MCQ 11: Tachycardia induced cardiomyopathy

Q. Most common cause of tachycardia induced cardiomyopathy is?
A. Atrial flutter
B. Atrial fibrillation
C. Ventricular tachycardia
D. Ventricular fibrillation

Answer: B

Explanation:

Tachycardia induced cardiomyopathy (TIC) is defined as systolic and/or diastolic ventricular dysfunction resulting from a prolonged elevated heart rate which is reversible upon control of the arrhythmia or the heart rate.
It is a rate dependent cardiomyopathy and those patients with higher tachycardia rates develop TIC earlier.
Abnormal calcium handling, reduced cellular energy storing, and abnormal energy use have been proposed as the underlying mechanisms responsible for this syndrome.
Pathologic changes start as early as 24-48 hours after onset of tachyarrhythmia in experimental models.
Most common cause is supraventricular tachycardia and of them most common sustained tachycardia is atrial fibrillation.

Comments

ECG Spotter

What is the diagnosis? Click the button below to view answer: Show Answer

The patient contacts the doctor over phone with this report. Obviously anxious because of his high heart rate (199 beats per minute) as detected by ECG machine. Should he be worried about this and come to emergency department as soon as possible? Correct answer- ECG machine has calculated his heart rate incorrectly. Heart rate is around 100 beats per minute. Other findings in this ECG include ST segment elevation in anterior chest leads along with presence of Q waves, denoting old MI changes with possibly development of LV aneurysm. In such cases, ST segment elevation can persist for long periods. Now, should he come to emergency department? Not because of detection of high heart rate. But, if he is having symptoms such as shortness of breath or chest pain, he should visit emergency department. Otherwise, if he is asymptomatic, he can schedule a regular visit with his cardiologist.

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