Autonomic Tachycardia Syndrome Essay

Autonomic Tachycardia Syndrome Essay
Autonomic Nervous System Disorder: Postural Orthostatic Tachycardia Syndrome
When something goes wrong with the autonomic nervous system, it can cause serious problems. Postural Orthostatic Tachycardia Syndrome (POTS)
is an abnormality of the autonomic nervous system, commonly defined as an inability to regulate the heart rate (Rowe 6). Patients with POTS will
experience symptoms that can limit daily activity and function (Agarwal et al. 478). Although treatment can be challenging, patients with POTS that
take an active role in the diagnosis and management of their care can improve their quality of life.
To understand POTS it is important to understand the role and function of the autonomic nervous system. The autonomic nervous system involves...
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In a healthy individual, blood vessels contract, heart rates increase and blood pressure adjusts with little effort (Langford 23). In patients with POTS,
the body does not have the ability to make appropriate adjustments. POTS patients require three times more energy to stand than a healthy person
(Grubb 2). Although an abnormal heart rate upon standing is common in patients with POTS, they will also experience other symptoms such as
fatigue, headaches, dizziness, heart palpitations, nausea, diminished concentration, fainting, coldness or pain in the extremities, chest pain and
shortness of breath ("POTS").
Patients with POTS will not feel better unless they are active, but they do not have the energy to be active ("POTS"). In patients surveyed, 97.2%
showed fatigue as a major concern, followed by dizziness, brain fog, and heart palpitations ("POTS"). A quiet activity, such as sitting at a desk, or a
small amount of physical activity can cause fatigue that can last twenty four to seventy two hours (Rowe 3). Research has shown that almost half of
POTS patients will experience at least one episode of fainting which is why it is sometimes nicknamed the fainting disease
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A Patient With A Suspected Dvt
What is an appropriate focused assessment and care to provide a patient with a suspected DVT? A focused assessment is an assessment that centers
directly on the chief complaint that a patient presents with when they arrive to seek out care. In this case, our assessment is focused on a potential deep
vein thrombosis (DVT). A DVT is a essentially a ball of blood cells that are clumped together impeding blood flow which can cause irritation to the
vein and potentially more dangerous problems. If the thrombus moves, it can travel through the body and into the lungs and impeded breathing which
is not good. Therefore, it is essential to catch DVT's right away and treat them to prevent them from moving. The first thing that needs to be assessed
when a patient presents with a suspected DVT is their level of consciousness and their vital signs including the heart rate, blood pressure, respirations,
temperature and oxygen saturation. Next, assess the site of the expected DVT, and perform a neurovascular assessment which comparing to the
same site on the opposite side of the patients body. Check for adequate circulation by assessing for pink color distal to the site. While performing
this assessment, you want the area distal to the site to be pink to ensure there is adequate blood flow. If it is whitish in color, this is a sign of a DVT
and needs to be documented. While assessing color, also assess the site directly for any color deviation from the clients natural skin color. If the

Supraventricular Tachycardia
Supraventricular tachycardia:
Supraventricular Tachycardia is a cardio–vascular disease which occasionally results in abnormally fast heartbeat which is not related to exercise, stress
or illness.
Early doctors were researching arrhythmia in heart beat as a result of unknown abnormal neuro–cardio mechanisms of the heart, one of theories was
that SA and AV nodes were interfering with each other's bio
–electrical impulses another theory was that the right side of the septum was hypersensitive
to electrical impulse, all were more else on the right track because we know now that SVT is a result of a faulty electrical connections of the heart.
The abnormally fast heartbeat caused by SVT, lasts in episodes lasting for several hours. During an episode

Example Of EKG Interpretation
EKG Interpretation
1.You are a nurse working in the Emergency Department of a hospital. You are asked to admit a patient who came in with chest pain. When you arrive
to assess the patient you find them unresponsive.
a.Please analyze the rhythm (below). R–R, Regular or Irregular (.1 pt.) irregularRate: (.1 pt.) Unmeasurable
PR interval: (.1 pt.) Not measurableQRS: (.1 pt.) none
QT: (.1 pt.) 8 secRhythm: (.3 pt.) highly irregular
b.What is the necessary immediate intervention? (.1 point)
The next action for this patient is to defibrillate very soonest to stop the patient from going to cardiac arrest
c.What are two typical precipitating factors that occur with this rhythm? (.1 pt.)
i.Is having an untreated ventricular tachycardia, electrocution accidents and presents of heart conditions at birth. ii. Chaotic, rapid and irregular rhythms
hence causing ventricular Fibrillation
2.You are a nurse caring for a patient on a telemetry unit. The patient was admitted for hypotension andtachycardia several days ago. The patient has
stabilized and needs to achieve therapeutic levels for prophylactic treatment prior to discharge.
a.Please analyze their strip (below).
Regular or Irregular (.1 pt.)RegularRate: (.1 pt.) 101–160 bpm
PR interval: (.1 pt.) 0.12–0.20secondsQRS: (.1 pt.) 0.06–0.12 seconds
QT: (.1 pt.) 6 secRhythm: (.3 pt.) Regular The patient has been determined to have this dysrhythmia chronically and is

Abbey Mcneill Case Study
As if freshman gym class were not horrible enough, imagine having your heart spike to 200 beats per minute, while swimming, and not being able to
bring it back down. To make it even worse, imagine having this elevated rate continuing for over eight hours, with no pauses or rests. Ever since her
freshman year of high school, Abbey McNeill has had difficulties regulating her heart rate; unfortunately, it was not until her freshman year of college
that she was correctly diagnosed with AVRNT, or AV node reentrant tachycardia. Mainly, this condition causes the heart to spike for no apparent reason,
lasting usually about fifteen minutes, and then dropping back to normal. Although this condition leads many individuals to shy away from physically
taxing activities, Abbey has... Show more content on Helpwriting.net ...
One rule she had trouble following was watching how much sugar she was eating. "Whenever I would eat too much sugar I would regret it because
my heart rate would spike and it was just really annoying." However, she does admit that she would still fall into the trap of the sugary sweets and
eat more than she should have. Sweets and sugar have too strong of a hold on her to be completely let go of. Along with cutting back on her sugar,
Abbey also could not have too much caffeine. Of course, the one drink that is known for its caffeine amount was the one Abbey could not have. Coffee.
She admits that, at one time, she did want to try it, but never did. "Everyone kept telling me that coffee was the greatest thing, and now that I have
tasted it, I am kind of glad that I wasn't allowed to drink it because I think that it's disgusting. Definitely don't regret staying away from it." She does
struggle with occasionally having too much Dr. Pepper though. "Sometimes I just needed the caffeine, even though I knew I shouldn't have it. It's just
too

