Heart

Heart Block

by

It means recurrent sudden attacks of unconsciousness
caused by impaired conduction of the impulse that regulates the
heartbeat; often applied specifically to atrioventricular heart block.

HEART BLOCK CAUSES

  • Depression of conductivity is most commonly due to ischaemia, fibrosis or inflammation of the A. V. bundle.or to vagal stimulation.
  • Myocardial infarction is the commonest cause.
  • Idiopathic focal fibrosis – is a common cause of chronic heart block.
  • Rheumatic fever and Diphtheria.
  • Drugs, e-g., Digitalis,quinine etc.
  • Cardiomyopathies.
  • Disordered.atrial rhythms, .e.g.auricular fibrillation and flutter.
  • Congenital causes, e.g. ventricular
  • septal defect or maldevelopment of the bundle, etc.
  • Aortic stenosis

TYPES OF HEART BLOCK

  • First Degree – All S.A, impulses are allowed to pass through A,V. node but the time is prolonged.
  • Second Degree – Here S.A. impulses are not allowed to pass through A. V. node from time to time.
  • Third Degree of complete heart block -Here no S. A. impulses are allowed to pass through A. V. node,therefore ventricles generate their own rhythm 30 to 40 per minute.

SYMPTOMS & SIGN

Heart attack is major sign of heart block.

  • First Degree heartblock – can be diagnosed only by E.C.G.
  • Second Degree heart block – here, from time to time, some S. A. impulses are not allowed to pass through A.V.node.
  • Thus auricles contract but not the ventricles resulting in absence of heart sound and missing of pulse.
  • This may occurs at regular Intervals giving rise to 2:1or 3:1 heart blocks or may occur irregularly.E.C.G. helps in the diagnosis.

Third Degree or complete heart block

  • Pulse rate 36 -40 per minute.
  • Rhythm regular; Volume high; Tension – high.
  • Condition of arterial wall may be sclerosed.
  • Character – may be collapsing. The pulse is a fixed pulse.
  • Carotid artery may show carotid dance at a rate of 36 to 40 per minute.
  • Jugular veins – show auricular pulsations at a rate of 72 per minute.
  • Auscultation of mitral area – the intensity time, which is, called canon sound. E.C.G. will be the diagnosis.

COMPLICATIONS

The gravest danger of complete heart block is

Stokes-Adam’s Syndrome

MANAGEMENT

  • Complete Heart Block in acute myocardial infarction requires treatment to prevent undue bradycardia or asystole.
  • Isoprenaline, as anintravenous infusion.
  • Tablet Neoepinine 20-mgm. 1-tablet every 4hourly sublingually.
  • Steroids in some cases may be given.

Note -All the medicine and treatment should be apply only on the direction of your Physician not on the basis of content.