This document discusses different types of cardiac arrhythmias, including tachyarrhythmias (fast heart rhythms) and bradyarrhythmias (slow heart rhythms). It describes various supraventricular tachycardias such as sinus tachycardia, paroxysmal supraventricular tachycardia, atrial flutter, and atrial fibrillation. It also discusses ventricular tachycardias including ventricular tachycardia and ventricular fibrillation. Treatment options are provided for each type of arrhythmia. The document additionally covers normal heart rate ranges by age and types of bradyarrhythmias such as sinus bradycardia.
This document discusses pediatric cardiac arrhythmias. Some key points:
- Arrhythmias are classified based on site of origin such as the sinus node, atria, AV node or ventricles. Common arrhythmias include sinus tachycardia, supraventricular tachycardia, and ventricular tachycardia.
- Presentation of arrhythmias in children varies by age. Neonates may experience atrial flutter or ectopic atrial tachycardia. Older children may experience WPW syndrome or AV nodal re-entrant tachycardia.
- Diagnosis involves analyzing the ECG for heart rate, QRS width, and P wave relationship to the
- Tricuspid atresia is a congenital heart defect where the tricuspid valve is absent, preventing blood flow from the right atrium to the right ventricle. It occurs in approximately 1-2.4% of congenital heart disease cases.
- There are several types depending on anatomy and relationship of arteries. The most common type has normally related arteries and a small ventricular septal defect.
- Without intervention, few infants survive beyond 6 months due to hypoxia. Surgical options include shunts to increase/decrease pulmonary blood flow or corrective surgeries like the Fontan procedure.
- Long term complications can include heart failure, arrhythmias, and liver
This document discusses coarctation of the aorta, including its embryology, nomenclature, pathophysiology, natural history, and clinical features. Some key points include:
- Coarctation of the aorta is a congenital narrowing of the aorta near the ductus arteriosus. Left untreated, 50% of patients will die within 10 years primarily due to heart failure.
- Associated anomalies include ventricular septal defects (40% of cases) and bicuspid aortic valves (46% of cases).
- Long-term complications include hypertension, aneurysm formation, dissection, and rupture.
- Natural history studies show mortality rates increase significantly from 25% at age
This document discusses supraventricular tachycardia (SVT) in pediatric patients. SVT is the most common abnormal heart rhythm seen in children and the most common arrhythmia requiring treatment. It is usually caused by re-entry mechanisms involving an accessory pathway or the atrioventricular node. Diagnosis involves obtaining an electrocardiogram during episodes to identify P wave patterns. Treatment options include vagal maneuvers, medications like adenosine, calcium channel blockers, or beta blockers, and cardioversion. Radiofrequency ablation can provide a cure for refractory or recurrent cases. Proper diagnosis of the underlying SVT mechanism guides selection of the most appropriate treatment approach.
The document discusses Long QT Syndrome (LQTS), an inherited heart condition characterized by an abnormally prolonged QT interval on electrocardiograms. It describes the causes and types of LQTS, including LQT1, LQT2 and LQT3, which are associated with different genetic mutations and ECG patterns. The main symptoms of LQTS are syncope and cardiac arrest, typically in children or teenagers. Diagnosis involves measuring the QT interval and identifying risk factors. Treatment focuses on beta-blockers, lifestyle changes and implantable cardioverter-defibrillators for high-risk patients.
Presentation on basic principles of pediatric ecg with important examples: BY Dr. Nivedita Mishra (PGY2 PEDIATRICS, TRIBHUVAN UNIVERSITY TEACHING HOSPITAL,KATHMANDU,NEPAL)
This document discusses supraventricular tachycardias (SVT). It defines different types of SVT including paroxysmal SVT, which is common in emergency rooms. Quality of life is often poor for those with paroxysmal SVT. The document discusses mechanisms of SVT including reentry circuits, enhanced automaticity, and triggered activity. It provides details on differentiating AV nodal reentrant tachycardia from AV reentrant tachycardia using electrocardiogram findings. Treatment options discussed include carotid sinus massage, adenosine, and catheter ablation.
This document discusses pediatric cardiac arrhythmias. Some key points:
- Arrhythmias are classified based on site of origin such as the sinus node, atria, AV node or ventricles. Common arrhythmias include sinus tachycardia, supraventricular tachycardia, and ventricular tachycardia.
- Presentation of arrhythmias in children varies by age. Neonates may experience atrial flutter or ectopic atrial tachycardia. Older children may experience WPW syndrome or AV nodal re-entrant tachycardia.
- Diagnosis involves analyzing the ECG for heart rate, QRS width, and P wave relationship to the
- Tricuspid atresia is a congenital heart defect where the tricuspid valve is absent, preventing blood flow from the right atrium to the right ventricle. It occurs in approximately 1-2.4% of congenital heart disease cases.
- There are several types depending on anatomy and relationship of arteries. The most common type has normally related arteries and a small ventricular septal defect.
- Without intervention, few infants survive beyond 6 months due to hypoxia. Surgical options include shunts to increase/decrease pulmonary blood flow or corrective surgeries like the Fontan procedure.
- Long term complications can include heart failure, arrhythmias, and liver
This document discusses coarctation of the aorta, including its embryology, nomenclature, pathophysiology, natural history, and clinical features. Some key points include:
- Coarctation of the aorta is a congenital narrowing of the aorta near the ductus arteriosus. Left untreated, 50% of patients will die within 10 years primarily due to heart failure.
- Associated anomalies include ventricular septal defects (40% of cases) and bicuspid aortic valves (46% of cases).
- Long-term complications include hypertension, aneurysm formation, dissection, and rupture.
- Natural history studies show mortality rates increase significantly from 25% at age
This document discusses supraventricular tachycardia (SVT) in pediatric patients. SVT is the most common abnormal heart rhythm seen in children and the most common arrhythmia requiring treatment. It is usually caused by re-entry mechanisms involving an accessory pathway or the atrioventricular node. Diagnosis involves obtaining an electrocardiogram during episodes to identify P wave patterns. Treatment options include vagal maneuvers, medications like adenosine, calcium channel blockers, or beta blockers, and cardioversion. Radiofrequency ablation can provide a cure for refractory or recurrent cases. Proper diagnosis of the underlying SVT mechanism guides selection of the most appropriate treatment approach.
The document discusses Long QT Syndrome (LQTS), an inherited heart condition characterized by an abnormally prolonged QT interval on electrocardiograms. It describes the causes and types of LQTS, including LQT1, LQT2 and LQT3, which are associated with different genetic mutations and ECG patterns. The main symptoms of LQTS are syncope and cardiac arrest, typically in children or teenagers. Diagnosis involves measuring the QT interval and identifying risk factors. Treatment focuses on beta-blockers, lifestyle changes and implantable cardioverter-defibrillators for high-risk patients.
Presentation on basic principles of pediatric ecg with important examples: BY Dr. Nivedita Mishra (PGY2 PEDIATRICS, TRIBHUVAN UNIVERSITY TEACHING HOSPITAL,KATHMANDU,NEPAL)
This document discusses supraventricular tachycardias (SVT). It defines different types of SVT including paroxysmal SVT, which is common in emergency rooms. Quality of life is often poor for those with paroxysmal SVT. The document discusses mechanisms of SVT including reentry circuits, enhanced automaticity, and triggered activity. It provides details on differentiating AV nodal reentrant tachycardia from AV reentrant tachycardia using electrocardiogram findings. Treatment options discussed include carotid sinus massage, adenosine, and catheter ablation.
commonly used for medical students, and helpful to use this ppt to study for them, and also a common man can understand very easily what is coarctation of aorta.
This document summarizes various types of atrial arrhythmias:
- Wandering pacemaker involves the pacemaker site transferring between the SA node and other areas of the atria.
- Premature atrial contractions (PACs) are early atrial impulses followed by normal sinus rhythm.
- Atrial tachycardia overrides the SA node impulse with a rapid atrial rate over 150 bpm.
- Atrial flutter involves the AV node conducting impulses to the ventricles at a ratio, with the ventricular rate either controlled or uncontrolled.
- Atrial fibrillation involves rapid discharges from multiple foci in the atria, so no organized depolarization is detectable
Total anomalous pulmonary venous connections seminar ppt.Pawan Ola
This document provides information on total anomalous pulmonary venous connection (TAPVC). It defines TAPVC as a condition where the pulmonary veins drain anomalously into the right atrium or systemic veins rather than the left atrium. The document discusses the history, classification, embryology, clinical features, investigations and management of TAPVC. It describes the different types of TAPVC based on the site of drainage and presence of obstruction. Echocardiography is highlighted as the main diagnostic tool to identify the anomalous connections and assess for obstruction. The clinical presentation and hemodynamics vary depending on the type and presence of obstruction.
