About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Pulseless Ventricular Tachycardia (VT) Treatment
Introduction
Pulseless ventricular tachycardia (VT) is a life-threatening cardiac arrhythmia requiring immediate intervention. It is classified as a shockable rhythm in cardiac arrest, meaning defibrillation is the primary treatment.
Steps of Treatment
1. Confirm the Diagnosis
- Pulseless VT presents with rapid ventricular contractions but no effective cardiac output.
- The patient is unresponsive and has no detectable pulse.
2. Initiate Basic Life Support (BLS)
- Begin chest compressions immediately (rate: 100-120 per minute, depth: at least 5 cm/2 inches for adults).
- Ensure high-quality CPR with full chest recoil and minimal interruptions.
- Provide oxygen and use a bag-valve mask with a high concentration of oxygen.
3. Defibrillation
- As soon as an automated external defibrillator (AED) or manual defibrillator is available, deliver a shock:
- Biphasic: 120-200 J (manufacturer-specific)
- Monophasic: 360 J
- Resume CPR immediately after the shock for 2 minutes before checking rhythm again.
- Repeat defibrillation as needed every 2 minutes if VT persists.
4. Advanced Cardiac Life Support (ACLS) Measures
- Epinephrine (1 mg IV/IO every 3-5 minutes) to enhance coronary perfusion.
- Amiodarone (300 mg IV bolus, then 150 mg if needed) or Lidocaine as an alternative antiarrhythmic.
- Reassess and treat reversible causes (the 5 H’s & 5 T’s):
- Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo/Hyperkalemia, Hypothermia
- Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary/coronary)
5. Post-Resuscitation Care
- If return of spontaneous circulation (ROSC) occurs, initiate targeted temperature management (TTM) to improve neurological outcomes.
- Identify and treat the underlying cause of VT.
- Consider placing an implantable cardioverter-defibrillator (ICD) in patients at high risk of recurrence.
Conclusion
Pulseless VT is a medical emergency that requires rapid CPR, immediate defibrillation, and adherence to ACLS protocols. Early intervention significantly improves survival and neurological outcomes.
Source recommendations
1. 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
- https://professional.heart.org/en/science-news/2020-aha-guidelines-for-cpr-and-ecc
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000918
- https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001194
- https://pubmed.ncbi.nlm.nih.gov/33081530/
2. European Resuscitation Council Guidelines 2021
- https://cprguidelines.eu/guidelines-2021
- https://www.sciencedirect.com/science/article/pii/S0300957221000551
- https://cprguidelines.eu/
- https://www.sciencedirect.com/science/article/pii/S0300957221000630
- https://pubmed.ncbi.nlm.nih.gov/33773835/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.