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🔴Cardiomyopathy
▪︎Group Of Diseases Affects Myocardium (Heart Muscle) That Results in Progressive Mechanical Or Electrical Cardiac Dysfunction
▪︎Usually Due To Genetic Disorders
🔰Hypertrophic Cardiomyopathy (HCM/Thick Stiff Muscle) ▪︎Most Common Form Of Cardiomyopathy ▪︎Most Common Cause Of Death in Young Athletes ▪︎Due To Genetic Autosomal Dominant Disorder That Leads To Progressive LV Muscle Thickening & Hypertrophy ▪︎Eventually Results in Diastolic Dysfunction (Impaired Ventricular Filing) 🔹Features Of HCM 📍1. Asymptomatic 📍2. Symptoms Of Heart Failure ( Due To Diastolic Dysfunction) 📍3. Effort intolerance Symptoms (Angina/SOB/Syncope Due To LV Outflow Obstruction From Interventricular Septal Hypertrophy HOCM) 📍4. Mitral Regurgitation (MR Due To LV Hypertrophy) 📍5. Sudden Death (Due To Arrhythmia Or Severe LV Outflow Obstruction) 📍5. Jerky Pulse نبض قوي 📍5. Double Impulse Apex Beat اكثر من نبضة 📍6. Pan Systolic & Mid Diastolic Murmurs (Increase By Valsalva Maneuvers) 🔹Dx Of HCM 📍1. Echo (Confirm Dx) ➡️ Thickened Asymmetrical LV Walls 📍2. Abnormal ECG Changes (Features Of LV Hypertrophy) : ▪︎L Axis Deviation ▪︎Tall R Wave ▪︎Deep S Wave ▪︎Q Wave in Lead I,II,III,aVF,V4-5-6 ▪︎Deep T wave Inversion 📍3. Genetic Test 📍4. Family Hx Of Same Condition 🔹Mx Of HCM 📍1. Relive Symptoms & Prevent Syncopal Attacks ➡️ BB/CCB/Disopyramide 📍2. Tx Of Arrhythmia ➡️ Amiodarone 📍3. Surgical Resection Of Hypertrophic Septum (Myectomy Or Septal Ablation) ➡️ Relive Symptoms Of Outflow Obstruction 📍4. For High Risk Patients Of Sudden Death ➡️ ICD (Implantable Cardiac Defibrillator) 📍5. Heart Transplantation (For Severe Cases) 📍6. Screening Of The 1st Degree Relatives
🔰Dilated Cardiomyopathy (Weak Thin Muscle) ▪︎Disorders Results in Progressive Dilatation Of The LV Or RV (Increase Ventricular Mass But With Normal Or Reduced Wall Thickness) ▪︎Eventually Results in Impairment Of LV Contraction (Systolic Dysfunction) With Mitral & Tricuspid Regurgitation 🔹Risk Factors For Dilated Cardiomyopathy 📍1. Genetic Disorders : ▪︎Autosomal Dominant Disorder ▪︎X-Linked Skeletal Muscular Dystrophy (Becker & Duchenne) 📍2. Autoimmune Reaction After Viral Myocarditis 📍3. Chronic Alcohol Consumption 📍4. HIV Infection 📍5. Hypothyroidism 📍6. Chemotherapy 🔹Clinical Features Of Dilated Cardiomyopathy 1. Asymptomatic 2. Symptoms Of Heart Failure (Systolic Dysfunction) 3. Arrhythmia & Thromboembolism 4. Chest Pain 5. Sudden Death 6. Family Hx Of The Same Condition 🔹Dx Of Dilated Cardiomyopathy 1. Echo 2. Cardiac MRI 3. ECG Changes 4. Genetic Test 🔹Mx Of Dilated Cardiomyopathy 1. Control HF & Arrhythmia 2. ICD Or Cardiac Resynchronisation Device 3. Cardiac Transplantation
🔰Restrictive Cardiomyopathy (Stiff Ventricles) ▪︎Disorder Causing Fibrosis Or Substance Accumulation inside The Myocardium Of The Ventricles ▪︎Results in High Atrial Pressure Due To Atrial Contraction Against Stiff Ventricles ▪︎Eventually Results in Diastolic Dysfunction (Impaired Ventricular Filling) ▪︎Poor Prognosis & Eventually Need Heart Transplantation 🔹Causes Of Restrictive Cardiomyopathy 📍1. Amyloidosis (Most Common) 📍2. Glycogen Storage Disorders 📍3. Idiopathic Perimyocyte Fibrosis 📍4. Genetic (Familial) 📍5. Sarcoidosis/Haemochromatosis 📍6. Malignancy 🔹Features Of Restrictive Cardiomyopathy 1. Asymptomatic 2. Symptoms Of Heart Failure (Diastolic Dysfunction) 3. Atrial Hypertrophy & Dilatation 4. Atrial Fibrillation (AF) 🔹Dx Of Restrictive Cardiomyopathy 1. Echo 2. CT/MRI 3. Endomyocardial Biopsy (Confirm Dx) 🔹Mx Of Restrictive Cardiomyopathy 1. Mx Of Heart Failure 2. Anticoagulants 3. Heart Transplantation
Continue for topic of arrhythmia.
