· Conducted during or directly after initial management of patients

· ECG: specific findings may indicate underlying condition (see above)

· Laboratory

o Cardiac enzymes

o Electrolytes

o TSH

o Drug levels and toxicology screen

o Arterial blood gases

· Imaging

o Coronary angiography

o Echocardiography

o Nuclear imaging

References: ^{[1][5][6][7][8]}

NOTES

FEEDBACK

Treatment

· Resuscitation for V-fib

o Advanced Cardiac Life Support (ACLS)

o If V-fib does not respond to the standard ACLS protocol (refractory V-fib), consider administration of lidocaine, procainamide, or magnesium

· Post-resuscitation care

o Intensive care monitoring

§ Control/management of vital signs and removal of acute metabolic imbalances (e. g., electrolyte disturbances)

§ Mild therapeutic hypothermia

o Maintain application of antiarrhythmics that were used during successful resuscitation (usually IV amiodarone or IV lidocaine)

o Consider administration of beta blockers

o Treat underlying causes (e. g., treatment of CAD)

o ICD (implantable cardioverter-defibrillator) in patients without a readily reversible or treatable cause and/or with a high risk of recurrent, hemodynamically significant V-fib

References: ^[1][5]

NOTES

FEEDBACK

References

Goyal SK. Ventricular Fibrillation. In: Rottman JN Ventricular Fibrillation. New York, NY: WebMD. http: //emedicine. medscape. com/article/158712. April 28, 2014. Accessed February 12, 2017.

Podrid PhJ, Cheng J. Pathophysiology and etiology of sudden cardiac arrest. In: Post TW, ed. UpToDate . Waltham, MA: UpToDate. https: //www. uptodate. com/contents/pathophysiology-and-etiology-of-sudden-cardiac-arrest. Last updated August 21, 2016. Accessed February 25, 2017.

Podrid PhJ. Reentry and the development of cardiac arrhythmias. In: Post TW, ed. UpToDate . Waltham, MA: UpToDate. https: //www. uptodate. com/contents/reentry-and-the-development-of-cardiac-arrhythmias. Last updated April 10, 2016. Accessed February 25, 2017.

Mayo Clinic Staff. Ventricular Fibrillation. http: //www. mayoclinic. org/diseases-conditions/ventricular-fibrillation/basics/symptoms/con-20034473. Updated: October 31, 2014. Accessed: February 25, 2017.

Agabegi SS, Agabegi ED. Step-Up To Medicine. Baltimore, MD, USA: Lippincott Williams & Wilkins; 2013

Compton SJ. Ventricular Tachycardia. In: Rottman JN Ventricular Tachycardia. New York, NY: WebMD. http: //emedicine. medscape. com/article/159075. December 30, 2015. Accessed February 12, 2017.

Prutkin JM. ECG tutorial: Ventricular arrhythmias. In: Post TW, ed. UpToDate . Waltham, MA: UpToDate. https: //www. uptodate. com/contents/ecg-tutorial-ventricular-arrhythmias. Last updated December 2, 2015. Accessed February 18, 2017.

Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary. Circulation . 2006; 114: p. 1088-1132. doi: 10. 1161/CIRCULATIONAHA. 106. 178104. | Open in Read by QxMD

Herold G. Internal Medicine. Cologne, Germany: Herold G; 2014

10.

Chen MA. Ventricular fibrillation. https: //medlineplus. gov/ency/article/007200. htm. Updated: May 4, 2015. Accessed: February 25, 2017.

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