and then there's third degree block. There are also different ways heart block is classified such as AV block, SA block, duration, frequency, and completeness.
Diagnosis
Diagnosis of heart block in a patient normally starts with the primary care physician. When the patients doctor detects that there may be a problem with their patients heart they will usually refer that patient to a specialist, like a cardiologist. "A cardiologist is a doctor who has devoted their professional life to the study of the heart and circulatory system" (Nihgov, 2016). The patient could also be referred to an electrophysiologist, "which is a cardiologist who specializes in the hearts electrical system" (Nihgov, 2016). The first thing the doctor will do is record
…show more content…
the patients personal and family medical history. Some information that the doctor will find helpful with their diagnosis would be what if any symptoms the patient has, if the patient has any other health problems like heart disease, if any of the patient’s family members has any form of heart problems, all types of medication the patient is currently taking including over the counter and herbal, how physically active the patient is, and weather the patient drinks alcohol smokes or does illegal drugs. The patient will also receive a physical exam, the doctor will be focusing on the patient’s pulse rate, checking the patient’s lower limbs for swelling, and look for any signs of other diseases that can cause heart rhythm problems. The patient will also undergo a number of tests to help diagnosis, most commonly used is an electrocardiogram, or EKG, this test records the hearts electrical activity, it shows how fast or slow the heart rate is, weather the hearts contractions are steady or irregular, and how strong or weak the electrical signal is in the heart. Ten to twelve electrodes are noninvasively placed in specific places on the surface of the patient’s skin. "On the EKG on heart beat has waveforms that are labeled P, Q, R, S, and T" (Practicalclinicalskillscom, 2016). The P represents the atria contracting and sending blood into the ventricles. The QRS together show the ventricle depolarization and contraction. The PR interval shows the time it takes the electrical signal to go from the SA node to the ventricles. T shows the ventricular repolarization. When a patient has bundle branch block the QRS is wider than normal. In first degree block the PR interval shows longer than normal. For second degree type I the PR intervals will get longer and longer for about three to four beats then a QRS will be missing all together then it will start over again, for second degree type II every couple beats a QRS will be randomly missing. Finally, in third degree heart block there will be many more P waves then QRS intervals, and the QRS intervals appear randomly. Other tests the doctor will probably order will be a holter monitor, which is a portable EKG that is warn for twenty-four to forty-eight hours.
The holter monitor records the patients hearts electrical activities, the patients usually record times of the day they experience symptoms in a journal. Another test used for diagnosis is an electrophysiology study, and EPS, this test includes passing a wire through a vein in the patients arm or thigh up to the heart. The wire records the electrical signals in the heart. An echocardiogram is used as well; this is an ultrasound or the heart. Finally, a stress test, which is when an EKG is preformed while the patient is on a treadmill and increasing intervals are set to watch how the heart reacts to physical …show more content…
stress. Bundle branch block One of the first types of heart block that is not as serious as the others is bundle branch block. "With this condition the electrical impulses are slowed or blocked as they travel through the specialized conducting tissue in one of the two ventricles" (Heart rhythm society, 2016). This is when one side of the bundle branches in the ventricles is defected and electrical signals flowing in this are slowed or blocked. The signal passes down from the SA node down past the AV node in to the bundle of His, then down into each ventricle simultaneously. When a patient has bundle branch block the signal is slowed or blocked on only one side of the ventricles. In some cases, this can cause the patient’s heart to have a slower than normal heart rate. Although patients do not normally show and signs or symptoms with this condition, some patients have been presented with experiencing tiredness or on rare occasion fainting spells. Treatment of bundle branch block is not usually needed, patient is just usually monitored on a yearly basis, unless the patient’s symptoms worsen. First degree heart block The next type of heart block is first degree, this is where the electrical impulses moving between the aorta and ventricles are delayed, or slowed down.
