Aritmi Nedir? Aritmi Çeşitleri Nedir?What is Arrhythmias? What is types of Arrhythmias?

Aritmi Nedir? Aritmi Çeşitleri Nedir?What is Arrhythmias? What is types of Arrhythmias?

Aritmi Nedir? Aritmi Çeşitleri Nedir?

Aritmi terimi, kalbin normal döngüsünde oluşturduğu elektrik atımındaki değişimi ifade eder. Kapteki elektrik atımı çok hızlı olabilir, çok yavaş olabilir, düzensiz olabilir.

Arrhythmia-hamilyon.com

Arrhythmia-hamilyon.com

Bu da kalbin hızını yani kan pompalama hızını arttırabilir, azaltabilir ya da düzensiz bir pompalama işlemi oluşur. Eğer kalp doğru düzgün kan pompalamazsa, akciğer, beyin ve diğer organlar düzenli bir şekilde çalışmaz, ya çalışmayı durdurur, ya da zarar görür.

normal kalp atışı videodaki gibidir. Görüldüğü üzere normal kalp atışı belirli bir düzende ve hep aynı şekilde gerçekleşir.

aritmi- ventrikuler-tasikardi

aritmi-ventrikuler-fibrilasyon

aritmi-heart-block

aritmi-bradikardi

aritmi-atriyal-tasikardi

aritmi-atriyal-fibrilasyon

Aritmi Çeşitleri nelerdir?

  • Atriyal Fibrilasyon = üst kalp odacığı düzensiz bir şekilde kasılır
  • Bradikardi = yavaş kalp atımı
  • İletim bozuklukları = Kalp normal bir şekilde atmamaktadır.
  • erken kasılma = erken kalp atması
  • Taşikardi = çok hızlı kalp atımı
  • Ventriküler fibrilasyon = kalbin alt odacığının düzensiz kasılması
  • Diğer ritm bozuklukları

 

  • Çocuklarda ritm bozukluğu

Normal kalp atışı güçlüdür, kalp pompası bir yumruk atmadan biraz daha kuvvetlidir. Kapalı devre kan sistemine düzenli ve durmadan kan pompalar.

  • Her gün ortalama olarak bir insanın 100,000 kez kalbi atar (kasılma ve gevşeme), ve 3000 litre kan pompalar.
  • 70 yıllık bir insan ömründe ortalama kalp atışı 2,5 milyardan fazladır.

 

What is Arrhythmias? What is types of Arrhythmias?

 

11 Ekim 2021
Okunma
bosluk

Türk Bilim İnsanlarından Mucizevi “Biyosensör” İcadı

Türk Bilim İnsanlarından Mucizevi “Biyosensör” İcadı

Ege Üniversitesi (EÜ) bünyesinde solunum sisteminden kansere kadar birçok hastalığa yol açan nitrik oksit sentaz enziminin aktivesinin ölçülebilmesi için bir biyosensör geliştirildi.

Üniversiteden meydana getirilen yazılı açıklamada, beyin, solunum, kalp damar, mide bağırsak sistemi dahil pek oldukca sistemde ve organda muntazam çalışmadığı vakit hastalıklara neden olan nitrik oksit sentaz enziminin aktivesinin ölçülebilmesi için emek verme başlatılmış olduğu kaydedildi.

Çalışmada EÜ Eczacılık Fakültesi Prof. Dr. Mehmet Şengün Özsöz, biyomühendis uzman Zeynep Yılmaz ve Atina Üniversitesinden Prof. Dr. Andreas Papapetropoulos’un vazife almış olduğu bildirildi.

Internasyonal TÜBİTAK Projesi ile meydana getirilen ve buluş sahibinin EÜ olduğu anlatılan açıklamada, çalışmada nitrik oksit sentaz aktivesinin kullanıcı dostu ucuz ve kolay bir yöntemle ölçülebilmesini elde eden bir yöntemin bulunmuş olduğu kaydedildi.

“Ulusal patent alınmış durumda”

Açıklamada görüşlerine yer verilen Ege Üniversitesi Rektörü Prof. Dr. Necdet Budak, vücutta nitrik oksit seviyesinin artması ve azalmasının, kalp, solunum, sindirim sistemi benzer biçimde birçok hastalığa sebep bulunduğunu, ekiplerinin bu aktiviteyi belirleyen bir biyosensör geliştirdiğini belirtti.

Sensör ile nitrik oksidin azaldığı ya da arttığı durumlarda söz mevzusu hastalıklara yönelik ilaç geliştirme ve doğru tedavi şekillerinin belirlenebileceğini aktaran Budak, şu değerlendirmede bulunmuş oldu:

“Bu anlamda ulusal patent alınmış durumda, patentin ticarileşmesi için de yatırımcılara gerekseme var. Toplumumuza sıhhat anlamında ciddi bir hizmet sunmuş olacağız.” ifadelerini kullandı.

Buluşlarının iki amacı olduğuna dikkati çeken Prof. Dr. Günay Yetik Anacak da biyosensörün hem enzimin aktivitesini hem de bir sitrüllin amino asidinin düzeyini ölçtüğünü bildirdi.

Bu enzim mühim bulunduğunu bildiren Prof. Dr. Anacak, şunları kaydetti:

“Hipertansiyonda, diyabette, solunum sistemi hastalıklarında, kanserde, seksüel fonksiyon bozukluklarında, mide bağırsak hastalıklarında, bunama ve alzheimer şeklinde hastalıkların hepsinde nitrik oksit sentaz enziminin değişik tiplerinin aktivitesinin düşüklüğü ya da fazlalığı problem, eğer biz enzimin aktivitesinin azalıp azalmadığını bulabilirsek ona bakılırsa tedaviyi yönlendirebiliriz. İlaç geliştirme aşamalarında da bu oldukça mühim. Günümüzde bu enzimin aktivitesini ölçen yöntem radyoaktivite gerektiriyor. Bundan dolayı bu enzimin aktivitesini değiştirecek ilaçların geliştirilmesi kolay olmuyor. Sadece bu yöntemle ilaç keşfi ve ilaç taramaları oldukca daha kolay olabilecek.”

Prof. Dr. Pınar Kara Kadayıfçılar da buluşlarının Türkiye’de ve internasyonal anlamda ilk kez meydana getirilen bir şey bulunduğunu, bu biyosensörle piyasaya sürülebilir süratli ve oldukca ucuz çipler geliştirilebileceğini belirtti.

3 Ekim 2021
Okunma
bosluk

Kalp Hastalıkları Facebook Grubumuz kuruldu.

Kalp Hastalıkları Facebook Grubumuz kuruldu.

merhaba değerli dostlarımız. facebook grubumuz kuruldu. Artık facebook grubumuzda da doktorlarımızla direkt temasa geçebilirsiniz.

 

https://www.facebook.com/groups/465244880295270/

30 Eylül 2021
Okunma
bosluk

Taşikardi Çeşitleri nelerdir? – What isTachycardia Types?

Taşikardi Çeşitleri nelerdir? – What isTachycardia Types?

Sinus tachycardia

The body has several feedback mechanisms to maintain adequate blood flow and blood pressure. If blood pressure decreases, the heart beats faster in an attempt to raise it. This is called reflex tachycardia. This can happen in response to a decrease in blood volume (through dehydration or bleeding), or an unexpected change in blood flow. The most common cause of the latter is orthostatic hypotension (also called postural hypotension). Fever, hyperventilation and severe infections can also cause tachycardia, primarily due to increase in metabolic demands.

An increase in sympathetic nervous system stimulation causes the heart rate to increase, both by the direct action of sympathetic nerve fibers on the heart and by causing the endocrine system to release hormones such as epinephrine (adrenaline), which have a similar effect. Increased sympathetic stimulation is usually due to physical or psychological stress. This is the basis for the so-called “Fight or Flight” response, but such stimulation can also be induced by stimulants such as ephedrine, amphetamines or cocaine. Certain endocrine disorders such as pheochromocytoma can also cause epinephrine release and can result in tachycardia independent nervous system stimulation. Hyperthyroidism can also cause tachycardia.[4]

Ventricular tachycardia

Ventricular tachycardia (VT or V-tach) is a potentially life-threatening cardiac arrhythmia that originates in the ventricles. It is usually a regular, wide complex tachycardia with a rate between 120 and 250 beats per minute. Ventricular tachycardia has the potential of degrading to the more serious ventricular fibrillation. Ventricular tachycardia is a common, and often lethal, complication of a myocardial infarction (heart attack).

Exercise-induced ventricular tachycardia is a phenomenon related to sudden deaths, especially in patients with severe heart disease (ischemia, acquired valvular heart and congenital heart disease) accompanied with left ventricular dysfunction.[5]

Both of these rhythms normally last for only a few seconds to minutes (paroxysmal tachycardia), but if VT persists it is extremely dangerous, often leading to ventricular fibrillation.

Supraventricular tachycardia

This is a type tachycardia that originates from above the ventricles, such as the atria. It is sometimes known as paroxysmal atrial tachycardia (PAT). Several types of supraventricular tachycardia are known to exist.

Atrial fibrillation

Atrial fibrillation is one of the most common cardiac arrhythmias. It is generally an irregular, narrow complex rhythm. However, it may show wide QRS complexes on the ECG if a bundle branch block is present. At high rates, the QRS complex may also become wide due to the Ashman phenomenon. It may be difficult to determine the rhythm’s regularity when the rate exceeds 150 beats per minute. Depending on the patient’s health and other variables such as medications taken for rate control, atrial fibrillation may cause heart rates that span from 50 to 250 beats per minute (or even higher if an accessory pathway is present). However, new onset atrial fibrillation tends to present with rates between 100 and 150 beats per minute.

AV nodal reentrant tachycardia (AVNRT)

AV nodal reentrant tachycardia is the most common reentrant tachycardia. It is a regular narrow complex tachycardia that usually responds well to the Valsalva maneuver or the drug adenosine. However, unstable patients sometimes require synchronized cardioversion. Definitive care may include catheter ablation.

AV reentrant tachycardia

AV reentrant tachycardia (AVRT) requires an accessory pathway for its maintenance. AVRT may involve orthodromic conduction (where the impulse travels down the AV node to the ventricles and back up to the atria through the accessory pathway) or antidromic conduction (which the impulse travels down the accessory pathway and back up to the atria through the AV node). Orthodromic conduction usually results in a narrow complex tachycardia, and antidromic conduction usually results in a wide complex tachycardia that often mimics ventricular tachycardia. Most antiarrhythmics are contraindicated in the emergency treatment of AVRT, because they may paradoxically increase conduction across the accessory pathway.

Junctional tachycardia

Junctional tachycardia is an automatic tachycardia originating in the AV junction. It tends to be a regular, narrow complex tachycardia and may be a sign of digitalis toxicity.

29 Eylül 2021
Okunma
bosluk

Noninvasive | 24 Hour BP Check

Noninvasive | 24 Hour BP Check

Noninvasive | 24 Hour BP Check

It is a easy and fairly painless take a look at to watch your blood strain over 24 hours. This check is used to make the analysis of raised blood stress and to evaluate blood stress management. You can be fitted with a blood stress cuff, which is connected to a small monitor worn across the waist and your blood strain shall be recorded routinely each hour. The monitor is concerning the dimension of a Walkman. The recorder is placed on in hospital and there’s no want so that you can keep in hospital following this. The recording tools might be worn all through the day and evening and is hardly noticeable underneath the garments. You won’t be able to tub or bathe whereas the recording gear is being worn. Some people discover that the squeezing of the arm when the blood strain is taken could be disturbing throughout the night time, however most usually are not affected by this

The system might want to returned on the identical time on the next day (except you’re having the check on a Friday, once we will ask you to take away it your self on the Saturday and return it on the next Monday earlier than 12.OO midday.

The recording is analyzed on the identical day as it’s returned and the result’s out there inside 24 hours.

Cirrhotic sufferers have disturbed systemic hemodynamics with decreased arterial blood strain, however this has not been investigated throughout day by day exercise and sleep. Systolic (SBP), diastolic (DBP), and imply arterial blood strain (MAP), and heart charge (HR) had been measured by an computerized ambulant gadget for monitoring blood stress in 35 sufferers with cirrhosis and 35 wholesome matched controls. Throughout the daytime, SBP, DBP, and MAP have been considerably decrease within the sufferers than within the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P < .0001 to P < .05). The nighttime blood pressures have been virtually comparable within the two teams (108 vs. 110; 65 vs. 67; 78 vs. 82 mm Hg, NS). Conversely, HR was considerably greater within the sufferers each within the daytime (86 vs. 72/min, P < .0001) and at night time (80 vs. 64/min, P < .0001). Consequently, the discount in blood stress and HR from daytime to nighttime was considerably decrease within the sufferers than within the controls (P < .0001 to P < .01). A number of regression evaluation confirmed HR, serum albumin, serum sodium, and clotting components 2, 7, and 10 as vital unbiased predictors of SBP in cirrhosis. In conclusion, cirrhotic sufferers have elevated HR, however surprisingly regular arterial blood stress through the nighttime, and the circadian variation in blood strain and HR is diminished, most likely due to an nearly unaltered cardiac output through the 24 hours. These outcomes could replicate a significant defect within the means of optimum regulation of blood strain in cirrhotic sufferers.

29 Eylül 2021
Okunma
bosluk

Invasive | Electrophysiologic Research

Invasive | Electrophysiologic Research

 Invasive | Electrophysiologic Research

To allow profitable elimination of an irregular heart rhythm we should have the ability to deduce the place it’s coming from. So as to do that we should carry on the palpitation or a minimum of have the ability to map the place the supply is. Subsequently generally palpitation should fulfill two most important standards if they’re to be handled. They have to be sustained (nevertheless in some instances one beat will be sufficient) and it should be tolerated by the affected person for lengthy sufficient to permit sufficient time for us to search out the supply.

What Ought to I Count on?

By the point that you simply arrive on the catheter laboratory you should have already seen the consent type (it is a written settlement by you to bear the process) however a health care provider will undergo the process with you once more and ensure you have requested all of the questions you need. The textual content contained within the consent types accommodates particular details about the dangers of the procedures. After additional checks you’ll be taken via to the catheter lab and positioned on the X-ray desk.Your pores and skin can be cleaned on the websites the place we’ll introduce the tubes and coated with sterile towels to keep away from an infection. Native anaesthetic will then be infused across the websites of introduction of the tubes, normally a patch about 1cm2 on the tops of each legs).