RHD affects ≈20 million people worldwide
highest in developing countries
significant morbidity and mortality
Subclinical detection adds to of secondary prophylaxis
echocardiographic definitions evolving
In 2012, the WHF published evidence-based
guidelines for the echocardiographic diagnosis of RHD
but these criteria have not yet been applied
The document discusses atrioventricular septal defects (AVSDs), which are characterized by the complete absence of the atrioventricular septum. It describes the anatomy, classification, epidemiology, presentation, investigations, and management of AVSDs. Key points include that AVSDs can be partial or complete, account for 4-5% of congenital heart disease, and require surgical repair in early infancy to prevent congestive heart failure and pulmonary hypertension. Left ventricular outflow tract obstruction is a potential postoperative complication.
Truncus arteriosus is a rare congenital heart defect where a single arterial trunk arises from the heart to supply the pulmonary and systemic circulations. It occurs when the embryonic truncus arteriosus fails to divide into the aorta and pulmonary artery. Left untreated, it causes cyanosis and heart failure in newborns. Surgical repair is now possible to connect the pulmonary artery to the right ventricle, improving survival rates to over 80% at one year of age compared to just 15% for uncorrected patients.
This document discusses various types of arrhythmias that can occur in children. It begins by describing the normal electrical conduction system of the heart and then discusses different types of tachyarrhythmias and bradyarrhythmias. Common pediatric tachyarrhythmias mentioned include supraventricular tachycardia, atrial flutter, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation. Long QT syndrome is also summarized. Treatment options for unstable and stable rhythms are provided.
The document discusses aortic regurgitation, including its anatomy, etiology, pathophysiology, epidemiology, clinical manifestations, diagnosis, and management. Key points include:
- Aortic regurgitation occurs when the aortic valve fails to close properly, allowing blood to flow back into the left ventricle during diastole.
- Causes include conditions like infective endocarditis, bicuspid aortic valve, hypertension, and Marfan syndrome.
- In acute severe cases, a rapid increase in left ventricular preload can cause pulmonary edema and cardiogenic shock. Chronic cases involve left ventricular dilation and hypertrophy to compensate for the increased preload over time.
- Physical exam may
This presentation is a simplified version of the various types of cardiac arrythmias seen in pediatric age groups. We have discussed supraventricular tachycarsias and prolonged QT syndrome in details here. Hope everyone finds it useful.
Tetralogy of Fallot (TOF) is a congenital heart defect characterized by four anatomical abnormalities - ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and overriding aorta. It was first described in detail in 1888. The physiology involves deoxygenated blood from the right ventricle being shunted away from the lungs due to pulmonary stenosis. Severity of cyanosis and murmurs depends on degree of pulmonary stenosis. Management involves treating spells and definitive surgical repair is usually done in early childhood.
Biatrial enlargement is diagnosed when criteria for both right and left atrial enlargement are present on the same ECG.
The diagnosis of biatrial enlargement requires criteria for LAE and RAE to be met in either lead II, lead V1 or a combination of leads.
1. A 30-year-old male with fever and altered mental status was found to have a potassium level disturbance based on his ECG.
2. ECG changes due to electrolyte imbalances can vary between individuals and depend on other electrolyte levels as well.
3. However, certain consistent ECG features often indicate increased or decreased potassium, making ECG useful for identifying electrolyte issues if prior tracings are available for comparison.
This document discusses aortic regurgitation (AR), which occurs when the aortic valve does not close properly, allowing blood to flow backward into the left ventricle. It can be caused by damage to the aortic valve leaflets or distortion of the aorta. Common causes include rheumatic heart disease, bicuspid aortic valves, hypertension, and Marfan syndrome. Over time, the left ventricle must work harder to compensate for the backflow of blood, which can lead to enlarged and weakened heart muscles. Symptoms may include palpitations, chest pain, and shortness of breath. Diagnosis involves listening for an early diastolic murmur and confirming the diagnosis with echocardiogram
The document discusses various types of vascular rings and slings that can form due to abnormalities in aortic arch development, including double aortic arch where both right and left arches are present and form a ring around the trachea and esophagus, and right aortic arch with an aberrant retroesophageal ligamentum arteriosum. It provides details on the embryology, clinical presentations, investigations, and surgical techniques for repairing different types of vascular rings and slings.
Tricuspid atresia is a congenital heart defect where the tricuspid valve is absent or not formed, preventing communication between the right atrium and right ventricle. It occurs in approximately 0.06 per 1000 live births with no gender predominance. The condition ranges in severity from complete absence of the tricuspid valve to stenosis. Early presentation includes severe cyanosis, hypoxemia, and acidosis in infants with low pulmonary blood flow, while those with higher flow present with heart failure symptoms later in infancy. Echocardiography can identify the absent tricuspid valve and associated defects. Without surgical intervention, few infants survive beyond 6 months, but current treatments including shunts and the
Approach to patient with Dilated CardiomyopathyNizam Uddin
This document provides an overview of dilated cardiomyopathy (DCM), including its definition, classification, etiologies, pathophysiology, clinical presentation, diagnosis and management. Key points include:
1) DCM is characterized by dilation and impaired contraction of the ventricles. Causes include genetic factors, viral myocarditis, toxins and idiopathic cases.
2) Diagnosis involves assessing history, symptoms of heart failure, echocardiogram showing reduced systolic function, and ruling out other potential causes.
3) Presentation varies from asymptomatic to heart failure symptoms. Management focuses on treating heart failure and its causes. Prognosis depends on the severity and reversibility of the underlying
Ventricular arrhythmias originate in the ventricles and include premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation. Ventricular tachycardia is defined as three or more consecutive ventricular beats at a rate over 100 beats per minute and can be caused by mechanisms like reentry, automaticity, and triggered activity. Polymorphic ventricular tachycardia includes conditions like torsades de pointes and Brugada syndrome. Acute management of sustained ventricular tachycardia includes termination attempts using antiarrhythmic drugs or cardioversion, while long term prevention focuses on drugs, ablation, or implantable cardioverter defibrillators depending on symptoms and left ventricular function.
Pulmonary stenosis (also called pulmonic stenosis) is when the pulmonary valve (the valve between the right ventricle and the pulmonary artery) is too small, narrow, or stiff. Symptoms of pulmonary stenosis depend on how small the narrowing of the pulmonary valve is
1) Supraventricular tachycardia (SVT) refers to any tachyarrhythmia originating above the ventricles and includes atrial and atrioventricular node tachycardias.
2) The most common type of SVT is atrioventricular nodal reentrant tachycardia (AVNRT) which occurs when there are two pathways in the AV node allowing reentry of electrical impulses.
3) Atrioventricular reentrant tachycardia (AVRT) occurs when an accessory pathway connects the atria and ventricles, allowing reentry via the AV node or accessory pathway.
The causes listed are all potential causes for syncope in children. The most common causes are neurocardiogenic syncope, breath-holding spells, and seizures. Other important considerations include cardiac causes like long QT syndrome, hypertrophic cardiomyopathy, and aortic stenosis.
This document discusses various pediatric dysrhythmias, their typical presentations, and treatment approaches. It describes that sinus arrhythmia, wandering atrial pacemaker, and isolated premature contractions are usually normal variants that do not require treatment. Supraventricular tachycardia is the most common arrhythmia requiring treatment and can often be terminated with vagal maneuvers, adenosine, or cardioversion. First degree atrioventricular block is commonly seen in neonates but generally does not cause bradycardia. Third degree atrioventricular block may require a pacemaker, especially if associated with slower heart rates or symptoms. Ventricular arrhythmias like tachycardia or fibrillation indicate serious underlying
commonly used for medical students, and helpful to use this ppt to study for them, and also a common man can understand very easily what is coarctation of aorta.
This document summarizes various types of atrial arrhythmias:
- Wandering pacemaker involves the pacemaker site transferring between the SA node and other areas of the atria.
- Premature atrial contractions (PACs) are early atrial impulses followed by normal sinus rhythm.
- Atrial tachycardia overrides the SA node impulse with a rapid atrial rate over 150 bpm.
- Atrial flutter involves the AV node conducting impulses to the ventricles at a ratio, with the ventricular rate either controlled or uncontrolled.
- Atrial fibrillation involves rapid discharges from multiple foci in the atria, so no organized depolarization is detectable
Total anomalous pulmonary venous connections seminar ppt.Pawan Ola
This document provides information on total anomalous pulmonary venous connection (TAPVC). It defines TAPVC as a condition where the pulmonary veins drain anomalously into the right atrium or systemic veins rather than the left atrium. The document discusses the history, classification, embryology, clinical features, investigations and management of TAPVC. It describes the different types of TAPVC based on the site of drainage and presence of obstruction. Echocardiography is highlighted as the main diagnostic tool to identify the anomalous connections and assess for obstruction. The clinical presentation and hemodynamics vary depending on the type and presence of obstruction.
