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Heart Blocks, Anatomy and ECG Reading, Animation.
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- Опубліковано 15 лют 2016
- The three degrees of AV nodal blocks, Mobitz type I and type II.
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Voice by: Sue Stern.
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Heart block is a group of diseases characterized by presence of an obstruction, or a “BLOCK” in the heart electrical pathway. A block may slow down the conduction of electrical impulses, OR, in more severe cases, completely stop them. Heart blocks are classified by location where the blockage occurs. Accordingly, there are: SA nodal blocks, AV nodal blocks, intra-Hisian blocks, bundle branch blocks and fascicular blocks.
Of these, AV nodal blocks, or AV blocks, are most clinically significant. In fact, very commonly, the term “heart block “, if not specified otherwise, is used to describe AV blocks. In AV blocks, the electrical signals are slow to reach the ventricles, or completely interrupted before reaching the ventricles.
There are three degrees of AV block:
First-degree AV block: the electrical signals are SLOWED as they pass from the SA node to the AV node, but all of them eventually reach the ventricle. On an ECG, this is characterized by a longer PR interval of more than 5 small squares. First-degree AV blocks rarely cause symptoms or problems and generally do NOT require treatment.
Second-degree AV blocks are divided further into type I and type II:
- In type I, the electrical signals are delayed further and further with each heartbeat until a beat is missing completely. On an ECG, this is seen as PROGRESSIVE prolongation of PR interval followed by a P wave WITHOUT a QRS complex. This is known as a “blocked” P wave or a “dropped” QRS complex. The cycle then re-starts over. As this usually repeats in regular cycles, there is a fixed ratio between the number of P waves and the number of QRS complexes per cycle. The number of QRS complexes always equals the number of P waves MINUS one. In this example, there are four P waves for every three QRS complexes. This is a “4 to 3” heart block. Second-degree type I blocks are usually mild and no specific treatment is indicated.
- In type II second degree blocks, some of the electrical signals do NOT reach the ventricles. On an ECG, this is seen as intermittent non-conducted P-waves. The PR interval, however, remains CONSTANT in conducted beats. In majority of cases, the successfully conducted QRS complexes may appear broader than usual. In some type II blocks, there is a fixed number of P waves per QRS complex. In this example, there are three P waves for every QRS complex and the condition is described as “3 to 1” heart block. However, as the nature of type II block is unstable, this ratio is likely to change over time. Second- degree type II is less common than second-degree type I but is much more dangerous as it frequently progresses to complete heart block or cardiac arrest. Implantation of an artificial pacemaker is recommended for treatment of this type of AV blocks.
Third-degree AV blocks are also referred to as complete heart blocks. In this condition, NONE of the electrical signals from the atria reach the ventricles. With NO input coming from the atria, the ventricles usually try to generate some impulses on their own. This is known as an “ESCAPE rhythm”. On an ECG, two independent rhythms can be seen: a regular P wave pattern represents atrial rhythm; and a regular, but UNUSUALLY slow QRS pattern represents the escape rhythm. The PR interval is variable as there is NO relationship between the 2 rhythms. Patients with third-degree heart blocks are at high risk of cardiac arrest. They require immediate treatment, cardiac monitoring and pacemaker implantation.
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GREAT INSTRUCTIONAL VIDEO FOR HEART BLOCKS. Well explained at a good pace. Thank you again.
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Best and most concise explanation I've found d yet! Perfect amount of information for renewing ACLS certification
I finally understand heart blocks. This video really helped me understand where the abnormalities were, so that I can pick the best drug to help the patient. Thank you!
Thank you for the clear and concise education...Best explanation I’ve heard
Thank you for this concise and precise explanation of heart block degrees. Excellent
This is the best channel ever to learn .
Good
BEST VIDEO EXPLAINING HEART BLOCKS EVERY. TIME
great presentations as usual, Dr. Marchand
Thank you so much...Thank you to the moon and back... I am a visual learner, so your videos have helped greatly....Now, I finally understand...those cardiac arrhythmias and heart blocks..I feel empowered...Thanks a million... I wish they played those videos at my medical University.. Easy to understand :)
You are welcome! Thanks for commenting! I am happy I could help.