The anaesthetic will sting because it first goes in however after this you need to really feel pushing and pulling solely and no ache. We’re additionally completely satisfied to present you sedation as and whenever you want it however sedation very barely will increase the dangers of the process and reduces our possibilities of bringing in your irregular rhythm thus making therapy unattainable. We’ll then introduce wires (electrode catheters) to the heart utilizing X-ray to information us. These wires permit us to each document the electrical exercise of the heart and stimulate the heart utilizing very small electrical currents.

When the wires are in place we then examine the hearts electrical system together with an try to convey in your signs of palpitation. We do that by recording the indicators collected by the catheters and by stimulating the heart with pacing. Many sufferers fear about us beginning the palpitations they discover their signs very distressing, however do not forget that we’re monitoring you rigorously all through and might cease any irregular rhythm every time we’ve got to.

 

This process is carried out in a cath lab, which is a specifically outfitted working room. Extra trendy cath labs comprise a video X-ray machine and enormous magnets (2-Three tesla, 2 ft. diameter) for manipulating the electrodes, along with different crucial gear.

An IV tube is usually inserted to maintain the affected person hydrated and to permit for the administration of sedatives, anesthesia, or medication.

With the intention to attain the heart with a catheter, a web site might be ready that may permit entry to the heart through an artery or vein, often within the wrist or groin. This website is then described because the insertion level.

A steel plate is positioned beneath the affected person between the shoulder blades, instantly underneath the heart. An automatic blood strain cuff is positioned on the arm, which periodically measures the affected person’s blood stress. A pulse oximeter is positioned on one of many affected person’s fingers, which steadily screens the affected person’s pulse and oxygen saturation of the blood.

The insertion level is cleanly shaved and sterilized. A neighborhood anesthetic is injected into the pores and skin to numb the insertion level. A small puncture is then made with a needle in both the femoral vein within the groin or the radial vein within the wrist, earlier than a information wire is inserted into the venous puncture. A plastic sheath (with a stiffer plastic introducer inside) is then threaded over the wire and pushed into the vein (the Seldinger method). The wire is then eliminated and the side-port of the sheath is aspirated to make sure venous blood flows again. It’s then flushed with saline. Catheters are inserted utilizing an extended information wire and moved towards the heart. As soon as in place, the information wire is then eliminated.

  • NOTE: It’s commonplace process to make use of the venous system, and place the catheter’s tip in the appropriate atrium at first of the process. The benefit of that is that the SA node is in the appropriate atrium, which is the place the place the process will begin testing the pacing system of the heart.

EP Examine

As soon as the catheter is in and all preparations are full elsewhere within the lab, the EP research begins. The 2 massive magnets are introduced in on both facet of the affected person. They’re massive and looming and can sandwich the affected person, however are capable of exactly management the place of the electrodes which are on the top of the catheters. The X-ray machine will give the physician a view of the heart and the place of the electrodes, and the magnets will enable the physician to information the electrodes by way of the heart. The magnets are managed with both a joystick or sport controller. The electrophysiologist begins by transferring the electrodes alongside the conduction pathways and alongside the inside partitions of the heart, measuring the electrical exercise alongside the best way.

The following step is pacing the heart, this implies he/she’s going to pace up or decelerate the heart by inserting the electrode at sure factors alongside the conductive pathways of the heart and actually controlling the depolarization charge of the heart. The physician will tempo every chamber of the heart one after the other, in search of any abnormalities. Then the electrophysiologist tries to impress arrhythmias and reproduce any circumstances which have resulted within the affected person’s placement within the examine. That is finished by injecting electrical present into the conductive pathways and into the endocardium at numerous locations. Final, the electrophysiologist could administer varied medication (proarrhythmic brokers) to induce arrhythmia. If the arrhythmia is reproduced by the medicine, the electrophysiologist will get hold of the supply of the irregular electrical exercise. All the process can take a number of hours.

Ablation

If at any step in the course of the EP research the electrophysiologist finds the supply of the irregular electrical exercise, he/she might attempt to ablate the cells which can be misfiring. That is accomplished utilizing high-energy radio frequencies (much like microwaves) to successfully “prepare dinner” the irregular cells. This may be painful with ache felt within the heart itself, the neck and shoulder areas.

Restoration

When the mandatory procedures are full, the catheter is eliminated. Agency strain is utilized to the location to stop bleeding. This can be executed by hand or with a mechanical gadget. Different closure strategies embrace an inside suture and plug. If the femoral artery was used, the affected person will in all probability be requested to lie flat for a number of hours (Three to six) to stop bleeding or the event of a hematoma. Attempting to sit down up and even raise the top is strongly discouraged till an satisfactory clot has fashioned. The affected person might be moved to a restoration space the place he/she can be monitored.

For sufferers who had a catheterization on the femoral artery or vein (and even a few of these with a radial insertion website), generally restoration is pretty fast, as the one harm is on the insertion website. The affected person will most likely really feel tremendous inside eight to 12 hours after the process, however might really feel a small pinch on the insertion website. After a brief interval of basic relaxation, the affected person could resume some minor exercise akin to light, quick, gradual walks after the primary 24 hours. If stairs have to be climbed, they need to be taken one step at a time and really slowly. All vigorous exercise have to be postponed till permitted by a doctor.

It is usually essential to notice that except directed by a health care provider, some sufferers ought to keep away from taking blood thinners and meals that include salicylates, resembling cranberry-containing merchandise till the clot has healed (1–2 weeks).

Issues

As with every surgical process, cardiac catheterizations include a generic record of potential problems. One of many problems which are typically reported entails some momentary nerve involvement. Typically a small quantity of swelling happens that may put stress on nerves within the space of the incision. Venous thrombosis is the most typical complication with an incidence ranging between zero.5 and a pair of.5%.[2] There have been reviews of sufferers feeling like they’ve scorching fluid like blood or urine working down their leg for as much as a month or two after the incision has healed. This often passes with time, however sufferers ought to inform their physician if they’ve these signs and in the event that they final.

Extra extreme however comparatively uncommon problems embrace: harm or trauma to a blood vessel, which might require restore; an infection from the pores and skin puncture or from the catheter itself; cardiac perforation, inflicting blood to leak into the sac across the heart and compromising the heart’s pumping motion, requiring elimination utilizing a needle below the breast bone (pericardiocentesis); hematoma on the web site(s) of the puncture(s); induction of a harmful cardiac rhythm requiring an exterior shock(s); a clot could also be dislodged, which can journey to a distant organ and impede blood stream or trigger a stroke; myocardial infarction; unanticipated reactions to the medicines used throughout the process; harm to the conduction system, requiring a everlasting pacemaker; loss of life.

25 Eylül 2021
Okunma
bosluk

Sinus tasikardisinde ekg nasil cikar

Sinus tasikardisinde ekg nasil cikar

Tipik bir sinus tasikardisi ekteki gibi olmaktadir. Sinus tasikardiniz varsa , ikinmak vb. Sekilde tasikardinizi durdurabilirsiniz. Eger bu cozum olmazsa diltizem beloc tarzi ilaclar kalbinizin atisini normale dondurecektir.  Yine donmezse damar yolundan hastane de beloc ya da diltizem verilir. Eger bu da cozum olmazsa en sonunda adenozin gerekmektedir. Adenozinin ozelligi kalbi durdurup tekrar attirabilmesidir.

Tum hastalarimiza gecmis olsun diliyoruz.
image

24 Eylül 2021
Okunma
bosluk

ATRİYAL FİBRİLASYON- ATRIAL FIBRILLATION

ATRİYAL FİBRİLASYON- ATRIAL FIBRILLATION

ATRİYAL FİBRİLASYON- ATRIAL FIBRILLATION

WHAT IS AF?

Atrial fibrillation (AF) is the commonest abnormal heart rhythm. It involves very rapid, irregular activity in the atria (the top chambers of the heart). The ventricles (the bottom, main pumping chambers of the heart) try to keep up and are therefore often fast and irregular too. AF can start and stop on its own after seconds, minutes or even hours. This is known as paroxysmal AF. Persistent AF is AF that does not stop on its own but will stop if a doctor treats it; the doctor may use medicines or a small electric shock (cardioversion). Permanent AF is AF which remains even after cardioversion.

AF

BUT WHAT ACTUALLY IS IT?

AF is a combination of two problems, a substrate (a heart that likes AF) and a trigger (rapid extra heart beats). In some patients the atria have become stretched making them more irritable. This might be because of a heart attack, heart failure, high blood pressure or valve disease, for instance. These patients may need only a few extra heart beats to start AF. For other patients, the atria are more normal but the patient has many, many more extra beats driving the heart into AF. These extra beats often come from the veins bringing blood back from the lungs in to the left atrium (the pulmonary veins). Other places in the atria can also produce these extra beats in addition. Some patients may only get AF during a particularly severe acute illness e.g. a pneumonia; these patients may not suffer AF again when well.

WHAT ARE THE PROBLEMS WITH AF?

First and foremost AF causes symptoms. AF means that the atria no longer contract well and thus the heart is somewhat less efficient. How much the patient notices this depends on the individual. It may produce symptoms such as tiredness, chest pain, breathlessness or dizziness for instance; some patients however have no symptoms.

As blood does not move well through the atria in AF it can form clots, particularly in a structure known as the left atrial appendage. These clots can leave the heart and block blood vessels producing damage, for example strokes. It is for this reason that blood-thinning drugs are so important.

Occasionally the ventricles are made to pump so fast for such a long time in AF that they can become weak – so-called tachycardiomyopathy. Heart rate control is particularly important in AF.

HOW DO WE TREAT AF?

There are many different treatments for AF. The treatment chosen will depend on whether the patient has symptoms, the condition of the patient’s heart, how long the abnormal rhythm has been present and whether it is paroxysmal or persistent. It is a complex and ever changing area and it is for this reason that it is so important to see a specialist with an expertise in this area.

Increasingly ablation is being used for selective patients with very symptomatic Atrial Fibrillation.

 

Atrial Fibrillation

WHAT IS AF?

Atrial fibrillation (AF) is the commonest abnormal heart rhythm. It involves very rapid, irregular activity in the atria (the top chambers of the heart). The ventricles (the bottom, main pumping chambers of the heart) try to keep up and are therefore often fast and irregular too. AF can start and stop on its own after seconds, minutes or even hours. This is known as paroxysmal AF. Persistent AF is AF that does not stop on its own but will stop if a doctor treats it; the doctor may use medicines or a small electric shock (cardioversion). Permanent AF is AF which remains even after cardioversion.

AF

BUT WHAT ACTUALLY IS IT?

AF is a combination of two problems, a substrate (a heart that likes AF) and a trigger (rapid extra heart beats). In some patients the atria have become stretched making them more irritable. This might be because of a heart attack, heart failure, high blood pressure or valve disease, for instance. These patients may need only a few extra heart beats to start AF. For other patients, the atria are more normal but the patient has many, many more extra beats driving the heart into AF. These extra beats often come from the veins bringing blood back from the lungs in to the left atrium (the pulmonary veins). Other places in the atria can also produce these extra beats in addition. Some patients may only get AF during a particularly severe acute illness e.g. a pneumonia; these patients may not suffer AF again when well.

WHAT ARE THE PROBLEMS WITH AF?

First and foremost AF causes symptoms. AF means that the atria no longer contract well and thus the heart is somewhat less efficient. How much the patient notices this depends on the individual. It may produce symptoms such as tiredness, chest pain, breathlessness or dizziness for instance; some patients however have no symptoms.

As blood does not move well through the atria in AF it can form clots, particularly in a structure known as the left atrial appendage. These clots can leave the heart and block blood vessels producing damage, for example strokes. It is for this reason that blood-thinning drugs are so important.

Occasionally the ventricles are made to pump so fast for such a long time in AF that they can become weak – so-called tachycardiomyopathy. Heart rate control is particularly important in AF.

HOW DO WE TREAT AF?

There are many different treatments for AF. The treatment chosen will depend on whether the patient has symptoms, the condition of the patient’s heart, how long the abnormal rhythm has been present and whether it is paroxysmal or persistent. It is a complex and ever changing area and it is for this reason that it is so important to see a specialist with an expertise in this area.

Increasingly ablation is being used for selective patients with very symptomatic Atrial Fibrillation.

23 Eylül 2021
Okunma
bosluk

Ectopic Beats

Ectopic Beats

Ectopic Beats

Key Factors:

  • Ectopic beats are early beats which are the commonest disturbance of heart rhythm.
  • They could be current with none signs, or as palpitations described as missed or additional beats, or sometimes trigger dizziness.
  • Most often reassurance is all that’s required, as they’re normally fully benign, and never a reason for heart illness.
  • Medication are not often wanted.
  • In sufferers who’ve suffered a heart attack beforehand, the presence of ectopic beats could demand extra thorough investigation to evaluate the longer term threat of extra harmful heart rhythms.

The time period ectopic beats means heart beats ‘misplaced’. It’s utilized nearly completely to early heart beats, and represents the commonest disturbance of heart rhythm. An instance of ectopic beats is proven within the ECG beneath. Ectopic beats typically happen as single beats, though might happen in pairs or be current each different beat. If three or extra happen in a row the time period non-sustained ventricular tachycardia is used.

Ectopic Beats

Determine 1

Ectopic beats are sometimes found by probability on an ECG or when performing extra extended monitoring. When ectopic beats do trigger signs, they’re usually described as ‘dropped beats’ or ‘additional beats’. Much less generally dizziness is reported.

Mostly there is no such thing as a different historical past of heart illness, and the scientific examination is regular. The ECG (aside from the ectopic beats) is often regular. In these circumstances reassurance is all that’s required, because the signs are utterly benign and the outlook for the long run is great. Generally decreasing caffeine or alcohol consumption might assist. In circumstances the place signs persist and remedy is required, a small dose of a drug comparable to a beta-blocker is commonly efficient.

On uncommon events, ectopic beats are seen in sufferers who’ve a historical past of heart illness, akin to a earlier heart attack. In these circumstances additional evaluation could also be required, reminiscent of an ultrasound scan (echocardiogram). It is because ectopic beats may be a marker of elevated threat for harmful disturbances of heart rhythm. If the exams do establish excessive danger then different remedies could also be thought-about.

 

23 Eylül 2021
Okunma
bosluk

Cardiomyopathy | Dilated

Cardiomyopathy | Dilated

 Cardiomyopathy | Dilated

Dilated cardiomyopathy (DCM) describes a weak spot of heart muscle leading to heart failure. The heart often enlarges and the weakened heart muscle results in signs similar to breathlessness, tiredness, dizziness, and in some chest ache. Some sufferers will concentrate on palpitations because of ventricular tachycardia, a quick rhythm arising from both of the 2 essential pumping chambers of the heart (ventricles). Dilated cardiomyopathy could also be secondary to viral an infection or inflammatory heart circumstances, or in some can be a genetic situation and located in different members of the family.