One Beat At a Time Essay
One Beat at a Time
When we think of cardio vascular diseases, we usually always associate them with the loss of a family member or friend. Almost everyone knows
of someone who is affected by these tragic diseases. Since the ancient times, there have been clues left showing possible cardio vascular diseases
within the Egyptian families. The earliest proof of a cardio vascular disease is of a 3,500 year old Egyptian mummy with a serious case of
arthrosclerosis, which was identified via modern CT scan. During the next few centuries little is known about cardio vascular diseases and the death
rate subsequently is low, until the turn of the Industrial age. Since this period of time cardio vascular diseases have hit hard at the heart leading ... Show
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Premature atrial contractions are early additional beats that start in the atria and are usually innocuous and usually don't require medical attention.
Premature ventricular contractions are one of the most prevailing arrhythmia where the heart will skip a beat due to stress, caffeine overindulgence, or
excessive exercise. Some people who have frequent contractions should seek medical attention, but if it is irregular it is usually harmless. Atrial
fibrillation is quite frequent which causes the atria to contract out of rhythm. Atrial flutter is a more organized version of atrial fibrillation where it's
caused by one or many rapid circuits in the atria. Paroxysmal supraventricular tachycardia originates above the ventricle and is known as a rapid heart
rate. Accessory pathway tachycardias are a form of rapid heart rate that is due to extra passageway between the ventricles and atria. AV nodal reentrant
tachycardia is another form of rapid heart rate that is caused through more than one passageway. These can both be treated with special therapy or
medication. Ventricular tachycardia is a hasty heartbeat that begins in the ventricle section of the heart. This hasty beat prevents the heart from
attaining the right amount of blood to fill up, thus causing the body to receive much less blood than usual. Ventricular fibrillations are inconsistent
impulses from the ventricles

A Clinical Experience Conducted As A Student Paramedic
Panic attack
The purpose of this assignment is to allow my reflection on a clinical experience conducted as a student paramedic. This experience is in regards to
dealing with adolescent experiencing a panic attack (PA). PA lie under two conditions.
National Institute of Health and Care Excellence (NICE) defines Panic disorder as characterized by recurring, unforeseen panic attacks followed by at
least 1 month of persistent worry about having another attack and concern about its consequences, or a significant change in behavior related to panic
attacks.
NICE defines generalised anxiety disorder a common disorder of which the central feature is excessive worry about a number of different events
associated with heightened tension.
Using Gibbs' 1988 model of reflection (see appendix 1) I will evaluate the incident and how this experience has improved my understanding of treatment
options.
This model has been chosen as it focuses on feelings which have been shown to involve a deeper level of learning (Wills 2010:213) and allows a
structured framework. I will reflect & evaluate upon my strengths and weakness in approach to adolescent panic attack.
Reflection is a process that enables practitioners to gain a deeper understanding of their experiences with patients to move towards more mindful and
effective practice (Johns 2005).
In accordance with the HCPC (2016) code of conduct, the patient will be given the pseudonym 'Ann ' to protect confidentiality.
Description
On

Delta Waves Case Study
A 45–year–old male comes into the emergency department with symptoms of acute dizziness, dyspnea, chest pressure, and palpitations. He states that
he feels that his heart is "racing.". He has a history of hypertension (HTN) and coronary heart disease (CAD) status post one bare metal stent. He is
currently on clopidogrel, aspirin, metoprolol, and Llisinopril. His BP blood pressure is 87/60 mmHg, pulse heart rate 160––170 beats/min, respirations
rate 26 breaths/min, oxygen saturation 90% on room air, and afebrile. His physical exam has pertinent positive findings of diminished global breath
sounds and rapid sinus heart sounds. He has no jugular venous distention (JVD), abdominal tenderness, nuchal rigidity, lower extremity swelling, or
focal ... Show more content on Helpwriting.net ...
Atrial fibrillation would not be in sinus rhythm and it would not have discernable P waves present on ECG tracing.
Choice "C" is not the best answer. Sinus vs. supraventricular tachycardia (SVT) is based on how high the heart rate is. If the heart rate is greater than
120 bpm with narrow QRS waves, it is considered SVT.
Choice "D" is not the best answer. The vignette states that the QRS length is less than 120 milliseconds. Ventricular tachycardia consists of wide QRS
waves that are greater than 200

Amiodarone Research Paper
Blood comes from the Superior and Inferior vena cava, into the right atrium. As the right atrium fills with blood, it contracts and the tricuspid valve
opens and the blood pumps into the valve. When the right ventricle is full the tricuspid valve close to ensure blood moves in the right direction. The
blood then moves to the right ventricle and into another valve called the Pulmonary valve. Then moves to the pulmonary artery and into the lungs. The
blood moves into the lungs and picks up fresh oxygen. Then it returns to the left heart through the pulmonary veins to the left atrium. It passes through
the mitral valve and enters the left ventricle. Oxygenated blood moves into the aortic valve and into the Aorta to reach all parts of the body ( heart.org).
An arrhythmia is when there is a problem with the heart rate or rhythm. During an ... Show more content on Helpwriting.net ...
This drug should be administered by a hospital or specialist. Amiodarone blocks Potassium and Sodium ion channels and effectively reduces any type
of arrhythmia( Moini, 2012).
Flecainide is a class 1c antiarrhythmic drug and used for ventricular dysrhythmias. Flecainide slows conduction velocity throughout the myocardial
conduction system and increases ventricular refractoriness ( Moini, 2012).
Two types of Vasodilators are:
Nitroglycerin dilates blood vessels by affecting vascular smooth muscle. In stable angina, it decreases cardiac oxygen demand, and in variant angina, it
increases oxygen supply ( Moini, 2012).
Hydralazine is a strong antihypertensive and is usually only used when a patient is unresponsive to other medications. When used, Hydralazine can
produce some serious adverse effects such as orthostatic hypotension, edema, headache, vertigo, dizziness fatigue, nausea, leukopenia and eczema.
Beta–adrenergic blockers

Supraventricular Tachycardi A Case Study
Supraventricular Tachycardia The heart is a muscular pump about the size of a fist. This muscle is continuously pumping blood to the circulatory
system at a rate on average of 100,000 times a day. Arrhythmia's can cause an abnormal rhythm to this rate because of a change in the heart's electrical
system. These arrhythmias can either cause the heart to beat too slowly, bradycardia, or tachycardia, where the heart beats too fast. Supraventricular
Tachycardia (SVT) is one specific form of tachycardia. When a person develops SVT it causes the heart tissue to develop activity similar to a
pacemaker in the upper chambers, or the region above the ventricles (AHA, 2015). This produces an abnormally fast heartbeat. Understanding this
condition is ... Show more content on Helpwriting.net ...
Short–term treatment can include the use of vagal maneuvers. If these are not successful at halting or slowing the abnormal rhythm then calcium
channel or beta blockers may be used. Long–term treatment can include agents that block the atrioventricular node or class IC or III antiarrhythmics.
Procainamide, ibutilide, flecainide, propafenone, and amiodarone can all be used to control the rhythm in patients (Carnell, J., & Amandeep, S., 2008).
For those patients that experience persistent episodes of SVT can have a catheter ablation procedure (Colucci, R et. al., 2010). A catheter ablation is a
low–risk procedure with a 90% success rate. This procedure uses radiofrequency heat in order to kill the area of the heart in which the irregular
heartbeat is originating. The purpose of killing this area is to resort the heart back to its original rhythm. With this procedure, the abnormal tissue can
be destroyed without causing any other damage to the heart. A doctor performs the catheter ablation by placing a sheath into the groin. The sheath is
then filled with electrode catheters. Through these catheters, the doctor is able to send small electrical impulses, which helps locate the damaged
tissue. Once the abnormal tissue is located the catheter is placed in that spot so that the radiofrequency can be sent into the tissue. This area is usually
1/5 of an inch (AMA, 2015). After the catheter ablation procedure, all of the abnormal tissue should be repaired and the patient should not experience
anymore SVT episodes. They are then also able to return to normal daily activities within a few

