atrioventricular block - this deterioration or absolute cessation of the passage of electrical impulses between the atria and ventricles, causing serious defects in hemodynamics and cardiac rhythm.Atrioventricular block several times frequently diagnosed in people who already have a history of any kardiopatologiya.
AV node - a significant part of the system of pulses, which is responsible for ensuring that the right atrium and ventricle, rhythmically and consistently reduced.Promotion of impulses that come from the sinus node, a little slow in the AV node, which allows reduced atrial and ventricle - is filled with blood.After a brief pause, the beam of His and legs impulses begin their journey in the direction of the ventricles, causing them to a state of excitation and contraction.This complex system and ensures the correct parts of the main body of the reduction and hemodynamic processes.
atrioventricular block reasons
According to its cause atrioventricular h
atrioventricular block caused kardiopatologiey arises because of fibrosis and sclerosis of the system in a variety of diseases.Call the blockade of cardiac origin may be rheumatic changes infarction, heart damage in syphilis, myocardial interventricular septum, various cardiomyopathies, myocarditis and collagen of any origin (diphtheria, thyrotoxic or autoimmune), amyloid, sarcoidosis, neoplastic processes in the heart, cardio.During atrioventricular block in organic defect may first be only a partial blockade that with the progression of the underlying disease may develop in the third degree.
cause the development of AV block are capable of some operations and surgical procedures: the installation of the prosthesis in the aortic valve, the intervention on the CHD, the introduction of a catheter into the right heart and others. Sometimes doctors registered as congenital atrioventricular block (approximately five cases per one hundred thousand newborns).If the blockade of the child from birth, you'll find that some areas of the system are simply not available.Every fourth child of the atrioventricular block is combined with a few anomalies.Very often
blockage is caused by an overdose of certain medical drugs (digitalis, diltiazem, verapamil, quinidine, beta-blockers, drugs based on lithium salts).
atrioventricular block symptoms
manifestations of the blockade and well-being in this pathology is directly dependent on what was caused by violation of the conductivity, what degree of blockade developed where there is damage to (the level), what other diseases CCC suffering people.
If block atrioventricular node does not reduce heart rate, then the patient will not feel or notice.The manifestations are noticeable only at sufficiently strong decrease in heart rate.Due to the fact that the heart rate and cardiac output is rapidly declining, at any load there is shortness of breath, unmotivated weakness, pain in the region of the sternum.
When atrioventricular block may start worrying symptoms such as confusion, dizziness, syncope, transient.When AV block second degree the patient feels "interruptions", "fading" the heartbeat, with third-degree often has attacks of Morgagni (sharp increasing weakness with severe dizziness, dark eyes, pain in the projection of the heart, confusion, loss of consciousness, the development of seizures, andacrocyanosis, which may progress to cyanosis).
Incomplete atrioventricular block usually has no significant, visible human manifestations.Sometimes this form of blockade of the patient may be concerned about the general deterioration, shortness of breath, fatigue, mild headaches.Usually these symptoms are charged to the fatigue of working days, and no one is seriously "wake-up call" of the body.
complete atrioventricular block will force to pay attention to their health, even the most indifferent to their well-being, as it is accompanied by breathing difficulties with loads and Traffic (dyspnea) and frequent pain, lightheadedness, and often leads to cardiac asthma.These people greatly increases the risk of developing a dangerous syndrome Morgagni-Stokes-Adams.
degree atrioventricular block
atrioventricular block has three degrees of development.The first degree has almost no noticeable symptoms.It can be detected only during ECG.In the study can be seen significantly delayed conduction (atrioventricular), in which electrical impulses still reach the goal - the ventricles.At this stage, no specific treatment was not necessary, the patient should treat your body more closely and know that under heavy braking, and bad habits can be more dangerous for a state.
for second-degree AV block is characterized by ventricular conduction of impulses in full.In this case, the human condition worsens in direct proportion to the length of the pause between pulses.If adequate care and proper treatment are not available, may develop even a complete atrioventricular block.In this case the pulses do not reach completely to the ventricles.
third degree - the absolute blockade.Atrioventricular conduction in such a course of the disease is broken completely.Atrial contraction takes control of the sinus node, the ventricles do your cuts at a very slow pace.All these changes entail a total violation of all hemodynamic processes in the body.
atrioventricular block treatment
If the doctor has a suspicion that the patient developed AV block, first of all it is necessary to find out history.The patient needs to know whether he endured myocarditis or myocardial infarction, took ever medication that can affect the conductivity (calcium channel blockers, digitalis drugs, lithium, beta-blockers and others.).When listening to the heart of man with AV block rhythm of the heartbeat is heard right at long intervals, which indicate that the ventricular contractions are absent.Present bradycardia, may be registered gun Strazhesko tone.Visually, it becomes evident that the neck veins pulsate stronger carotid and radial arteries.