Cardiac investigations corresponding to echocardiography (cadiac ultrasound) are helpful to evaluate heart perform, and coronary angiography could also be required to exclude the presence of coronary illness. Some sufferers might also require a biopsy of heart muscle to determine the analysis. An electrophysiological examine (electrical examine of the heart) could also be required to evaluate the reason for palpitations. Therapy choices embrace drug remedy for heart failure, antiarrhythmic drug therapy, catheter ablation and, extra generally, implantable cardiac defibrillator (ICD) remedy. Sufferers may additionally profit from biventricular pacing.

 

19 Eylül 2021
Okunma
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SVT | AVNRT

SVT | AVNRT

SVT | AVNRT

AVNRT or Atrio-ventricular nodal re-entry tachycardia is a supraventricular tachycardia (SVT); that may be a quick heart rhythm originating from above the ventricles. It’s the commonest common SVT, occurring extra typically in ladies. It could happen in childhood however is extra typically seen in sufferers of their twenties and thirties. It produces a sensation of quick, common palpitations which normally begin and cease all of a sudden. In some folks there could also be a transparent precipitant, resembling nervousness, caffeine, alcohol and many others. nevertheless that is certainly not at all times the case. Once in a while sufferers can also discover chest tightness, breathlessness or dizziness. After the palpitations go off some sufferers could really feel relatively torpid or could have to go urine.

Within the heart the sinus node drives the heart price. Electrical energy spreads to the atrioventricular (AV) node after which into the ventricles. Electrical energy reaches the AV node by two pathways, a quick one from above and a slower one from under. In many individuals (about 80%) there’s little or no distinction between these two pathways. Nevertheless in about 20% the pathways conduct at speeds totally different sufficient to be detected at an electrical research; a sluggish pathway and a quick pathway are seen. In a small proportion of those individuals the speeds are completely different sufficient to permit a circuit to be fashioned in sure circumstances the place electrical energy spreads down the sluggish pathway and again up the quick pathway, producing signs.

It’s attainable to cease the tachycardia when it’s working by slowing conduction although the AV node; some sufferers discover they’ll do that by consuming a chilly glass of water, breath holding, straining and so forth. In Accident and Emergency we will cease it with varied injections (adenosine, beta-blockers or verapamil for example) which additionally sluggish conduction. Some sufferers carry round medicines which may be taken at first of the palpitations to scale back their size, though this takes no less than about half an hour to work.

Determine 1

figure 3

Determine 2

The frequency of assaults might be lowered, typically considerably, by medicines taken in the long run; this in fact could should be a lifelong enterprise. Avoiding precipitants, reminiscent of smoking, alcohol and caffeine may cut back the frequency of assaults.

It’s potential to burn away (ablate) AVNRT in most individuals resulting in a everlasting treatment (see part on ablation). This, like some other ablation, includes passing a catheter whose finish will be heated into the heart, often through a vein on the high of the leg. The additional AV nodal (gradual) pathway is then positioned and burnt away. Normally AVNRT may be cured on the first try in 90-95% of individuals. If it returns, extra makes an attempt might be made. As with all different invasive process there are dangers though these are small. Happily problems solely happen in about 1% of sufferers. An important danger is that of damaging the AV node itself. On this state of affairs electrical energy can’t unfold kind the atria to the ventricles and the affected person requires a pacemaker. Though this isn’t preferrred, particularly in an adolescent, it’s on no account ‘the tip of the world’. Different dangers, damaging the vein on the prime of the leg via which the catheters are handed, blood leaks across the heart and so forth. are extraordinarily uncommon.

After the ablation sufferers have to lie flat for a number of hours to let the holes within the veins shut up. Usually sufferers shall be watched in a single day and if an ECG is ok the next day, discharged. Some sufferers discover occasional skips and jumps within the heart or a barely quicker pulse for the primary few weeks after the process, nevertheless these all the time settle.

 

 

18 Eylül 2021
Okunma
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KALP YETMEZLİĞİ- HEART FAILURE

KALP YETMEZLİĞİ- HEART FAILURE

Coronary heart Failure

What’s Coronary heart Failure?

This can be a situation primarily based on a deterioration within the skill of the heart to pump blood across the physique. It’s a progressive dysfunction affecting many organs and methods within the physique. A syndrome, arising from the lack of the heart to keep up an output to fulfill the wants of a person, at relaxation or at train. It’s characterised by a limitation in train capability with signs of breathlessness and fatigue.

It’s a frequent drawback affecting 1.5-2.zero% of the inhabitants and will increase with age, such that it impacts 6-10% of these aged 65-74 years. It will probably shorten life and locations limitations on bodily exercise and high quality of life. It’s chargeable for as much as 5% of all hospital admissions within the over 65 age group. It’s an growing downside within the Western world as extra individuals survive heart assaults and the inhabitants ages.

Causes

Within the developed world nearly all of sufferers with heart failure have issues with the blood provide to the heart or coronary artery illness. They’ve usually misplaced the perform of segments of the heart as a consequence of heart assaults or myocardial infarcts and therefore have an effect on its capacity to pump. Different causes embrace:

  1. Excessive Blood Strain
  2. Valvular Coronary heart Illness
  3. Toxins like alcohol
  4. Virus infections
  5. Metabolic illnesses like thyroid illness
  6. Inherited or Congenital
  7. Idiopathic (no trigger discovered)

The ultimate widespread pathway is similar with impaired pump perform of the heart and is generally resulting from impaired contraction (systolic perform) of the heart though, issues with rest (diastolic perform) are additionally recognised.

Indicators and Signs

Breathlessness

This is without doubt one of the essential signs with shortness of breath on exertion and a decreased train capability. This often represents fluid on the lungs (pulmonary oedema). It could possibly additionally happen when mendacity flat (orthopnoea) otherwise you will be woken from sleep with breathlessness (paroxysmal nocturnal dyspnoea)

Fatigue

Common tiredness or sluggishness is a standard characteristic and represents numerous organs and tissues just like the skeletal muscle not getting sufficient oxygen as a result of heart’s failure to pump blood across the physique adequately.

Ankle or leg swelling

This represents fluid retention as a compensatory mechanism by the physique to attempt to enhance the pumping perform of the heart. It’s usually handled with water tablets or diuretics.

Weight achieve or weight reduction

With ankle swelling there’s usually a achieve in weight because the physique retains fluid and common weighing is an effective manner of monitoring fluid standing. Within the absence of fluid retention sufferers can shed pounds and specifically muscle mass. That is because of the persistent poor blood provide to the physique musculature from the failing heart however tends to be a late function of heart failure.

Lack of urge for food

Swelling of the intestine because of fluid retention may cause bloating and a lack of urge for food however will also be associated to medicine.

Chest ache or angina

A decent heavy feeling within the centre of the chest radiating to the neck and jaw and down the left arm, notably if it happens with train can signify narrowing within the coronary arteries. That is the most typical reason behind heart failure notably if there was a heart attack up to now.

Palpitations

Sufferers typically expertise palpitations or an consciousness of an irregular heart beat. A couple of third of sufferers will develop an irregular heart rhythm or atrial fibrillation (see atrial fibrillation hyperlink)

How is Coronary heart Failure identified?

Preliminary evaluation is predicated on signs of breathlessness significantly if ankle swelling is current.

Investigations embody:

  1. ECG – This appears on the electrical exercise of the heart and should present proof of earlier heart assaults or an irregular heart rhythm
  2. CHEST X-RAY – This could present if the heart was enlarged and if there may be any fluid within the lungs
  3. ECHOCARDIOGRAM – That is an ultrasound scan of the heart that entails bouncing excessive frequency sounds waves off the heart to create a picture. That is the primary check for diagnosing heart failure. It seems to be on the measurement of the heart in addition to wall movement and the operate of the heart valves.
  4. AMBULATORY ECG MONITOR – This can be required examine palpitations and search for irregular heart rhythms. It’s also used to search for the extra harmful ventricular arrhythmias which can require evaluation for ICD (hyperlink) insertion.
  5. CARDIAC CATHETERISATION – That is an invasive check used to evaluate the state of the coronary arteries and in addition the importance of heart valve issues.
  6. CARDIAC MAGNETIC RESONANCE IMAGING (MRI) – This non-invasive take a look at makes use of sturdy magnetic fields to acquire an in depth picture of the heart It’s helpful when good pictures cannot be obtained by echocardiography.

 

 

17 Eylül 2021
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SVT | Wolff Parkinson White-Taşikardi

SVT | Wolff Parkinson White-Taşikardi

SVT | Wolff Parkinson White

Key factors:

  • The Wolff-Parkinson-White syndrome (WPW) is a situation by which sufferers are born with an additional electrical connection inside the heart which causes palpitations
  • The presence of this irregular pathway can typically be detected on a routine ECG
  • Hardly ever harmful disturbances of heart rhythm happen, and really not often sufferers with this situation could die all of the sudden
  • A cauterising process (ablation) is extremely efficient in curing most sufferers with this situation

Introduction

Regular heart exercise and heart exercise in sufferers with WPW.

Waves of electrical energy stream throughout and down the heart in an ordered vogue, and are chargeable for beating of the heart. The highest chambers of the heart, the atria, function priming chambers for the principle pumping chambers, the ventricles. Sufferers with WPW are born with a further electrical connection (accent pathway) between the atria and ventricles. This connection, which in actual fact is a really small muscle fibre, might lie on both the left or proper facet of the heart. Generally it lies near the conventional electrical pathways of the heart.

Determine 1 exhibits an ECG from a affected person with Wolff Parkinson White (WPW).

Determine 2 reveals a typical electrical circuit that trigger palpitations in sufferers with Wolff Parkinson White (WPW).

figure 3

Determine 1

supraventricular-tachycardia

supraventricular tachycardia

Determine 2

Signs

The most common symptom is palpitations (an consciousness of a speedy heartbeat). Generally sufferers expertise shortness of breath, dizziness or delicate chest discomfort throughout assaults. In a really small variety of sufferers very quick palpitations might happen, leading to extreme dizziness or perhaps a blackout. Sudden demise is a tragic however well-recognised complication of this situation that happens very hardly ever.

Investigations

It is very important carry out an ECG in all sufferers with palpitations, and in sufferers with WPW, the ECG normally provides the analysis. Often the analysis isn’t sure, and additional investigations are required.

Though 24 hour or longer intervals of monitoring could also be carried out, that is typically not required in sufferers with WPW. Most arrhythmia docs agree that ablation is the very best therapy, even when the heart rhythm on the time of signs has not been documented.

It’s usually fascinating to carry out an ultrasound scan of the heart (echocardiogram) to verify that there are not any abnormalities of the pumping chambers or heart valves.

The last word diagnostic take a look at, if the ECG findings should not clear-cut, is to carry out an electrophysiologic research (EPS) by inserting skinny wires into the heart by means of a vein on the prime of the leg. That is normally carried out instantly previous to endeavor a radiofrequency ablation.

Remedy

As very hardly ever harmful heart rhythms might happen in sufferers with WPW, most electrophysiologists advocate remedy. While medication might usually management palpitations, ablation offers a treatment for almost all of sufferers and is the widely advisable remedy. Please see the part on catheter ablation see catheter ablation part.

 

 

16 Eylül 2021
Okunma
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Koroner Arter Hastalığı Nedir?

Koroner Arter Hastalığı Nedir?

 

Koroner Arter Hastalığı

Koroner arter hastalığı nedir?

Koroner arter hastalığında, kalbin yüzeyindeki kalp kasına lüzumlu oksijen ve gıda maddelerini taşıyan damarlar (arterler) etkilenir.
Yaşlılık ve öteki birçok unsur, yumuşak ve esnek olan bu damarların sertleşmesine niçin olur. Bunlar zaman içinde damar içine doğru büyür ve “plak” adını alırlar. Yeteri kadar büyümüş olan bu plaklar zaman içinde koroner arter kan akımını engeller. Ek olarak plaklar düz ve pütürsüz olan damar yüzeyini bozup, pürüzlü bir hal almasına niçin olurlar. Bu pürüzlü yüzeyler pıhtı oluşumuna; bu pıhtılar ise zaman içinde kan akımını tamamen engelleyip ansızın damarın tıkanmasına niçin olabilir.

Coronary_arteries-hamilyon-koroner-arter-nedir

Coronary_arteries-hamilyon-koroner-arter-nedir

Koroner arter hastalığının tesirleri nedir?

Koroner arter hastalığında daralmış olan koroner arterlerde kalp kasına gelen kan miktarı azalır. Bitkinlik, göğüste gerginlik, bası hissi, yanma, çoğu zaman sol kola vuran ağrı, çeneye doğru yayılan ağrı şeklinde şikayetler, azalmış olan kan akımının göstergeleridir. Egzersiz ve stres benzer biçimde kalbin kan ihtiyacını arttıran durumlar bu şikayetleri başlatabilir ve dinlenildiğinde çoğu zaman geçer.
Eğer koroner arter ansızın tıkanır ise, kalbin o bölgesine kan akımı tamamen kesilir. Bu durumda bir miktar kalp kası kalıcı olarak zarara uğrar. Bu durum çoğunlukla geçmeyip uzun süre devam eden göğüs ağrısı ile beraber olur ve miyokard enfarktüsü yada kalp krizi olarak adlandırılır. Enfarktüste kalp kası, skar dokusu isminde olan ve kasılma kabiliyeti olmayan bir doku şeklinde iyileşir. Eğer skar dokusu minik ise iyileşme acele olur; geniş ise kalbin kanı pompalama kabiliyeti etkilenir, kalbin emek verme gücü azalır.

Koroner arterlerdeki daralmayı gidermek için ne yapmak gerekir?

Koroner arterlerde daralmaya yol açan plaklar çoğu zaman arterin belli bir bölgesinde bulunur. Daralmış kısmın ilerisinde çoğu zaman damar çapı normaldir. Koroner arter hastalığı bir yada iki damarı kapsıyor ise, darlık cerrahi işlem gerektirmeden genişletme ile açılabilir. Bu da minik bir balon yardımı ile gerçekleştirilir. Bu işlemin adı balon anjioplasti (PTCA)’ dir. Eğer koroner arter hastalığı birçok damarı kapsıyor ve karışık ise, koroner arter by-pass cerrahisi gerekir. Bu ameliyatla, daralmış damarlara kan elde eden yeni damarlar eklenmiş olur.