Digoxin Case Study Essay
Question 1:
Digoxin toxicity. Digoxin has a narrow therapeutic index and chronic toxicity is more likely in the elderly and those with renal impairment. Since
Mr Buchanan is 75 years old, he may already have some form of renal impairment and therefore is at a higher risk of developing toxic serums levels
if continually taking Digoxin (Australian Medicines Handbook, 2016 and Nickson, 2014). Digoxin toxicity can be caused by prolonged use, an
overdose or a general increase in the current dose (Australian Medicines Handbook, 2016). If Mr Buchanan is taking digoxin for an extended amount
of time, he may build up a tolerance to its effects due to being consistently exposed to the drug (Australian Medicines Handbook, 2016). This is
significant risk ... Show more content on Helpwriting.net ...
Document any abnormal results (lower or higher than normal levels) in the nursing progress notes. Encourage regular oral fluids to keep his kidneys
and renal tract hydrated. Monitor Mr Buchanan's fluid intake and output through a Fluid Balance Chart (FBC) and/or daily weighs. This is important
in Mr Buchanan's case as Digoxin is renally excreted and if his ability to excrete fluid decreases, digoxin levels may build–up and increase (Nickson,
2014) Consider a fluid restriction to prevent possible fluid overloading due to his decreased renal function (Vera, 2011). Perform a urinalysis when
possible to find levels of Specific Gravity (how concentrated the urine is), pH, Protein, Blood, Nitrites, Leukocytes, Ketones, Glucose and Bilirubin.
The results of this test can help identify any possible impairment in renal function and identify the presence of an infection (Vera, 2011).
Risk 3 – Arrhythmias due to drug induced QT prolongation Educate Mr Buchanan on the signs and symptoms of arrhythmias such as: A fluttering in
his chest. Chest pain. Shortness of breath. Light–headedness or dizziness.

Cardiac Arrest : The Side Effects Of Saving Lives
Cardiac Arrest – The Side Effects of Saving Lives
Antje Dangel
University of South Florida
Cardiac Arrest – Drugs Administered during Advanced Cardiac Life Support and Associated Complications
In 2014, heart disease remains the leading cause of death while cardiac arrest is one of the most devastating conditions patients and their families have
to face. Despite all efforts to elucidate management of cardiac arrest and implementation of advanced cardiovascular life support (ACLS) survival
rates post cardiac arrest remains at 23.9 % in adults and 40.2% in children, respectively (AHA, 2012). Nurses undergo extensive ACLS training every
two years and while algorithms, administration of emergency drugs, and procedures seem to be followed appropriately, rationales are often not well
understood. While some studies show evidence of short–term outcome advantage, insufficient evidence exists regarding administration of ACLS drugs
and improved long–term outcome. In this paper pharmacokinetics and pharmacodynamics, adverse effects of ACLS drugs, and anticipated long–term
adverse effects of intervention drugs post cardiac arrest are being discussed. Lastly, drug–drug interaction of ACLS drugs with commonly used cardiac
medications will be discussed. In the case study of JG, the patient went into cardiac arrest on the way to the hospital and he was pronounced after a
full code had been performed for three hours. The cause of cardiac arrest in regards to heart rhythm is

Electronic Health Records And Its Disadvantages
Electronic Health Record Issues in Health Care Health information systems must work for those that are at the point of service. This is because they
are the first point of contact and the face of the health care system. These individuals are usually doctors, nurses, physician assistants, and pharmacists
who are providing patient care and need to maintain patient trust. Patient who seeks medical advice trust that treatment decisions made from providers
consists of quality and care. By using electronic health records, provider communication will increase and medical errors will be reduced due to the
ease of use. However, among these advantages, complications such as user resistance, cost and patient safety continues to challenge electronic health
record implementations and further delay its use. In order to ensure electronic health records are ready for prime time, this paper will review the
current issues of electronic health records and its disadvantages. Following this review, possible solutions will be provided to address the pressing
issues of electronic health records. Finally, a conclusion will be made regarding how electronic health records should continue to deliver quality and
help providers develop a patient centered care.
User Resistance First of all, users resist system changes due to the loss of productivity and lack of technological support. This is because every time
there is a new system change, user work flows always change. When workflows change, the

Antiarrhythmic Research Paper
ANTIARRHYTHMIC2
Antiarrhythmic 1
Antiarrhythmic
Jessie L. Ladd
San Joaquin Valley College
Abstract
Antiarrhythmic drugs are prescribed for the treatment of heart conditions caused by arrhythmias. Arrhythmias are when the heart is beating abnormally,
such as atrial fibrillation, atrial flutter, ventricular fibrillation and ventricular tachycardia. There are five different groups of antiarrhythmic drugs.
Dependent on your symptoms and how severe they are will be the determining factor of what type of antiarrhythmic drug you will take. With any type
of medication, you take you will need to keep an eye out for side effects. Antiarrhythmic agents when used as directed can treat and prevent further
implications and possibly save your life. ... Show more content on Helpwriting.net ...
A recent study shows 1:4 American adults over the age of 40 are at risk of developing an abnormal heart rhythm (www.myvmc.com). Once an
arrhythmia has been diagnosed an antiarrhythmic agent can be prescribed. It is important that when taking an antiarrhythmic medication, directions or
how it should be taken is followed precisely. As long as the antiarrhythmic agent is taken as prescribed, they will help prevent further complication, such
as heart attacks and heart

Concept Map Of Acute Severe Asthma
Concept map of acute severe exacerbation of asthma in childhood
Aetiology:
An severe asthma exacerbation is inflamed and hyper–responsive airway obstruction, is initiated by
пЃ¬Viral infection of upper respiratory tract
пЃ¬Bacterial infection
пЃ¬Inhaled allergens
пЃ¬Environmental irritants
пЃ¬Emotion
пЃ¬Exercise
пЃ¬Medications
пЃ¬Poor asthma control
пЃ¬Obesity
trigger
Pathogenesis early response:
пЃ¬airway hyperresponsiveness and causes acute brochospasm.
пЃ¬allergen has been inhaled into airway, it will be recognised by antigen–presenting–cells (APC).
пЃ¬the APCs will then migrate to bronchus associated lymphoid tissues and induce the type 2 helper (Th2) cytokines response. B cell proliferation are
then stimulated by Th2 cells, leading to the plasma cells ... Show more content on Helpwriting.net ...
In conclusion, the airway hyperresponsiveness, odema of bronchial mucosa, increase mucus secretion, bronchospam will lead to airway obstruction
hence it will result in patient having wheezes and dyspnoea.
Clinical manifestation:
пЃ¬Increased respiratory rate and heart rate
пЃ¬Dyspnoea at rest, accessory muscle used with suprasternal retraction
пЃ¬Infants stop feeding

