Wed3November0844PM 3

In the management of cardiac arrhythmias:

True / False

Amiodarone has an elimination half-life of 10 days Correct

Adenosine causes coronary artery vasoconstriction Correct

The ECG features of Wolff-Parkinson-White (WPW) syndrome can mimic a myocardial infarction Correct

Wolff-Parkinson-White (WPW) syndrome is characterised by prolongation of the P-R interval, a delta wave and a widened QRS complex Incorrect answer selected

Atrial flutter is usually resistant to DC cardioversion Correct

Explanation

The ECG features of Wolff-Parkinson-White (WPW) syndrome are:

a shortened (not prolonged) P-R interval

a delta wave on the upstroke of the QRS complex, and

a widened QRS complex. It can be divided into types A and B.

The QRS complex in chest lead V1 is predominantly positive with type A, but is predominantly negative with type B. Thus, type A can be misinterpreted as a posterior myocardial infarct and type B can mimic an inferior myocardial infarct.

The ECG features of atrial flutter are regular 'saw tooth' flutter waves with a varying degree of atrioventricular block (2:1, 3:1 or 4:1). Atrial flutter is rarely resistant to DC cardioversion and it is often used to restore sinus rhythm.

Adenosine is a potent coronary dilator (not constrictor) but it can cause coronary steal in susceptible patients. Amiodarone has a very long elimination half-life (20-100 days).

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