Sinoatrial blockade - steps, methods of treatment. CA-blockade: type, step, cause of the diagnosis

Sinoauricular or sinoarthritic blockade is a type of deterioration of conduction. Characterized by the Danish stan- dard shvidkistyu abo general zupinka transmission of the heart impulse from the sinus node to all atria. Seeing at all - interruptions, or zavmirannya heart, shortly zamorochennya, zagalnaya weakness.

specialties of ailments

Sinoauricular block is one of the symptoms of sinus node weakness syndrome. At the same time, there is a blocking of electrical impulse between the hearts and the sinoartrial university. It is also characterized by timid asystole at the front of the heart and in the appearance of one or more than one lingering complex.

Sinoauricular block is rarely seen, and as it develops, it is most common in people (65%). You can get sick in any occasion.

ICD ailment code: 144.0-144.2.

About those, such as sinoauricular block of 1, 2, 3 stages і type, the rate of onset breaks.

Stage i type of sinoauricular block

Sinoauricular blockade of the 1st, 2nd and 3rd stages.

1st step is important to see on the electrocardiogram. At the same time, heart-shaped impulses are generated earlier, it is not necessary and necessary to reach the front of the heart. You can talk about sinoauricular blockade.
The 2nd step can also be viewed on the EKG. Not all of the impulses reach the front of the head and the little ones. On the cardiogram, it appears with the appearance of the periods of Samoilov-Venkerbach. In case of one heart cycle increase, the R-R interval is two head R-R intervals. In some cases, there is a blockage of the skin 2nd pulse, which follows the normal speed. Ce sinoauricular blockade 2: 1. In such cases, talk about Alorhythmy.
The 3rd stage of sinus blockade is the blocking of all impulses from the sinus node. This can lead to asystole and death of the patient. The role of water is to take on an atrioventricular vuzole, which is to carry out the system of shlunochkiv or at the front.

Causes of the blame

Prior to the main reasons, the development of a sinoauricular block is carried out:

organ_chne ushkodennya myocardium;
pidvishcheniye the tone of the bloating nerve;
striking the sinus node itself.

Poisonousness is the most frequent way to learn from children from:

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Sinoauricular block can also develop for the following reasons:

Intoxication with adrenergic blockers, serum glycosides, drugs K, chinidine;
defibrillation;
with reflex-induced tone of the bloating nerve.

symptoms

Sinoauricular block of the 1st stage does not manifest itself. Auscultation can reveal the visibility of a given heart rate through two or three normal cycles.

If the blockade of the 2nd stage is shown, it will be found in the frequency of the sinus impulse. With infrequent vipadannyah very quickly, a sick person can see:

zamorochennya;
discomfort in the breasts;
Significant weakness;
zadishka.

Symptoms of sinoauricular blockade, which are characterized by the appearance of deciduous cycles, are very fast, they look like this:

with a feeling of being overwhelmed by the heart;
noise in the vuha;
Rizka bradycardia.

With sinoauricular block organic exercises myocardium, the form is being taken.

As a result, asystole has developed, patients may develop Morganya-Edems-Stokes syndrome. It is also characterized by the deterioration of the blades of shkirny crooks, the non-stimulation of the flaws, the flies of the flies in front of the ochima, sudom, the second svidomosty, the ringing of the vuhah.

diagnostics

Basic methods of cleaning:

elektrokardіografiya, (EKG) signs of sinoauricular blockade are good for them to be seen;
Ultrasound heart.

After conducting electrocardiography, followed by the development of Sinoauricular blockade of the sinus bradycardia of the 2nd stage.

If sinus bradycardia is diagnosed, test the injected atropin. Pislya ny in the patients, the speed of the heart rhythm decreases by 2 times, at the same time, it decreases by 2 times. The blockade is in progress. In the case of normal functioning of the sinus node, the step rhythm will be part.

lykuvannya

Sinoauricular blockade of the 1st stage of treatment is not vimag. Renew the normal heart condition in addition to helping to diagnose the main ailment, or when you take the medication, which is damaged.

In case of blockade, it developed through vagotonia, it is effective є stasis of pedagogical or internal atropin.
To stimulate the automatism of the sinus node, use drugs-sympathomimetics. Tse ephedrine, alupten, izadrin.
Schob polypsychiatric metabolism of heart meat, priznachayut cocarboxylase, ribaxin, ATP. In case of overdose with medications, you can head b_l, Nudota, sleeplessness, dullness, blues.

We are sick with contraindications to take the heart of glucoside, beta-adrenergic blockers, antiarrhythmic drugs in the chinidine series, salt K, cordarone, drugs in rauwolfia.

Yakshho sinoauricular blockade is a sign of damage to the health of the patient, to trample on the asystole, to spend time hours, or on continuous stimulation in front of the heart, the installation of an electrocardiostimulator.