пЃ¬Patient talks in words or unable to speak, agitated or drowsy
пЃ¬Usually loud wheeze but may have silent chest
пЃ¬SaO2 less than 90%, PaO2 less 60mmHG, PaO2 greater than 45mmHg
пЃ¬PEFR/ FEV1 is at 26% to 39% predicted or percentage of personal best.
Diagnosis:
пЃ¬History and examination on risk factors, wheezing, dyspnea, tachypnea, chest tighteness
пЃ¬Tests:
1.Therapeutic trials with a short–acting Beta2 agonist
2.PEFR or FEV1
3.Blood gases level
Nursing management
пЃ¬Supply oxygen to keep Oxygen saturation above 90%
пЃ¬Administrate Medications as prescribed such as short–term acting beta 2 agonist and corticosteroid
пЃ¬Maintain fluid balance to prevent dehydration
пЃ¬Monitoring patient's cardiorespiratory status using Pediatric Asthma Score
Clinical course of severe asthma exacerbation
пЃ¬Usually includes emergency department visit and likely hospitalization
пЃ¬Inhaled short–acting Beta2 agonist can partially relieve the exacerbation
пЃ¬Symptoms can last more than three days after the treatment of Oral systematic corticosteroid
пЃ¬Adjunctive therapies
Prognosis
пЃ¬the prognosis of an acute exacerbation is good under the

Postural Orthostatic Tachycardia Syndrome (POTS)
What is POTS? Postural Orthostatic Tachycardia Syndrome (POTS) is a type of dysautonomia1 that affects numerous people around the world.
When diagnosing POTS, a Tilt Table test is frequently used and the heart rate of the patient must increase by 30 beats per minute (bpm) or more, or
be over 120 bpm, within the first 10 minutes of being placed in the vertical position from the supine position and with an absence of orthostatic
hypotension2. Patients affected with POTS may have symptoms that range in severity. Although many POTS patients are able to continue with
typical activities, some POTS patients are not able to. For others that are not able to fulfill a normal life, symptoms may be so severe that everyday
activities such as bathing, eating, walking, or standing can be difficult or impossible. POTS patients have trouble changing positions because there
is decreased blood flow to the brain. When there is decreased blood flow to the brain, it can cause severe dizziness and fainting (Garland). "Many
people, who have POTS, experience presyncope. During presyncope episodes, symptoms are similar to a faint but no loss of consciousness is
experienced" (Pots–). POTS patients can also have severe pain that is debilitating. Sometimes POTS patients will have other diseases or complications
along with POTS that disables them.

History Of Present Illness : 34 Year Old Woman With A...
History of present illness: 34–year–old woman with a history of Wolff Parkinson White Syndrome complains of intermittent palpitations since 2005.
She has had a 24–hour Holter, which was unremarkable. She came in for a follow–up visit and had an EKG done that revealed the presence of
pre–excitation. The patient reports a daily sensation of palpitations that lasts for several minutes. The patient reports lightheadedness with the
palpitations without syncope. The patient underwent an exercise treadmill evaluation, which showed no evidence of ischemia. The echocardiography
revealed a structurally normal heart. Delta waves were noted during evaluation but resolved at higher heart rates. Wolff–Parkinson–White syndrome
(WPW) is a conduction disorder of the heart that is caused by pre accessory pathway resulting in tachyarrhythmias. Kesler & Lahham (2016) state,
"Approximately 0.07% of the population often presents with the chief complaint of palpitations". A diagnosis of WPW is made in conjunction with
certain characteristics. Characteristics of WPW include: a short PR interval < 0.12 second caused by a faster electrical conduction through the
accessory pathway than the atrioventricular node, upsloping of the QRS and a delta wave. The delta wave is indicative of rapid ventricular
depolarization caused by the rapid conduction through the accessory pathway (Kesler & Lahham, 2016, p. 469).
CEBM, Level 4
Past Medical History: In addition to her current condition the patient has a

Patient Assessment Essay
After reading this case study, this assignment will focus on the appropriate assessment and management that should be undertaken by paramedics to
give this patient the best possible care. This will be achieved by following the five key stages of patient assessment from Pilbery et al. (2013, pp.
114–239). This will consist of the Scene management, primary assessment, History taking, Secondary assessment and reassessment of the patient.
Following this, the patient's presenting complaint would be managed according to the findings and relevant guidelines.
Based on the primary survey, it is understood that there is no danger. Therefore, making it safe for a crew to enter and examine the patient. Safety is
extremely important in pre–hospital care ... Show more content on Helpwriting.net ...
Furthermore, According to Cretikos et al. (2008), an adult with a respiratory rate of over 24 breaths per minute in combination with other evidence of
physiological instabilities, can sometimes be an early indicator that a patient may be critically ill.
This patient has oxygen saturation levels of 94%on air. Thus, she is considered to be within the lower–level of being within the normal range. At this
moment, it would not be necessary to give emergency oxygen according to the Guideline for emergency oxygen use in adult patients (2008). However,
due to the saturations being in the lower range, it is advised that the saturation probe stays on the patient's finger. This would be as a precautionary
measure in case she becomes hypoxic (Henderson, 2014).
Her heart rate is high at 110 beats per minute (bpm). In medical terms, any person who has over 100bpm is classed as having Supraventricular
tachycardia (NHS Choices, 2015). Increased heart rate can be caused due to the increased respiratory effort or overuse of ОІ2–agonist (Henderson,
2015). Increases in breaths per minute are a sign that there is a reduced amount of oxygen getting to the lungs. This in turn, will show a reduction of
oxygen in the blood. As a result, in order to compensate, the heart will then work faster in an effort to provide the necessary amount of oxygen to the rest

The Death Of The Doctor
Lately your heart has been beating so fast you feel like you had just run a marathon. You have gone to the doctor's since, you have been worried
about your pulse and were just informed about your condition. Now, rest easy, it's not as scary as it might seem. Having a pulse of 150 beats per
minute is scary in its own way and tends to make you worry, but rest assured, 150bpm is not necessarily normal, but it's nothing you are going to die
from. I have been through and have experienced this and am looking forward to helping you to be informed and relaxed during your discovery and
throughout the procedures of fixing this problem.
The doctor knocks on the door, he/she informs you of your condition "Supraventricular Tachycardia," but for now let's just abbreviate it as "SVT." You
will have to have surgery called an "SVT ablation "to fix this heart problem, but for the mean time, you are put onto something called "Beta–Blockers",
which prevents the chemical that creates fight or flight, known as adrenaline. Your doctor has requested you to go to your local hospital, where you
will get a certain amount of test done on you, for example; a stress test, Electric shock management, CAT scan, and a blood test. These test will give
a bases on your condition. Your surgery is going to keep you overnight so be well prepared for an overnight stay and for a driver to take you home.
You will sign in at the post–op desk and fill out the required information. A little panicky you must be still