You have such a melodious voice to explain these subjects. Your teaching skills really hit home !
@@Alilamedicalmedia Why do arrhythmia reduce/ end with Beta Blockers and Flavedon mr ,an anti angina drug?
Great resource. Very clearly explained
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well said and demonstrated. Easy to understand.
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Subscribed! Finally understand heart blocks!
Thank you for helping me understand heart blocks
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Very well explained🗣
Hello, I have a question about my situation. I was born with a congenital heart defect called partial AV canal and had 2 open heart surgeries when I was a child.
Now I am 33 years old and my ECG shows these electrical conduction defects:
- first degree atrioventricular block (PR max 244 ms)
- complete right branch block (QRS 142 ms)
- left anterior hemiblock.
I also add that on the echocardiogram my ejection fraction is 60%. The cardiologist says that for the moment there is no need to wear a pacemaker because the heart is working well, but I would also like your opinion.
Thank you so much 😊
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It was really clear and clarified a lot of questions I had. Thanks so much.
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Nicely explained
Thank you!
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You are welcome. Thanks for watching!
A couple days ago I waded through an hour-long CEU video on blocks. It left me bewildered, and feeling stupider for having watched it. This vid said more in around 4 minutes that that one did in 60.
Thanks, short videos are our specialty :)
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But why do heart blocks appear? I had arrhythmia and they were diminished by increasing Nebivolol from 5 mg to 10 mg alongwith Flavedon mr... why??
심방에서 심실로 내려가는 전기신호가 손상이 된다든지 제대로 전달이 되지를 않는 경우를 심차단(heart block) 또는 · AV
Thank u
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...
Thanks
What is the difference between type 2 a and b blocks? Seems subtle.
DOCTOR R AN ANGEL... 😇🙏🍎🌃💚🌎🦁
@ 1.53 is it not PQ segment ? It was mentioned PR .
nice
Has anyone ever come across only 1 PR lengthening then a missed QRS? Mobitz 1 or 2? Aware mobitz 1 is usually multiple PR lengthenings before the missed QRS and Mobitz 2 is zero lengthenings prior so it doesn’t seem to fit into either? Happens to me several times every night when sleeping but ECG is neat all day long, scared this could be Mobitz 2 and I’m not on a pacemaker though!
방실차단 ;
(atrio-ventricular block, AV block)은 “심방과 심실 사이”의 전도가 늦어지거나 완전히 없어지는 경우를 말한다. ...
현기증은
기립성 저혈압의 증상 ...
❤
Good
Best
Well explained 👏 👌
I went to the doctors to get cleared for a non invasive spinal surgery. My restring BPM is around 40-50. Closer to 40 when I'm really still and calm. I constantly workout and focus on pretty intense endurance training and have also been in and out of martial arts most of my life. I also ride BMX agressively back and forth to work almost everyday. I have relatively normal blood preasure. My systolic sometimes runs high if I feel anxiety in situations like TAKING MEDICAL TESTS. When I'm home and I test myself my blood preasure is always normal. After taking an ECG/ekg (i forget which) I was told they suspect an AV block. I never have had any symptoms infact I feel great with lots of energy. No dizzyness, no passing out, no nausea, no nothing. Now they want to send me to a heart specialist.
Is it not more likely I have an athletes heart and that my heart has made adaptations and that the walls of my ventricals are just thicker than the average person? Thank you.
It is true that athletes have higher force of contraction and higher stroke volume then normal people hence bpm can be lower but it can still maintain the required amount of cardiac output.