RHD affects ≈20 million people worldwide
highest in developing countries
significant morbidity and mortality
Subclinical detection adds to of secondary prophylaxis
echocardiographic definitions evolving
In 2012, the WHF published evidence-based
guidelines for the echocardiographic diagnosis of RHD
but these criteria have not yet been applied
The document discusses atrioventricular septal defects (AVSDs), which are characterized by the complete absence of the atrioventricular septum. It describes the anatomy, classification, epidemiology, presentation, investigations, and management of AVSDs. Key points include that AVSDs can be partial or complete, account for 4-5% of congenital heart disease, and require surgical repair in early infancy to prevent congestive heart failure and pulmonary hypertension. Left ventricular outflow tract obstruction is a potential postoperative complication.
Truncus arteriosus is a rare congenital heart defect where a single arterial trunk arises from the heart to supply the pulmonary and systemic circulations. It occurs when the embryonic truncus arteriosus fails to divide into the aorta and pulmonary artery. Left untreated, it causes cyanosis and heart failure in newborns. Surgical repair is now possible to connect the pulmonary artery to the right ventricle, improving survival rates to over 80% at one year of age compared to just 15% for uncorrected patients.
This document discusses various types of arrhythmias that can occur in children. It begins by describing the normal electrical conduction system of the heart and then discusses different types of tachyarrhythmias and bradyarrhythmias. Common pediatric tachyarrhythmias mentioned include supraventricular tachycardia, atrial flutter, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation. Long QT syndrome is also summarized. Treatment options for unstable and stable rhythms are provided.
The document discusses aortic regurgitation, including its anatomy, etiology, pathophysiology, epidemiology, clinical manifestations, diagnosis, and management. Key points include:
- Aortic regurgitation occurs when the aortic valve fails to close properly, allowing blood to flow back into the left ventricle during diastole.
- Causes include conditions like infective endocarditis, bicuspid aortic valve, hypertension, and Marfan syndrome.
- In acute severe cases, a rapid increase in left ventricular preload can cause pulmonary edema and cardiogenic shock. Chronic cases involve left ventricular dilation and hypertrophy to compensate for the increased preload over time.
- Physical exam may
This presentation is a simplified version of the various types of cardiac arrythmias seen in pediatric age groups. We have discussed supraventricular tachycarsias and prolonged QT syndrome in details here. Hope everyone finds it useful.
Tetralogy of Fallot (TOF) is a congenital heart defect characterized by four anatomical abnormalities - ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and overriding aorta. It was first described in detail in 1888. The physiology involves deoxygenated blood from the right ventricle being shunted away from the lungs due to pulmonary stenosis. Severity of cyanosis and murmurs depends on degree of pulmonary stenosis. Management involves treating spells and definitive surgical repair is usually done in early childhood.
Biatrial enlargement is diagnosed when criteria for both right and left atrial enlargement are present on the same ECG.
The diagnosis of biatrial enlargement requires criteria for LAE and RAE to be met in either lead II, lead V1 or a combination of leads.
1. A 30-year-old male with fever and altered mental status was found to have a potassium level disturbance based on his ECG.
2. ECG changes due to electrolyte imbalances can vary between individuals and depend on other electrolyte levels as well.
3. However, certain consistent ECG features often indicate increased or decreased potassium, making ECG useful for identifying electrolyte issues if prior tracings are available for comparison.
This document discusses aortic regurgitation (AR), which occurs when the aortic valve does not close properly, allowing blood to flow backward into the left ventricle. It can be caused by damage to the aortic valve leaflets or distortion of the aorta. Common causes include rheumatic heart disease, bicuspid aortic valves, hypertension, and Marfan syndrome. Over time, the left ventricle must work harder to compensate for the backflow of blood, which can lead to enlarged and weakened heart muscles. Symptoms may include palpitations, chest pain, and shortness of breath. Diagnosis involves listening for an early diastolic murmur and confirming the diagnosis with echocardiogram
The document discusses various types of vascular rings and slings that can form due to abnormalities in aortic arch development, including double aortic arch where both right and left arches are present and form a ring around the trachea and esophagus, and right aortic arch with an aberrant retroesophageal ligamentum arteriosum. It provides details on the embryology, clinical presentations, investigations, and surgical techniques for repairing different types of vascular rings and slings.
Tricuspid atresia is a congenital heart defect where the tricuspid valve is absent or not formed, preventing communication between the right atrium and right ventricle. It occurs in approximately 0.06 per 1000 live births with no gender predominance. The condition ranges in severity from complete absence of the tricuspid valve to stenosis. Early presentation includes severe cyanosis, hypoxemia, and acidosis in infants with low pulmonary blood flow, while those with higher flow present with heart failure symptoms later in infancy. Echocardiography can identify the absent tricuspid valve and associated defects. Without surgical intervention, few infants survive beyond 6 months, but current treatments including shunts and the
Approach to patient with Dilated CardiomyopathyNizam Uddin
This document provides an overview of dilated cardiomyopathy (DCM), including its definition, classification, etiologies, pathophysiology, clinical presentation, diagnosis and management. Key points include:
1) DCM is characterized by dilation and impaired contraction of the ventricles. Causes include genetic factors, viral myocarditis, toxins and idiopathic cases.
2) Diagnosis involves assessing history, symptoms of heart failure, echocardiogram showing reduced systolic function, and ruling out other potential causes.
3) Presentation varies from asymptomatic to heart failure symptoms. Management focuses on treating heart failure and its causes. Prognosis depends on the severity and reversibility of the underlying
Ventricular arrhythmias originate in the ventricles and include premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation. Ventricular tachycardia is defined as three or more consecutive ventricular beats at a rate over 100 beats per minute and can be caused by mechanisms like reentry, automaticity, and triggered activity. Polymorphic ventricular tachycardia includes conditions like torsades de pointes and Brugada syndrome. Acute management of sustained ventricular tachycardia includes termination attempts using antiarrhythmic drugs or cardioversion, while long term prevention focuses on drugs, ablation, or implantable cardioverter defibrillators depending on symptoms and left ventricular function.
Pulmonary stenosis (also called pulmonic stenosis) is when the pulmonary valve (the valve between the right ventricle and the pulmonary artery) is too small, narrow, or stiff. Symptoms of pulmonary stenosis depend on how small the narrowing of the pulmonary valve is
1) Supraventricular tachycardia (SVT) refers to any tachyarrhythmia originating above the ventricles and includes atrial and atrioventricular node tachycardias.
2) The most common type of SVT is atrioventricular nodal reentrant tachycardia (AVNRT) which occurs when there are two pathways in the AV node allowing reentry of electrical impulses.
3) Atrioventricular reentrant tachycardia (AVRT) occurs when an accessory pathway connects the atria and ventricles, allowing reentry via the AV node or accessory pathway.
The causes listed are all potential causes for syncope in children. The most common causes are neurocardiogenic syncope, breath-holding spells, and seizures. Other important considerations include cardiac causes like long QT syndrome, hypertrophic cardiomyopathy, and aortic stenosis.
This document discusses various pediatric dysrhythmias, their typical presentations, and treatment approaches. It describes that sinus arrhythmia, wandering atrial pacemaker, and isolated premature contractions are usually normal variants that do not require treatment. Supraventricular tachycardia is the most common arrhythmia requiring treatment and can often be terminated with vagal maneuvers, adenosine, or cardioversion. First degree atrioventricular block is commonly seen in neonates but generally does not cause bradycardia. Third degree atrioventricular block may require a pacemaker, especially if associated with slower heart rates or symptoms. Ventricular arrhythmias like tachycardia or fibrillation indicate serious underlying
The document discusses several pediatric cardiology emergencies including newborn problems presenting as cyanosis or low cardiac output. Cyanosis may be caused by right-sided obstructive lesions, abnormal circulations, or left-sided obstructive lesions. Treatment involves prostaglandins, restoring acid-base balance, and surgery. Low cardiac output can be caused by muscle diseases, heart rate problems, or left-sided obstructive lesions. Other issues discussed include hypercyanotic spells in infants/children with tetralogy of Fallot or pulmonary atresia, congestive heart failure, and arrhythmias including supraventricular tachycardia.
