Dr. Usman's Cardiology Notes

A 15 year old boy brought by his father to your clinic with complain of loss of consciousness while playing football. He had two episodes of syncope in past after failing the exam. His physical examination revealed no murmur/ additional heart sound. His ECG and echocardiography both were normal. He underwent ETT which showed NSVT with changing axis a. What is diagnosis? b. How will you treat him initially? c. When ICD is indicated? d. Name the genetic mutation e. Name the treatment option apart from ICD and medical therapy Answers: a.       CPVT b.       Avoidance of competitive sports (football) Beta-blockers class I c.          Aborted cardiac arrest Recurrent Bidirectional or polymorphic VT despite optimal medical therapy Recurrent syncope despite optimal medical therapy d.       Cardiac Ryanodine receptor 2 (RYR2) e.       LCSD (Left cardiac sympath...

  A 16 year old girl accompanying his father in cardiology clinic suddenly collapsed after listening fire alarm in hospital. Senior cardiology fellow successfully resuscitated her. On recovery her physical examination was normal. On inquiry his father informed that she fainted twice at home after doorbell with spontaneous recovery. a) What do you think happened to this young girl? b) Describe two characteristic ECG findings c) How will you manage her? d) Which genetic mutation cause this disease? e) Is flecainide indicated? Answers : a.       Polymorphic VT (Underlying long QT type II) b.       QTc > 480 msec, Low amplitude notched T wave c.        Beta-blockers   (Propanolol, Nidolol) and ICD if recurrent syncope despite on beta blockers or if contraindication to beta blocker and in survivors of cardiac arrest d.       KCNH2 e.       No Referenc...