ECG education

Drugs and the heart

Vivienne Miller

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Abstract

Articles in this section are inspired by, but not based on, real cases to illustrate the importance of knowledge about ECGs in relation to clinical situations in general practice. Management is not discussed in detail.

Key Points

  • Take time with patients who have psychiatric illness or drug problems to obtain a complete medical history early in your care of them.
  • It is important to listen to all patients and then investigate appropriately, even if they have difficulty giving you detailed information.
  • Do not ignore a short PR interval or prolonged QTc interval on ECGs of patients who have had cardiac events or who have a family history of cardiac events.
  • Be aware of medications and illicit drugs that prolong QT intervals; if patients are taking more than one of these regularly, an ECG to check the QT interval is wise.
  • Some patients cannot cope with further investigations; remind them gently and positively of the need for these each time you see them.

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