Cardiac arrhythmias are abnormalities in the heart's rhythm that can cause symptoms ranging from palpitations to sudden death. The two main types are bradycardias, which are slow heart rates below 60 bpm, and tachycardias, which are fast heart rates over 100 bpm. Arrhythmias can arise from problems in the sinus node, atria, AV junction, or ventricles due to issues with automaticity or re-entry of electrical impulses. Common arrhythmias include sinus tachycardia/bradycardia, premature beats, atrial fibrillation, and heart blocks. Treatment depends on the specific arrhythmia and symptoms but may include lifestyle changes, medications
- The document discusses the anatomy and physiology of the heart's conduction system and how it generates the normal cardiac rhythm. It describes the roles of the sinoatrial node, atrioventricular node, Bundle of His, and Purkinje fibers in conducting electrical impulses through the heart.
- Various types of cardiac arrhythmias are defined based on disruptions to the heart's normal conduction system. These include premature beats, rhythms originating from the atria, AV junction, or ventricles. Characteristics like P wave presence/morphology, rate, and regularity are used to identify arrhythmias.
- A 12-lead electrocardiogram (EKG or ECG) is used to
This document discusses the classification, diagnosis, and management of arrhythmias in children. It describes how tachycardias can be classified based on characteristics like heart rate, QRS width, and stability. The key steps in diagnosis involve obtaining an electrocardiogram (ECG) during arrhythmia, in sinus rhythm, and after administering adenosine. The document outlines how different arrhythmias respond to treatments like adenosine, cardioversion, and medications. It emphasizes the importance of correctly diagnosing the arrhythmia before providing treatment.
2013 Pediatric Subspecialty Boot Camp_Dysrhythmias Danny Castro
This document discusses pediatric dysrhythmias and their management. It aims to review the normal cardiac conduction system, common pediatric dysrhythmias including their mechanisms and classifications, and the approach and management of critical dysrhythmias according to Pediatric Advanced Life Support guidelines. Key topics covered include how to interpret an electrocardiogram, different types of supraventricular and ventricular tachycardias/bradycardias, and treatment algorithms for pulseless arrest, tachycardia with a pulse, and bradycardia with a pulse.
Torsades de pointes is a type of ventricular tachycardia where the QRS complex twists around the isoelectric baseline on an ECG. It is associated with a prolonged QT interval from long QT syndrome. Torsades de pointes can be triggered by an R-on-T premature ventricular contraction and can degenerate into ventricular fibrillation if not treated. Treatment involves withdrawing any offending drugs, administering magnesium sulfate, antiarrhythmic medications, and electrical cardioversion or defibrillation as needed.
Kawasaki disease is a vasculitis that predominantly affects children under 5 years old. It is characterized by fever, rash, swelling of hands and feet, irritation and redness in the mouth and lips, and swelling of lymph nodes in the neck. If not treated, it can lead to aneurysms of the coronary arteries and heart disease. The cause is unknown but thought to be infectious. Diagnosis is based on symptoms and exam findings. Treatment involves high dose aspirin and intravenous immunoglobulin which reduces fever and risk of coronary aneurysms in most cases.
The document discusses various pediatric arrhythmias including tachycardias and bradycardias. It provides details on normal heart rates at different ages and describes common supraventricular tachycardias like AV nodal reentrant tachycardia, accessory pathway mediated tachycardias. It also discusses idiopathic ventricular tachycardia and management strategies for different arrhythmias including medication and ablation. Congenital complete heart block is described along with its association with maternal autoimmune conditions.
Torsade de pointes is a type of ventricular tachycardia associated with a prolonged QT interval on an electrocardiogram. It is caused by early afterdepolarizations and transmural reentry in the ventricles. Risk factors include hypokalemia, hypomagnesemia, female gender, heart failure, congenital long QT syndrome, and use of drugs that prolong the QT interval by blocking potassium currents. Management involves removing the offending drug, correcting electrolyte abnormalities, overdrive pacing, magnesium supplementation, and use of beta blockers, antiarrhythmics, or an implantable cardioverter-defibrillator in high risk patients.
This document discusses the assessment and treatment of arrhythmias. It begins by outlining the ABCDE approach and importance of monitoring for adverse signs when initially assessing a patient. Treatment depends on whether the patient is stable or unstable. For unstable patients, electrical cardioversion may be needed while antiarrhythmic drugs are used for stable patients. Specific treatments are provided for different types of tachycardias and bradycardias. Atropine is the first treatment for bradycardia while pacing is reserved for unresponsive patients.
1. Stroke in children differs from adults, with congenital and developmental risk factors being more common than chronic risk factors. Presentation can also be more subtle.
2. Guidelines recommend brain imaging, preferably MRI, for any child presenting with clinical stroke symptoms. Further vascular imaging and cardiac echocardiography within 48 hours is also advised.
3. A thorough evaluation should include blood tests to check for coagulation disorders, inflammation, infection and other metabolic causes. Prothrombotic factor screening is important to identify inherited risks and guide family screening.
Neonatal ECG part 2, includes Atrial and ventricular hypertrophy f/b conduction disturbances and AV conduction heart block f/b electrolyte abnormalities and there ECG changes.
This document discusses cardiac arrhythmias, abnormal heart rates and rhythms. It defines tachyarrhythmias as increased heart rate and bradyarrhythmias as decreased heart rate. For tachyarrhythmias, it describes sinus tachycardia, supraventricular tachycardia including paroxysmal SVT, atrial flutter, and atrial fibrillation. It also discusses ventricular tachycardia and ventricular fibrillation. For bradyarrhythmias, it discusses sinus bradycardia, atrioventricular block including first, second and third degree block, sick sinus syndrome, and asystole. It provides electrocardiogram findings and treatment approaches for each type.
The rhythm is best analyzed by looking at a rhythm strip.
On a 12 lead ECG this is usually a 10 second recording from Lead II.
Confirm or corroborate any findings in this lead by checking the other leads.
A longer rhythm strip, recorded perhaps recorded at a slower speed, may be helpful.
1. The document discusses various types of arrhythmias including normal sinus rhythm, altered automaticity, reentry, and conduction block.
2. Specific arrhythmias covered include sinus bradycardia, sinus tachycardia, junctional tachycardia, ectopic atrial tachycardia, AV nodal reentrant tachycardia, AV reentrant tachycardia, atrial flutter, atrial fibrillation, and ventricular tachycardia.
3. The document provides tips for diagnosing arrhythmias by examining heart rate, rhythm regularity, QRS width, P wave presence, and relationship between P waves and QRS complexes.
This document provides an overview of atrial fibrillation (AF) and atrial flutter. It discusses the characteristics, mechanisms, ECG features, causes and clinical outcomes of AF. It also covers the classification, mechanisms, ECG patterns and examples of atrial flutter. Key points include that AF is characterized by disorganized atrial activation and irregular ventricular rhythm, while flutter involves a reentrant circuit in the right atrium causing a regular atrial rate of 300 bpm. Complications of AF include increased risk of stroke, heart failure and cardiac death.
This document provides an overview of cardiac arrhythmias that may be seen in the surgical intensive care unit (SICU). It begins with definitions of normal sinus rhythm and mechanisms of arrhythmias including automaticity, ectopic foci, and reentry. Common arrhythmias are then described in more detail such as sinus bradycardia, atrial fibrillation, ventricular tachycardia, and various forms of heart block. Causes and management of arrhythmias are discussed with a focus on the relevant medical literature. Antiarrhythmic drug classes and their uses and side effects are also reviewed.
This document discusses various types of arrhythmias, their mechanisms, and EKG characteristics. It covers normal sinus rhythm, altered automaticity such as sinus bradycardia and tachycardia, reentry mechanisms including AV nodal reentrant tachycardia and atrial flutter, conduction blocks, and helpful questions for identifying unknown arrhythmias based on rate, rhythm regularity, QRS width, P waves, and relationship between P waves and QRS complexes.
This document discusses various cardiac emergencies including bradycardia, acute coronary syndromes, wide-complex tachycardias and ventricular tachycardia, pericardial tamponade, and more. It provides details on clinical presentation, differential diagnosis, ECG findings, and initial management for each condition. The treatment for unstable and pulseless rhythms like ventricular tachycardia involves immediate defibrillation, CPR, intubation, medications like epinephrine, amiodarone, lidocaine, and considering causes of electrolyte imbalances.
This document summarizes various cardiac arrhythmias including supraventricular arrhythmias like premature atrial complexes, atrial fibrillation, and atrial flutter as well as ventricular arrhythmias such as premature ventricular complexes and ventricular tachycardia. For each arrhythmia, it describes the characteristic ECG patterns including P wave morphology, QRS width, and rhythm irregularity. It also discusses distinguishing features, causes, and clinical implications of different arrhythmias.