#BBB@Clinicalinternalmedicine #Ectopic_beats #AB_Block@Clinicalinternalmedicine
🔰Sick Sinus Syndrome (SinoAtrial Disease)▪︎It's A Dysfunction in The SA Node Mostly Due To Degenerative Changes Occurs in Older People
🔹Features Of Sick Sinus Syndrome📍1. Paroxysmal Atrial Arrhythmias (Tachycardia/Flutter/Fibrillation) 📍2. Tachy-Brady Syndrome (Alternation Between Tachycardia & Bradycardia) مثل المولد العاطلة ساعة عالية وساعة ناصية 📍3. AV Block 📍4. Pause in The Rhythm (Risk Of Sudden Cardiac Arrest) 📍5. P Wave Sometime Present & Other Times Absent 📍6. Normal QRS Shape (Narrow) 📍7. Cause Symptoms (Palpitation/Syncope/Dizziness)
🔹Mx Of Sick Sinus Syndrome📍1. Acute Severe Bradycardia : ▪︎IV Atropine (0.5mg [Maximum 3mg]) ▪︎IsoPrenaline ▪︎Adrenaline ▪︎Temporary Pacemaker 📍 2. Then Do Permanent Pacemaker
🔰Atrioventricular Conduction Block (AV Block)▪︎Disease Affect AV Node Results in Delay Or Blockage Of The Electrical Signals Coming From The SA Node
🔹Clinical Features Of AV Block📍1. Recurrent Sudden Attacks Of Syncope (Stokes Adam's Attacks) 📍2. Brief Seizures With Rapid Recovery (Cerebral Ischaemia) 📍3. Pallor (Death Like Appearance When Heart Stops) Then Skin Flush (When Heart Starts Beating Again)
🔹Types Of AV Block📍1. 1st Degree Block : ▪︎Prolonged PR Interval (>200 ms [>0.2 Sec]) ▪︎Could Be Normal Due To Sleep/Athletics ▪︎Could Be Abnormal Due To Diseases Affects Conduction Systems ▪︎No Tx Needed 📍2. 2nd Degree Mobitz I (Wenckebach) Block : ▪︎Progressive Lengthening Of PR Interval Until Dropped Beat Occurs (No QRS Complex After P Wave) ▪︎Need Tx Only If Severely Symptomatic 📍3. 2nd Degree Mobitz II Block : ▪︎Intermittent Drop Beats Without Changes in PR Interval (Fixed PR interval But Some P Waves Not Conducted) ▪︎Usually Due To Disease in His-Purkinje System ▪︎Risk Of Syncope/Dizziness/Sudden Cardiac Death (Need Tx Of Course) 📍4. 3rd Degree Block : ▪︎Complete AV Block Leads To Complete Dissociation Between Atrial & Ventricular Contraction ▪︎Usually Occurs Due To Severe Anterior Or Inferior Mi Or Idiopathic ▪︎Slow Regular Rhythm (20-50/Min) But Abnormal QRS Shape ▪︎Rate Not Change With Respiration ▪︎Variable PR Interval
🔹Mx Of Heart Block📍1. Symptomatic Transient Block After MI ➡️ Atropine/IsoPrenaline/Temporary Pacemaker 📍2. 3rd Degree/Asymptomatic Mobitz II Block/Symptomatic BradyArrhythmias ➡️ Need Permanent Pacemaker
🔰Bundle Branch Block (BBB)▪︎Damage To R Or L Bundle Of Heart Results in Delayed Ventricular Contractions
🔹Features Of BBB📍1. Broad Abnormal QRS Shape 📍2. RBBB ➡️ RSR Pattern In V1-2 📍3. LBBB ➡️ M Shaped in V5-6/I/aVL
🔹Causes Of BBB📍1. RBBB : ▪︎Normal Variant ▪︎ASD ▪︎RV Hypertrophy ▪︎PS (Pulmonary Valve Stenosis) ▪︎Pulmonary Embolism ▪︎CAD (Coronary Artery Disease) 📍2. LBBB (Always Abnormal) : ▪︎Aortic Valve Disease ▪︎Hypertension ▪︎Cardiomyopathy ▪︎LV Hypertrophy ▪︎CAD (Coronary Artery Disease)
🔹Mx Of BBB ➡️ Permanent Pacemaker