Kapak Hastalıkları

Kalpte 4 tane kapak bulunur. Yaşamın herhangi bir döneminde, çeşitli sebeplere bağlı olarak, bu kapakların bir yada birden fazlasında problem çıkabilir. Bu hastalığın sebepleri ise doğumsal yada kalıtsal olabilir. En fazla etkilenen kapaklar aort ve mitral kapaktır. Sadece üçüncü olarak triküspit kapak da etkilenerek problem çıkarabilir. Kapakla ilgili hastalık, kapağın daralması sonucu kan akımının azalması yada yetmezliği sonucu kanın geriye kaçması durumudur. Darlık yada yetmezlik tek tek görülebileceği benzer biçimde, her ikisi birden de meydana gelebilir.

Kalp kapaklarında görülen bu hastalık kalbin yükünü daha çok arttıracağı için, uzun sürmesi halinde kalbin yapısında geri dönüşü zor bozukluklara niçin olabilir.

Damar Hastalıkları

 

 

Coronary_arteries-hamilyon-koroner-arter-nedir1

Coronary_arteries-hamilyon-koroner-arter-nedir1

Anevrizma

 

Anevrizma, büyük damarların balonlaşması anlamına gelmektedir ve yaşamsal tehdit oluşturur. Bu balonlaşma derhal kalp çıkımında (göğüs boşluğunda) olabildiği şeklinde, karın boşluğunda da olabilir. 4 santimetre.’nin üzerindeyse kesinlikle ameliyat edilmelidir.

Karotis

Beyni besleyen boyun damarlarındaki darlık anlamına gelen karotis hastalığı; kalp hastalarında çoğunlukla görülmektedir. Bu damarlar elde uyuşma, baş dönmesi, nüzul, hatta ölüme yol açabilir. Kalp ameliyatı olacak her hasta ameliyat öncesinde bu yönden denetim edilmekte ve gerekirse ameliyat edilmektedir.

Ateroskleroz (Bacak damarlarında tıkanıklık)

Sistemik bir hastalık olan ateroskleroz (damar tıkanıklığı), koroner damarları olduğu şeklinde bacak damarlarını da etkileyerek ağrı, adım atma güçlüğü benzer biçimde şikayetlere yol açabilir. Eğer hastanın adım atma mesafesi 50 metrenin altına düşmüş ise, periferik by-pass adında olan cerrahi girişim uygulanmalıdır.

Ritim Bozuklukları (Atriyal Fibrilasyon)

Kalbimiz dört odacığa bölünmüştür. Üstten alta doğru bölündüğünde, kalbimizin iki yarısından her birindeki odacıklar, üst (atriyum – kulakçık) ve alt odalar (ventikül – karıncık) olacak şekilde iki bitişik pompa oluştururlar. Tek bir kalp atışı esnasında pompalar iki aşamalı bir devirde işlerler. Ilkin, daha minik atryumlar (kulakçıklar) kasılır ve gevşemiş ventrikülleri kanla doldurur. Yarım saniye sonrasında, güçlü ventriküller (karıncıklar) kasılır ve atriyumlar gevşeyip dolarken, kanı vücut dolaşımına verirler. Etkili kan dolaşımı için bu çekme ve pompalama sisteminin ritmik uyum içinde emek vermesi gerekir. Buna ek olarak etkili bir kan dolaşımı için vücut dinlenmedeyken düzgüsel bir kalpte dakikada 60 ile 100 atış olan muntazam bir kalp hızı kontolüne gerekseme vardır. Bu iki faktörün düzenlenmesi kalbin elektriksel sistemi tarafınca oluşturulur. Her kalp atışı normalde sinüs düğümleri denilen özelleşmiş bir grup hücreden oluşur. Üst sağ atriyumda yer edinen sinüs düğümü kalbinizin organik kalp pilidir (pacemaker). Kalp atışlarını başlatan elektriksel ikazları kendiliğinden üretme kabiliyeti vardır. Düzgüsel kalp ritmi “sinüs ritmi” diye adlandırılır.

Kalp aritmileri kalbin elektriksel sisteminde kusurlar oluşmasının herhangi bir aşamasında oluşabilir. Aritmileri nereden kaynaklandıklarına (atriyumlar yada ventriküller) yada sebep oldukları kalp atış hızına bağlı olarak sınıflandırırız. Taşikardi – dakikada 100 atıştan daha çok – süratli kalp atışına karşılık gelir. Barikardi yavaş – dinlenmede dakikada 60 atıştan daha azca – kalp atışına karşılık gelir. Her taşikardi yada barikardi bir hastalığı belirtmez. Örnek olarak bir egzersiz esnasında kalp dokulara oksijence varlıklı kan sağlamak için hızını arttırırken sinüs taşikardisi oluşturması normaldir. Atletlerin kalpleri oldukça verimli çalıştığından kalp atışları dinlenmede dakikada 60 atışın altındadır.

Atriyal fibrilasyon, atriyum odacıklarının süratli ve düzensiz atışıdır ve en yaygın görülen aritmidir. Atriyal fibrilasyon oluşma riski başlıca 65’ten sonrasında yaşlandıkça kalbinizin işlevlerini etkileyebilecek düzgüsel aşınma ve eskimeye bağlı olarak artış gösterir. Atriyal fibrilasyon esnasında atriyumların elektriksel faaliyeti uyumsuz hale gelir. Atriyumlar o denli süratli çarpar ki, – dakikada 300 ile 400 atışa ulaşacak kadar süratli – titremeye başlarlar (fibrilasyon). Elektriksel dalgalarda da, sakin bir gölete bir avuç çakıl taşı attığınızda oluşan durum benzer biçimde aynı düzensiz etkinlik vardır. Kalbin kulakçıklarındaki elektrik karmaşası, karıncıkların da düzensiz çalışmasına neden olur. Bundan dolayı nabız kimi zaman süratli, kimi zaman yavaş, bazı atımlarda dolgun, bazı atımlarda da zayıftır.

Atriyal fibrilasyon klinikte en sık karşılaşılan ritim bozukluklarındandır. Romatizmal kalp hastalığı, hipertansiyon, kalp yetersizliği benzer biçimde yapısal kalp hastalıkları atriyal fibrilasyon gelişimi için mühim birer risk faktörüdür. Atriyal fibrilasyon yaşam standardını düşüren semptomlarının yanı sıra, sistemik emboli, hemodinamik bozukluk, taşikardiye bağlı miyopati şeklinde komplikasyonlara yol açmaktadır.


Atriyal fibrilasyonlu hastalarda sinüs ritminin sağlanmasının üç yolu vardır:

 

  1. İlaç tedavisiyle; Bir grup ilaçlar bilhassa yeni atriyal fibrilasyona girmiş hastalarda sinüs ritminin yine temininde başarılıdır. Başarı oranı AF süresinin uzunluğuyla ve birlikte rol alan ek bir kalp rahatsızlığının varlığıyla azalır.
  2. Anjiyografik yollarla; kalpte belli ileti yollarının anjioda “kateter ablasyon” denilen bir yöntemle etkisiz hale getirilmesi ve erken yakalanmış AF olgularında bilhassa birlikte rol alan başka bir kalp hastalığı yoksa denenebilir.
  3. Ameliyatla; ritim bozukluğuna neden olan kalp ileti sistemi etkisiz hale getirilerek düzgüsel sinüs ritmi tesis edilir.

 

13 Eylül 2021
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What is Cardiomyopathy | Hypertrophic

What is Cardiomyopathy | Hypertrophic

What is Cardiomyopathy | Hypertrophic

Hypertrophic cardiomyopathy (HCM) describes a thickening of heart muscle, generally leading to obstruction to the emptying of blood from the heart. This in flip results in dizziness, breathlessness, chest ache and on events fainting, significantly throughout or simply after train. Some sufferers can even pay attention to palpitations as a consequence of an adjunct pathway (see Wolff Parkinson White Syndrome) or ventricular tachycardia, a quick rhythm arising from both of the 2 major pumping chambers of the heart (ventricles). Hypertrophic cardiomyopathy is a genetic situation, and due to this fact generally present in different relations.

Cardiac investigations resembling an ECG and echocardiography (cardiac ultrasound) are often diagnostic, however coronary angiography could also be required to exclude the presence of coronary illness. Some sufferers may additionally require a biopsy of heart muscle to ascertain the prognosis. An electrophysiological research (electrical examine of the heart) could also be required to evaluate the reason for palpitations and set up the placement of an adjunct pathway in these with Wolff Parkinson White syndrome to facilitate catheter ablation. Remedy choices embrace drug remedy to scale back the obstruction to heart emptying, antiarrhythmic drug remedy, catheter ablation of an adjunct pathway, and an implantable cardiac defibrillator (ICD) for these liable to sudden cardiac demise.

 

13 Eylül 2021
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Invasive | Implantable Loop Recorder

Invasive | Implantable Loop Recorder

 

 Invasive | Implantable Loop Recorder

Generally sufferers current with rare however extreme signs which may be brought on by an arrhythmia. If preliminary investigations fail to disclose the trigger, it isn’t doable to determine the most effective therapy. In these circumstances it’s typically fascinating to attempt to file the heart rhythm on the time of any additional episode, not understanding when this may occasionally happen. One method to obtain that is to implant a small recording machine underneath native anaesthetic beneath the pores and skin on the entrance of the chest. That is referred to as an implantable loop recorder, and in contrast to a pacemaker, no wires are wanted. This ingenious machine which has a battery life of roughly 15 months robotically data and shops very quick and gradual heart beats. As well as, by inserting a small magnet over the system throughout or inside a couple of minutes after the occasion, the machine might be triggered to file the episode. By interrogating the machine (like checking a pacemaker), the heart rhythm on the time of the episode might be seen, and a prognosis made. The system can then be eliminated and the right remedy given.

 

Syncope, outlined because the transient lack of consciousness with spontaneous restoration, is a typical medical grievance encountered in medical apply.

Present estimates present that syncope accounts for three.5% of all emergency room visits and between 1% and 6% of all hospital admissions.1–four Roughly 30% of individuals will expertise syncope no less than as soon as throughout their lifetime. There are three intervals of life when syncope is extra frequent: the primary of those is seen in toddlers the place pallid breath-holding and reflex anoxic seizures are the principal causes. A second peak is seen throughout adolescence and younger maturity, when neurocardiogenic syncope is commonest. The final peak happens within the sixth and seventh a long time of life, when arrhythmias (from natural or degenerative heart illness) and orthostatis predominate.1–three

Though scientific historical past and examination mixed with laboratory testing are ample in acquiring a prognosis in lots of sufferers, there are nonetheless some who expertise rare cardiac arrhythmias which can be elusive in nature and tough to detect. In these people, extended ambulatory monitoring with exterior (and extra lately implanted) electrocardiographic recorders have been of nice profit.

Utilizing a standardized, stepwise method to sufferers with recurrent syncope admitted to the emergency division has been demonstrated to considerably improve diagnostic yields.5–eight Apparently, these research confirmed that invasive testing measures added little to establishing a prognosis. Nonetheless, regardless of ample scientific analysis mixed with non-invasive testing, the analysis of syncope could also be unclear in a big proportion of sufferers. By permitting for extended electrocardiographic monitoring, implantable loop recorders (ILRs) can present a extra sure correlation between a affected person’s signs and documented abnormalities in heart rhythm. By comparability, conventional strategies of monitoring, corresponding to Holter monitor or an exterior loop recorder, are hardly ever efficient in capturing these fleeting arrhythmic occasions, due to both insufficient period of monitoring or failure of the affected person to appropriately activate the gadget. Against this, the ILR not solely permits for extended monitoring (as much as three years) however it additionally has the flexibility to auto-activate when an arrhythmia is current, permitting episodes to be captured unbiased of affected person activation of the gadget. The storage functionality of ILRs is restricted (e.g. 42 minutes Reveal DX) with older information being changed as newer recordings are saved. This might at instances lead to lack of vital knowledge until the machine is incessantly interrogated which might be made potential with out frequent workplace visits by the distant monitoring function obtainable with present ILR’s.

The implantable loop recorders

There are two ILRs out there available on the market. These embody the Reveal DX and XT by Medtronic (Minneapolis, MN) and the Affirm by St. Jude Medical (St. Paul, MN) . A 3rd gadget, the Sleuth by Transoma (St. Paul, MN), had been obtainable however is now not made. The Reveal XT and DX are small, rectangular units that measure 62×19×eight mm and weigh 17 g. A pair of built-in sensing leads situated on the shell of the machine permits for recording of a single lead bipolar electrogram, which may be downloaded through radiofrequency with a particular programmer. The gadget is often implanted into the subcutaneous tissue within the left pectoral space underneath native anesthesia. As famous earlier than, present units have an estimated battery lifetime of 36 months. The Reveal XT contains an algorithm for atrial tachycardia and atrial fibrillation detection based mostly on irregularities in RR intervals.

12 Eylül 2021
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ATRİYAL DÜZENSİZ KALP ATIMI- ATRİYAL FLUTTER

ATRİYAL DÜZENSİZ KALP ATIMI- ATRİYAL FLUTTER

 

 

 

ATRİYAL DÜZENSİZ KALP ATIMI- ATRİYAL FLUTTER

Typical Atrial Flutter

Key points

  • Atrial flutter is a specific supraventricular arrhythmia commonly seen in middle aged and elderly patients
  • It often occurs in patients with heart failure or high blood pressure
  • A small increased risk of stroke is associated with this arrhythmia and blood thinning is often recommended
  • Control with drugs alone is often ineffective, and recurrent symptoms are common
  • Curative ablation is possible in nearly all patients, although atrial fibrillation, a common related arrhythmia, is often seen following ablation

Introduction

Atrial flutter is a special type of supraventricular arrhythmia. It arises from the upper chamber on the right side of the heart, the right atrium. Electricity circulates around this chamber at a rapid rate and drives the main pumping chambers (ventricles) at a fast rate, often 100 to 150 beats per minute. The diagram above demonstrates the typical electrical circuit in atrial flutter.

Symptoms

Patients with atrial flutter often complain of tiredness or shortness of breath on exercise. The arrhythmia is often persistent and does not start and stop spontaneously like other supraventricular arrhythmias. Whilst palpitations may be experienced they are often not prominent.