"first degree block is caused by a conduction delay at the AV node or bundle of His" (Ekg academy, 2016). Due to this it causes about a half second delay for the bottom two ventricles to contract. In some patients this causes a slower then normally heart rate, hand rarely causes any symptoms. First degree heart block is a common condition in highly trained athletes. It is also common for certain medications to cause first degree heart block. Typically, no treatment is needed for this condition, other than regulation of medication the patient may by taking, the patient is just normally monitored yearly, unless the patient’s symptoms
worsen.
There are several different heart problems that show up as an abnormal EKG reading. For example, a heart block can occur when there is a delay in the signals coming from the SA node, AV node, or the Purkinje fibers. However, clinically the term heart block is used to refer to an AV block. This delays or completely stops communication between the atria and the ventricles. AV block is shown on the EKG as a delayed or prolonged PR interval. The P wave represents the activity in the atria, and the QRS complex represents ventricular activity. This is why the PR interval shows the signal delay from the AV node. There are three degrees of severity, and if the delay is greater than .2 seconds it is classified as first degree. Second degree is classified by several regularly spaced P waves before each QRS complex. Third degree can be shown by P waves that have no spacing relationship to the QRS complex. Another type of blockage is bundle branch block. This is caused by a blockage in the bundle of His, creating a delay in the electrical signals traveling down the bundle branches to reach the ventricles. This results in a slowed heart beat, or brachycardia. On an EKG reading this is shown as a prolonged QRS complex. A normal QRS is about .8-.12 seconds, and anything longer is considered bundle branch block. Another type of abnormal EKG reading is atrial fibrillation, when the atria contracts very quickly. On the EKG this is shown by no clear P waves, only many small fibrillating waves, and no PR interval to measure. This results in a rapid and irregular heartbeat. On the other hand, ventricular fibrillation is much more serious and can cause sudden death if not treated by electrical defibrillation.
The primary concern for Mr. Miller would be preventing further ischemia and necrosis of the myocardial tissues, preventing serious complications such as cardiac dysrhythmias and heart failure, as well as relieving his chest pain that radiates to his left arm. Preventing further ischemia and necrosis of the myocardial tissue will help prevent the development of heart failure due to myocardial infarction, whereas relieving his pain will help reduce his episodes of shortness of breath, and will also help to reduce any anxiety and restlessness he may be having from being in pain and short of breath.
Both tests are very useful for assessing the pulmonary and cardiac system health of the individual being examined. This involves examining the individual’s response to the test by assessing their BP, HR, oxygen intake abilities, and using this information to infer whether they have some type of internal impairment. This includes
In this lab, I took two recordings of my heart using an electrocardiogram. An electrocardiogram, EKG pg. 628 Y and pg. 688 D, is a recording of the heart's electrical impulses, action potentials, going through the heart. The different phases of the EKG are referred to as waves; the P wave, QRS Complex, and the T wave. These waves each signify the different things that are occurring in the heart. For example, the P wave occurs when the sinoatrial (SA) node, aka the pacemaker, fires an action potential. This causes the atria, which is currently full of blood, to depolarize and to contract, aka atrial systole. The signal travels from the SA node to the atrioventricular (AV) node during the P-Q segment of the EKG. The AV node purposefully delays
Cardiomyopathy, by definition, means the weakening of the heart muscle. The heart is operated by a striated muscle that relies on the autonomic nervous system to function. Cardiomyopathy is diagnosed in four different ways based on what caused the illness and exactly what part of the heart is weakened. The four main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular dysplasia. One other category of cardiomyopathy that is diagnosed is “unclassified cardiomyopathy.” Unclassified cardiomyopathy is the weakening of the heart that does not fit into the main four categories.
Heart disease is one of the most common causes of the mortality and morbidity in most well developed countries. They come in different forms such as stroke and other cardiovascular diseases and it’s the number one cause of death in the state of America. In the year 2011 alone nearly 787,000 people were killed as a result of this epidemic. And this included Hispanic, Africans, whites and Americans. As for the Asian Americans or pacific Islanders, American Indians and the natives of Alaska, the concept to them was a second only to cancer. However, statistics has proved that a person gets heart attack every 34 seconds and in every 60 seconds, someone dies out of it which include other related event. Additionally, majority of the women are the
During a physical examination, a specialist may hear a heart murmur which will prompt a referral to a pediatric cardiologist for an analysis. Diagnostic testing will vary by the child’s age, clinical condition, and institutional preferences. Such test may incorporate a chest X-ray, electrocardiogram, echocardiography and cardiac catheterization. A chest X-ray uses unseen X-ray beams to cr...
