Perioperative medicine & anaesthesia · UKMLA & AKT

Bradyarrhythmias and heart block

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise bradyarrhythmias and heart block — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Bradycardia = heart rate <60 bpm; symptoms often only below 40 bpm
  • Dizziness, syncope (Stokes-Adams attacks), fatigue, palpitations, dyspnoea, chest pain
  • Adverse features requiring immediate treatment (Resus Council UK):
  • Shock - hypotension (SBP <90 mmHg), pallor, cold peripheries, confusion
  • Syncope - loss of consciousness due to cerebral hypoperfusion
  • Myocardial ischaemia - ischaemic chest pain or ECG changes
  • Heart failure - pulmonary oedema, elevated JVP, third heart sound

If ANY adverse feature is present, treat immediately - do not wait.

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