Investigations

This usually includes, in addition to an ECG, a chest X-ray and an ultrasound scan (echocardiogram). More detailed investigations including an angiogram to look at the blood supply of the heart may be carried out. An ECG showing atrial flutter is shown. In addition routine blood tests are taken, including a test for thyroid function, as an overactive thyroid can precipitate this arrhythmia.

Treatments

The elements of treatment often include:

  1. Avoidance of excess caffeine and particularly alcohol
  2. Drugs to slow the heart rate. Drugs used for this might include beta blocking agents, calcium antagonists or digoxin
  3. Blood thinning agents, typically warfarin, to protect against blood clots and stroke
  4. Cardioversion. This involves the delivery of an electric shock across the heart to restore a normal rhythm. It is carried out under a brief general anaesthetic and is usually effective in the short term. Atrial flutter has a tendency to recur however
  5. More powerful drugs designed to prevent recurrences of the arrhythmia. They are effective in some patients, although one of the drugs often used, amiodarone, may have side effects limiting its use
  6. Radiofrequency ablation is effective at eliminating the arrhythmia in at least 90% of cases. The procedure is carried out in a very similar way to the ablation of other supraventricular arrhythmias (see ablation section). The main risk in having this procedure is an approximately 1% risk that slow heart beats may result, requiring treatment with a permanent pacemaker. Many patients with atrial flutter also experience a related arrhythmia called atrial fibrillation. Unlike atrial flutter, fibrillation arises from the left atrium. It is a more complex arrhythmia than atrial flutter (see atrial fibrillation section).

 

Atrial Flutter -ENGLISH VERSION

Typical Atrial Flutter

Key points

  • Atrial flutter is a specific supraventricular arrhythmia commonly seen in middle aged and elderly patients
  • It often occurs in patients with heart failure or high blood pressure
  • A small increased risk of stroke is associated with this arrhythmia and blood thinning is often recommended
  • Control with drugs alone is often ineffective, and recurrent symptoms are common
  • Curative ablation is possible in nearly all patients, although atrial fibrillation, a common related arrhythmia, is often seen following ablation

Introduction

Atrial flutter is a special type of supraventricular arrhythmia. It arises from the upper chamber on the right side of the heart, the right atrium. Electricity circulates around this chamber at a rapid rate and drives the main pumping chambers (ventricles) at a fast rate, often 100 to 150 beats per minute. The diagram above demonstrates the typical electrical circuit in atrial flutter.

Symptoms

Patients with atrial flutter often complain of tiredness or shortness of breath on exercise. The arrhythmia is often persistent and does not start and stop spontaneously like other supraventricular arrhythmias. Whilst palpitations may be experienced they are often not prominent.

Investigations

This usually includes, in addition to an ECG, a chest X-ray and an ultrasound scan (echocardiogram). More detailed investigations including an angiogram to look at the blood supply of the heart may be carried out. An ECG showing atrial flutter is shown. In addition routine blood tests are taken, including a test for thyroid function, as an overactive thyroid can precipitate this arrhythmia.

Treatments

The elements of treatment often include:

  1. Avoidance of excess caffeine and particularly alcohol
  2. Drugs to slow the heart rate. Drugs used for this might include beta blocking agents, calcium antagonists or digoxin
  3. Blood thinning agents, typically warfarin, to protect against blood clots and stroke
  4. Cardioversion. This involves the delivery of an electric shock across the heart to restore a normal rhythm. It is carried out under a brief general anaesthetic and is usually effective in the short term. Atrial flutter has a tendency to recur however
  5. More powerful drugs designed to prevent recurrences of the arrhythmia. They are effective in some patients, although one of the drugs often used, amiodarone, may have side effects limiting its use
  6. Radiofrequency ablation is effective at eliminating the arrhythmia in at least 90% of cases. The procedure is carried out in a very similar way to the ablation of other supraventricular arrhythmias (see ablation section). The main risk in having this procedure is an approximately 1% risk that slow heart beats may result, requiring treatment with a permanent pacemaker. Many patients with atrial flutter also experience a related arrhythmia called atrial fibrillation. Unlike atrial flutter, fibrillation arises from the left atrium. It is a more complex arrhythmia than atrial flutter (see atrial fibrillation section).
10 Eylül 2021
Okunma
bosluk

NEFES DARLIĞI NEDİR?- WHAT İS SHORTNESS OF BREATH?

NEFES DARLIĞI NEDİR?- WHAT İS SHORTNESS OF BREATH?

Nefes darlığı nedir?

Nefes darlığı genel ve hoş olmayan belirtidir ve bir azalma egzersiz kapasitesine bağlı olarak azalır ya da artar. Nefes almak ya çok zordur, çok hızlıdır ya da rahatsızlık verici şekildedir. Nefes darlığı genellikle akciğer ve göğüs kasları vücudun oksijen taleplerine ulaşamadığı zamanlarda oluşur. Bazı insanlar uykuda ya da uzandığında nefes darlığı hissederler (ortopne), ya da nefes darlığı çekerek uykudan uyanırlar. (paroksimal noktürnal disapne)

 

sleep-apnea-hamilyon.com

sleep-apnea-hamilyon.com

Nefes darlığı acil ve  profesyonel tıbbi tanı ve tedavi gerektirir. Nefes darlığı çeşitli daha az ciddi nedenleri de olmakla beraber, çok sayıda ciddi nefes darlığına sebep olan durumlar vardır.

Nefes darlığı nedenleri nelerdir?

Nefes darlığı kalp veya akciğer problemleri nedeniyle olabilir, ya da başka sorunlar veya hastalıklar nedeniyle olabilir.

Nefes darlığı göğüs ağrısı, çarpıntı, ayak bileğinde şişlik ya da öksürük gibi diğer ilgili belirtilerle sonuçlanabilir.

 

Kalpten kaynaklı nefes darlığı sorunları nelerdir?

kalp yetmezliği
Hızlı veya Yavaş Kalp Ritimleri
kalp krizi
Anjin
Kalp kapakçığı hastalığı
Perikardiyalde bozukluk  (kalbin etrafında sıvı)

Akcigerden kaynaklı nefes darlığı sorunları nelerdir?

sigara içme
göğüs enfeksiyonu
astım
Kronik Akciğer Hastalığı
Pnömotoraks (Çöken akciğer)
akciğer Kanseri
Pulmoner Emboli (Kan pıhtısı)
akciğer Fibrozis

Nefes darlığının diğer sebepleri aşağıdaki gibidir?

kilolu olmak,
Stres veya anksiyete
Gebelik
Anemi
Nörolojik hastalıklar ve Kas Hastalıkları

Genel olarak yeni başlamış olan  nefes darlığı için doktordan tıbbi yardım almalısınız.

 

 

 

 

What is shortness of breath – ENGLiSH VERSiON

What is breathlessness?

Breathlessness is a common and unpleasant symptom and presents as a decreased exercise capacity. Breathing can either be too hard, too fast or just uncomfortable. It generally occurs when the lungs and chest muscles do not reach the body’s oxygen demands. Some people feel short of breath when lying flat (orthopnoea) or awake from sleep breathless (paroxysmal nocturnal dyspnoea).

Shortness of breath needs immediate professional medical diagnosis and treatment. It may indicate numerous severe medical conditions, although there are also various less serious causes of breathlessness.

Causes

Breathlessness can be due to heart or lung problems commonly or related to other problems or disorders.

There may be other related symptoms like chest pain, palpitations, ankle swelling or cough which help with diagnosing the cause of the shortness of breath.

Heart Problems

  1. Heart Failure
  2. Fast or Slow Heart Rhythms
  3. Heart Attack
  4. Angina
  5. Valvular Heart Disease
  6. Pericardial Effusion (Fluid around the heart)

Lung Problems

  1. Smoking
  2. Chest infection
  3. Asthma
  4. Chronic Lung Disease
  5. Pneumothorax (Collapsed lung)
  6. Lung Cancer
  7. Pulmonary Embolus (Blood Clot)
  8. Lung Fibrosis

Other causes

  1. Overweight
  2. Stress or anxiety
  3. Pregnancy
  4. Anaemia
  5. Neurological and Muscle Disorders

In general patients who have new onset breathlessness should seek medical advice.

9 Eylül 2021
Okunma
bosluk

ANİ KARDİYAK ÖLÜMLERİ- VENTRİKÜLER FİBRİLASYON-Sudden Cardiac Death/Ventricular Fibrillation

ANİ KARDİYAK ÖLÜMLERİ- VENTRİKÜLER FİBRİLASYON-Sudden Cardiac Death/Ventricular Fibrillation

Sudden Cardiac Death/Ventricular Fibrillation

Sudden Cardiac Death/Ventricular Fibrillation

figure 1

ani kardiyak ölümlerinde görülen EKG ( şekil 1) kalp ritminin düzensizliğini, ventriküler fibrilasyonu , genel ritm bozukluğunu ve sonucunda ani ölümü göstermektedir.

 

Kardiyak-Arrest-dairesel-Algoritma-hamilyon.com

Kardiyak-Arrest-dairesel-Algoritma-hamilyon.com

Hastaların çoğu ansızın  ve beklenmedik bir şekilde koroner arter hastalığı sebebiyle ölmektedir. Bu durum önceden bilinememektedir. Genç hastalarda – genellikle 35 yaşın altındaki insanlarda, birkaçından az olmak kaydıyla, kalıtsal kalp şartları ve durumu bu olaya sebep olmaktadır. Bu durum hipertropik kardiyomipati, uzun QT sentromu ve Burgada sendromu olarak isimlendirilen halleri içerir.

Ani ölüm hakkında bilinçli olmak için aşağıdakileri bilmeniz gerekir :

 

  1. Ventriküler fibrilasyon ile ölümü gerçekleşen insanların sayısı gün geçtikçe azaltılmaktadır. BU hastaların ventriküler fibrilasyona sebep olan durumları düzeltilmelidir. Bu da örneğin koroner arter rahatsızlığıdır. Koroner arter rahatsızlığı düzeltilirse, hasta sağlığına kavuşur. BUna ek olarak, özel aletler, örneğin implant edilebilir defibrilatör de genellikle kullanılır ve ventriküler fibrilasyona çözümdür.
  2. Eğer genç hastalar aniden ölürse, ventriküler fibrilasyon hastalığına sahip hastanın yakınları da acilen kontrol edilmelidir ve gelecekteki riski azaltmalıdır. Kontrol edilen akrabalara gerekirse, implant edilebilir defibrilatör verilebilir.
  3. Ani kardiyak ölüme sebebiyet verecek hadiseleri daha iyi anlamaya çalışmamız, bizi hangi hastalarda bunun gerçekleşebileceği konusunda aydınlatmaktadır. Tehlikeli aritmi dediğimiz hadiseye kim daha yakındır bunu anlayabiliyoruz. Eğer daha önce kalp atağı – kalp krizi geçirmiş iseniz, mümkündür ki iler de de buna yakalanabilirsiniz. Bu hastaların ultrason ile kalplerindeki hasara bakılmalı ve geleceğe daha rahat çıkmaları sağlanmalıdır.

Lütfen ayrıca, ventriküler taşikardi, kardiyomipati ve implant edilebilir kardioverter defibrilatör konularımızı da okuyun.

 

Sudden Cardiac Death/Ventricular Fibrillation

Sudden Cardiac Death/Ventricular Fibrillation

figure 1

figure 1

The rhythm strip above (figure 1) shows the totally disorganised disturbance of rhythm, ventricular fibrillation, the common rhythm that causes sudden death.

The majority of patients who die suddenly and unexpectedly have coronary artery disease. Often this was previously unknown. In younger patients – typically age less than 35 years, one of a number of less common, although often inherited heart conditions may be the cause. These include hypertrophic cardiomyopathy, long QT syndrome and the recently recognised Brugada syndrome.

Awareness of sudden death is important for a number of reasons

  1. Increasing number of people who collapse with ventricular fibrillation are successfully resuscitated. These patients must be investigated to identify possible underlying causes, such as coronary artery disease that can be treated. In addition, special devices such as the implantable defibrillator are commonly implanted. Evidence exists that these devices may prolong life.
  2. If young patients die suddenly, it is very important that close relatives are screened for inherited conditions that may place them at increased risk for the future. In selected relatives, treatment with the implantable defibrillator may be recommended.
  3. We are becoming increasingly skilled at identifying people who are at increased risk for dangerous arrhythmias, so that treatment can be offered. For instance, anyone who has suffered a heart attack in the past should probably undergo screening with an ultrasound scan of the heart to assess the degree of damage.

Please also see the sections on ventricular tachycardia, cardiomyopathy and implantable cardioverter defibrillator

3 Eylül 2021
Okunma
bosluk

Invasive | Flecainide Problem

Invasive | Flecainide Problem

Invasive | Flecainide Problem

What’s Brugada syndrome?

Brugada syndrome is a comparatively just lately found inherited situation that makes the sufferer extra vulnerable to heart rhythm issues. It’s attributable to an abnormality of the sodium ion channels of the cardiac cell partitions. These channels modify the chemical content material of the cells and because of this alter the electrical cost and behavior of the cells. As a result of the cardiac cell contraction is managed by electrical exercise then abnormalities of the electrical properties of the cell ends in disturbance of the heart rhythm.

What issues does Brugada trigger?

Due to electrical abnormalities of the electrical cells sufferers which have Brugada syndrome are susceptible to creating quick heart rhythms with none warning. The quick heart rhythms that they get are VENTRICULAR TACHYCARDIA or VENTRICULAR FIBRILLATION. These trigger the heart cells to contract so shortly and/or chaotically that the heart not pumps blood. This ends in a drop in blood circulate to the mind and bathrooms of consciousness. If this doesn’t appropriate itself inside a couple of minutes or will not be corrected by therapy then the sufferer will die. This example known as SUDDEN CARDIAC DEATH and is a uncommon however tragic occasion which regularly happens in youthful sufferers.

How frequent is it?

Brugada is a uncommon situation and it’s estimated that it has a prevelance of 1-5/10000 within the West and doubtless extra frequent in Asia.

How do I do know if I’ve Brugada?

One of many issues with Brugada syndrome is that sufferers really feel completely effectively till they’ve their first scientific occasion which could be sudden dying. It is vital that could be a shut member of the family dies younger or is recognized with the situation to be screened for Brugada (see beneath). Sometimes the issue is picked up on a routine ECG carried out for well being medicals. The ECG has a attribute look of partial proper bundle department block and ST section elevation within the anterior chest leads. This look can range in its severity which may make the analysis tough and it’s doable for sufferers who’ve Brugada to sometimes have a standard trying ECG. In sufferers whom we suspect Brugada (i.e. sufferers with c lose members of the family or signs of blackout and a suspicious ECG) it’s attainable to substantiate or refute the prognosis by performing a Flecainide infusion check.

