Atrioventricular block

Atrioventricular block impulses from the process of atrial spread ventricular disorders, according to their degree of block is divided into three degrees: first work degree atrioventricular block sinus impulses transmitted from atrial ventricular time extend; Ⅱ degree atrioventricular block as part of the sinus impulse can not spread to the ventricular; Ⅲ degree atrioventricular block (the complete atrioventricular publicity guide block) all can not be spread to the ventricular sinus impulse to As for the control of ventricular pacemaker to block parts of the following activities. Atrioventricular block can be temporary, permanent, the latter can also become more common. Permanent atrioventricular block more common in organic heart disease, such as rheumatic heart disease, coronary heart disease, myocarditis, digitalis or quinidine poisoning. Occasionally in the vagus nerve hypertonicity and cardiac surgery. This disease belongs to Chinese medicine “palpitations", “palpitation category.

Clinical manifestations

First-degree atrioventricular block more without symptoms, can also be weakened by the first heart sound silly now. First the Liao-degree atrioventricular conduction block ventricle string slower dizziness. Palpitations, fatigue, weakness, shortness of breath and other symptoms. Cardiac auscultation, heart rate irregular heartbeat and pulse lacuna phenomenon. Ⅲ degree atrioventricular block, the light only slow heartbeat, auscultation cardiac Slow and rules, about 30 to copies of impressions, the strength of the first heart sound ranging. Severe cases, heart palpitations, dizziness, fatigue. Chest tightness or even heartbeat pause, cause fainting or convulsions.

[Diagnosis]

1. Mainly based on the patient’s clinical manifestations, combined with the EKG to make a diagnosis.

2. ECG characteristics

0.20秒。">(1) The first work degree atrioventricular block: both QRS complex after every P wave, but pR interval> 0.20 seconds.
(2) Ⅱ degree atrioventricular block
① the Mohs J type (Wenckebach phenomenon): PR interval gradually extended, while the RR interval gradually shortened, and even the P wave QRS complex is not a descendant of ventricular shedding; ventricular lacuna pR between and restore the previous time limit, so again and again.
② Mohs type Ⅱ: PR interval is fixed, associated with irregular ventricular drain pump. Was 4:3,3:1 or 2:1, 3:1 atrioventricular block, this type of block parts below the atrioventricular junction.
(3) Ⅲ degree atrioventricular block: P-wave and QRS wave is completely divorced from the relationship, the FP distance and RR equidistant, ventricular string slow atrial strings, may be normal or widened QRS wave group shape deformity (ventricular pacing atrioventricular bundle branch below).

[Treatment]

1. Western medical treatment: first of all should be treated for the cause. The acute infection given anti-business; vagal tone is too high atropine crystal; digitalis poisoning should be immediately discontinued; myocarditis can be applied when the adrenal cortex hormones.
His bundle branch above block, more performance to one degree or Ⅱ degree type I atrioventricular block, the prognosis is good, and does not affect blood flow dynamics, such as asymptomatic, no special treatment.
Ⅱ degree type Ⅱ and Ⅲ degree atrioventricular block, ventricular string more than slow and affect hemodynamics, mainly to improve ventricular the series improve symptoms and prevention of A Sishi syndrome, drug treatment can be used isopropyl adrenaline, ephedrine, atropine crystal, glucocorticoid Caesar and other factors. The weight should consider installing artificial pacemaker.

2. Chinese medicine treatment

(1) weak heart yang, palpitations, shortness of breath, chest discomfort, dizziness, fatigue, cold extremities body cold, pale tongue white, pulse was fine and late.
    The mooring method: warm macaroni Yang.
    Recipe: 20 grams Astragalus, Codonopsis, Poria, Atractylodes, Semen, Polygalaceae, Salvia 10 grams, Guizhi, licorice 6 grams each.
(2) heart deficiency: weak waist, chest palpitations, dizziness, hold your breath, looking minimalist, chills, body tired fatigue, fat tongue moss thin, thin pulse.
    Consistent method: Warming Yang, Qi Yang Xin.
    Recipe; heterophylla, Salvia, psoralen 15 grams, 6 g system of films, of turmeric, Cyperi angelica, red peony, Ophiopogon, Schisandra 10 grams each, ginger, Zhigancao 6 grams each.