Learn from life @RVA, U.S.A.

stroke. You are considered to have a family history of  cardiovascular disease  if: your father or brother was under the age of 55 when they were diagnosed with  cardiovascular disease  or your mother or sister was under the age of 65 when they were diagnosed with  cardiovascular disease . If you have family history of  cardiovascular disease , make sure you tell your doctor or nurse. They may want to check your  blood pressure  and  cholesterol . If you are over 40 years of age, you can visit your doctor and ask for a heart health check to find out your risk of getting  cardiovascular disease .

Vital(BP): hypo, hyper. PEx(JVP): volume status -------------------------------- 1st. PI(3-7)= contractility and volume status(high volume only cause high PI) overload = high PI. low volume = low PI. (=low volume = low preload = RV failure, arrhythmia same thing) HTN = low PI low BP = low PI. (only overload cause high PI = with high preload, but otherwise, BP, volume => cause low PI) 2nd. Flow(4-6) overload, 3rd. Power(surge = only thrombus, 4-6) hypotension route (BP) => high VADFL = vasodilator, sepsis = R/O => low VADFL(most common)  with high JVP => RV failure, PE/tamponade, pneumothorax                                                                               , then adjust LVAD(higher)                                                 with low JVP => volume depletion, arrhythmia(bleeding, volume                                                                                                                               depleted) 

75 year old male with PMH of CAD (Stent to OM in 2014), and sustained VT. He underwent St Jude DDD ICD implant 7/8/2016. In 2017 he received multiple shocks for sustained VT. He then underwent EPS and ablation at UVA on 4/24/17, at that time LV and RV endocardial voltages were normal and ablation was done in the LVOT and RVOT based on pace mapping (per reports). He has since had recurrent sustained VT treated by ATP and NSVT. He underwent repeat VT ablation (thought to be triggered VT from aorto-mitral contuinity ) with non inducible VT at the end of the procedure. however, last night he had recurrent episodes of ventricular tachycardia in the VT monitor zone of the device (asymptomatic , no therapies recieved). He has been on sotalol 80 mg TID at home. Will plan to go upto 120 mg BID today and then 160 mg BID tomorrow if the 120 mg dose is tolerated. 1- Increase sotalol to 120 mg BID today 2- ECG 2 hours after each dose 3- If QTc remains < 500 ms/ increase in QTc <15%,will