Irregular genes have been recognized for Brugada syndrome however the listing of genes recognized shouldn’t be exhaustive and it’s due to this fact not potential to make sure that a affected person has not bought Brugada if the screening is adverse. As well as genetic screening takes a while to carry out (as a lot as 6 months for some sufferers) and subsequently is of analysis curiosity however not an awesome assist in deciding the best way to handle sufferers at current.

What issues does it trigger?

As talked about above Brugada trigger cardiac rhythm issues which lead to sudden dying or blackout. It mostly manifests itself within the third and fourth decade of life however can current earlier in sure ethnic teams. Nonetheless the vast majority of sufferers who’ve Brugada would not have rhythm issues. The occasion price for sufferers who haven’t skilled signs could be very low starting from zero to eight% over three years observe up.

How is it handled?

Though Brugada syndrome has the potential to trigger dire penalties these penalties may be prevented by means of and implantable defibrillator (ICD). This doesn’t forestall the cardiac rhythm issues brought on by Brugada however can forestall sufferers dying from them. One of many issues with Brugada is that many sufferers might have haven’t any cardiac rhythm issues and should by no means use an ICD even when they’ve one implanted. As well as ICD’s carry dangers each on account of the implant process and the next adjustments in leads and turbines which may be needed sooner or later in these younger sufferers. Due to this fact it’s unwise to implant defibrillators with out good motive and proof of potential profit. To attempt to decide which sufferers are more likely to have issues and due to this fact want an ICD various research have examined whether or not excessive danger sufferers will be recognized. In essence the sufferers who’ve had signs on account of cardiac arrhythmia are at excessive threat. Sufferers which have irregular rhythms (ventricular tachycardia or ventricular fibrillation) purchased on artificially at electrophysiological research are at barely elevated danger and possibly additionally ought to have an ICD. As might be gathered from this text the choice as as to whether to implant an ICD just isn’t straight ahead and the choice must be made after detailed dialogue with the physician and affected person as to the dangers and advantages for that particular person. Finally the suggestions of the physician are a finest guess of what would possibly occur sooner or later primarily based on the statistics from earlier research of many sufferers. Sadly docs are nonetheless not capable of predict the long run nevertheless.

Flecainide infusion problem

What’s a Flecainide infusion problem?

As mentioned above, the abnormality of Brugada is within the sodium channel of the cardiac cell partitions. As well as the ECG isn’t at all times irregular in all sufferers so it might be potential to overlook the prognosis. Due to this fact in sufferers in whom there’s a excessive stage of suspicion that they might have Brugada i.e. sufferers with shut household family members with Brugada, sufferers with syncope of unknown trigger, or sufferers with an equivocal ECG it’s attainable to convey the ECG abnormalities out by utilizing Flecainide. This can be a sodium channel blocker that’s used as a heart rhythm controlling drug (antiarrhythmic). Partially blocking among the sodium channels with Flecainide has little or no impact on the ECG in sufferers who’ve regular cardiac cells however in sufferers with the Brugada abnormality the ECG turns into clearly irregular.

How is it carried out?

The affected person has a drip put right into a vein within the hand or arm and is related to a 12 lead ECG machine. After a baseline ECG is carried out the flecainide is slowly infused over 10 to 15 minutes. A 12 lead ECG is carried out each minute and examined for any adjustments. If the ECG adjustments considerably then the infusion is stopped and the affected person saved in hospital for about 12 hours till the Flecainide results have worn off. If the ECG doesn’t change then the affected person can go dwelling after recovering for an hour, figuring out that they don’t have Brugada syndrome.

Is it harmful?

Issues from a accurately performe­d Flecainide problem are so uncommon that few have ever been reported in medical literature. It is vital that it’s carried out by an skilled doctor who is ready to interpre t the ECG appropriately and cease infusions if the ECG modifications. It’s also vital that full resuscitation amenities together with a defibrillator can be found. For that reason these exams are sometimes carried out in an train testing lab or in a catheter lab. The London Arrhythmia centre has the most important and most skilled group of electrophysiologists within the UK and Europe and none of its docs have ever seen a complication from this check as of Could 2006.

A typical Brugada kind ECG

 

25 Ağustos 2021
Okunma
bosluk

Taşikardinin Gizli Sebebi – UYKU APNESI

Taşikardinin Gizli Sebebi – UYKU APNESI

Taşikardinin Gizli Sebebi – UYKU APNESİ

Günümüzde taşikardi hastalığının çeşitli sebepleri vardır. Bunların yanında herkesin bilmediği fakat sonuçta taşikardiye sebebiyet veren bir hastalık vardır. Bunun ismi uyku apnesidir. Öncelikle taşikardi nedir? sorusunu açıklayalım:

uyku_apnesi_tasikardi_hamilyon.com

uyku_apnesi_tasikardi_hamilyon.com

Taşikardi Nedir?

Taşikardi kalbin belirli bir ritimde atması gerekirken, farklı ve yüksek ritimlerde atmasıdır. Taşikardi olan insanlar kalbin hızlı atmasından dolayı huzursuzluk hissederler. Kişiden kişiye göre değişmek üzere, taşikardi hastalığı farklı kalp ritimlerine sebep olur. Fakat taşikardi olduğunuzda belirli bir ritimin üzerinde atıyorsa kalbiniz, kasılmasına rağmen kan pompalamamaya başlar. Bu rakam genellikle 230 ve üzeridir. Peki kalp neden hızlı atar? Taşikardiyi tetikleyen şey nedir?

Taşikardiyi neler tetikler? Taşikardiyi neler başlatır?

Kalp neden hızlı atmaya başlar? Kalbin hızlı atmasına, taşikardinin başlamasına ne sebep olur bu konu üzerinde duralım. Vücut öyle bir yapıdır ki kendi kendine yetmesi için üretilmiştir. Genellikle vücut dışarıdan bir etki olmadan rahatlıkla yaşar. Vücut her hücreye kan taşıyan bir kalbe sahiptir. Beyin kalbi kontrol ederken vücudun oksijen ihtiyacına göre kalbin atımını sağlar. Örneğin spor yaparken; beyin, vücudun oksijen ihtiyacını görüp hücrelere daha fazla kan gitmesini sağlamak için kalbin daha hızlı atmasını sağlar. Veyahut uyku durumuna geldiğimizde yani somnabolizma ve katabolizma durumuna geldiğimizde, beyin kalbin daha yavaş calışmasını sağlar ve rahat bir uyku uyuruz. Peki bu bahsettiğimiz UYKU APNESİ NEDİR? biraz da bu konudan bahsedelim.

UYKU APNESİ NEDİR?

Uyku apnesi, nefes yollarında et vb. tıkanıklıkltan dolayı nefesin uyurken belirli süreler durmasıdır. Bu süre uyku apnesinin durumuna göre 3-5-7-10-15 sn sürer. Belirli bir süreden sonra uyku apnesi çok tehlikelidir hatta gizli ölüm sebebi bile olabilir.  Peki uyku apnesi ile taşikardinin ilgisi nedir?

 

Taşikardi ve uyku apnesi arasındaki ilişki nedir?

Uyuduğunuzu düşünün. Kalbiniz rahat bir şekilde atıyor ve vücut uyku moduna girmiş. Kanda taşınan oksijen miktarı yeterli. Fakat sonra ne oluyor. Uyku apnesi oluyor. Nefes alma belirli süreler duruyor ve tekrar başlıyor. Bu süreler içerisinde oksijen girişi yeterli olmadığı için hafif bir uyanma durumuyla kişi tekrar nefes almaya başlar. Bu süreç gece boyunca defalarca tekrarlanır. Nefes durduğu zaman, belirli bir süre sonra kalp hızlı atmaya başlar ki hücrelere yeterli oksjien yetişsin. Bu beynin kendini koruma mekanizmasıdır.

Beyin yeterli kan yetişsin diye kalbi hızlı attırmak için genelde kullanılmayan elektrik noktalarına kalpteki elektrik düğümlerine sinyal gönderir ve kalp o noktalardan atmaya başlar. Böylece taşikardi başlamış olur.

 

Uyku apnesi iseniz acilen tedavisini yapınız. Uyku apnesi tedavisi nasıl yapılır? bir sonraki konumuzda değineceğiz.

 

 

ilgili konular - interesting subjects

16 Şubat 2021
Okunma
bosluk

VENTRİKÜLER ARİTMİ- VENTRİKÜLER TAŞİKARDI- Ventricular Arrhythmia | Ventricular Tachycardia

VENTRİKÜLER ARİTMİ- VENTRİKÜLER TAŞİKARDI- Ventricular Arrhythmia | Ventricular Tachycardia

VENTRİKÜLER ARİTMİ- VENTRİKÜLER TAŞİKARDI

Ventriküler taşikardi Nedir?

Ventriküler taşikardi (VT), kalbin iki ana karıncığının hızlı ritimle hareket etmesini belirtir. Ventriküler taşikardi sırasında ( VT) normal olarak verimli şekilte atmaz, ve nefes darlığı, çarpıntı, gögüs ağrısı, baş dönmesi vb. bir dizi belirti gösterir. Hızlı ventriküler taşikardi ( VT), bilinç kaybına sebebiyet verir ve ventriküler fibrilasyona sebep olur, bu da kardiyak ölümüne (cardiac arrest) sebep verir

ventricular-tachycardia-ventrikuler-tasikardi

ventricular-tachycardia-ventrikuler-tasikardi

Ventriküler taşikardinin normal sebepleri koroner hastalığı ve kardiyomiyopati olarak belirtilir, fakat ayrıca yapısal olarak normal kalp atışları olan hastalarda da meydana gelmektedir. Bu hastalarda, ventriküler taşikardi, uzun QT sndromu ya da brugada sendromu olarak ta isimlendirilen genetik şartlarla ilişkilindirilir.

 

Ventriküler taşikardi ve koroner hastalık (Coronary Disease) arasındaki ilişki nedir?

Bir ya da daha çok koroner arterin daralması ya da kapanması kalp kaslarının yara dokusuyla değişmesine yol açar. Ventriküler taşikardi, bu yara noktalarının etrafında oluşur ve ani kardiyak ölümlerine yol açar. Ekokardiyografi (kardiyak ultrason da denilir) gibi kardiyak araştırmaları, sol ventriküler fonksiyonları tespit için faydalıdır, ve koroner arter hastalığının çeşidini anlamak için koroner anjiyografi gereklidir.  Bazı hastalar ayrıca koroner balon anjiyoplasti ve stent takma ile ya da koroer arter bypass ameliyatı ile revaskülarizasyona ihtiyaç duyabilirler. Elektropsikolojik araştırmalar ( kalbin elektrik haritasının çıkarılması) ventriküler taşikardinin sebebini bulma da gerekli olabilir.

vent-tachy-rhythm-hamilyon.com

vent-tachy-rhythm-hamilyon.com

Tedavi için antiaritmi ilaçları, kateter ablasyon ve genel olarakta implant kardiyak defibrilatör kullanılabilir. İmplat kardiyak defibrilatör ani kardiyak ölümlerin önlenmesi için gereklidir.

 

Ventriküler taşikardi  ve kardiyomiyopati (Ventricular tachycardia and cardiomyopathy)

Kardiyomiyopati, kalp kasının hastalanması ve görevini yerine getirmemesi demektir. Kardiyomiyopati Ventriküler taşikardiye ve ani kardiyak ölümlere sebebiyet verir. Kalp kasının hastalığının iki ana biçimi, hipertropik ve dilated kardiyomiyopati’dir fakat aritmiyogenik sağ ventriküler displasiya, ventriküler taşikardinin artmasına sebep olan sağ ventrikülde kalıtsal olmasıyla ortaya çıkan bir hastalıktır. Ekokardiyografi ile kalbin ne kadar büyük olduğu araştırılır ve sol ventrükülerin fonksiyonu sorgulanır, ve koroner hastalığın varlığı ya da yokluğunun saptanması için  koroner anjiyografi gerekebilir. Bir çok hasta ICD tedavisi ile ani kardiyak ölümlerden korunabilir fakat kateter ablasyon Ventriküler taşikardi den korunmak için kesin çözüm gibidir.

Ventriküler taşikardi, kalpte kardiyomiyopati ve koroner hastalığın varlığından dolayı kalbin normal yapısındaki değişmeden kaynaklanır. Bu hastalarda, daha çok iyi huyludur, fakat daha çok görülme olasılığı vardır. Bunu anlamak için ekokardiyografi ve koroner anjiyografi gerektirir. Katater ablasyon, aritmiye sebep olan kısadevreleri ve odak noktalarını yok etme de oldukça başarılıdır.

Uzun QT sendromu, Ventriküler taşikardiye ve kardiyak ölümlere sebep olan genetik bir anomalidir. (anormalliktir.)

 

Brugada Sendromu (Brugada Syndrome)

Brugada sendromuna sahip hastalar ve yakınları, Uzun QT sendromu ile aynı şartları taşırlar, ventriküler taşikardinin ve ani ölüm riskinin çok olduğu hastalardır. Uzun QT sendromundaki gibi, elektrokardiyografik değişimlere dikkat edilse de tam olarak anlaşılmaz.

 Ventricular Arrhythmia | Ventricular Tachycardia ENGLİSH VERSION

What is ventricular tachycardia?

Ventricular tachycardia (VT) describes a fast rhythm originating in either of the two main pumping chambers of the heart (the ventricles). During VT the heart doesn’t beat as efficiently as normal and as a consequence symptoms including palpitations, breathlessness, chest pain and dizziness are often present. Rapid ventricular tachycardia may lead to loss of consciousness and degenerate into ventricular fibrillation, causing cardiac arrest (figure 1).

Common causes of VT include coronary disease and cardiomyopathy, but it may also occur in patients with a structurally normal heart. In these patients VT may be associated with a genetic condition such as long QT syndrome or Brugada syndrome.

Ventricular tachycardia and coronary disease

Narrowing or blockage of one or more coronary arteries may lead to replacement of heart muscle with scar tissue. VT can arise from areas around scars and increases the risk of sudden cardiac death. Cardiac investigations such as echocardiography (cadiac ultrasound) are useful to assess left ventricular function, and coronary angiography may be required to identify the severity of coronary artery disease. Some patients may also require revascularisation with coronary balloon angioplasty and stenting or coronary artery bypass surgery. An electrophysiological study (electrical study of the heart) may be required to assess the circuits responsible for VT. Treatment strategies include antiarrhythmic drug treatment, catheter ablation and, more commonly, implantable cardiac defibrillator (ICD) therapy (figure 2). In this setting an ICD provides the greatest protection against sudden cardiac death.

