THIRD DEGREE HEART BLOCK (BASICS) ALSO CALLED AS COMPLETE HEART BLOCK . WHEN ATRIAL CONTRACTION IS NORMAL BUT NO BEATS ARE CONDUCTED TO THE VENTRICLES. THIS MAY OCCUR IN PATIENT WITH MYOCARDICAL INFARCTION OR IT MAY BE CHRONIC (USUALLY DUE TO FIBROSIS AROUND THE BUNDLE OF HIS). LET'S MAKE IT SIMPLE: 1. REGULAR P-P INTERVAL. 2. REGULAR R-R INTERVAL. 3. MORE P WAVES ARE PRESENT THAN QRS COMPLEXES. NOTE: NO RELATIONSHIP BETWEEN P WAVES AND QRS COMPLEXES, BUT AS I MENTIONED SAME NUMBER OF BIG BOX IN-BETWEEN (P-P INTERVAL AND R-R INTERVAL)
LEFT VENTRICULAR HYPERTROPHY (LVH) BASICS ECG CHANGES IN LVH SIMPLE CONCEPT: IN LEAD AVL - TALL (R-WAVE) - > 11 mm (greater than 11mm, it's consider LVH) TALL (R-WAVE) IN V5-V6 AND DEEP (S-WAVE) IN V1 (some of this greater than 35mm, then the patient has LVH) E.G: COUNT (R-WAVE) IN V5 = 25mm AND COUNT (S-WAVE) IN V1 = 20mm (together we have 45mm) [ANYTHING GREATER THAN 35 mm, it's consider LVH] NOTE: 1) SINUS RHYTHM, RATE 83/MIN AND NORMAL AXIS. 2) TALL R-WAVE IN LEADS V5-V6 (R-wave in lead v5, 40mm) AND DEEP S- WAVES IN LEADS V1-V2. 3) INVERTED T-WAVES IN LEADS 1,VL AND V5-V6. OVERVIEW: LEFT VENTRICULAR HYPERTROPHY CAUSES A TALL R-WAVE (GREATER THAN 25mm) IN LEAD V5 (OR) V6 AND DEEP S-WAVE IN V1 (OR) V2, BUT IN PRACTICE SUCH "VOLTAGE" CHANGES ALONE ARE UNHELPFU...
DIGOXIN - CARDIAC GLYCOSIDES ( BASICS ) HELPS,THE HEART TO PUMP MORE EFFICIENTLY, INHIBITS NORMAL FUNCTION OF Na+/K+ PUMP. HOW DOES IT AFFECTS THE HEART[ POSITIVE AND NEGATIVE EFFECTS] POSITIVE: INOTROPIC EFFECT ON THE HEART: SQEEZES/CONTRACTS HARDER. NEGATIVE: CHRONOTROPIC EFFECT ON THE HEART: BEATS SLOWER. NEGATIVE: DROMOTROPIC EFFECT ON THE HEART; SLOWS IMPULSES SENT THROUGH AV NODE RESULTS; HEART SQEEZES MORE BLOOD OUT = INCREASED STROKE VOLUME = INCREASED CARDIAC OUTPUT DRUG USED FOR: HEART FAILURE, CARDIOGENIC SHOCK, A.FIB, A.FLUTTER. EFFECT ON ECG: THE ADMINISTRATION OF DIGOXIN CAUSES (T-WAVE) INVERSION - CHARACTERISTICALLY WITH SLOPING DEPRESSION OF THE ST SEGMENT. IT IS HELPFUL TO RECORD AN ECG BEFORE GIVING DIGOXIN, TO SAVE LATER CONFUSION ABOUT THE SIGNIFICANCE OF T-WAVE CHANGES. THERAPEUTIC: 0.5 - 2 ng/ml (ANYTHING GREATER THAN 2ng IT'S CONSIDER TOXI...
Good info Doctor
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