Unsustained v-tach

julie.cruz-sjejulie.cruz-sje
in CDI Talk Archive
My co-worker has a case we cannot agree on for PDX....63 yo male with c/o "palpitations and cp". Found to be in unsustained V-tach with rate of 160-180 and treated with Lidocaine prehosp. Pt had hx of CAD, MI x8, DM, chr systolic heart failure, AAA repair. Pt did have a cardioverter/defibrillator implanted after admission. I am thinking the PDX would be the V-tach (reason for admission), my co-worker believes it would be CAD as V-tach is a symptom....I think I may be wrong on this one. Can anyone shed some light on this?

Comments

  • Unknown
    edited May 2016
    I would agree with the V-tach



  • dvitalone1dvitalone1
    edited May 2016
    YOU CANNOT ASSUME A LINK BETWEEN THE V TACH AND CAD.....V TACH IS WHAT 4 OF US HERE AGREE AS PDX

  • cynthia.a.goeweycynthia.a.goewey
    edited May 2016
    I too agree with VT as pdx.
    Cindy

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited May 2016
    From the description provide, V-Tach is clearly the reason for admit.


    Consider the documented evaluation, w/u and therapy - was pt admitted
    urgently with the V-Tach and did admit orders include IV meds to control
    the V-Tach?

    Conversely, what was done to evaluate and treat any documented CAD?


    Paul Evans, RHIA, CCS, CCS-P
    Supervisor, Clinical Documentation Integrity, Quality Department
    California Pacific Medical Center
    2351 Clay #243
    San Francisco, CA 94115
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
  • ssalinasssalinas
    edited May 2016
    Based on info given, I would go with V-tach. There are many causes of V-tach and a relationship is not assumed between the CAD and VT. Tx was directed at the VT and was the acute condition that occasioned the stay.

  • tpeytontpeyton
    edited May 2016
    I agree with the VT

    Tracy M Peyton RN, CCDS
    Case Management
    Bradford Regional Medical Center
    Upper Allegany Health Systems
    116 Interstate Parkway
    Bradford, PA 16701
    814-558-0406
  • fentona@bronsonhg.orgfentona@bronsonhg.org
    edited May 2016
    Here's some info. Hope it helps.
    VT generally is a consequence of ischemic or structural heart disease or electrolyte deficiencies (eg, hypokalemia, hypocalcemia, hypomagnesemia). It can also be triggered by the following (see Etiology):

    Use of sympathomimetic agents (from intravenous inotropes to illicit drugs such as methamphetamine or cocaine)
    Systemic diseases that affect the myocardium, such as sarcoidosis, systemic lupus erythematosus, hemochromatosis, and rheumatoid arthritis
    Other structural congenital disorders, such as right ventricular dysplasia and tetralogy of Fallot
    Digitalis toxicity - Can lead to biventricular tachycardia.
    Inherited channelopathies[1]
    Drugs that prolong the QT complex (eg, type 1A antidysrhythmics, droperidol and related phenothiazines)

    Amy

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