If suspected atrioventricular block ECG is an essential method of research.At the first level of the blockade on the ECG PQ seen an increase by 0.20 seconds and more when the second is seen in sinus rhythm and pauses for loss of ventricular complexes after P-wave, the appearance of complexes Wenckebach-Samoilova.When the third degree ECG gives information about the number of ventricular complexes is almost three times less than the atrial (from twenty to fifty times per minute).If the doctor is not enough to establish the diagnosis of ECG is assigned to daily monitoring.During this study it is possible to detect not only the atrioventricular block, but also to trace the relationship of symptoms with the loads and the use of any drugs.
As already mentioned, in the therapy needs only second to the third stage, as shown in the first observation of the dynamics.Treatment of the serious symptoms and conditions associated with atrioventricular block, depending on the nature of pathology and disturbing symptoms.If the reason for the blockade is in the medication, it will be enough just to hold a dosage adjustment (decrease) or to stop the drug entirely, replacing it safer.If a person has kardiopatologii attendant can be assigned to the beta-agonists.It is now widely used and Izadrin Dobutamine and Atropine.When atrioventricular block one percent Atropine is administered four times (interval - six hours) in one milliliter.Izadrin recommend to use the tablet under the tongue with an interval of two to three hours.Usually it does not take more than forty-eight hours, as during this time the rhythm of the heartbeat is restored.If a serious condition, you can start introducing the drug into a vein drip.To do this, one milliliter of solution of the drug (0.02%) was mixed with five hundred milliliters of five percent of glucose.The system set up in the ten to twenty drops in sixty seconds.In the next one to three days means taking sublingually.
If atrioventricular block accompanies myocarditis or heart attack, treatment strategy has certain peculiarities.First, put the patient with an IV isoproterenol (one milliliter of 0.02% solution per half-liter five percent glucose).When the effect is obtained and the heart began to decline at a rate of fifty to sixty times per minute, it is necessary to transfer the patient to tablets alupenta.Alupenta give one tablet four to six hours.The main drawback of these tools - unstable effect, dry mouth.
If the patient has coronary artery disease or angina, the appearance of pain episodes while taking isoproterenol or alupenta can participate.During insertion into the vein izadrina must enter prednisolone (up to one hundred and eighty milligrams).
When atrioventricular block with myocarditis is an effective treatment with high doses of prednisolone for a week - ten days.The day allowed to eighty milligram doses of the drug in the same three steps.Once the effect has been achieved, the dose should be slowly reduced to fifteen - ten milligrams, and within four to eight weeks completely cancel prednisolone.
If the patient developed a complication of atrioventricular block - acute heart failure, need to enter into a vein Glucagon.First, the syringe is administered in an amount of five milligrams, and then through the flow (from two to ten mg to sixty minutes).
If atrioventricular block is for chronic appoint Corinfar, teopeka, Belloidum.Corinfar usually drink three times daily for one or two tablets.Duration of the doctor decides.In the first couple of days teopeka drink half a tablet once a day, and later - on the whole tablet once.If people began to complain about the worsening of sleep, poor appetite, stomach pain, head, the amount of drug necessary to reduce, and if the symptoms are gone - to cancel all.Teopeka not apply if the patient hyperthyroidism, epilepsy and pregnancy.In gastric ulcer and duodenal use this drug very carefully monitored.Belloidum conduct therapy for a week, after a three-day break, repeat the course.Take the medicine at the same pills from three to six times a day.If developed daytime sleepiness, reduced dose Belloidum.The drug is not used when a person is sick glaucoma.
If atrioventricular block occurred congestive heart failure, it is advisable to enter into the scheme of treatment of diuretic drugs, vasodilators.From the use of diuretics hydrochlorothiazide, metolazone, furosemide, spironolactone and others. Hydrochlorothiazide taken once a day dosage - from twenty five to one hundred milligrams.Metolazone prescribe ten milligrams, one time a day.Furosemide dosage selected individually, the multiplicity of reception - once or twice a day, the amount of the drug - from twenty to two hundred milligrams.Spironolactone take twice a day for fifty - one hundred milligrams.
If conservative treatment of atrioventricular block specific results are not shown, the patient is prescribed an operation, which consists in the implantation of a pacemaker.After this operation, all the unpleasant symptoms of a person stop worrying.The pacemaker put in and if the patient has a third level of the blockade, but it does not bother him.This is done to prevent the occurrence of sudden cardiac death.
atrioventricular block - is a serious disease that is able to deliver a lot of troubles.That is why it is important to have regular checkups by a cardiologist in the presence of what some kardiopatology.This is especially true of older people.It is also necessary to eat right, eat foods with potassium and magnesium in its composition.