THIRD DEGREE HEART BLOCK AND LETHAL RHYTHMS

                                                       Third degree AV block

The patient in third degree heart block is likely to display 
the EKG rhythm seen above. Typically, in a healthy heart,
the atria contract at the same time, forcing blood into the
ventricles. This is followed by the ventricles contracting, 
at the same time, pushing blood out of the heart.

In third degree heart block, because the heart is damaged,
it cannot pump as effectively as a healthy heart. This causes
the atria and ventricles to beat independently of each other. 
The P wave may not be followed by the QRS. The EKG
tracing above demonstrates this. This means blood flow
is lacking.

Symptoms  include: chest pain, feeling lightheaded and 
hypotension.

Causes of third degree heart block:
- cardiomyopathy
- surgical intervention
- medications such as beta blockers, 
calcium channel blockers and Digoxin

Treatment may vary. AHA has guidelines in place for the
course treatment. Oxygen will be required. Atropine may be
used first depending, on how stable the patient is. The doctor
may choose transcutaneous pacing first and later, have a 
permanent pacemaker put in.

Documentation of all interventions, is important. Please 
read the image above, for more helpful information.






                                                                     Lethal rhythms
***American Heart Association has protocols in place for each 
EKG rhythm that requires immediate intervention.

There are some EKG rhythms that are considered to be lethal.
Instant intervention is necessary for good outcomes. Here are
the most lethal rhythms:

Asystole - sometimes referred to as " flat-line. The electrical
heart's conduction system is not functioning. There are no
ventricular contractions. The patient is pulseless and
unresponsive.

PEA - the patient in PEA will have a heart rhythm, but is 
unresponsive. This may be caused by hypovolemia, cardiac
 tamponade, pneumothorax, drug overdose, thrombosis,
 and trauma.

Ventricular Tachycardia - There may or may not be a pulse
present. The ventricles are beating rapidly and there is no
effective blood flow. Ventricular Tachycardia without a pulse
is treated the same as ventricular fibrillation. Typically the
patient will be unresponsive and require immediate CPR
and defibrillation.


Comments

Post a Comment

Popular posts from this blog

HELPFUL INFORMATION ABOUT AN AORTIC ABDOMINAL ANEURYSM

Image
  Scenario: Mr. S is an elderly male who has a longstanding history of hypertension. He suddenly develops throbbing  in the abdomen. He notified his doctor and was admitted to the hospital for tests. A CAT scan would reveal an  Abdominal Aortic Aneurysm. Surgical intervention for AAA was done emergently. Following surgery, Mr.S was transferred to the ICU  for a higher level of care. During his stay, his vital  signs, neurological, cardiac and respiratory status   would all be monitored. Please click on the links for more learning: Hemodynamic Monitoring Info for the layperson
Read more

CHEST PAIN ASSESSMENT AND EKG - QUIZ

Image
Chest pain is a very common complaint . It may occur anywhere and anytime, even at rest. It may be related to stress or actual damage to the heart. A patient having a heart attack, may very readily complain of chest pain. Helpful hints: If the patient in your care is complaining of chest pain,   immediate action should be taken to assess the pain. Chest pain may be sharp, severe and stabbing. It may also feel like pressure in the chest or  Like a pair of hands squeezing the chest.  It is important to do a pain assessment on a scale of 1-10 and document results. It is also of note to ask the patient to describe the character  and duration of the pain. Always remember to document all interventions. Follow your Institution's policies, procedures and MD orders for chest pain. Do you know your heart Simple EKG interpretation: The EKG (Electrocardiogram) is a noninvasive, simple diagnostic test. It is  a reflection of  the electrical conduction system of the heart. It consists of 12 lead
Read more

CARDIOGENIC SHOCK - QUIZ QUESTIONS

Image
Myocardial infarction A heart attack is the layman's term for a (MI) myocardial infarction.     It is caused by  a lack of blood supply to the heart muscle. A blood clot  or plaque, may obstruct the flow of blood. This typically occurs in the    patient with CAD (   coronary artery disease) .  Symptoms include:                           chest pain which may radiate to the shoulder and jaw, pressure or                                                             tightness in the chest, anxiety, nausea, vomiting and shortness of breath.                                                                                                              Cardiogenic shock The left ventricle receives its blood supply from the LAD ( left anterior descending) artery. If the flow of blood to the left ventricle is obstructed by a clot or plaque, part  of the heart muscle may die. This lack of blood flow to the left ventricle causes pump failure. Cardiogenic shock may result from pump failure.     
Read more