🔰Atrial Ectopic Beats (ExtraSystoles/Premature Atrial Contraction)
▪︎Signal From Ectopic Focus Near The Atrial Tissue Causing Premature Atrial Contraction▪︎Usually Benign But Has Risk Of Progression into AF ▪︎Could Occurs Due To Elevated Atrial Pressure (Mitral Valve Disease Or Heart Failure)
🔹Features Of Atrial Ectopic Beats📍1. Abnormal P Shape 📍2. Premature Normal Shape QRS (Two QRS Complexes Near Each Other) 📍3. Slightly Irregular Rhythm 📍4. Could Develops Symptoms (Sensation Of Missed Beat/Strong Beat)
🔹Mx Of Atrial Ectopic Beats ➡️ Beta Blockers (BB) If Symptomatic
🔰Ventricular Ectopic Beats (Premature Ventricular Contraction)▪︎Signal From Ectopic Focus Near The Ventricular Tissue Causing Premature Ventricular Contraction ▪︎More in Old Ages & Usually Benign
🔹Features Of Ventricular Ectopic Beats📍1. Two Different QRS Complexes : ▪︎One Broad Bizarre QRS With No P Wave (From Ectopic Focus) ▪︎One Normal QRS (From SA Node) 📍2. Irregular Rhythm 📍3. More At Rest & Disappears By Exercise 📍4. Could Develops Symptoms (Irregular Heart Beat/Missed Or Strong Beat/Irregular Or Weak Pulse)
🔹Mx Of Ventricular Ectopic Beats ➡️ BB/Catheter Ablation
🔰Long QT Syndrome▪︎Acquired Or Inherited Diseases Results in QT Interval Prolongation (>470ms in Men & >480ms in Women) ▪︎Risk Of Progression into PolyMorphic VT (Torsades De Pointes)
🔹Causes Of QT Prolongation📍1. Inherited Mutations 📍2. Electrolytes Disturbances (Low Ca/K/Mg) 📍3. Drugs (TCA/Erythromycin/Methadone/Amiodarone) 📍4. Hypothermia
🔹Mx Of Long QT Syndrome1. Avoids Drugs Prolonged QT Interval 2. Implantable Cardiac Defibrillator (ICD)
🔰Torsades De Pointes (PolyMorphic VT)▪︎It's A Complication Of QT Prolongation That Results in Rapid Irregular QRS Complexes Polymorphic in The Shape (Twist Around The Baseline) ▪︎Start As Bradycardia With Long QT Interval Then Become Polymorphic VT
🔹Mx Torsades De Pointes📍1. IV Mg (1-2g Over 10-15Min) 📍2. Isoprenaline (0.5-5μg/min) 📍3. BB 📍4. Implantable Cardiac Defibrillator (ICD) 📍5. Atrial Pacing Device 📍6. Left Stellate Ganglion Block
🔰Normal Arrhythmia
🔸A. Sinus Arrhythmia▪︎It's A Change in RR Interval During Respiration Due To Change in Heart Rate (Increase HR in Inspiration/Decrease HR In Expiration) ▪︎Normal Phenomena & More Obvious in Children
🔹Causes Of Sinus Arrhythmia Disappearance1. Diabetes Neuropathy 2. Autonomic Dysfunction 3. Increased Sympathetic Activation
🔸B. Sinus Tachycardia▪︎HR >100BPM Due To Sympathetic Activation (Exercise/Emotions)
🔸C. Sinus Bradycardia▪︎HR <60BPM Due To Parasympathetic Activation (At Rest/In Athletics) ▪︎Symptomatic Bradycardia After MI ➡️ Need IV Atropine (0.6-1.2mg) ▪︎Persistence Symptomatic Bradycardia ➡️ Need Permanent Pacemaker
💎Gardner-Diamond syndrome, also known as
painful bruising syndrome or psychogenic purpura, is a rare medical condition characterized by painful, spontaneous bruises (ecchymoses) that appear on the skin, often triggered by emotional or physical stress.