ECG Atrial and Junctional rhythms Dr SarfarazSarfaraz Ahmad
This document discusses various types of atrial and junctional dysrhythmias seen on electrocardiograms (ECGs), including atrial fibrillation, flutter, tachycardia, and premature atrial contractions as well as junctional rhythms, accelerated junctional rhythms, tachycardias, and premature junctional contractions. Mechanisms and treatments for supraventricular tachycardia are explained, including catheter ablation procedures to treat conditions like Wolff-Parkinson-White syndrome.
The document discusses various types of arrhythmias and their mechanisms. It describes ectopic beats that originate from locations other than the sinoatrial node, and explains that they can cause single beats or take over the heart rhythm. The mechanisms of arrhythmias include altered automaticity, triggered activity, and reentry. Reentry involves unidirectional block and different conduction speeds that allow an impulse to circulate and repeat, creating a reentrant circuit. The document outlines several specific types of arrhythmias like atrial fibrillation, atrial flutter, atrioventricular nodal reentry, and Wolff-Parkinson-White syndrome.
This document provides information on cardiac conduction systems, normal ECG rhythms, cardiac arrhythmias, and arrhythmia management. It defines normal sinus rhythm on ECG and describes the two main types of arrhythmias as bradycardia and tachycardia. Nine common arrhythmias are defined including atrial flutter, atrial fibrillation, junctional rhythm, and various ventricular arrhythmias. Treatment options for arrhythmias include electrical cardioversion, antiarrhythmic medications, and pacemakers.
The document discusses tachyarrhythmia and heart rhythm abnormalities. It describes symptoms such as palpitations, chest tightness, and fainting. Causes include physiological issues, heart disease, psychological factors, and substance use. Types are discussed such as too slow or too fast heart rates. Diagnosis involves measuring heart rate and examining the P wave, QRS complex, regularity, and relationships between P wave and QRS. Specific arrhythmias like atrial flutter, atrial fibrillation, ventricular tachycardia, and WPW syndrome are described.
Cardiac rhythm disorders in neonates can include sinus arrhythmias, tachyarrhythmias like atrial tachycardia and supraventricular tachycardia, and ventricular arrhythmias like premature ventricular contractions and ventricular tachycardia. The document discusses how to read an ECG, defines various normal and abnormal rhythms like sinus bradycardia, and outlines their evaluation and treatment approaches. Genetic arrhythmia syndromes are also mentioned.
1. Arrhythmias are disorders of cardiac impulse formation and propagation that are broadly divided into tachyarrhythmias and bradyarrhythmias.
2. Common arrhythmias include atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, heart blocks, and ventricular fibrillation.
3. Treatment depends on the type of arrhythmia but may include medications, cardioversion, ablation, pacemakers, or implantable cardioverter-defibrillators.
This document discusses the approach to diagnosing and managing patients presenting with palpitations. It outlines common causes of palpitations including sinus rhythm, ectopic beats, supraventricular tachycardia, atrial fibrillation, atrial flutter, and ventricular tachycardia. For diagnosis, it recommends performing a 12-lead ECG and considering additional testing like Holter monitoring if needed to correlate rhythms with symptoms. Management depends on diagnosis but may include reassurance, lifestyle changes, or referral to cardiology depending on risk factors and abnormal findings.
This document provides an overview of supraventricular tachycardia (SVT), including its definition, classification, and management. It discusses 10 specific types of SVT in detail: sinus tachycardia, inappropriate sinus tachycardia, sinus node re-entrant tachycardia, postural orthostatic tachycardia syndrome, focal atrial tachycardia, multifocal atrial tachycardia, macro-re-entrant atrial tachycardias, atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia, and non-re-entrant junctional tachycardias. For
The PR interval is the time from the onset of the P wave to the start of the QRS complex.
It reflects conduction through the AV node.
The normal PR interval is between 120 – 200 ms (0.12-0.20s) in duration (three to five small squares).
If the PR interval is > 200 ms, first degree heart block is said to be present.
PR interval < 120 ms suggests pre-excitation (the presence of an accessory pathway between the atria and ventricles) or AV nodal (junctional) rhythm.
The patient, a 43-year-old female, presented with palpitations, dyspnea, and chest pain after physical exertion. She has a history of rheumatism and mitral stenosis but had been stable until now. Her symptoms suggest new onset atrial fibrillation precipitated by exertion in the setting of underlying heart valve disease.
Similar to pediatrics.Cardiac arrhythmias.(dr.hader) (20)
This document discusses child development from birth through adolescence. It covers the major areas of development - gross motor, fine motor, language, social/emotional - and provides typical milestones for various age groups like sitting up alone by 6 months and walking by 12-15 months. The document also mentions tools for assessing development like the Denver Developmental Screening Test and discusses prolonged development during school age and the biological, psychological, and social changes of adolescence.
This document discusses the vectorial approach to electrocardiography (ECG) interpretation. It explains that the vectorial approach views the standard ECG as representing three-dimensional vector forces over time, whereas a standard ECG shows only magnitude. By combining data from different ECG leads, one can derive information about the direction of forces. It also discusses how to interpret information about the frontal plane from limb leads and the horizontal plane from precordial leads, including the orientation and meaning of waves in each lead. Finally, it notes that ECGs differ between infants/children and adults due to anatomical differences, with infants typically showing right ventricular dominance.
The document discusses several vaccines including BCG, DTP, polio, Hib, MMR, rotavirus, varicella, hepatitis A, and pneumococcal. It provides information on the nature of the vaccines, indications for use, efficacy, administration schedule and route, storage requirements, adverse reactions and contraindications. Specific details are given for dosage, intervals between doses, age for administration and booster schedules for many of the vaccines.
The document contains medical terminology related to gynecology and obstetrics procedures, diagnoses, and conditions. Terms include descriptions of stages of labor, perineal injuries, reproductive anatomy, cysts, cancers, pregnancies, fertility treatments, versions, syndromes, and more. The document provides a list of brief medical terms and descriptions related to women's health and childbirth.
1) The document provides immunization recommendations for children and teens from birth through 18 years of age. It outlines the recommended vaccines, dosing schedules, catch-up schedules, and contraindications.
2) Key recommended vaccines include hepatitis B, DTaP, polio, influenza, varicella, MMR, and Hib. The schedules provide the ages for routine administration, number of doses, minimum intervals between doses, and other guidance.
3) The document also lists contraindications and precautions for each vaccine, such as previous allergic reactions, immunosuppression, or moderate to severe acute illness. It aims to help healthcare providers appropriately immunize children and teens on time.
The document outlines an assessment examination for OBGYN consisting of 7 rooms evaluating various skills. Room 1 involves taking a history from a pregnant patient with vaginal bleeding and abdominal pain. Room 2 examines skills and findings from examining a patient after a normal vaginal delivery. Room 3 involves multiple choice questions about uterine sounds, speculums, oxytocin, curettes, and hysterosalpingograms. Room 4 presents an emergency preeclampsia case to diagnose, manage, and plan a delivery for. Room 5 involves analyzing a partogram to diagnose failure to progress labor and determine management. Room 6 presents an emergency ectopic pregnancy case to diagnose and manage. Room 7 involves identifying indications for various clinical presentations and procedures from
The document outlines an assessment examination for pediatrics consisting of 11 rooms. In each room, students will demonstrate skills in history taking, physical examinations including respiratory, abdominal, and cardiovascular, interpret various tests and x-rays, diagnose conditions like iron-deficiency anemia, immune thrombocytopenic purpura, diaphragmatic hernia and recurrent aphthous ulcers. Students will also assess developmental age, recommend catch-up vaccinations, and identify clinical tools like pulse oximetry, intravenous fluids, and nebulizers along with their uses.
This document summarizes information on several drugs used to treat gynecological conditions. It describes the components, mechanisms of action, usages, dosages and side effects of drugs like Mirena (intrauterine device), Yasmin (oral contraceptive), Primolut (progesterone), Depo Provera (contraceptive injection), and drugs used for fertility treatments, menstrual disorders, pre-eclampsia and postpartum hemorrhage.
This document provides information on hysterosalpingography (HSG) procedures, including equipment used, indications, contraindications, timing, normal findings, and various abnormal findings. It lists conditions that can be evaluated with HSG such as infertility, congenital uterine anomalies, recurrent miscarriage, abnormal bleeding, and uterine masses. Potential risks including pain, bleeding, infection, and allergic reaction are noted. Images demonstrate normal uterine anatomy and various uterine anomalies detectable on HSG.