Automated External Defibrillator ( Aed )
AED Research 1. How does an AED work? Automated external defibrillator (AED) is a small computerized device used to analyze heart rhythms
and provide an electric shock, if needed, to restore the normal electrical activity of patients' heart. When a patient is suspected of having a sudden
cardiac arrest CPR is performed until an AED device is available. If the device is available, when turning the machine on the voice of the device will
guide the first responder through the process. There are adhesive pads with electrodes sensors that are required to stick onto the chest of the
unconscious patient. Once the pads are stick onto the chest, the electrodes then send information about the person's heart rhythm to the AED. The
devices will then analyzes the heart rhythm and determine if an electric shock is needed. Once the device detect that a shock is needed the device will
warn first responders to stand clear, then the machine will automatically delivered the shock. If the person is still not breathing, continue on with CPR
while the machine recharge. Once the machine is ready it will again analyze the heart rhythms then provide an electric shock. (U.S. Department of
Health and Human Services [HHS], National Institutes of Health [NIH], National Heart, Lung, and Blood Institute [NHLBI], 2011). 2. What are the
"shockable rhythms" an AED recognizes and describe each? There are two shockable rhythms an AED is able to recognize. The first shockable
rhythms is ventricular

Syncope Research Paper
Syncope Syncope is when you lose consciousness and drop to the ground. Syncope may also be called fainting or passing out. It is caused by a
sudden drop in blood flow to the brain. While most causes of syncope are not dangerous, syncope can be a sign of a serious medical problem. Signs
that you may be about to faint include: Feeling dizzy or light–headed. Feeling nauseous. Seeing all white or all black in your field of vision. Having
cold, clammy skin. If you fainted, get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the
hospital. HOME CARE INSTRUCTIONS Have someone stay with you until you feel stable. Do not drive, use machinery, or play sports until

Wolff-Parkinson White Syndrome Essay
Wolff–Parkinson White Syndrome Wolff–Parkinson White syndrome is a heart condition where there is an extra electrical pathway or circuit in the
heart. The condition can lead to episodes of rapid heart also known as tachycardia. Wolff–Parkinson White syndrome, also known as WPW, is present
at birth. People of all ages, even infants, can experience the symptoms related to WPW. Episodes oftachycardia often occur when people are in their
teens or early twenties. Most of the time, a fast heart beat are not life threatening, but serious heart problems can occur. Treatments for Wolff
–Parkinson
White syndrome can stop or prevent episodes of fast heart beats. A catheter–based procedure, known as ablation can permanently correct the heart ...
"Wolf–Parkinson–White syndrome is associated with some forms of congenital heart disease, such as Ebstein's anomaly." (Mayo Clinic Staff). The
heart is made up of four chambers. The two upper chambers known as the atria, and the two lower chambers known as the ventricles. The rhythm of
your heart is controlled by the sinus node. The sinus node is almost like a natural pacemaker which is located in the atrium. The sinus node gives off
electrical impulses that start every heartbeat. "Electrical impulses travel across the atria causing the atria muscles to contract and pump blood in the
ventricles." (Mayo Clinic Staff). The electrical impulses eventually arrive at a cluster of cells known as the atrioventricular node or the AV node. The
AV node slows down the signal before sending it to the ventricles. By this delay, it allows the ventricles to fill with blood causing the electrical
impulses to reach the muscles of the ventricles so they can contract and pump blood to the lungs and the rest of the body. When a person has WPW
syndrome an extra electrical pathway connects the atria and the ventricles. This means that an electrical signal can bypass the AV node. When the
impulses use this alternative route through the heart, the ventricles are activated to early. Looped electrical impulses and disorganized electrical
impulses are two major types of rhythm disturbances. A looped electrical impulse is when electrical

Meriem Hale Case Summary
The patient, Meriem Haile has been complaining of chest pains along with many other symptoms. She had cardiac catheterization, coil occlusion of
PDA, done at the age of 16, for congenital defect. Now she has been diagnosed with SVT (supraventricular tachycardia), occurring 8% of the time.
She complains of headaches that come after any physical activity, such as going up stairs. She used to be able to run cross country, but now stopped
doing any exercise due to the recurring headaches. She also complains of experiencing blackout when standing up from a sitting position. She gets
red spots in the palms of her hands and sometimes feet when she feels very tired. Her palms of the hands easily peel with any type of physical
exertion. She wakes

Essay On Syncope
Introduction: Orthostatic symptoms are common in children and adolescents such that 15% experience syncope once in their teenage years.1 A
comprehensive history, physical examination, bedside orthostatic testing and an ECG are usually sufficient for diagnosis combined with prevention
measures for postural intolerance and reassurance being sufficient in most cases.2–4 Many patients with orthostatic intolerance (OI) have limitations of
daily activities with reduced school attendance and impaired quality of life.5
A subset of children with OI may have an underlying disorder (autoimmune condition, mitochondrial insufficiency, diabetes mellitus etc.) and thus
diagnosis can be elusive and expensive.6 Syncope is obvious and readily recognized to the extent that patients are frequently evaluated in an emergency
room and office setting. Clinical characteristics are described in children with syncope but literature is limited in describing those many patients who
present with symptoms other than syncope.7,8 We studied the epidemiological and clinical characteristics of children and adolescents with OI who had
autonomic dysfunction based on head up tilt table test (HUTT).
Materials and methods
From November 2010 to June 2012, we obtained medical records of patients with OI and HUTT. Our institutional review board approved this study.
We collected demographic and clinical data together with physiological data in Microsoft Excel sheet (Microsoft Office 2010). Data also... Show more
content on Helpwriting.net ...
Fisher exact test compared the physiological data and utilized a non–parametric Mann–Whitney test to compare continuous variables. We utilized the
Mantel Haenszel for adjusted three–way contingency testing. Type I error rate of 5% was accepted as being of statistical significance. STATA (v.12,
College station) statistical software performed all

Mma And Regina Settled On The Couch
mma and Regina settled on the couch. Regina casually leaned sideways against the back, facing Emma, with her legs tucked underneath herself, while
Emma sat rigidly, fiddling with her hands.
"Why don't you start by telling me what you have?" Regina asked.
Emma took a deep breath, "Okay. Well, I have Ehlers–Danlos, Postural Orthostatic Tachycardia Syndrome, or POTS for short, and Chronic Lyme
Disease."
"I've heard of Lyme disease, but I didn't know it could be chronic? And what are the other two?"
"Ehlers–Danlos is a genetic condition where basically my body sucks at making collagen. The collagen my body produces is faulty. It's um...it's kinda
like if you replaced a bottle of glue with honey, it will be sticky, but it won't hold well, so... Show more content on Helpwriting.net ...
It doesn't make what you're going through any less significant. And what you're going through doesn't make you any less of a person."
"So...you still–you still want to, like, hang out with me and stuff? Even though I sleep a lot and sound like an idiot when I talk and can't walk long
distances and–"
Regina chuckled and placed a kiss on the blonde's lips. "Yes, I still want to 'hang out with you and stuff.' So what if we can't run marathons together or
go hiking through the mountains. I'm happy spending time with you no matter what we do."
"Really?" Emma said, shocked.
"Yes, really."
"You're awesome. You know that?"
Regina laughed at what seemed to be the blonde's favorite description of her. "I do believe you said that once before." At that moment, Emma let out a

huge yawn. "You're exhausted aren't you? I can tell you're not feeling well either."
"I'm fine."
Regina raised an eyebrow in response.
"Okay, okay! I feel like crap. I usually take a nap and have a day in bed after skating."
"You can take a nap here. I don't mind."
"I'll be–"
"Fine?" Regina finished for her. She could tell Emma constantly pushed herself too much and was determined to get her to take a nap. "At least lie
down. We can keep talking, just lie down, please?" Emma conceded and let her head be guided into Regina's lap. Gentle fingers stroked Emma's hair,
and