There is a video message about those who, in their home minds, are struggling with the allergy for help ... juice:

prophylaxis

In the case of young people, such a disease, such as a sinoauricular block, prophylaxis such as such, not sleep. Basically, as a result of death, so tse put down the causes of the deterioration of the heart provinces and post-mortem spasterisya at the cardiologist (arrhythmologist).

accelerating

Negative inheritance of sinoauricular blockade in a positive rhythm, in an increase in the organic lesions of the heart. Call for the development of ecclesiastical arrhythmias.

forecast

Those who will need to show themselves a sinoauricular blockade, will become more seized from the main ailment. Great importance is also the scope of the steps of conductivity and the manifestation of their pathologies to the rhythm.

Zakvoryuvannya, scho does not show itself, in the main, not wicked, be-like damages in hemodynamics.
In the development of the Morgany-Adams-Stokes syndrome, the prognosis is unpleasant.

Zupinka sinus node- the same kind of damage to the impulse, if sinus vuzol- the main lead to the rhythm, for which period it ceases to function.

sinoatrial blockade- this kind of deterioration of the conductivity, when an impulse originated in the sinus node, it is impossible to "pass" to the atrium. Shcho with zupintsi sinus node... when synagogue blockade , key picture Identical. Moreover, it is not always possible to navigate the EHC to see one kind of one thing. To that we are united in one article.

When there are cardiac arrhythmias on the EKG, so there are pauses in the heart of the robot. Tse does not mean that when a sinus vunot is zupyns, a lyudin will instantly bend. The nature has told about pіdstrakhuvannya.

In case of a sinus node, the function of driving the rhythm is taken on the anterior or atrioventricular vuzole. If there are some reasons that two djerels are being brought up, then the back-up djerels will turn on the dumbbells. However, I can’t smell a stench in my heart, because the frequency, like a stench can generate, I don’t change 30-40 strokes into quill, and at least in a short drop.

It is necessary to say that the zupinka of the sinus node can take a short hour, for such a description, the electrocardiograms can finish one zupinka for the fix, and after a few seconds the old rhythm will turn, so that the reserve jerels on the right do not have to reach.

There are a lot of reasons for the sinus university, and in any case it is necessary to go beyond the cardiological situation, since the sinus university is not responsible for the problem, and the reason itself will be to start the tactics of treatment and the forecast will take over.

At the end of the story, the hearts of the children are stretching out their lives to atrial rhythm And the rhythm of the atrioventricular z'єdnannya. While the backup dummy was completely safe, it was adequate to the robot's heart, and if the stench could not cope, then there was only one way - implantation of a cardiac pacemaker.

sinoauricular block heart - damage to the conduction of an impulse from the sinus (sinoatrial) node to the myocardium of the atrium. Tsey B.'s view with. to make it sick in case of organ changes in the myocardium of the atrium, ale innocent in practically healthy people with an increased tone of the bloating nerve. There are three stages of sino-auricular block (SAB): I stage - allowing the transition of an impulse from the sinus node to the anterior; II stage - blocking of the conduction of additional impulses; III step - on the outside of the impulses from the university to the atrium.

Causes sinuauricular (CA) blockade mozhut Buti coronary atherosclerosis pravoї koronarnoї arterії, zapalnі through transformatsіynih Change log in the right peredserdі of rozvitkom sclerotic Change log, vnaslіdok mіokarditu, obmennodіstrofіcheskіh torn down in peredserdyah, rіznih іntoksikatsіy i in pershit Cherga sertsevimiglіkozidami, β - blockers, protiaritmіchnimi preparations hіnіdinovih row , otrunnya phosphorusorganic speeches. Bezposrednі causes of SA blockade:

1) the pulse does not vibrate in the sinus node;

2) the strength of the impulse of the sinus node is insufficient for depolarization of the pedicles;

3) the impulse is blocked by the sinus node and we correct

Sinoauricular block can be I. II. III stage.

+ Succeed lіkuvannya

sinoauricular block

Sinoauricular block. In case of impaired conductivity, the impulse is blocked at the level between the sinus node and in front of the heart.

Ethiology and pathogenesis. Sinoauricular block can be supported by the operation on the heart, in the period infarct myocardium, in case of intoxication with heart glucosides, on the background of taking chinidine, fecal preparations, beta-blockers. Most often, it is restructuring when the myocardium is affected in the atrium, especially near the sinus node, sclerotic, igniting or dystrophic processes, sometimes - for defibrillation, even more rarely - in practically healthy patients with tonic conditions. Sinoauricular block is susceptible to occur in individuals of the child; among men in more cases (65%), less in women (35%).

Mechanism of sinoauricular block until the present hour is not closed. It is not the nutritional status that is the reason for the blockade of lowering anxiety in front of the heart, but rather the impulse to drive in the university itself. In the last few years, sinoauricular block is more and more often seen as a syndrome of weakness of the sinus node.

Klinika. Ailments in case of synoauricular blockade are not susceptible to any mischief, and they see short hours of foulness before an hour of heart failure. Zrіdka with trivial zupinka heart Morgany Edems-Stokes syndrome can be diagnosed.