This document summarizes antepartum hemorrhage (APH), defined as bleeding in the third trimester between 24 weeks of pregnancy until delivery. Placenta previa, where the placenta covers all or part of the cervical os, is a major cause of APH, accounting for 30% of cases. Ultrasound is used to diagnose and grade placenta previa. Management depends on gestational age and bleeding severity, and may involve bed rest, blood transfusions, or caesarean section which is usually required for complete placenta previa. Complications of placenta previa include preterm birth, malpresentation, postpartum hemorrhage, and in rare cases
This document provides information on ectopic pregnancy, including:
1. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tubes.
2. Risk factors include STIs, IUD use, infertility history, smoking, and assisted reproduction.
3. Symptoms can include abdominal/pelvic pain, vaginal bleeding, and in severe cases, hypovolemic shock from rupture. Diagnosis involves ultrasound and beta-hCG levels.
4. Treatment options are expectant management, surgery (laparoscopy or laparotomy), or medical management with methotrexate depending on factors like size and symptoms. The goal is to preserve
This document defines gestational trophoblastic disease and describes the pathological classification and genetic features of complete and partial hydatidiform moles. It also discusses the clinical presentation, diagnosis, treatment, and follow up of molar pregnancies. The main treatment is surgical evacuation, followed by careful monitoring of hCG levels to detect persistent trophoblastic tissue which may develop into invasive mole or choriocarcinoma in about 10% of cases. Close follow up for years after evacuation is important to identify and treat malignant cases early through chemotherapy.
Menstrual disorders are common reasons for women to see their doctor. They include menorrhagia (excessive bleeding), dysmenorrhea (painful periods), and amenorrhea/oligomenorrhea (absent or infrequent periods). Menorrhagia is defined as blood loss over 80ml and affects around 5% of women annually. It can be caused by pelvic issues, systemic diseases, or dysfunctional uterine bleeding. Treatment involves addressing the underlying cause, using medications like NSAIDs or hormonal drugs, or pursuing surgical options like endometrial ablation or hysterectomy if medications fail. A thorough history, examination, and testing are required to diagnose the cause and properly manage menorrhagia.
Oxygen therapy is indicated for patients with low blood oxygen levels and is commonly provided after surgery. Supplemental oxygen can be administered through a nasal cannula, which provides oxygen through prongs in the nose and is comfortable for patients. The amount of oxygen received depends on factors like flow rate and breathing. A flow of 6L/min provides about 44% inhaled oxygen. Different types of face masks provide varying oxygen concentrations depending on their design and flow rates, such as whether they include reservoirs or valves. Air-entrainment masks use the Venturi effect to mix oxygen and room air for stable oxygen levels.
meidicine. first seizure.(dr.muhamad tahir)student
This document discusses the management of a first seizure. It defines seizures and classifies them as generalized or partial. Common causes of first seizures include idiopathic, infections, tumors, and strokes. Management involves documenting the seizure history, examining the patient, checking glucose and other basic labs, observing the patient, and providing advice about seizure precautions and follow up. Recurrence is common within 6 months, especially for symptomatic causes or those with abnormal EEGs or family history of epilepsy.
1. Paracetamol toxicity results from formation of a reactive metabolite that binds to cellular proteins, causing cell death and hepatic or renal failure. Acetylcysteine replenishes glutathione stores and is highly effective if given within 8 hours of overdose.
2. Salicylate poisoning causes respiratory alkalosis, metabolic acidosis, and organ damage. Treatment involves correcting dehydration and acidosis with sodium bicarbonate. Hemodialysis is effective for removing salicylates from the body.
3. Tricyclic antidepressant overdose can cause arrhythmias, hypotension, and seizures due to sodium channel blockade. Treatment involves sodium bicarbonate to correct
1. The document discusses various levels of impaired consciousness ranging from confusion to coma and defines them. It also describes the anatomy of the reticular activating system and two patterns of coma - diffuse cerebral injury or focal brainstem injury.
2. Specific causes of diffuse cerebral injury or focal brainstem injury that can lead to coma are provided. Evaluation of a comatose patient involves assessing level of consciousness, brainstem reflexes, and determining if focal neurological signs are present.
3. Management may involve giving thiamine, dextrose, naloxone and flumazenil in cases of diffuse injury without a known cause. For focal injuries, neuroimaging is important to identify structural
Chronic renal failure refers to the irreversible deterioration of renal function over years. It initially presents as biochemical abnormalities and eventually leads to uraemic symptoms as the excretory, metabolic and endocrine functions of the kidneys fail. Common causes include diabetes, hypertension, and glomerulonephritis. Management involves identifying and treating the underlying disease, slowing progression, managing complications, and renal replacement therapy for end-stage disease.
This document discusses geriatric medicine and the aging population. It notes that the elderly population is growing significantly both in developed and developing countries. Physiological changes that occur with aging can impact multiple body systems and lead to atypical disease presentation and an increased risk of adverse drug reactions. A comprehensive geriatric assessment considers medical, psychological, functional, social and environmental factors when evaluating elderly patients.
Polymyalgia rheumatica (PMR) is a clinical syndrome characterized by muscle pain and stiffness affecting the neck, shoulders, and hips that is associated with an increased erythrocyte sedimentation rate. It predominantly affects those over age 50 and women are more commonly affected than men. Treatment involves corticosteroids which provide rapid relief of symptoms for most patients. Tapering of steroids over 12-18 months is usually needed.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
2. Cardiac ArrhythmiasCardiac Arrhythmias
Abnormal rate and or rhythm of the heart can beAbnormal rate and or rhythm of the heart can be
physiological or pathological, congenital or acquired,physiological or pathological, congenital or acquired,
transient or chronic, self-limited or life threatening. Fortransient or chronic, self-limited or life threatening. For
all of which ECG is essential to make a diagnosis.all of which ECG is essential to make a diagnosis.
((I) Tachyarrhythmia (increased H.R.):I) Tachyarrhythmia (increased H.R.):
1- Sinus tachycardia1- Sinus tachycardia: a physiological compensatory: a physiological compensatory
mechanism due to rapid discharge from S.A. node inmechanism due to rapid discharge from S.A. node in
response to:response to:
A- Certain physiological events as crying, pain,A- Certain physiological events as crying, pain,
anxiety and exercise.anxiety and exercise.
B- Certain pathological events as fever, shock,B- Certain pathological events as fever, shock,
hypoxia, H.F. , anemia orhypoxia, H.F. , anemia or
C- Due to certain drugs as atropine, adrenaline orC- Due to certain drugs as atropine, adrenaline or
theophylline.theophylline.
ECG shows tachycardia with normal "P", normal 1:1 AVECG shows tachycardia with normal "P", normal 1:1 AV
conduction and normal QRS.conduction and normal QRS.
3.
4. 2- Supra ventricular tachycardia2- Supra ventricular tachycardia "S.V.T."; the discharge is"S.V.T."; the discharge is
from an abnormal mechanism proximal to thefrom an abnormal mechanism proximal to the
bifurcation of "His" bundle. It is of 3 types:bifurcation of "His" bundle. It is of 3 types:
A- Paroxysmal S.V.T.: caused by "Re-entry"A- Paroxysmal S.V.T.: caused by "Re-entry"
phenomenon through the AV node or through otherphenomenon through the AV node or through other
conducting pathways. SVT affects all ages fromconducting pathways. SVT affects all ages from
fetal life onward.fetal life onward.
The paroxysm occurs suddenly without an event cause orThe paroxysm occurs suddenly without an event cause or
follows an infection or a physical factor and usuallyfollows an infection or a physical factor and usually
occurs at rest. The H.R. is between 180 and 300 /min.occurs at rest. The H.R. is between 180 and 300 /min.
short attacks for minutes or hours may be tolerated butshort attacks for minutes or hours may be tolerated but
prolonged and severe forms may lead to C.C.F.prolonged and severe forms may lead to C.C.F.
The attack may spontaneously terminate as suddenly asThe attack may spontaneously terminate as suddenly as
it began. Polyuria may occur due to release of atrialit began. Polyuria may occur due to release of atrial
nitriuretic peptide.nitriuretic peptide.
Maneuvers that increase vagal tone (unilateral carotidManeuvers that increase vagal tone (unilateral carotid
sinus massage, valsalva maneuver, abdominal pressure,sinus massage, valsalva maneuver, abdominal pressure,
pressure on the eye ball [not in young infants] and icepressure on the eye ball [not in young infants] and ice
pack on the face) may successfully terminate the attackpack on the face) may successfully terminate the attack
5. SVT may be precipitated by nasal decongestantsSVT may be precipitated by nasal decongestants
(sympathomimetics).(sympathomimetics).
ECG reveals a very fast rate, normal "P", normal 1:1 AVECG reveals a very fast rate, normal "P", normal 1:1 AV
conduction and normal QRS.conduction and normal QRS.