Ineffective Communication In Nursing
Ineffective Communication My patient, C.R., came into the hospital due to chronic renal failure (CRF). He was scheduled to have his second round of
dialysis done on the intensive care unit (ICU). Dialysis nurse was present in the room, setting up the machine for continuous renal replacement therapy
(CRRT) and noticed that the patient went into symptomatic supraventricular tachycardia (SVT). Being thrown into SVT causes the heart rate to speed
up over 150 and can cause the patient to have pain in their chest, feeling lightheaded and fatigued, and have shortness of breath. At the same time, C.R.'s
nurse walked into the room and the patient's rhythm converted into ventricular tachycardia (VT). At the time the patient converted to VT, he became...
This situation is just a good example of poor communication and lack of patient knowledge. The nurse received report from the off going nurse and
was not told a code status of the patient. She then did not attempt to learn of the patient's code status after receiving report, going about her daily tasks
and med passes. Since she was uneducated about the patient's status, she was unable to be a proper patient advocate and inform the code team that this
patient did not want life saving measures

Cardiac Dysrhythmias : Medical Careers
Eduardo Cardenas
Cardiac Dysrhythmias: Supraventricular Tachycardia
N254: Medical Surgical Nursing II
Mr. Decker
Medical Careers Institute
Date of Submission
1/7/2016
Cardiac Dysrhythmias: Supraventricular tachycardia
Supraventricular tachycardia is increase in heart rate over 150 bpm due to do the over firing or redirected firing of the SA Node conduction above the
ventricles. With supraventricular tachycardia the patient can have an abrupt onset and termination of rhythm, flattened or retrograde conduction P
waves and narrow QRS waves specifically less than 0.08 second (Kyle, 2012).
Clinical Manifestations and Pathophysiology The clinical manifestations of supraventricular tachycardia are palpitations, dizziness, ... Show more
content on Helpwriting.net ...
The nurse should also palpate pulses, noting rate, regularity, amplitude, and symmetry. This is done to differentiate in equality, rate, and regularity of
pulses that are indicative of the effect of altered cardiac output on systemic or peripheral circulation (Vera, 2013). Another nursing management is to
monitor vital signs. Assess adequacy of cardiac output and tissue perfusion, noting significant variations in BP/pulse rate equality, respirations, changes
in skin color, temperature, and level of consciousness. The rationale although not all dysrhythmias are life–threatening, immediate treatment may be
required to terminate dysrhythmia in the presence of alterations in cardiac output and tissue perfusion (Vera, 2013).
The nurse should also administer supplemental oxygen as indicated, Insert and maintain IV access, reduce patient stimulation, tell the patient to splash
cold water on their face, or to do a vagal movement to help decrease heart rate (Kyle, 2012). Adenosine (Adenocard) is the drug of choice of to treat
supraventricular tachycardia if vagal maneuvers have not worked due to its short half–life and minimal side effects. Other medications that can be used
to suppress supraventricular tachycardia can be

Ventricular Toxicity
Amiodarone and Ocular Toxicity An arrhythmia is a problem associated with the electrical activity of the heart resulting in a heartrate that can be too
fast (tachycardia) or too slow (bradycardia). Arrhythmias are generally categorized as ventricular or supraventricular.1 Ventricular arrhythmias are a
condition in which extra heartbeats originate from the lower chambers of the heart and can be classified as ventricular tachycardia, ventricular
fibrillation, or premature ventricular contractions. Supraventricular arrhythmias originate in the upper chambers of the heart and can be less serious
than ventricular arrhythmias. Both types of arrhythmia can cause shortness of breath, chest tightness, dizziness, or syncope. The National Institute ...
Macaluso et al reviewed 73 cases of amiodarone induced optic neuropathy and concluded that onset is insidious, usually bilateral, and characterized by
disc swelling that stabilizes after drug discontinuation.10
Although there are multiple reports of optic neuropathy caused by amiodarone, a major challenge is discerning whether the optic neuropathy has a
direct causal relationship with amiodarone use or is due to other factors that increase ones risk in developing NAION. NAION is the most common
cause of vision loss in individuals over

Harvey Vs Philophysiology
1.Origin of discovery
a.Ancient Egyptians, Greeks, and the Chinese are responsible for the early study of the heart.
(1)"The ancient Egyptians, Chinese and Greeks are credited with measurement and characterization of peripheral pulses and their association with
illness"
(2)For thousands of years, the only way physicians could examine their patients' hearts was through palpitations of the pulse.
b.Claudius Galen
(1)The work of Claudius Galen furthered the link between cardiac functions and the pulse.
(2)"Galen's work set the stage for William Harvey's first description of the circulatory system and thereafter the function of the heart"
c.Electrocardiography modernized the study of cardiac rhythms.
(1)August Desir ... Show more content on Helpwriting.net ...
(a)"An electrical signal from the ventricles causes an early heart beat that generally goes unnoticed"
(b)"The heart then seems to pause until the next beat of the ventricle occurs in a regular fashion"
(2)Ventricular tachycardia
(a)Electrical signals cause the heart to beat faster.
(b)"Arises from the ventricles (rather than from the atria)"
(3)Ventricular fibrillation.
(a)"Electrical signals in the ventricles are fired in a very fast and uncontrolled manner"
(b)The heart begins to quiver.
5.Experiments testing Arrhythmia
(1)At the University of Calgary, scientists have discovered the origin of calcium–triggered arrhythmias through the use of molecular biology,
electrophysiology, and genetically engineering mice.
(a)Utilizing a genetically modified mouse model they were able to manipulate the sensor.
(b)This allowed them to prevent calcium–triggered arrhythmias.
(2)"The calcium–sensing– gate mechanism discovered here is an entirely novel concept with potential to shift our general understanding of ion channel
gating, cardiac arrhythmogenesis, and the treatment of calcium–triggered arrhythmias"
(a)These findings further the study of calcium