Continue for topic of arrhythmia.
#AF
#SVT@Clinicalinternalmedicine SVT
🔰Supraventricular Tachycardia (SVT)▪︎Paroxysmal (Intermittent) Episodes Of Tachycardia Due To Ectopic Focus Above The Ventricular Level (Near SA Or AV Node)
🔹Common Features To All SVT📍1. Regular Rhythm 📍2. No P Wave 📍3. QRS Shape Normal Or Abnormal
🔹Types Of SVT
🔸A. AVNRT (Atroventricular Nodal Re-Entrant Tachycardia More Common)📍1. Due To Re-Entry Circuit At AV Node 📍2. No Structural Heart Disease 📍3. Regular Rhythm 📍4. Normal Shape QRS (Narrow) 📍5. Tachycardia (120-240/Min)
🔸B. AVRT (Atroventricular Re-Entrant Tachycardia)📍1. Due To Abnormal Accessory Pathway Connecting The Atria With The Ventricles (Bundle Of Kent) 📍2. Type Of The Connection : ▪︎Retrograde (From Ventricles To Atria Called Concealed Connection) ➡️ Produce Normal QRS Shape ▪︎Antigrade (From Atria To Ventricles Called Manifest Connection) ➡️ Produce Abnormal QRS Shape With Delta Waves 📍3. If Symptoms Of Tachycardia Develops (Palpitation/Syncope/Dizziness) ➡️ Called WPW (Wolff Parkinson White Syndrome) 📍4. Have Risk Of Progression To VT (Collapse/Syncope/Death)
🔹Mx Of SVT
🔸A. Hemodynamiclly UnStable ➡️ Synchronised DC Shock
🔸B. Hemodynamically Stable📍1. Vagal Maneuvers (Carotid Sinus Massage/Face Immersion in Cold Water/Valsalva) 📍2. No Response : ▪︎IV Adenosine (6mg Then 12mg Then 12m Given Rapidly Followed By Normal Saline Flush [Give Time 2-3Min Before Dose Repeat & Maximum is Only 3 Doses]) ▪︎IV Verapamil (Isoptin Given For Patients With Asthma 5 mg Over 1-2Min [Maximum Only 2 Doses]) ▪︎IV Propranolol (inderal 1 mg Over 1-2 Minutes [Maximum Only 5 Doses]) ▪︎Synchronised DC ▪︎IV Amiodarone Then Synchronised DC 📍3. Still No Response (Incessant SVT) ➡️ Only Rate Control In ER Then Catheter Ablation in Future
🔸C. WPW Mx▪︎Catheter Ablation Of The Accessory Pathway ▪︎Digoxin & CCB Contraindicated (They Increase Conduction Through The Accessory Pathology)
🔰Atrial Tachyarrhythmia
🔸A. Atrial Flutter (Regular Rhythm)▪︎Ectopic Focus in Right Atrium With Large Re-Entry Circuit Causing Very High Atrial Rate (250-300/Min) With Effective Contraction & Regular Rhythm ▪︎Usually Associated With AV Block (2:1/3:1/4:1 Conduction Ratio) يعني الاذين يعطي للبطين اشارتين او ثلاث او اربع اشارت ، بس يعبر منهن فقط اشارة وحدة
🔹Causes Of Atrial Flutter📍1. Ischemic Heart Disease 📍2. Right Atrial Dilatation (Due To Pulmonary Embolism Or Valvular Disease) 📍3. Drugs 📍4. Unknown Ateiology
🔹Features Of Atrial Flutter📍1. Normal QRS Shape (Narrow) 📍2. Regular Rhythm 📍3. No P Wave (Saw Tooth Flutter Waves Present Instead) 📍4. Carotid Sinus Pressure & Adenosine Can Reveal More Flutter Waves
🔸B. Atrial Fibrillation (AF Irregular Rhythm)▪︎Rapid Uncoordinated Atrial Contractions With Irregular Rhythm Due To Ectopic Focus At The Atria & Re-Entry Circuit ▪︎Most Common Sustained Cardiac Arrhythmia (Chronic But Have Risk Of Emergency) ▪︎More Common Than Atrial Flutter ▪︎High Risk Of Systemic Embolism & Stroke
