Heart block

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Heart block

  1. 1. Definition  Mechanism  Significance  Treatment 
  2. 2. Second degree heart block implies intermittent conduction  Some impulses are conducted to ventricles whereas others are not 
  3. 3. Myocardial infarction  Myocarditis  Rheumatic fever  Drugs i.e beta blockers and digitalis  Hyperkalemia 
  4. 4. Mobitz type I  Mobitz type II  2:1 block 
  5. 5. Conduction defect in the AV node  AV conduction time progressively lengthens before a blocked beat 
  6. 6. Progressive lengthening of PR interval  One non-conducted P wave  Next conducted beat has a shorter PR interval than the preceding conducted beat ,cycle repeats  Normal QRS complexes 
  7. 7.  Mobitz type I is usually benign and prognosis is good
  8. 8. Usually due to block within the bundle of His  Most beats are conducted but occasionally there’s atrial contraction without subsequent ventricular contraction 
  9. 9. PR interval remains constant  Some P waves are not conducted( i.e more P waves than QRS complexes)  QRS complexes are wide 
  10. 10.  Risk of progression to complete heart block is greater than type I
  11. 11. May represent as type I or type II block  Two p waves to each QRS complex therefore called 2:1 block 
  12. 12. Asymptomatic Mobitz type I doesn’t require any treatment  Atropine for pt’s presenting with asystole  pacemaker 
  13. 13. No communication between atria and ventricles  Atrial contraction is normal but no beats are conducted to the ventricles  Ventricles are excited from depolarizing focus within the ventricular muscle 
  14. 14. Normal P waves  Normal QRS complexes  No orchestration between the Ps and QRSs 
  15. 15. Congenital  Acquired: MI drugs( digoxin, beta blockers) severe hyperkalemia Infective endocarditis acute rheumatic fever 
  16. 16. Dual chamber permanent pacemaker  Atropine is effective for early heart blocks but trial of atropine while waiting for pacer to be set up is acceptable in third degree heart block 

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