On palpation of pulse and auscultation heart Vyyavlyayutsya vipadannya heart is very fast and a great dyastolic pause. Vipadannya significant number of hearts is very fast before bradycardia. rhythm heart correct or more often irregular changes in the blockade step, whiskey quickly, extrasystoles.

There are three stages of sinoauricular blockade. With blockade of the first stage, it will take an hour to pass the pulse from the sinus node to the atrium. Such a deterioration in performance cannot be registered on the electrocardiogram and is deprived of additional electrograms. clinіtsі Sponsor in two options: without Samoilov-Wenckebach periods and with Samoilov-Wenckebach periods.

First option It is developed electrocardiographically according to the pauses, in which every day the P wave is associated with the QRST complex. If there is one heart cycle, then the R-R interval increases to the lower main R-R interval or is smaller. The value of the R-R interval lies in the number of scho vypali hearts very quickly. Allow us to suspect one sinus impulse, but sometimes it means a normal cutaneous velocity (Allorhythmia). This is a sinoauricular block (2: 1) that spills out as a sinus bradycardia. Of course, it is possible to use only the probes with atropin abo physical options on came the submission to the rhythm, or on the electrocardiogram.

Stage II sinoauricular block With the periods of Samoilov-Venkebakh (another version), there are such special features:

1) the frequency of discharges in the sinus node will become permanent;

2) the longest R-R interval (pause), including the blocking of the sinus impulse, shorter than the trivial baseline R-R interval, before the pause;

3) next to the next pause, the step of shortening the R-R intervals is observed;

4) the first R-R interval, coming after the next pause, trivially higher than the last R-R interval, before the pause. In a number of cases, with a wide range of blockade options, before long pauses (impulses), the R-R interval is not shortened, but rather raised.

Stage III sinoauricular block characterized by a general blockade of impulses from the sinus node with a steady rhythm from the lower parts of the conductive system (more often than not, they suppress rhythms from the atrio-lowliness).

Diagnostics. Sinoauricular blockage is followed by the development of sinus bradycardia, sinus arrhythmia, blockage atrial extrasystoles, stage II atrio-shlunochkovy blockade.

Sinoauricular blockade and sinus bradycardia can be differentiated for additional probes with atropine or physical changes. Have sick with a sinoauricular blockade during cich tests, a subset of the heart rhythm is observed, and then a rapid change in 2 times (elimination and renewal of blockade). With sinus bradycardia, the rhythm is more frequent. In case of sinus arrhythmia, the pause is not tied to the act of dysfunction, but in case of sinus arrhythmia, it is tied.

With blockade atrial extrasystoles on the electrocardiogram є izolation of the P wave, at that time, with the synauricular blockade of the P wave, the complex QRST is associated with it (i.e., Vipada will increase the heart cycle). Difficult to find out in that way, as the P-wave is angry with the T-wave, in front of a pause.

In stage II anteroposterior block, the P wave is gradually rebuilt at the exit from the sinoauricular block;

Lіkuvannya sinoauricular blockade maє buti is aimed at eliminating the cause, її viclikal (intoxication with heart glucosides, rheumatism, ischemic ailment heart ta in.).

With a significant decrease in the heart rhythm, on the smallest there is a fouled or a short-hour loss of svidomosty, it is necessary to reduce the tone of the bloating nerve and the tone of the sympathetic nervous system... At the same time, 0.5-1 ml of 0.1% difference of atropin is used either internally or in drops (in addition to 5-10 drops 2-3 times a day). inodi give effect adrenomimetic koshty- zfedrin i preparations isopropylnoradrenaline (orciprenaline or alupent and isadrin). Ephedrine should be consumed in a dose of 0.025-0.05 g 2-3 times a day, or at a dose of 5% in a dose of 1 ml. Orciprenalin (alupent) should be injected into a vein at 0.5-1 ml of 0.05% range, internally, or 1-2 ml in a vein, or in tablets at 0.02 g 2-3 times a day. Izadrin (novodrin) is indicated for the language (before re-drying) by] / g-1 tablet (in 1 tablet - 0.005 g) 3-4 or more times a day. It is necessary to remember, in case of overdosing of drugs, there may be headache, heartache, tremulousness, dullness, sleeplessness, nudota, blues (div. Takozh "Antiarrhythmic zasobi").

In important cases, especially with the diagnosis of Morganya-Edems-Stokes syndrome, electrical stimulation of the anterior heart is shown (in the state of the art - timchasova, in chronic ones - postin).

Prognosis for sinoauricular block to lay down from the nature of the main ailment, as well as from the steps of the її and triviality, in the manifestation of the breakdown of the rhythm. In most cases, there are no symptoms or severe hemodynamic disorders. However, the blockade is supervised by Morganya Edems-Stokes syndrome, the prognosis of unpleasantness.

prevention of sinoauricular blockade є important zavdanny, so as the pathogenesis її is not clear enough. Yak і in case of a broken rhythm, respect is guilty, but lykuvannya the main zhvoryuvannya, scho є the reason for the blockade.

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