🔹Causes Of AF📍1. Alcohol/Caffeine/Thyrotoxicosis 📍2. Rheumatic Fever & Mitral Valve Diseases 📍3. Ischemic Heart Disease 📍4. Atrial Myxoma 📍5. Pulmonary & Systemic Hypertension 📍6. Drugs & Infections 📍7. Unknown Ateiology (Lone AF)
🔹Features Of AF📍1. Normal QRS Shape (Narrow) 📍2. Irregular Rhythm 📍3. Irregularly Irregular Pusle 📍4. No P Wave (Fibrillatory Waves Present instead)
🔹Types Of AF📍1. Paroxysmal ➡️ Intermittent Self Terminate Episodes Within 7 Days 📍2. Persistent ➡️ Prolonged Episodes >7 Days Need Manual Termination 📍3. Long Standing ➡️ Continuous Episodes For >1 Year Need Manual Termination 📍4. Permanent ➡️ Long Standing Episodes Not Terminated By Any Methods (Or Decision Has Been Made To Not Do Further Termination Attempts)
🔹Mx Of AF & Atrial Flutter
🔸A. Hemodynamically UnStable ➡️ Synchronised DC Shock
🔸B. Hemodynamically Stable📍1. Give Anticoagulant (Heparin) بغض النظر عن وقت دخول المستشفى 📍2. Onset Of AF Less Than 48h :
🔻I. Do Cardioversion Using :▪︎Propafenone Or Flecanide ➡️ If No Structural Heart Disease ▪︎Amiodarone ➡️ If Structural Heart Disease Present ▪︎Synchronised DC Shock ➡️ If No Response To Drugs
🔻II. Stops Anticoagulant If No Risk Of Thrombus📍3. Onset Of AF More Than 48h Or Unknown Duration ➡️ Do Trans-EsoPhageal Echocardiography (Looking For Intra-Cardiac Thrombus) :
🔻I. No Thrombus ➡️ Do Cardioversion Then Stops Anticoagulant
🔻II. Thrombus Present▪︎Do Only Rate Control + Continue Anticoagulant For 4 Weeks ▪︎Then Do Cardioversion (Rhythm Control) After The Thrombus Disappears ▪︎Then Continue On Anticoagulant For 3Months
🔸C. Mx Of Chronic AF📍1. Rate Control : ▪︎Only Control Heart Rate Without Restoration Of Normal Sinus Rhythm ▪︎Using BB Or CCB Or Digoxin Or Combination (BB + Dilitiazem + Digoxin) 📍2. Rhythm Controls (Better) : ▪︎Restore To Normal Sinus Rhythm ▪︎Done If Patient Has : •Heart Failure •Reversible Causes Of AF •New Onset AF (<3m) •No Severe Structural Heart Disease •Young Age (<65) ▪︎Using Drugs Or DC Shock 📍3. Ablation Therapy (If No Response To Other Measures) 📍4. Anticoagulants :
🪀Indications For Anticoagulants :▪︎AF Present After 48h Or Unknown Duration ▪︎AF Due To Mitral Valve Disease ▪︎Chronic AF
🪀Types Of Anticoagulants :▪︎Factor Xa Inhibitors (Rivaroxaban/Apixaban/Edoxaban) (Anti Dot is Andexanet alpha) ▪︎Direct Thrombin Inhibitors (Dabigatran) (Anti Dot is idarucizumab) ▪︎Warfarin/Heparin
الكتاب رائع ومهم
اهم ما يمكن أن تتعلمه في الطب ال red flags or alarm bells
الكتاب فية 50 Symptom بس
لكنه ممتاز جدا ..وبيقول الـ Red flags لكل Symptom
Repost from N/a
🕊️✨ اللهم صلِّ على الحبيب المصطفى محمدٍ القائد المجاهد، والبطل المقدام، الذي علّمنا أن العزة بالجهاد وأن النصر مع الصبر. صلاةً تثبت بها أقدام المجاهدين، وتقوي بها عزائم المرابطين، وتزلزل بها عروش الظالمين. وسلم عليه وعلى آله الطاهرين، عدد ما تعاقب الليل والنهار وعدد طلقات المجاهدين في سبيلك.🕊️🍃✨
