Medical history (history of illness) represents an important component in the diagnosis of ventricular flutter. External history What happened? Pre-existing conditions (cardiovascular disease?) Allergies Medication history Antiarrhythmics (medications for cardiac arrhythmias).
Cardiovascular (I00-I99). Ventricular fibrillation – life-threatening pulseless cardiac arrhythmia in which disordered excitations occur in the ventricles of the heart and the heart muscle no longer contracts in an orderly fashion. Ventricular tachycardia – cardiac arrhythmia with too fast heartbeat, which starts from the ventricles.
The following are the most important diseases or complications that may be contributed to by ventricular flutter: Psyche – Nervous System (F00-F99; G00-G99). Anxiety Cardiovascular system (I00-I99) Sudden cardiac death (PHT) Jumping to a different heart rhythm
A comprehensive clinical examination is the basis for selecting further diagnostic steps: Assessment of consciousness using the Glasgow Coma Score (GCS). General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes Neck vein congestion? Central cyanosis? (bluish discoloration of skin and central mucous membranes, e.g., tongue). Auscultation … Ventricular Flutter: Examination
2nd order laboratory parameters – depending on the results of the history, physical examination, etc. – for differential diagnostic workup Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Electrolytes – potassium, magnesium Thyroid parameters – TSH Highly sensitive cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI); creatine kinase (CK, … Ventricular Flutter: Test and Diagnosis
Therapeutic target Restoration of a sufficient circulation Therapy recommendations Ventricular flutter, like ventricular fibrillation, requires immediate defibrillation (shock generator; treatment method for the life-threatening arrhythmia). Adrenaline (sympathomimetic). Amiodarone (antiarrhythmic drug; 300 mg i.v. after third unsuccessful defibrillation; evidence-based) or lidocaine (100 mg i.v.) In Adams-Stokes syndrome, immediate resuscitation and defibrillation. See also under “Further therapy.”
Obligatory medical device diagnostics. Electrocardiogram (ECG; recording of the electrical activity of the heart muscle). Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification. Echocardiography (echo; cardiac ultrasound) – for suspected structural heart disease. Long-term ECG – ECG … Ventricular Flutter: Diagnostic Tests
The following symptoms and complaints may indicate ventricular flutter: Leading symptom Rapid loss of consciousness
Pathogenesis (disease development) Ventricular flutter is a cardiac arrhythmia with very rapid, regular contractions of the heart. There is usually a transition to ventricular fibrillation. Etiology (causes) Disease-related causes Cardiomyopathy (heart muscle weakness). Coronary artery disease – atherosclerosis (arteriosclerosis, hardening of the arteries) of the coronary arteries. Myocardial infarction (heart attack) Medication Antiarrhythmics – medications … Ventricular Flutter: Causes
General measures Review of permanent medication due topossible effect on existing disease. Conventional non-surgical therapy methods Defibrillation (“shock generator”) – restoration of normal heart activity by strong electric shocks. The device used is called a defibrillator. Vaccinations The following vaccinations are advised: Flu vaccination Pneumococcal vaccination Regular checkups Regular medical checkups Psychotherapy If necessary, psychotherapy … Ventricular Flutter: Therapy