Some patients with SVT have WPW syndrome and are atSome patients with SVT have WPW syndrome and are at
higher risk for sudden death from WPW syndrome.higher risk for sudden death from WPW syndrome.
During the paroxysm the ECG misses WPW picture which isDuring the paroxysm the ECG misses WPW picture which is
in the form of short P-R and slow upstroke QRS (deltain the form of short P-R and slow upstroke QRS (delta
wave).wave).
If the above measures fail I.V adenosine 0.05 mg/kg bolusIf the above measures fail I.V adenosine 0.05 mg/kg bolus
repeated every 2 min for several times.repeated every 2 min for several times.
When available DC cardioversionWhen available DC cardioversion
Other drugs used in SVT include; Phenylphrine,Other drugs used in SVT include; Phenylphrine,
Edrophonium, Amiodarone, Quinidine, Procainamide,Edrophonium, Amiodarone, Quinidine, Procainamide,
propranolol and Verapamil (not used in infants).propranolol and Verapamil (not used in infants).
After cessation of the acute paroxysm maintenance drugsAfter cessation of the acute paroxysm maintenance drugs
as Digoxin (not in presence of WPW), Propranolol,as Digoxin (not in presence of WPW), Propranolol,
Amiodarone, Verapamil, etcAmiodarone, Verapamil, etc…….should be used for 1 year..should be used for 1 year.
Recurrences are common in older children and may indicateRecurrences are common in older children and may indicate
for radiofrequency ablation therapy.for radiofrequency ablation therapy.
9. B- Atrial flutter: a very uncommon form ofB- Atrial flutter: a very uncommon form of
tachyarrhythmia, caused by an abnormal atrial focustachyarrhythmia, caused by an abnormal atrial focus
discharging at a very high rate (300-500/min)discharging at a very high rate (300-500/min)
producing atrial "sawtooth" flutter waves on ECG.producing atrial "sawtooth" flutter waves on ECG.
As the AV node can not transmit all these impulses a degreeAs the AV node can not transmit all these impulses a degree
of AV block occurs.of AV block occurs.
ECG shows a regular sawtooth "P" waves and a regular QRSECG shows a regular sawtooth "P" waves and a regular QRS
complexes but there is one QRS for each 2 or 3 P waves.complexes but there is one QRS for each 2 or 3 P waves.
This conduction is rare in normal heart.This conduction is rare in normal heart.
Treatment includes vagal maneuvers, adenosine andTreatment includes vagal maneuvers, adenosine and
synchronized DC cardioversion.synchronized DC cardioversion.
10. C- Atrial fibrillation: mostly seen in older children withC- Atrial fibrillation: mostly seen in older children with
chronic rheumatic heart disease, usually mitralchronic rheumatic heart disease, usually mitral
stenosis. Thyrotoxicosis may be the cause. It isstenosis. Thyrotoxicosis may be the cause. It is
characterized by irregular discharges from atrialcharacterized by irregular discharges from atrial
foci resulting in an irregular disorganized atrial ratefoci resulting in an irregular disorganized atrial rate
of 350-600/min. patients are liable to haveof 350-600/min. patients are liable to have
thromboemboli and stroke.thromboemboli and stroke.
The ventricular response is variable, resulting in a veryThe ventricular response is variable, resulting in a very
irregular beating.irregular beating.
ECG shows:ECG shows:
Absent "P" waves (irregular base lines)Absent "P" waves (irregular base lines)
Irregular P-R intervals (irregular ventricularIrregular P-R intervals (irregular ventricular
contractions)contractions)
Normal shapes QRS complex.Normal shapes QRS complex.
Treatment is by digitalization which restores theTreatment is by digitalization which restores the
ventricular rate to normal although the atrial fibrillationventricular rate to normal although the atrial fibrillation
usually persists, followed by Amiodaroneusually persists, followed by Amiodarone±± Warfarin.Warfarin.
11.
12.
13. 3- Ventricular tachyarrhythmia3- Ventricular tachyarrhythmia: the rapid heart rate: the rapid heart rate
originates from abnormal ventricular mechanisms.originates from abnormal ventricular mechanisms.
Two main forms are known:Two main forms are known:
A-A- Ventricular tachycardiaVentricular tachycardia; a serious condition which may; a serious condition which may
change to fatal ventricular fibrillation, predisposed bychange to fatal ventricular fibrillation, predisposed by
myocarditis, cardiomyopathy, digoxin toxicity, hypoxiamyocarditis, cardiomyopathy, digoxin toxicity, hypoxia
or severe electrolyte imbalance.or severe electrolyte imbalance.
Clinically there is tachycardiaClinically there is tachycardia ±± syncope and suddensyncope and sudden
death may occur. ECG shows rapid wide QRS notdeath may occur. ECG shows rapid wide QRS not
preceded by P waves.preceded by P waves.
I.v. lidocaine is essential to prevent fibrillation and death.I.v. lidocaine is essential to prevent fibrillation and death.
B-B- Ventricular fibrillationVentricular fibrillation: a potentially fatal dysrhythmia: a potentially fatal dysrhythmia
which cause death within few minutes unlesswhich cause death within few minutes unless
immediate resuscitative measures ere provided.immediate resuscitative measures ere provided.
Clinically the patient suddenly loses consciousness withClinically the patient suddenly loses consciousness with
no detectable heart beat and the ECG shows totalno detectable heart beat and the ECG shows total
disorganization with absent QRS.disorganization with absent QRS.
Immediate cardiac massage, i.v. amiodarone orImmediate cardiac massage, i.v. amiodarone or
lidocaine,intracardiac adrenaline and artificial ventilationlidocaine,intracardiac adrenaline and artificial ventilation
+ cardioversion when available.+ cardioversion when available.
14. (II) Bradyarrhythmia:(II) Bradyarrhythmia:
Bradycardia is considered to be present when the heartBradycardia is considered to be present when the heart
rate is less than the lower normal limit for age .rate is less than the lower normal limit for age .
The lower limit of heart rate in awake state is:The lower limit of heart rate in awake state is:
Newborn 90/min.Some what less during sleepNewborn 90/min.Some what less during sleep
Infant 100/min.Infant 100/min.
Young children 80/min.Young children 80/min.
Older children 60/min.Older children 60/min.
Bradyarrhythmias include:Bradyarrhythmias include:
1- Sinus bradycardia (S.B.);1- Sinus bradycardia (S.B.); characterized by abnormallycharacterized by abnormally
slow heart rate caused by discharge from S.A. node.slow heart rate caused by discharge from S.A. node.
Sinus bradycardia may be physiological (during sleepSinus bradycardia may be physiological (during sleep
and in athletes), pathological (syncope or raised intra-and in athletes), pathological (syncope or raised intra-
cranial pressure) or caused by drugs (Digoxin orcranial pressure) or caused by drugs (Digoxin or
propranolol)propranolol)
Clinically there is bradycardia which increases withClinically there is bradycardia which increases with
exertion (crying), a point which differentiates sinusexertion (crying), a point which differentiates sinus
bradycardia from AV block.bradycardia from AV block.
ECG shows a slow rate but normal P-QRS-T complexes.ECG shows a slow rate but normal P-QRS-T complexes.
15. 2- Atrioventricular block;2- Atrioventricular block; it is of three types:it is of three types:
A- First degree AV block: prolonged P-R interval but allA- First degree AV block: prolonged P-R interval but all
the atrial impulses are conducted to the ventricle.the atrial impulses are conducted to the ventricle.
B- Second degree; failure of conduction of some of theB- Second degree; failure of conduction of some of the
atrial impulses to the ventricle.atrial impulses to the ventricle.
It is subdivided in to two forms:It is subdivided in to two forms:
Mobitz type I (wenckebach);Mobitz type I (wenckebach); in which the P-P intervalin which the P-P interval
remains constant, but there is progressive increase of theremains constant, but there is progressive increase of the
P-R interval until a "P" wave is not conducted. After thisP-R interval until a "P" wave is not conducted. After this
dropped beat the cycle starts again with a short P-Rdropped beat the cycle starts again with a short P-R
interval.interval.
Mobitz type IIMobitz type II; P-R interval remains constant, but an; P-R interval remains constant, but an
occasional atrial beat does not conduct to the ventricle.occasional atrial beat does not conduct to the ventricle.
Syncope may occur and the conduction may change toSyncope may occur and the conduction may change to
complete AV block.complete AV block.
16.
17. C- Third degree (complete heart block): no atrialC- Third degree (complete heart block): no atrial
impulse reaches the ventricles.impulse reaches the ventricles.
The cause may be;The cause may be;
Congenital, usually associated with maternal SLE.Congenital, usually associated with maternal SLE.