🔰Ventricular Tachyarrhythmia
🔸A. Ventricular Tachycardia (VT) & Ventricular Fibrillation (VF)
▪︎These Are TachyArrhythmia Originates From The Ventricles Usually After Extensive Ventricular Damage
▪︎VT & VF Are The Most Common Cause Of Sudden Cardiac Death Due To Arrhythmia
🔹Causes Of VT & VF
📍1. Ischemic Heart Disease (Extensive MI)
📍2. Chronic Coronary Artery Disease (CAD)
📍3. Structural Heart Disease (Cardiomyopathy)
📍4. Ventricular Aneurysm
📍5. Electrolytes Disturbances (K/Mg)
📍6. Drugs (Digoxin Toxicity)
📍7. Normal Heart VT (Abnormal Automaticity in RV Or Fascicles Of The Left Bundle Branch)
🔹DDX Of VT
📍1. SVT With Bundle Branch Block Or WPW Syndrome
📍2. IdoVentricular Rhythm After Recovery From MI (Transient & Not Require Tx)
🔹Features Of VT
📍1. Rapid Ventricular Contraction (HR >120BPM)
📍2. Broad Abnormal QRS Shape (Wide Complex Tachycardia) & No Identifbile P Wave
📍3. Regular Rhythm (Fixed R-R Intervals)
📍4. Symptomatic (Palpitation/Dyspnea/Lightheadedness) Or Asymptomatic
📍5. Patient Risk Of Haemodynamic Instability (Hypotension/Syncope/Cardiac Arrest)
📍6. Other Pathognomonic Features :
▪︎Hx Of Previous MI
▪︎AV Dissociation (Like Complete Heart Block)
▪︎Capture & Fusion Beats On ECG
▪︎Left Axis Deviation On ECG
▪︎No Response To Adenosine Or Carotid Massage
🔹Features Of VF
📍1. No QRS Complex Can Be Identified
📍2. ECG is Totally Disorganized (Chaotic VT With Very Rapid Irregular Fibrillatory Waves)
📍3. No pulse
🔸C. Pulseless VT ➡️ Wide Abnormal Shape QRS With Regular Rhythm But No Pulse
يشبه الVT بس مافيه نبض
🔸D. Ventricular Standstill ➡️ P Wave Present/No QRS/No Pulse
فيه فقط P Wave وايضا مافيه نبض
🔹Mx Of TachyArrhythmia
🔸A. VT Mx
📍1. Haemodynamically Unstable ➡️ Synchronised DC Shock + IV Amiodarone (150-300mg)
📍2. Hemodynamiclly Stable :
▪︎IV Amiodarone Or Lidocaine
▪︎Synchronised DC Shock (If No Response To Drugs)
▪︎Pacemaker (in The Right Ventricle & Set Its Rate At 15-20BPM) طريقة تحوير مال اهل الاختصاص معليكم فيها
📍3. Prevention Of Further Attacks :
▪︎Implantable Defibrillator
▪︎Catheter Ablation
▪︎Beta Blockers
🔸B. VF & Pulseless VT & Standstill Mx
📍1. CPR
📍2 Asynchronised DC (Defibrillator) Shock
🔴Cardiac Arrhythmia
▪︎Arrhythmia It's A Disturbances in The Electrical Rhythm Of The Heart That Can Occurs in Diseased Or Healthy Heart
🔷Mechanisms Of Arrhythmia
🔸A. TachyArrhythmia Due To
📍1. Increased Automaticity :
▪︎Means Increase In The Activity Of The SA Node Due To The Presence Of Ectopic Focus
موجود منطقة بالقلب فيها مجموعة خلايا غير طبيعية تنتج كهرباء وتسويلنا مشاكل
▪︎Single Activation Of SA Node ➡️ Results in Ectopic Beat
▪︎Repeated Activation Of The SA Node ➡️ Results in Ventricular Tachycardia (VT)
📍2. Re-Entry Circuit :
▪︎Most Common Cause Of TachyArrhythmia
▪︎Electrical Single Produced From Ectopic Focus & Maintained By Re-Entry Circuit Around Scarred Heart Tissue ➡️ Results in Tachyarrhythmia (Different Types Of Arrhythmia)
