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Symptoms of disease - violation of ventricular conduction

Violation of a heart rhythm, associated with slowing or cessation of the flow of electric impulse for the conducting system of the heart is called the heart of the blockade.

As a part of the blockade are divided into:

- VRS (sinoatrial), when the slowing of nerve impulse transmission occurs at the level of muscles of the atrium
- cardioversion-ventricular - a violation of the mitral node
- intraventricular - at the level of beam Guisa and his feet.

Atrial blockade arise in violation of conductivity in the conducting system of the muscles of the Atria. On the background of the usual rhythm is loss reduction infarction and there is a pause, equal to approximately two cuts. With a permanent form of such a blockade of its hard to tell from just a slow rhythm of the heart - bradycardia. This type of blockade is possible in healthy people and in patients with ischemic heart disease, inflammatory diseases of the heart muscle, in case of poisoning, in case of overdose of certain drugs (heart glycosides, quinidine, verapamil). When expressed extent of the blockade of the patient is possible fainting and even seizures, loss of consciousness with cramps. Sometimes the blockade may move to a different rhythm disturbance - flickering or of atrial flutter.

Violations of cardioversion-ventricular conduction (atrioventricular block) occurs when the violation of the electrical impulse from the Atria to the ventricles at the level of mitral node. Such violations conductivity occur in many diseases of the heart, especially often in the course of rheumatic lesions, ischemic heart disease, myocardial infarction, cardiosclerosis, congenital heart disease, cardiomyopathy. Occasionally, a rhythm disturbance occurs in healthy trained people from pilots and cosmonauts.

Cardioversion-ventricular blockade is of three degrees:
- I degree. All the impulses from the Atria reach the ventricles, but holding them slowed down. Diagnosed the blockade on the change of teeth on the electrocardiogram. Treatment with atrioventrikuliarna blockade of the first degree depends on the underlying disease, sometimes requires the installation of a pacemaker.
- II degree. When the second degree atrioventricular blockade not all of the impulses from the Atria are conducted to the ventricles and the fall of the individual ventricular contraction. On the electrocardiogram find the first signs of a deceleration of or normal complexes, and then registered only Zubets, the corresponding reduction of the Atria, and the contraction of the ventricles is absent. Fall out may every fifth, fourth, third, etc. reduction. The blockade which arise without previous deceleration of can go into full atrioventricular blockade. Treatment of the blockade of the second degree also significantly depends on the underlying disease. Sometimes the use of atropine, isoproterenol. If the heart rate is reduced considerably applies constant stimulation of the heart - pacemaker.
- III degree. Full cardioversion ventricular blockade. When the electrical impulse from the Atria to the ventricles are not conducted at all, and the Atria and ventricles are reduced in the right rhythm, but independently of each other. The frequency of ventricular contractions are usually high, and ventricles are reduced in a slow rhythm 30-50 per minute. Under this form of blockade in the patient may experience bouts of Morgagni-Adams-Stokes, when disturbed consciousness, may be convulsions, cyanosis (blueness) of the person, pain in the heart. The pulse and, accordingly, reduction of the heart at this moment there are no. Attacks occur because of a temporary cessation of blood circulation. The prognosis for such a degree atrioventricular blockade serious. Patients disabled, they have developed heart failure. Be part of the thrill during Sports events and bet on Asia Cup, Indian Premier League and major football events with 1xbet free bet offer “No Risk Bet“. This can be claimed without a 1xbet promo code free bet in the registration form. To be qualified for this offer, your first step would be to create an account. Then, you will need to make a minimum first deposit of 10 EUR. Indian players are eligible to take this casino bonus offer, but the payment options and minimum deposit can vary from your bank and country of residence. So, we also recommend visiting the operator’s site for further details. At attacks Morgagni-Adams-Stokes sometimes you have to do indirect heart massage and make artificial ventilation lung. Emergence such attacks or at least initial of their manifestations (seizures, dizziness, weakness) is an absolute indication for continuous electrical stimulation.

Implantation of a pacemaker requires and to patients who have heart rate less than 50 beats per minute even if the complaints they have no. Patients with implanted pacemakers should always be under the supervision of a physician.

The conductive system of the ventricles is presented beam Guisa, which is divided into two legs of the right and left. Right foot consists of a wide beam, which branches out in the muscles of the right ventricle.
Left foot beam Guisa is divided into front and back of the branches, which branch in muscle, respectively front and back walls of the left ventricle. Branching in muscle, the two legs form a network of so-called Purkinje fibers.

The way sinus pulse excitation of the ventricles. In normal sinus impulse, passing on the conducting system of the ventricles, excites interventricular partition and then on the feet beam Guisa simultaneously excites both ventricle. For the simultaneous excitation of the ventricles sinus impulse is required of 0.10+0,02", T. E. not more than 0,12 with.

When blockades feet beam Guisa is changing and the way of excitation of the ventricles, and the time of their initiation. We consider in detail these changes, mindful of the fact that the route of the excitation of the ventricles is displayed on the ECG form of the QRS complex, and the time of their initiation - width of the same complex.

Distinguish the following types of blockade feet beam block:
(a) the Blockade of the right leg of the beam block.
b) the Blockade of the left foot beam block.

The blockade feet to heavy disturbances of hemodynamics not lead, it all depends on the nature of the underlying process. When a blockade may be splitting of the first tone.

Diagnostics mainly on ECG: a nonsimultaneous of pulses on the ventricles, increases the time of their distribution, from this broadens and digested QRS. Depending on the width of the distinguished:
(a) partial blockade (0,10-0,12 sec);
b) complete blockade of the (0.12 sec).

When the siege of the left foot beam block is observed deviation of the axis of the heart to the left " reminds me of a hypertrophy of a left ventricle, but the blockade is observed expansion of the QRS complex, high split R I a standard electrodes and in the left chest (5,6).

During the blockade of the right leg of the beam block these changes occur in the right chest leads (I, II), a widening set of QRS. The blockade of the right leg is classical and SARS.

(a) Classical: the I of the standard lead a very small R and deeply split S. In the III standard entering the split deep R.
b) SARS (blockade Wilson). The R-wave normal height, prong S small but broad.

Left foot of block has two branches - the front and the rear. This is still emit the front and rear semi-blockade. They usually do not lead to a broadening of the ventricular complex, manifest a sudden the deflection of an electrical axis of the heart: the left at the front semiblock, to the right at the back semiblock.



Which diseases there is violation of ventricular conduction

Violation of ventricular conduction occur mainly in the beam Guisa, in which the electrical impulse is carried out in the ventricle and his legs - the right and left. To the occurrence of ventricular blockades lead ischemic heart disease, myocardial infarction, myocarditis, cardiomyopathy, infectious endocarditis, violations of the number of electrolytes (potassium, calcium, chloride) in the blood.

Sometimes there are congenital blockade one of feet beam Guisa, often right, or branches of the feet beam Guisa. Congenital blockade is usually not reflected in the quality of life and do not lead to any disease of the heart. Ventricular blockade is usually easy to diagnose on the electrocardiogram. They have typically looking complexes. In themselves blockade feet beam Guisa do not represent danger for the life of the patient their clinical significance is determined by the possibility of their progression and transition to full atrioventricular blockade, or they can serve as an indicator of the heart of any pathological process. Very rarely arises trifascicular blockade, when the electrical impulse is blocked for all branches, then there can be a necessity in constant pacemaker.



Which doctor should I contact if there is a violation of ventricular conduction

  • Cardiologist
  • Arrhythmologist


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