When a person has Atrial Fibrillation, the sinoatrial node releases multiple quick impulses at a rate of 350 -600 times per minute. When this happens, the ventricles respond by beating around 120- 200 beats per minute, making it tough to identify an accurate heart rate. This arrhythmia can be the result of various things. During a normal heart beat, the electrical impulse begins at the sinoatrial node and travels down the conduction pathway until the ventricles contract. Once that happens, the SA node fires again and the process keeps on cycling (Ignatavicius & Workman, 2013).
According to “Heart Disease and Marfan Syndrome” (n.d.), if the disease is suspected, the doctor will perform a physical exam of the eyes, heart and blood vessels, and muscle and skeletal system. After, a history of symptoms and information about family members will be obtained to determine if you have it. A chest x-ray, an electrocardiogram, and an echocardiogram can also be used to evaluate the heart and blood vessels to detect heart rhythm problems. A transesophageal echocardiogram may also be used, along with an MRI, CT scan, or a slit lamp eye exam to check for dislocated lenses. The various symptoms of Marfan syndrome allow doctors to diagnose the condition and provide treatments that can help the
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
The study of cardio physiology was broken up into five distinct parts all centering on the cardiovascular system. The first lab was utilization of the electrocardiogram (ECG). This studied the electrical activities of the heart by placing electrodes on different parts of the skin. This results in a graph on calibrated paper of these activities. These graphs are useful in the diagnosis of heart disease and heart abnormalities. Alongside natural heart abnormalities are those induced by chemical substances. The electrocardiogram is useful in showing how these chemicals adjust the electrical impulses that it induces.
Just as breast cancer is killing our African American women, heart disease is also one of the major diseases killing our women. Heart disease is one of the nation’s leading causes of death in both woman and men. About 600,000 people die of heart disease in the United States (Americas heart disease burden, 2013). Some facts about heart disease are every year about 935,000 Americans have a heart attack. Of these, 610,000 are a first heart attack victim. 325,000 happen in people who have already had a heart attack. Also coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and loss of productivity. Deaths of heart disease in the United States back in 2008 killed about 24.5% of African Americans.
Bradycardia can be very serious. Some of the symptoms are loss of consciousness, heart failure, or death. Slow heart rates are caused by heart block. The hearts natural pace-maker fails to be conducted to the ventricles, the hearts main pumping chambers.
The heart is a pump with four chambers made of their own special muscle called cardiac muscle. Its interwoven muscle fibers enable the heart to contract or squeeze together automatically (Colombo 7). It’s about the same size of a fist and weighs some where around two hundred fifty to three hundred fifty grams (Marieb 432). The size of the heart depends on a person’s height and size. The heart wall is enclosed in three layers: superficial epicardium, middle epicardium, and deep epicardium. It is then enclosed in a double-walled sac called the Pericardium. The terms Systole and Diastole refer respectively and literally to the contraction and relaxation periods of heart activity (Marieb 432). While the doctor is taking a patient’s blood pressure, he listens for the contractions and relaxations of the heart. He also listens for them to make sure that they are going in a single rhythm, to make sure that there are no arrhythmias or complications. The heart muscle does not depend on the nervous system. If the nervous s...
This reflection of vital signs will go into discussion about the strengths and weaknesses of each vital sign and the importance of each of them. Vital signs should be assessed many different times such as on admission to a health care facility, before and after something substantial has happened to the patient such as surgery and so forth (ref inter). I learned to assess blood pressure (BP), pulse (P), temperature (T) and respiration (R) and I will reflect and discuss which aspects were more difficult and ways to improve on them. While pulse, respiration and temperature were fairly easy to become skilled at, it was blood pressure which was a bit more difficult to understand.