فيه مشكلتين ، الاولى منطقة بالقلب فيها مجموعة خلايا غير طبيعية تنتج كهرباء وتسويلنا مشاكل
والثانية فيها نسيج غير طبيعي بالقلب لمن توصلة هاذا الكهرباء راح يقويها ويخليها تلف وتدور حول نفس المنطقة لحد ما تسببلنا مشاكل
📍3. Triggered Activity :
▪︎Two Depolarisations Arise From The Cardiac Cells At The Same Time (Normally Should Be Only One)
هنا فيه مشكلة بخلايا القلب نفسها جاي تعطي كهرباء مرتين بنفس الوقت
▪︎Usually Occurs in Patients With Coronary Artery Disease (CAD)
🔸B. BradyArrhythmia Due To
📍1. Reduced Activity Of The SA Node
مشكلة بالمولدة ضعيفة
📍2. Abnormal Conduction Pathways
مشكلة بالوايرات
📍3. Abnormal AV Node
مشكلة بالتلفزيون، اصلا بيتكم هو عاطل بالأول
🔷Determine Type Of Arrhythmia
🔸A. TachyArrhythmia
📍1. Narrow QRS Complex (QRS <0.12s)
▪︎Normal Narrow QRS Shape Due To Electricity Originates Above The Ventricles (From SA Node) Then Pass To The AV Node To Activate The Ventricles
كهرباء قوية ومخربطة بس طالعة من مكانها الصحيح ، بالتالي شكل الQRS يكون طبيعي
▪︎Patient is Usually Haemodynamically Stable (Less Risk)
🪀Examples Of Narrow Complex TachyArrhythmia :
I. Atrial Fibrillation (AF Irregular Rhythm)
II. Atrial Flutter (Regular Rhythm)
III. SupraVentricular Tachycardia (SVT Can Produce Abnormal QRS Shape Due To Abnormal Pathway Connecting The Atria With Ventricles)
صح هية طالعة من مكانها الصحيح والمفروض الشكل مال الQRS يكون طبيعي ، بس مرات اكو واير زايد او توصالة غير طبيعية تخرب السالفة كلها
IV. Wolff Parkinson White Syndrome (WPW)
V. Sinus Tachycardia
📍2. Wide QRS Complex (QRS >0.12s)
▪︎Abnormally Wide QRS Complex Shape Due To Electricity Not Originates From Its Normal Pathway
▪︎Usually Originates From The Ventricle Itself
يعني الكهرباء بدل ما تجي من الاعلى (من الاذين) وبعدها تروح للبطين ، هنا لا الكهرباء تطلع مباشرة من البطين
▪︎Normal Pathway Should Be From SA Node Then To AV Node Then To The Ventricles هذا الطبيعي
▪︎In These Types Of Arrhythmia The Patient is Usually Haemodynamically Unstable (Risky)
🪀Examples Of Wide Complex TachyArrhythmia :
I. Ventricular Tachycardia (VT Regular Rhythm But Abnormal QRS Shape)
II. Ventricular Fibrillation (VF Irregular Rhythm & Abnormal QRS Shape)
III. Brugada Syndrome
IV. Long QT Syndrome
🔸B. BradyArrhythmia Examples
📍1. Sinus Bradycardia
📍2. Sick Sinus Syndrome
📍3. AV Block
📍4. Bundle Branch Block
🔷Clinical Features Of Arrhythmia
📍1. Asymptomatic
📍2. TachyArrhythmia Usually Present With Palpitation/Dizziness/Dyspnea/Chest Discomfort/Syncope
📍3. BradyArrhythmia Usually Present With Features Of Low Cardiac Output (Fatigue/Pallor/Light Headedness/Syncope)
📍4. Ectopic Beats Usually Present With Sensation Of Missed Beat Or Strong Or Irregular Beat
📍5. Cardiac Arrest & Death
موضوع الليلة بعنوان Arrhythmia
Cardiac arrhythmia
Ventricular tachyarrythmia
4-Oxford Case of Histories in Gastroentrology and Hepatology.pdf2.53 MB