Ventricular tachycardia and cardiomyopathy

Cardiomyopathies, diseases of heart muscle, can result in VT and sudden cardiac death. The two main forms of heart muscle disease are hypertrophic and dilated cardiomyopathy, but arrhythmogenic right ventricular dysplasia, a disease predominantly of the right ventricle is being increasingly recognised as a cause of VT, and other signs of this condition may be absent in the early stages of the disease. Echocardiography is required to assess left ventricular function and heart cavity size, and coronary angiography may be required to identify the presence or absence of coronary disease. Most patients will require ICD therapy for protection against the risk of sudden cardiac death, but catheter ablation may be useful to target a focus or circuit causing recurrent VT.

Ventricular tachycardia and the structurally normal heart VT can occur in the absence of coronary disease or cardiomyopathy. In these patients it is usually benign rather than life threatening but can be highly symptomatic. Investigations required include echocardiography and in some, coronary angiography. Catheter ablation is often successful in eliminating the focus or circuit responsible for the arrhythmia and effecting cure (figure 3).

Long QT syndrome is a genetic abnormality that can lead to VT and cardiac arrest. The diagnosis is usually made by a 12 lead ECG, but an exercise test may be required to identify those with latent long QT syndrome manifest as a lack of QT shortening during exercise. Beta-blockade remains the mainstay of treatment, especially in the type l and ll subtypes, but symptomatic patients despite beta-blockade may require defibrillator implantation or sympathectomy. Long QT type 3 patients are at particular risk as their first presentation may be sudden cardiac death, and prophylactic implantation of an ICD is recommended.

Brugada Syndrome

Patients and relatives with Brugada syndrome, an inherited condition similar to long QT syndrome, are at increased risk of ventricular arrhythmias and sudden death. Like long QT syndrome, electrocardiographic changes may not be present at rest and drug challenge with ajmaline or flecainide may be needed to reveal the underlying ECG abnormalities. Those with a history of blackouts or documented ventricular arrhythmias require an ICD for long term protection against the risk of sudden death. Asymptomatic patients require further risk stratification by means of an electrophysiological study, with those with inducible ventricular arrhythmias also requiring an ICD.

ilgili konular - interesting subjects

19 Mayıs 2014
Okunma
bosluk

Başdönmesi-Göz kararması- Dizzy Spells / Blackouts

Başdönmesi-Göz kararması- Dizzy Spells / Blackouts

Baş dönmesi -Göz kararması nedir?

Bu konumuzda taşikardinin bir belirtisi olan baş dönmesi ve göz kararmasından bahsedeceğiz.

dizzy-hamilyon.com

dizzy-hamilyon.com

Kalp hastalığı olan insanlarda şuur kaybı, bilinç kaybı,bilinç kapanması ya da sersemlik, başdönmesi, göz kararması gibi belirtilerde gözlenebilir.

Nüfusun %50 si baygınlık yada fenalaşma yaşar. Bunun farklı bir şekli de bilinç kaybı ya da geçici hafıza kaybıdır.baygınlık geniş bir nedenler zincirinden dolayı meydana gelir ama genel büyük sebebi kan basıncının aniden düşmesidir ki bu da beyne giden oksijenin daha az olmasını sağlar ve kan içerisinde giden oksijen hücreleri geçiş azaldığı için azalır.

Genellikle, ama her zaman değil, bireysel etkisi dengeyi kaybetme ya da bayolma hissidir, ya da baş dönmesidir. Tüm bu olanlardan sonra kişinin gözlerine bir perde iner yani karanlıklaşır, duyma yavaşlar ve azalır ve kişi kendini kaybeder. Kusma, bulantı, terleme ve kendinde olmama sebebiyle kalp atışları hızlı ve kuvvetlice olur. Bunun sebebi kalbin az giden oksijeni daha fazla göndermek için çok atmasıdır.

Gerçek baygınlıkta, bilinçlilik yok olur ve kasların güç kaybı sebebiyle hasta eğer ayaktaysa bayılabilir. Baygınlık başladığında istemsiz kas gerilmeleri ve hareketleri olabilir, bu da beyne giden oksijenin az olmasındandır ve bu fenomen epilepsi hastalarında görülen hastalıkla aynı özellikleri taşımaktadır. Hasta aniden epilepsi hastası gibi yere düşer ve titremeye başlar. Beden bu titremelerle ve yere düşmeyle kan dolaşımını normal haline getirmeye çalışır. Beyin ve kan dolaşımı genellikle kısa sürede kendini yeniler ve hasta bir iki dakikada kendine gelir. Bu sıksık görülür fakat kolay bir şekilde geçer.

baygınlık terimi ayrıca medikal terim olarak sinkop – baygınlık olarakta bilinir ve Yunanca bir terim olarak bilinir. literatürde bu durum kısa kesilme olarakta bilinir.

 

 

 

Dizzy Spells / Blackouts – English Version

 

It is estimated that 30-50% of the population will experience a fainting episode or “black-out” at some stage during their lives.  Fainting occurs for a wide variety of reasons but the common denominator is usually a sudden drop in blood pressure, which leads in turn to a transient reduction in blood flow and oxygen supply to the brain.

Usually, but not always, the affected individual will be aware of lightheadedness or dizziness just prior to passing out and may also report that their vision darkened or hearing faded prior to losing consciousness.  Nausea, vomiting, sweating, and an awareness of a fast or forceful heartbeat may also be reported.

In true fainting, loss of consciousness is invariably associated with loss of muscle tone resulting in the patient slumping to the ground if standing up at the time.  Occasionally, mild jerking movements will occur as a consequence of the reduced amount of oxygen reaching the brain, and this phenomenon should not be confused with the seizure-like activity that is seen in association with epilepsy.  Upon falling to the ground, blood flow to the brain is usually quickly restored and the patient invariably recovers consciousness within a minute or two; though it will often seem as though they have been unconscious for much longer.

The entity of fainting is also known by the medical term “syncope” which comes from a Greek word, which literally means “to cut short.”

Fainting is so common that it is accepted by most people as “one of those things” and it is usually only after several episodes have occurred that patients will seek medical attention.

 

ilgili konular - interesting subjects

19 Mayıs 2014
Okunma
bosluk

Kalp Ritim Bozukluğu Belirtileri – YAVAŞ KALP ATIŞI

Kalp Ritim Bozukluğu Belirtileri – YAVAŞ KALP ATIŞI

Kalp Ritim Bozukluğu Belirtileri – YAVAŞ KALP ATIŞI – slow hearth beat.

Kalp Ritim Bozukluğu Belirtileri – YAVAŞ KALP ATIŞI

Kalp atış hızı, sağ atriyumdaki sinotriyal düğümdeki atış üreteci tarafından saptanır. Her kalp atışında elektrik, sinatriyal düğümden atriyaya doğru yayılır. Elektrik, atriyoventriküler düğümden geçerek ana pompalama ventillerine ulaşır.

 

slow-heart-beating-hamilyon.com

slow-heart-beating-hamilyon.com

Kalp normalde 50-70 atar. Bu atış sayısı dinlenirken bazen azalır bazen alınan ilaçlardan dolayı artış gösterir. Kalp atış hızı normal insanlarda egzersiz ya da spor yapıldığında artar ki bu da normaldir. Kalp hızının artması demek vücudun bazı bölgelerinde daha fazla oksijene ihtiyaç duyması demektir. Oksijen kan ile taşındığı için kanın, oksijen gereken bölgeye daha fazla gelip daha fazla oksijen bırakması demektir.

Yavaş kalp atışı SİNOTRİYAL DÜĞÜMDEKİ PROBLEMDEN dolayı oluşabilir ki bu duruma bazen hasta sinüs sendromu da denir. Çünkü elektrik bu bölgeye gelir fakat atriyaventriküler düğüm ( kalp sektesi, kalp bloklanması) tarafından durdurulur.

Yavaş kalp atışı bazen hiç belirti göstermeyebilir bazende BAŞI DÖNMÜŞ GİBİ KONUŞMA, NEFESSİZLİK, YORGUNLUK ya da BAYGINLIK meydana gelebilir.

Kalp atış hızının düşük olması tedavi edilmesi gereken birşeydir.  Kalp atış hızınız yavaşsa eğer bu durum çeşitli ilaçlar ile düzeltilebilir. Eğer bu durum ilaçlar ile çözülemezse KALP PİLİ takılması gereklidir. Kalbinize kalp pilinin nasıl takıldığını diğer makalelerde öğrenebilirsiniz.

Slow Heart Beat

The speed at which the heart beats is determined by its own pacemaker (the sinoatrial node) in the right atrium.

During each heart beat electricity spreads from the sinoatrial node across the atria. The electricity reaches the main pumping chambers (the ventricles) by passing through the atrioventricular node.

The heart normally beats between about 50 and 70 times a minute when you are resting although it is sometimes slower in very fit people and as a result of certain drugs such as beta blockers. The heart rate should rise with exercise although the maximum heart rate varies considerably between people.

A slow heart beat can occur either because of a problem with the sinoatrial node (sometimes called sick sinus syndrome) or because electricity gets held up or blocked in the atrioventricular node (heart block)

A slow heart beat may cause no symptoms or may cause dizzy spells, blackouts, breathlessness or tiredness.

Treatment of excessively slow heart beats may include stopping or reducing the dose of any drugs that slow the heart beat and occasionally fitting a pacemaker.

ilgili konular - interesting subjects

12 Mayıs 2014
Okunma
bosluk

HIZLI KALP ATIŞI-ÇARPINTI-Fast Heart Beat-Palpitations

HIZLI KALP ATIŞI-ÇARPINTI-Fast Heart Beat-Palpitations

HIZLI KALP ATIŞI-ÇARPINTI-Fast Heart Beat-Palpitations

Bilindiği üzere insan kalbi senede 50 milyon kez atar ve üç buçuk milyon litre kanı pompalar.

Normal şartlar altında sağlıklı bir insan kalbi dakikada 60 -100 arası atar ve normal şartlarda biz bunun farkında bile değilizdir.

heartbeat-fast-hamilyon.com

heartbeat-fast-hamilyon.com

Diğer yandan, egzersiz yaptığımızda kalp atışlarımızın 100 ün üzerine çıkması oldukça normaldir. Uyurken ise kalp atışlarımızın 60 ın altına düşmemesi gerekir. Eğer uyurken kalp atışlarımız atmışın altına düşüyorsa kalbimizde bir problem var demektir.

Palpilasyon terimi ( çarpıntı), latince “palpitare” kelimesinden türetilmiştir ve anlamı çırpınmak demektir. Farklı manalarada gelse de çarpıntı işaret eder ki o insan kalbinin hızlıysa çok hızlı, yavaşsa çok yavaş çarptığının farkındadır ve kalbin çok fazla kuvvet sarfettiğinin bilincindedir.

Dolayısı ile doktorunuza “bende çarpıntı var” dediğinizde doktorunuz sizin durumunuzu anlamak için ve hastalığın sizdeki durumunu anlamak için çeşitli sorular soracaktır.
Eğer bir insanın kalp atışları 100 atışın üzerinde ise, taşikardi olarak tanımlanır. Hastanın taşikardi olduğunu anladıktan sonra yapılması gereken diğer iki şey, kalp ritminin düzenli ve hızlı attığımı, yoksa düzensiz ve hızlı attığının tespitidir. İkinci şey ise taşikardinin bir anda mı başladığı yoksa kendini sırayla geliştirerek hızlı kalp atışına mı neden olduğudur.

 

aşamalı olarak artan taşikardiler genellikle egzersiz ile normal fiziksel vücut ayarlamasından ya da duygusal hislerden dolayı oluşur. Fakat ayrıca eğer çok ateşiniz varsa ya da iyi değilseniz de taşikardiniz olabilir. Ayrıca farklı sebeplerden dolayı da oluşabilir. Eğer hızlı kalp atışlarınız oluyorsa yani taşikardiniz oluyorsa bunun sebebi tiroid bezlerinin fazla aktif olmalıdır.

Taşikardiniz düzensiz olduğunda, bu hastalığınızın halbin yukarı haznesinde normal olmayan ritim yükselmesi – atriya – oluşuyor yani atriyal fibrilasyon var demektir.

Aniden başlayan taşikardiler genellikle kalbin elektrik kablolama sisteminde, elektriksel kısa devreden dolayı oluşur. Eğer mümkünse, kalbinizde böyle bir taşikardiniz varsa acilen EKG çektirmeniz gerekir. EKG kalbin elektriksel atışlarını ve kalp atışlarının düzenini gösterir. Kalbinizde taşikardiniz varken çektirdiğiniz EKG, kalbinizde oluşan kısa devrenin sebebini doktorun anlamasını sağlar ve doktorunuz kalbinizde oluşan taşikardiye yani kalbinizin hızlı çarpmasına tedaviler sunar.

Belirtilen bu kalp hastalıkları semptomlarının mizacını anlamak için (hızlı kalp atışı, çarpıntı, evham hissetme, nefes kesilmesi, gögüs sıkıntısı ya da baş dönmesi) özel testler  ile  belirtilerin gelişiminin tipi öğrenilebilir.

EKG testi kalbin hızını ve kalbin ritmini yakalar ve kaydeder. Hasta kalbinin hızlı atışının ya da kalbindeki çarpıntının farkındayken , doktorun  kesin hastalık takibinin yapması için mükemmel derecede yardım eder.

Bu şekilde araştırmalar – HOLTER TAKILMASI ve HOLTER KAYDI olarak belirtilir- 24 saat boyunca EKG kaydını yapar ve hastanın kalbinde hızlı ritm oluşursa yani hastanın kalbi hızlı atarsa yada çarpıntı oluşursa kayda başlar. Bu şekilde kalp atışının doğası anlaşılır. Yani “kalbiniz neden hızlı atıyor?” sorusuna cevap bulunur.

Bir çok durumda hızlı kalp atışı ya da kalp çarpıntısı – ki kalp atışının normal hızlanmasının farkında olmanız- herhangi bir tedaviye gerek duyulmaz. Çoğu zaman kalbinizin hızlı atmasının tedavisi, kendiliğinden geçmesidir. Kalbiniz hızlı attığında derin derin nefes almalısınız. Kalbiniz hızlı attığında havadar bir yere yani temiz hava olan bir yere çıkmalısınız. Çoğu zaman öksürmek taşikardiyi sonlandırır.

