CARDIAC ARRYTHMIAS - Its incidence and management in Emergency Department

purpose of the study - What is the frequency and diagnosis of Dysrhythmias in patients visiting to Emergency Department and what are the management practises for the same.

summary-

A few of the most distressful causes of heart malfunctions occur due to abnormal rhythmicity of the heart known as CARDIAC ARRYTHMIAS.

They can be described as irregular rhythm of beating of the heart which can be either slower than normal (<60/min) or faster (>100/min) and can occur in any individual of any age. In it usually the electrical activity of the atria is not in co-ordination with the electrical beat activity of the ventricles. Hence the atria and  SA Node have lost their ability of being the supreme primary pump as well as electric impulse generator.

Symptoms pertaining because of cardiac arrythmias are commonly being presented to the emergency departments of the hospitals for evaluation and consultation in all age groups.

The code "cardiac abnormalities", which include ‘Cardiac Arrythmias’, is assigned to individuals who complain of palpitations, dyspnea, pre-syncope/collapse, gastrointestinal symptoms, chest pain, uneasiness, tachycardia, or bradycardia. A differential diagnosis of the type of arrythmia is then established after analysis of the clinical presentation and heart rhythm in a 12-lead Electrocardiogram.

Priorities for managing cardiac arrhythmias in the emergency department (ED) include-

·      Early recognition and triaging with management,

·      quick assessment of any potential hemodynamic instability,

·      finding and treating the inherent or precipitating cause,

·       a thorough evaluation of the patient’s medical history with special focus on the risk of thromboembolism.

Cardiovascular arrhythmias are then primarily treated by ED doctors using either a rate-controlling or rhythm-controlling approach. Priority should be given to managing thromboembolism risks.

Medical therapy includes administering pharmacological agents for rate control including Calcium blocker- verapamil, diltiazem, Beta blocker- metoprolol, adenosine, lignocaine and amiodarone as well as correcting electrolyte abnormalities like magnesium or potassium.

Rhythm control approach for managing cardiac arrythmias are also being practised in ED either by use of drugs or by electrical cardioversion.

Therefore, the purpose of this study is to estimate the prevalence of cardiac arrhythmias, their diagnosis, complication rate, management and outcomes in our tertiary care hospital’s emergency department.