Acquired; digixin, post cardiac surgery, or bacterialAcquired; digixin, post cardiac surgery, or bacterial
endocarditis.endocarditis.
Clinically; most are asymptomatic, heart rate is aroundClinically; most are asymptomatic, heart rate is around
50/min, may increase by 10-20 on exercise or atropine.50/min, may increase by 10-20 on exercise or atropine.
Symptoms include fatigue, exercise intolerance, syncopeSymptoms include fatigue, exercise intolerance, syncope
(stokes-Adams attacks) and rarely sudden death may(stokes-Adams attacks) and rarely sudden death may
occur.occur.
Systolic murmurs are commonly heared. CardiomegalySystolic murmurs are commonly heared. Cardiomegaly
and elevated blood pressure may be detected.and elevated blood pressure may be detected.
ECG: QRS duration may be prolonged.ECG: QRS duration may be prolonged.
Prognosis of the congenital complete heart block is good.Prognosis of the congenital complete heart block is good.
Some who have exercise intolerance, progressiveSome who have exercise intolerance, progressive
cardiomegaly or Stokes-Adams attacks need implantationcardiomegaly or Stokes-Adams attacks need implantation
of the permanent cardiac pace maker.of the permanent cardiac pace maker.
18.
19. 3- Sick Sinus Syndrome "SSS"3- Sick Sinus Syndrome "SSS"
This form of Bradyarrhythmia usually follows cardiac surgery,This form of Bradyarrhythmia usually follows cardiac surgery,
myocarditis, myocardial ischemia or cardiomyopathy. SSS ismyocarditis, myocardial ischemia or cardiomyopathy. SSS is
characterized by profound unresponsive sinus bradycardia withcharacterized by profound unresponsive sinus bradycardia with
or without periods of tachycardia (bradycardia- tachycardiaor without periods of tachycardia (bradycardia- tachycardia
syndrome) manifests as dizziness and syncope. In symptomaticsyndrome) manifests as dizziness and syncope. In symptomatic
cases drugs as digoxin or ventricular pacemaker are necessary.cases drugs as digoxin or ventricular pacemaker are necessary.
4- Asystole;4- Asystole; complete cessation of cardiac contraction, (flat ECG)complete cessation of cardiac contraction, (flat ECG)
may follow bradycardias or results from sever hypoxia,may follow bradycardias or results from sever hypoxia,
acidosis, shock, hypothermia, electrolyte disturbances oracidosis, shock, hypothermia, electrolyte disturbances or
hypovolemia. Stressful procedures as lumber puncture,hypovolemia. Stressful procedures as lumber puncture,
intubation or intra venous canulation may cause cardiacintubation or intra venous canulation may cause cardiac
arrest.arrest.
Extrasystoles (premature beat): these are mostly benign andExtrasystoles (premature beat): these are mostly benign and
occur in normal children. They may also accompany variousoccur in normal children. They may also accompany various
organic (inflammation, ischemia, fibrosis) heart disease or beorganic (inflammation, ischemia, fibrosis) heart disease or be
drug induce (digoxin)drug induce (digoxin)
They result from isolated discharge from an ectopic atrial orThey result from isolated discharge from an ectopic atrial or
ventricular focus.ventricular focus.
The atrial extrasystoles are shown on ECG as;The atrial extrasystoles are shown on ECG as;
Abnormally shaped "P" waveAbnormally shaped "P" wave
Normal QRSNormal QRS
No compensatory pauseNo compensatory pause
20. The ventricular extrasystoles are shown on ECG by:The ventricular extrasystoles are shown on ECG by:
Wide bizarre QRS, inverted "T" and a compensatory pause.Wide bizarre QRS, inverted "T" and a compensatory pause.
Long Q-T SyndromeLong Q-T Syndrome
"LQTS""LQTS"
This is a rare condition characterized by prolonged QTThis is a rare condition characterized by prolonged QT
interval, syncopal attacks. Nerve deafness, hemiplegia,interval, syncopal attacks. Nerve deafness, hemiplegia,
petit-mal may be present. LQTS may be a cause of SUIDS.petit-mal may be present. LQTS may be a cause of SUIDS.
There may be an abnormality in the sympatheticThere may be an abnormality in the sympathetic
innervation of the myocardium.innervation of the myocardium.
LQTS may be familial (both A.R. and A.D. are known) orLQTS may be familial (both A.R. and A.D. are known) or
acquired due to:acquired due to:
Drugs as phenothiazine ,Hypokalemia, hypocalcemia orDrugs as phenothiazine ,Hypokalemia, hypocalcemia or
hypomagnisemia ,Hypothermia ,Cerebrovascular diseaseshypomagnisemia ,Hypothermia ,Cerebrovascular diseases
or Neck surgery.or Neck surgery.
TreatmentTreatment includes propranolol, di-phenyl hydantoin andincludes propranolol, di-phenyl hydantoin and
left stellate ganglionectomy.left stellate ganglionectomy.
The mortality is high (75%) without treatment.The mortality is high (75%) without treatment.
21.
22. Cardiomyopathy “CMPCardiomyopathy “CMP””
This entity means myocardial dysfunction, which could be familialThis entity means myocardial dysfunction, which could be familial
or results from different other diseases like muscle dystrophy,or results from different other diseases like muscle dystrophy,
glycogen storage disease , hemochromatosis etc.glycogen storage disease , hemochromatosis etc.
C.M.P is of 3 distinctive forms :C.M.P is of 3 distinctive forms :
1. Congestive (dilated) C.M.P ; characterized by CCF ,arrhythmias ,1. Congestive (dilated) C.M.P ; characterized by CCF ,arrhythmias ,
mitral or tricuspid murmurs and emboli.mitral or tricuspid murmurs and emboli.
X-ray shows cardiomegalyX-ray shows cardiomegaly
Prognosis is bad.Prognosis is bad.
2. Restrictive C.M.P: also presents as C.C.F. with cardiomegaly ,2. Restrictive C.M.P: also presents as C.C.F. with cardiomegaly ,
distant heart sounds , but usually no murmurs .distant heart sounds , but usually no murmurs .
ECG shows low voltage, arrhythmias, ST and T changes.ECG shows low voltage, arrhythmias, ST and T changes.
3. Obstructive : characterized by obstruction to left ventricle and3. Obstructive : characterized by obstruction to left ventricle and
interventricular septum.interventricular septum.It is also termed Idiopathic HypertrophicIt is also termed Idiopathic Hypertrophic
Subaortic Stenosis (IHSS)Subaortic Stenosis (IHSS)
30 % of cases of IHSS are familial but usually appears after30 % of cases of IHSS are familial but usually appears after
childhood.childhood.
23. Management :Management :
In general there is no specific treatment for C.M.P.In general there is no specific treatment for C.M.P.
Anti failure (vasodilator , Diuretics and ACE inhibitor )Anti failure (vasodilator , Diuretics and ACE inhibitor )
Anticoagulant when emboli are suspectedAnticoagulant when emboli are suspected
Beta blockers are used for hypertrophic CMPBeta blockers are used for hypertrophic CMP
Anti arrhythmic agent.Anti arrhythmic agent.
Surgical myotomy in some forms of localized obstruction.Surgical myotomy in some forms of localized obstruction.
Repair or replacement of mitral valve may be needed.Repair or replacement of mitral valve may be needed.
Cardiac transplant in terminal cases.Cardiac transplant in terminal cases.
24. MyocarditisMyocarditis
Causes of which are numerous including:Causes of which are numerous including:
Different virusesDifferent viruses
Bacterial toxinsBacterial toxins
Parasitic infection.Parasitic infection.
Fungal infection.Fungal infection.
Collagen vascular diseases.Collagen vascular diseases.
Metabolic and nutritional diseases.Metabolic and nutritional diseases.
Neuromuscular disorders.Neuromuscular disorders.
IEMIEM
Blood disorders.Blood disorders.
Drugs.Drugs.
Corornary artery damage.Corornary artery damage.
25. Viral myocarditis is, however the most common form,Viral myocarditis is, however the most common form,
symptoms of which are usually abrupt especially insymptoms of which are usually abrupt especially in
neonates with unexplained breathlessness, gallop rhythm,neonates with unexplained breathlessness, gallop rhythm,
shock ,C.C.F. &arrhythmia. ECG shows ; low voltage , STshock ,C.C.F. &arrhythmia. ECG shows ; low voltage , ST
and T changes , X-ray shows cardiomegaly.and T changes , X-ray shows cardiomegaly.
Treatment :Treatment :
O2O2
Bed restBed rest
Anti failureAnti failure
Steroid especially in presence of cardiovascular collapseSteroid especially in presence of cardiovascular collapse
and conduction disturbance.and conduction disturbance.