Treatment For Inappropriate Sinus Tachycardia
ABSTRACT
Inappropriate Sinus Tachycardia is a chronic medical condition with a wide variety of clinical presentations making it, sometimes, very insidious at the
time of the diagnosis. Several therapeutic options including, pharmacotherapy, cardiac rehabilitation and modification or ablation of the sinus node
have been proposed for the management of Inappropriate Sinus Tachycardia. But due to the complexity and not well understood pathophysiology, it can
be difficult to manage despite the numerous treatment options currently available. The purpose of this review is to analyze the treatment for
Inappropriate Sinus Tachycardia focusing on the role of newer therapy and the potential benefits in the management of this cardiac rhythm ... Show
more content on Helpwriting.net ...
[4]
The clinical presentation of patients with IST can vary due to the diversity of its multiple symptoms including: intermittent palpitations, dyspnea,
dizziness, lightheadedness, pre–syncope, syncope, chest pain, myalgia, and fatigue. [12] Associated psychological and emotional problems can also be
seen, but no relationship with IST has been identified. [8]
Using a criteria of a resting heart rate >100 bpm and an average heart rate of >90 bpm on 24–hour Holter monitoring, Still et al., estimated the
prevalence of IST in a middle–aged population of men and women. The IST prevalence was 1.2% (7 of 604 patients) [2], including both symptomatic
and asymptomatic patients. IST has also been reported in older population. [5] Although, IST is believed to be a chronic condition, long–term
complications are few. IST has been associated with tachycardia–induced cardiomyopathy in isolated cases [6][7] and no mortality has been yet
reported.
IST is a medical entity that should be diagnosed by exclusion, medical history and physical examination and should be assessed thoroughly, aiming to
the potential causes of sinus tachycardia, thus, thyroid disease, medications, hypovolemia, panic attacks, anxiety and substance abuse should be ruled
out. A 12–lead EKG is useful for recording tachycardia and defining sinus rhythm, which helps differentiate IST from

Clinical Manifestations Of A Health Concern And The...
Tanisha Lafayette
Widener University
Abstract
Advanced practice nurses are known for analyzing and collecting data to help implement interventions and positive outcomes for the public. There are
a numerous health conditions in the United States that advanced practice nurses (APNs) play a vital role in research and practicing evidence based
medicine. The many influences that may negatively impact a patients health include social, environmental, and physical factors. This paper will discuss
the importance of researching evidence on a health concern and the modalities developed through the implementation of programs for postural
orthostatic patients. There is a need for more to take part in the research and contributions to evidence based research in understanding Postural
Orthostatic Tachycardia and its clinical manifestations in the general population.
Introduction
Defining Postural Orthostatic Tachycardia and StatisticsPostural orthostatic tachycardia syndrome (POTS) is considered an autonomic disorder, that
affects between 1,000,000 to 3,000,000 people worldwide (Dysautonomia International, ). "Postural orthostatic tachycardia syndrome (POTS), is an
autonomic disorder characterized by an exaggerated increase in heart rate that occurs during standing, without orthostatic hypotension" (Thanavaro,
2011). This syndrome consist of an elevated heart rate of 120 beats or more when changing positions from sitting to standing after standing for 10

Extreme Bradycardia Case
Introduction: We present a case of extreme bradycardia in a patient with Batten Disease Background: Batten Disease is a rare and fatal autosomal
recessive neurodegenerative disorder, regarded as the juvenile form of neuronal ceroid lipofuscinoses (NCL). It is most commonly associated with
mutations in the CLN3 gene and involves lipofuscins accumulation in the neuronal tissues. We present a case of first degree arterioventricluar block in
a patient with batten disease, treated with permanent pacemaker implantation Case: Our case is a 29 year old man with Batten disease, severe
cognitive impairment and epileptic disorder sent from his primary doctor's office for extreme bradycardia. Electrocardiogram (EKG) in the emergency
room showed episodes

Cardiac Arrests Of Children, And Opening The Reality Of...
Abstract Almost everyone who works in EMS has this one thing in common, the fear of the pediatric call. Due to those calls being few and far
between, the skills needed for a pediatric call are rarely at their best. There are also some who don't keep their pediatric skills as sharp as others,
because of the low amount of calls they might run on kids. This paper will be focusing on cardiac arrests in children, and opening the reality of how
common it is becoming. Everything from what causes it, what is the most common cause, and the unexplainable. The what's, how's and whys are all
questions that we will be expected to know. There is so much that goes into these patients, physically and mentally. Knowing these things and
understanding how to handle these situations is just as important as knowing the information for a registry test. In almost most of these incidents the
family doesn't care how much you know, they care about how much you care. Cardiac Arrests in Children We have heard it more than once, the high
school football player who has never had a health issue in his life, playing on a chilly, friday night, collapses in the middle of the game. The player
dies instantly. What was the cause, why did it happen, and how can it be prevented are all common questions that friends, family and the strangers that
share the story on facebook, are all asking. As an autopsy is finished it is concluded that the young athlete died of a heart abnormality that was never

The Cardiac Effects Of Intractable Seizures
The Cardiac Effects of Intractable Seizures in Children
Short running title: Heart and intractable seizures
1–Hatem H. El Shorbagy: (MD), Department of Pediatric–Faculty of Medicine– Menofia University–Egypt.
2– Naglaa M. Kamal: (MD), Department of Pediatric – Faculty of Medicine– Cairo University, Egypt.
3– Mostafa A.Salama: (MD), Department of Pediatric – Faculty of Medicine– Benha University– Faculty of Medicine– Egypt.
4– Ahmed A.Azab: (MD), Department of Pediatric– Faculty of Medicine– Benha University– Egypt.
5–Naglaa F. Barseem: (MD), Department of Pediatric–Faculty of Medicine– Menofia University–Egypt.
6– Mohamed M. Bassiouny: (MD), Department of Pediatric – Faculty of Medicine– Tanta University–Egypt.
7– Ibrahim A.Ghoneim: (MD), Department of clinical pathology– Faculty of Medicine– Al–azhar University– Egypt.
Corresponding author:
Hatem Hamed Elshorbagy.
Tel:00966567500908.
E.mail:shorbagy732000@yahoo.com.
The author to whom communication will be directed: Hatem Hamed Elshorbagy,
Tel:00966567500908.
Address Department of Pediatric, Menofia University
E.mail:shorbagy732000@yahoo.com.
Abstract
Objectives: We aimed to evaluate serum levels of heart–type fatty acid binding protein (H–FABP) during seizures compared to their interictal levels
and healthy controls and changes in heart rate (HR) and HR variability in epileptic children with intractable seizures.
Methods: We included 30 epileptic seizures in 25 children with intractable epilepsy and 30

