Temporary support of heart rate 65 the heart rate can

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Temporary support of heart rate 65
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The heart rate can be increased by :- Correction of electrolyte derangement Correction of inhibition of excessive vagal tone With holding of drugs with A- V nodal blocking Adjunctive pharmacotherapy :- Atropine Isoproteronol 66
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Complete Heart Block: Atrial rate 100 bpm Ventricular rate only 15 bpm! This patient needs urgent treatment with atropine / isoprenaline and pacing. 67
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Wolff-Parkinson-White Syndrome :- Incidence  0.1 to 3.0 The prevalence is higher in males and decreases with the age. Have normal hearts. Cardiac defects reported including Ebstein 's anomaly, MVP (Mitral Valve Prolapse), and cardiomyopathies. In W.P.W. syndrome an ectopic ( usually right sided ) A.V. conduction pathway is present. 68
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In WPW the accessory pathway is often referred to as the Bundle of Kent , or atrioventricular bypass tract. Location of Accessory pathway Left lateral (50%) Postero septal (30%) Right anteroseptal (10%) Right lateral (10%) Pre excitation resulting from left sided accessory is called type A pre excitation. Pre excitation resulting from right sided accessory pathway is called type B pre excitation. 69
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ECG features of WPW in sinus rhythm are PR interval <120ms Delta wave – slurring slow rise of initial portion of the QRS QRS prolongation >110ms ST Segment and T wave discordant changes – i.e. in the opposite direction to the major component of the QRS complex 70
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Type A WPW pattern with dominant R wave in V1 71
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Dominant S wave in V1 — this pattern is known as “Type B” WPW and indicates a right-sided accessory pathway. 72
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73
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Lown-Ganong-Levine syndrome:- The features of LGL syndrome are a very short PR interval with normal P waves and QRS complexes and absent delta waves. AV nodal (junctional) rhythm:- Junctional rhythms are narrow complex, regular rhythms arising from the AV node. 74
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The ST segment is the flat, isoelectric section of the ECG between the end of the S wave (the J point) and the beginning of the T wave. It represents the interval between ventricular depolarization and repolarization. ST Segment 75
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Acute myocardial infarction Coronary vasospasm (Printzmetal’s angina) Pericarditis Benign early repolarization Left bundle branch block Left ventricular hypertrophy Ventricular aneurysm Brugada syndrome Ventricular paced rhythm Raised intracranial pressure Causes of ST Segment Elevation 76
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Myocardial Infarction:- Acute STEMI may produce ST elevation with either concave, convex or obliquely straight morphology. Septal (V1-2) Anterior (V3-4) Lateral (I + aVL, V5-6) Inferior (II, III, aVF) Right ventricular (V1, V4R) Posterior (V7-9) Anterolateral STEMI 77
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Myocardial Infarction:- Acute STEMI may produce ST elevation with either concave, convex or obliquely straight morphology.
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  • Winter '16
  • jean grey
  • Cardiac electrophysiology, QRS, Rate

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