In many cases fast heartbeats/palpitations, which are shown to be due to the simple awareness of normal accelerations in the heart’s rate, do not require any specific treatment, merely reassurance that nothing untoward has occurred.

Bununla birlikte, atriyal fibrilasyon sebebiyle ya da elektrik devrelerinde kısa devre oluşması ile hızlı kalp atışı ya da çarpıntı, genellikle tedavi gerektirir ve ters sonuçları engellemek için, hızlı kalp atışının risklerini azaltmak için bu tedavi gereklidir.

Taşikardi hastalığının tedavisini yani çarpıntının tedavisinin çeşitleri vardır. Bunlardan birisi KATETER ABLASYON dur. KATETER ABLASYON tekniği ilerleyen konularımızda anlatılacaktır. Günümüzde kateter ablasyon çoğu hastanede uygulanmaz. Özel yöntemler gerektiren kateter ablasyon , %98 kalp atışının normal seyrine dönmesini sağlar.

Hamilyon.com sağlıklı günler diler.

 

  Fast Heart Beat | Palpitations

Remarkable as it may seem the healthy human heart beats 50,000,000 times a year, pumping the equivalent of three and a half million litres of blood around the body in the process.

Under normal resting conditions a healthy heart will beat 60 to100 times per minute and, more often than not, we are completely unaware of this routine bodily function as it is usually almost imperceptible under normal circumstances.

On the other hand, when we exercise it is quite normal for our heart rate to increase above 100 beats per minute and, during sleep, it is not uncommon for our heart rate to fall below 60 beats per minute.

The term palpitation, which is derived from the Latin word palpitare meaning “to flutter”, may mean different things to different people but generally speaking it indicates that the affected person is unduly aware that their heart is beating – fast or slow, regular or irregular, or even more forceful than usual.

So one can appreciate that there is no single definition for the term palpitation and when a patient uses this term to describe their symptoms their doctor will want to ask further questions in order to characterise the precise nature in a particular individual.

When a person’s heart rate exceeds 100 beats per minute the term tachycardia may be used by their doctor to describe this state.  The next two things to be ascertained if a patient presents with tachycardia are whether the heart rhythm is regular or irregular and whether the tachycardia develops gradually over time or starts abruptly.

Gradual onset tachycardias are usually due to normal physiological adjustments that occur with exercise or emotion but may also occur if a patient develops a high fever or is unwell for other reasons such as anaemia or an overactive thyroid gland.

When tachycardias are irregular, it may be that the patient has developed an abnormal rhythm arising from the heart’s upper chambers – the atria – most commonly atrial fibrillation.

Tachycardias that start abruptly are usually due to an electrical short circuit in the wiring system of the heart.  If possible, during such a tachycardia, it is very helpful to obtain an electrical trace of the heart – known as an ECG (or “EKG” in North America) – during the tachycardia as this will usually provide the treating doctor with clues as to the most likely cause for the short circuit, thereby allowing the doctor to advise the patient about the nature of their problem and the various treatments available.

In addition to discussing the nature of any associated symptoms the patient may notice when experiencing their fast heartbeats or palpitations – eg a feeling of apprehension, breathlessness, chest discomfort, or dizziness – it may be necessary to organise specific tests designed to obtain ECG information during a typical episode of symptoms.

Such a prolonged ECG recording may capture the heart’s rate and rhythm when a patient is aware of their fast heartbeats/palpitations, greatly helping the doctor to make an accurate diagnosis.  Such investigations – which may be known as Holter recordings, 24-hour taped ECG recordings or patient activated cardiac event recordings – can be most helpful in determining the precise nature of fast heartbeat/palpitation symptoms.

In many cases fast heartbeats/palpitations, which are shown to be due to the simple awareness of normal accelerations in the heart’s rate, do not require any specific treatment, merely reassurance that nothing untoward has occurred.

However, fast heart beating or palpitation symptoms due to atrial fibrillation or an electrical short circuit generally do require treatment either to control symptoms or to reduce the potential risk of adverse consequences.  The range of treatment options available will vary from teaching the patient simple measures to self-terminate an episode, to prescribing specific medication to prevent/terminate episodes, to thinning the blood if there is an increased risk of stroke, or to a key-hole technique known as catheter ablation which may cure their condition.

 

ilgili konular - interesting subjects

10 Mayıs 2014
Okunma
bosluk

SVT-ATRIAL TAŞİKARDİ nedir-What is Atrial Tachycardia

SVT-ATRIAL TAŞİKARDİ nedir-What is Atrial Tachycardia

SVT | Atriyal TAŞİKARDİ -TÜRKÇE VERSİYON

 

heart-pulse-hamilyon.com

heart-pulse-hamilyon.com

SVT-atriyal taşikardi

Ana noktalar:

  • Atrial taşikardi, suprevantriküler taşikardinin beklenmeyen bir biçimidir.
  • Bazen kalbi hasta olan insanlarda görülür, ama sık sık normal kalbe sahip hastalarda da görülür.
  • Genelde iki taraflı görülür, fakat antipatik semptomlara neden olabilir.
  • Semptomlar çok bıktırıcı olursa, ilaçlar aritmiyi kontrol edebilirler ve yakma işlemi ile (ablasyon) sık sık tedavi edilebilir şekildedir.

Atriyal Taşikardi Nedir?

Atriyal taşikardi, kalp atriyasının herhangi bir yerinde küçük bir alandaki dokuda meydana gelir(resime dikkatlice bakınız).  Bu odak noktası kıvılcımı verir ve kalbe doğru ilerletir, kalp atışını düzenleyen doğal dokudan çok daha düzensizdir. Genel olarak, Odak noktası kıvılcımı fasilalarla yani ara ara verir (bu paroksimal atriyal taşikardi olarakta bilinir) fakat sıklıkla günlerce ya da ayda bir kez olup devam edebilir. Bazı hastalarda ( özellikle yaşlı olanlarda  ya da belirli kalp rahatsızlığı olanlarda) bir odak noktasından daha fazla odak noktası vardır. Yani çoklu odak noktası.

Atrial Taşikardi Niçin Meydana Gelir?

Atrial taşikardi çeşitli nedenlerle meydana gelebilir. Doğum kusurlarını da içeren kardiyak nedenler, kapakçık problemleri ve hasar görmüş ya da güçsüzleşmiş kalp kası (örneğin kalbin inflamasyonu ya da birincil kalp çarpıntısı sebepleriyle) bunlar arasında sayılabilir.  Bu süreç ayrıca alkol ya da uyuşturucu zehirlenmesi  veya aşırı aktif troid&böbreküstü bezi gibi metabolik rahatsızlıklar  ile de  tetiklenebilir. Bununla birlikte, çoğu hastada belirli bir sebep bulunamaz. Eğer ATRİYAL TAŞİKARDİNİZ   var ise doktorunuz nedenlerini bulmak için basit testler ( kan testi, ECG, kalp taraması) yapacaktır, fakat hiç bir belirli sonuç çıkmama durumuna karşı hazırlıklı olmalısınız. Yaşlı insanlarda, atrial taşikardinin kısa çatlakları oldukça normaldir ki normal olarak görülebilir.

Hangi Belirtiler Atriyal Taşikardiyi Tanımlar?

Belirtiler çok değişkendir. Çok insan belirti görmez, ya da basitçe palpilasyon (gögüste kalp çarpıntısı hissedilmesi). Ara sıra atriyal taşikardi, baş dönmesine, nefes alma zorluğuna ya da gögüs ağrısına neden olur. Eğer taşikardiniz oldukça hızlıysa, kalbinizin normal atışından olduça farklı olduğunu hissediyorsanız, TAŞİKARDİ nin bir evresindesinizdir.  Sağlıklı kalbe sahip genç insanlar, bazı nedenlerden dolayı, bu belirtilere yaşlı insanlardan daha fazla sahip olurlar ki kalp hızlarındaki çok az (ılımlı) bir artış , taşikardinin farkına varmalarına sebep olmaz.

Atriyal Taşikardi Nasıl Teşhis Edilir?

Atriyal Taşikardinin teşhis edilme yöntemi, taşikardi evresinde yani kalbiniz hızlı atarken Elektrokardiyografi çekip grafiğe bakmaktır.  Bazen şans eseri örneğin bir hastane ziyaretinde ya da ECG testi sırasında kaydedilebilir. Eğer sizin doktorunuza söylediğin belirtiler  atriyal taşikardiye uyum sağlıyor fakat elektro grafiği (ECG) çekilmediyseniz, doktorunuz 24 saatlik grafiği çekmeye çalışacak, bunun için size HOLTER takacaktır. HOLTER kalbin üzerine takılan ve sizinle birlikte 24 ya da 48 saat çalışan bir küçük cihazdır ki sizin kalbinizle ilgili tüm bilgileri doktorunuza verir. Sonuçta amaç kalbin hızlı atarkenki grafiğini çekmektir.

Atriyal Taşikardi Tehlikeli midir?

Çeşitli belirtilere neden olsa da atriyal taşikardi genelde asla tehlikeli değildir. Kalp hızlı atışı, taşikardi nöbetleri sırasında eğer anjin( bogaz ya da gögüs ağrısı ve iltihabı) gibi başka problemler olmadıkça  tolare edebilir. Bununla birlikte eğer kalp bir hafta boyunca ara vermeden hızlı atarsa, kalp ve beden güçsüz kalır. Eğer bu tarz bir durumunuz var ise bu durum eğer taşikardi başarılı bir şekilde tedavi edilirse yok edilebilir.

Atriyal taşikardinin, kan pıhtısı ya da felç riskini arttırdığı gözlenmemiştir ve antikoagülasyon ( kanın inceltilmesi) gerekli değildir. Fakat doktorlar aspirini önerirler ya da coraspin kullanmanızı öğütlerler. Eğer atriyal fibrilasyon gibi rahatsız edici diğer ritim bozuklukları görülürse kuvvetli ilaçlar ( warfarin) gerekli olabilir.

Atriyal Taşikardi Nasıl Tedavi Edilir?

Atriyal taşikardinin genel olarak tehlikeli olmaması sebebiyle, tedavi sadece gerekli görüldüğü takdirde yapılır. Bu gerekli görüldüğü takdirdeki durum çok sıklıkla kalbin hızlı atması demektir ki bu da kalbin genişlemesine sebep olabilir. Bu durumlarda yapılması gereken ilk hareket ilaçla düzeltmektir. İlaç olarak genelde DİLTİZEM kullanılır. Daha kuvvetli ilaçlarda bulunmaktadır. Eğer ilaç ile tedavi sözkonusu değilse, yani atriyal taşikardinin ilaç ile tedavisi başarılı olmaz ise, bu durumda KATETER ABLASYONU denilen ameliyat yöntemi devreye sokulur.

SVT | Atrial Tachycardia -ENGLISH VERSION

Key factors:

  • Atrial tachycardia is a reasonably unusual type of supraventricular tachycardia
  • It’s typically seen in sufferers with diseased hearts however typically happens in sufferers with in any other case regular hearts
  • It’s almost at all times benign however may cause disagreeable signs
  • Drugs could also be used to manage the arrhythmia if signs are troublesome, and it’s usually curable with a cauterising process (ablation)

What’s atrial tachycardia?

Atrial tachycardia arises from a small space (focus) of tissue, anyplace within the atria of the heart (see diagram). This focus begins to fireside and drive the heart, extra quickly than the heart’s pure pacemaker. Normally, the main focus fires solely intermittently (that is typically often called paroxysmal atrial tachycardia) however often it may well proceed for days and even persist for months at a time. In some sufferers (particularly the aged or these with different vital heart illness) there’s a couple of irregular focus

Why does atrial tachycardia happen?

Atrial tachycardia can happen for quite a lot of causes. Cardiac causes embody start defects, valve issues, and broken or weakened heart muscle (e.g. from a previous heart attack or irritation of the heart). Episodes may also be triggered by drug/alcohol intoxication or by metabolic disturbances reminiscent of an overactive thyroid or adrenal gland. Nonetheless, in most sufferers no explicit trigger is discovered. When you’ve got atrial tachycardia your physician will need do do some easy checks (blood exams, ECG, heart scan) to rule out these causes, however you need to be ready for the likelihood that no particular trigger is discovered. In older folks, quick bursts of atrial tachycardia are so frequent that they are often thought of regular.

What signs does atrial tachycardia trigger?

Signs range enormously. Most individuals both haven’t any signs in any respect, or are merely conscious of palpitation (fast beating within the chest). Sometimes, atrial tachycardia causes breathlessness, dizziness, or chest ache. In case your tachycardia could be very quick, you usually tend to discover the distinction between your regular heart rhythm and an episode of tachycardia. Younger individuals with wholesome hearts are, for some purpose, usually extra conscious of signs than older individuals, in whom a modest enhance within the heart price could go un-noticed.

How is atrial tachycardia identified?

The one method to diagnose atrial tachycardia is by acquiring an ECG recording throughout an episode. Typically that is recorded by probability, for instance throughout a hospital go to for signs, or throughout an train ECG take a look at. In case your description suggests to your physician that you’ve got a tachycardia, however no ECG has been obtained, the physician will normally attempt to seize an episode by ordering a 24h tape or an occasion monitor. Lastly, it could be attainable for a heart rhythm specialist to begin an episode throughout electrophysiologic examine.

Is atrial tachycardia harmful?

Though it could possibly trigger signs, atrial tachycardia is sort of by no means harmful. The heart can often tolerate a quick charge remarkably nicely and episodes of tachycardia not often trigger issues except there are different issues resembling angina. Nevertheless, if the heart is compelled to beat quick with no break for weeks on finish, it will probably finally turn out to be weakened. Even at this stage, the impact is commonly reversible if the tachycardia is efficiently handled.

Atrial tachycardia itself has not been related to an elevated danger of blood clots or stroke, and anticoagulation (blood-thinning) just isn’t normally required. Nonetheless, your physician could select to suggest aspirin. Stronger remedy (warfarin) could also be required if there are different rhythm disturbances comparable to atrial fibrillation.

How is atrial tachycardia handled?

As a result of atrial tachycardia will not be typically harmful, remedy is just required whether it is inflicting you signs. Typically the rhythm disturbance is an opportunity intermittent discovering on an ECG and no therapy is required. Nonetheless, if you happen to expertise disagreeable signs or a completely elevated heart price is risking heart enlargement, your physician might advocate remedy with medicine or catheter ablation.

 

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19 Aralık 2010
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