A Multi System Disease Of Unknown Etiology
Sarcoidosis is a multi–system disease of unknown etiology. The diagnosis is confirmed when non–caseating granulomas are identified in tissue
biopsies, predominantly from the lung parenchyma or the mediastinal lymph nodes and is supported by compatible clinical and radiological features.
[1] Cardiac manifestations may occur in isolation or may precede, follow or occur concurrently with the involvement of the lungs and other organs. All
components of the heart may potentially be involved. The most common are conduction abnormalities leading to bradyarrhythmias and syncope,
ventricular tachycardias and the development of congestive heart failure. [2, 3]
The location and extent of granulomatous infiltration accounts for variations in cardiac ... Show more content on Helpwriting.net ...
[5, 6] Japanese Ministry of Health (JMH) published criteria are the current established method for non–invasive clinical diagnosis. [2, 5] Imaging
modalities suggested by the JMH criteria include gallium–67 scintigraphy and late gadolinium–enhanced cardiovascular magnetic resonance
(LGE–CMR). [2] However, only 5–10% of patients with sarcoidosis present with clinical evidence of myocardial involvement based on the above
criteria while autopsy studies indicate that cardiac involvement is present in up to 25–50% of cases implying that there is a significant proportion of
sub–clinical cardiac sarcoidosis not detected with the existing criteria. [1, 7] Nuclear imaging modalities have shown significant advances and rapid
growth in the field of the diagnosis and monitoring of cardiac involvement in sarcoidosis. Promising results show high sensitivity for identifying
pathophysiological activity at an early stage before structural changes have occurred as well as value of reproducible activity quantification when
emphasizing in therapy monitoring. Although gallium–67 scintigraphy has traditionally been used in sarcoidosis patients, cardiac positron emission
tomography (PET) along with myocardial perfusion scans have shown superiority that mostly includes higher sensitivity in detecting active

Atrial Relaxation
Moreover, atrial stimulation close to the AV BT insertion site results in maximal preexcitation. Failure of atrial stimulation to increase the amount of
preexcitation can occur because of markedly enhanced AVN conduction, the presence of another AV BT, or pacing
–induced block in the AV BT due to
the long ERP of the BT (Kuo et al, 1996). FIGURE 4: Effect of atrial extrastimulation on preexcitation. A: Manifest preexcitation during normal sinus
rhythm (NSR) with HV interval value of –11 msec. Atrial extrastimulation (AES) increased the degree of preexcitation (HV interval value of–64
msec). B: An earlier coupled AES produced more pronounced preexcitation with HV interval value of–93 msec. C: A more premature AES produced
full preexcitation with the His bundle activated retrogradely , with VA conduction over the AVN & an echo beat (atrioventricular reentry) (Issa et al,
2012). Atrioventricular echo beats (Figure 5) occur secondary to: anterograde conduction of the atrial stimulus over the AVN
–HPS & retrograde
conduction over an AV BT (concealed or
... Show more content on Helpwriting.net ...
A: Each of the atrial paced impulses (S1) conducts anterogradely over the slow AVN pathway. The last paced impulse also conducts retrogradely up
the fast AVN initiate typical AVNRT with RBBB. B: Each of the atrial paced impulses conducts anterogradely over the slow AVN pathway with a
long PR interval resulting in crossing over, which can mimic a 1:2 AV. Following anterograde conduction down the slow pathway, the last paced
impulse also conducts retrogradely over the fast pathway, initiating typical AVNRT. C: Atrial pacing from the coronary sinus ostium (CS os) induces
typical AVNRT. The last paced impulse conducts over both the fast and slow AVN pathways resulting in a 1:2 response (i.e., 2 ventricular responses);
this is followed by induction of typical AVNRT with RBBB (Issa et al,

How My Heart Surgery That Changed My Life
For the childhood memory I chose when I had heart surgery when I was in 6th grade. I couldn't think of many others that changed me as much as this
one did. I was born with a condition called SVT (Supraventricular Tachycardia). I lived with it all my live. Whenever I got hit in the chest really hard
my heart would race, and pound abnormally. The highest it got was 250–270 BPM (Beats Per Minute). I was in the fire station when they saw how fast
it was beating. I was 12 when I was forced by my parents to get surgery instead of medication. I broke down emotionally because it was my first
major surgery and I couldn't stand it. It was the worst experience in my life, and it will only get worse. The surgery. The day of the surgery I had
many panic, and anxiety attacks on the way there. I will never forget the feeling I had in the waiting room. When I was getting ready for the surgery
I got so sick. I was so nervous. They had to give me something to calm me down. The used to calm me down started wearing off as I was being taken
to the operating room...my luck. The surgery was supposed to take 20–30 mins. For me, the surgery took 5–6 hours.... Show more content on
Helpwriting.net ...
The day after the surgery was just as bad as the day of the surgery. I was wheel chaired out of the hospital, and I felt tired, groggy, exhausted, and
overall just terrible. On the car ride home my heart was hurting a lot and I was having a lot of irregular issues with my heart. I was having more
panic and anxiety attacks. The incision wounds partly reopened so that was really scary. This experience changed me quite a bit and not in a good
way. It was one of the worst experiences in my life. It has made me constantly worry about my heart and health. I have really bad anxiety when it
comes to my heart. Or anything for that matter. I am always worrying about my heart. This experience changed the way I felt about surgery and what
people go through. I dislike surgery so

Hand, Foot-Mouth Disease
Hand, Foot and Mouth Disease
Francesca Longobardo
Western University of Health Sciences
Senior Seminar
Mr. Medina
November 24, 2014
Student Name: Francesca Longobardo PA–S Date & time of Interview: 11/7/2014 10:40
PATIENT WRITE
–UP/SOAP NOTE PRESENTATION
SUBJECTIVE DATA:
Identifying data (ID): 1 y/o male, Hispanic
Chief Complaint (CC): rash x 3days
History of Present Illness (HPI): The child's mother reports that a rash started under the buttocks, the rash was erythematous and vesiculated. The rash
had spread to the palms of his hands and soles of his feet. The vesicles and ulcers were also located on the buccal mucosa. Very happy and
non–distressed child. He had no other associated symptoms, he was able to eat and drink. ... Show more content on Helpwriting.net ...
This is usually a clinical diagnosis, but can be determined by viral polymerase chain reaction and ELISA analysis. The best place to culture for viral
polymerase chain reaction is the throat. Clinical presentation tends to be a child with fever and ulcerated rashes that can affect the palms of the hands
and soles of the feet. There are no diagnostic imaging studies that can help determine infection. The disease is usually treated symptomatically by
reducing the fever and introducing fluids to help with dehydration and making sure the patients intakes proper nutrients. With proper symptomatic
treatment the patient can greatly diminish the severity and enhance the prognosis of the disease.
References
Lin, J.Y., & Shih, S.R. (2014). Cell and tissue tropism of enterovirus 71 and other enteroviruses infections. Journal of Biomedical Science, 21(18), 1–6.
Repass, G.L., Palmer, W.C., & Stancampiano, F.F. (2014). Hand, foot, and mouth disease:
Identifying and managing an acute viral syndrome. Cleveland Clinic Journal Of Medicine, 81 (9), 537–543.
Hu, P., Hou, S., Du, P.F., Li, J.B., & Ye, Y. (2012). Paroxysmal Supraventricular Tachycardia in an Infant with Hand, Foot, and Mouth Disease. Annals
of Dermatology 24( 2), 200–202

Tan, C. H., Lai, J.K.F., Sam, I.C., & Chan, Y.F. (2014), Recent developments in antiviral agents against enterovirus 71 infection,

Autonomic Tachycardia Syndrome Essay

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