Your heart may still be having a heart block but you still feel energetic because of your healthy lifestyle, don't ignore the issue and do get it properly diagnosed.
can continuos shouting on anyone everyday and getting irritated + tensed can cause heart blockage
I believe you would be more likely to develop an atrial fibrillation or ventricular arrhythmia rather than a heart block; there is substantial evidence linking enhanced sympathetic activation with ventricular arrhythmias and sudden cardiac death. In a case of extreme irritation and tension, the sympathetic part of your autonomic nervous system is activated which is a response mechanism to agitation. Chronic levels of sympathetic (also called "flight or fight") responses can lead to serious problems, such as ventricular arrhythmias. Heart blocks are more often caused by aging or by the swelling/scarring of the heart from something like coronary artery disease.
@@karlhempel4231 Do blockages in Coronary arteries cause heart blocks and if so can Angioplasty reduce the probability??
방실차단이란?
방실전도차단은
심방의 전기 자극이
방실 전도계의 병적인 불응 현상이나 절단에의하여
심실로 전도되는데에
장애가 생긴현상을 말한다.
I hate the surgeons who recommend the double open surgeries of abdominal aortic aneurysm and Bypass together with lots of fake promises on 19/10/2019 without discussing any word of risk and without mentioning it in the prescription.
I also hate the same surgeons who confuse the patient's attendant after a month on 11/11/2019 by disclosing the risk factors when payment complete, admission done and most of the formalities before OT completed leaving little scope to depart the hospital .
What are the problems of the surgeons of the private or corporate hospitals to discuss the risk complications well in advance before the payment of package amounts ?
What is the mystery that they have to take a month to disclose the true facts of risks at the fag end ?
I also hate the hospitals where a patient gets both blood infection and sepsis.
I had had the most tragic experience to take home the body of my father with the deep wounds of five open surgeries of AAA, CABG, CHOLESTOMY, TREAKESTOMY and THORACENTESIS in coffin from Bangalore to Bengal.
I had the biggest ever blunder by trusting a particular corporate hospital in Bangalore.
Henceforth, my family and friends will never trust any private and corporate hospitals.
방실 블럭의 정의, 종류, 증상, 원인 및 치료에 관한 사항은 다음과 같다.
1. 정의 :
방실 블럭(atrio-ventricular block)이란 “동방결절”에서 발생된 충격파가 “방실결절”과 “His bundle”을 통과할 때 지연되거나 차단되는 경우를 말하며,
전도장애 중에서 발생빈도가 가장 높고, 임상적으로도 아주 중요 하다.
2. 종류
1）제1도 방실블럭
(first degree A-V block) : 방실결절에서의 전도 장애로 심방과 심실의 전도시간이 지연된다.
2）제2도 방실블럭 (second degree A-V block, incomplete heart block) : 심방에서 전달되는 전기 자극이 부분적으로 차단되어 심실에 전달되므로 가끔 “심실 수축”이 탈락된다.
“실신 발작”의 기왕력이 있거나 협심증, 심근경색 에 의한 것, QRS 폭이 넓은 경우는 더욱 위험하다.
① type-Ⅰ (Mobitz 제1형 블럭) : P-R 간격이 점점 연장되다가 결국 QRS가 1회 탈락하는 것을 말한다.
② type- Ⅱ(Mobitz 제2형 블럭) : P-R 간격이 일정하다가 예고 없이 QRS군이 탈락한다.
3）제3도 방실블럭
(third degree A-V block, complete heart block) : 완전한 심방블럭으로 심방의 자극이 “방실결절”에서 차단되고, 심방과 심실이 “독립적으로 수축”하는 상태를 말한다.
3. 증상 :
一제1도 방실블럭은 별다른 증상이 없으며 일상생활 에도 지장이 없는 경우가 대부분이다.
一제2도 방실블럭의 type- Ⅱ이 type- Ⅰ보다 위험한데
제3도 방실블럭으로 악화되는 경향을 가진다.
一제3도 방실블럭은 완전 차단되어 자체 조율이 되지 않으므로 영구적 “인공 심박 조율기”를 달고 살아야 한다.
4. 원인 :
一제1도 방실블럭은 일반적으로 전도계의 퇴행성 변화에 따른 이차성으로 노령 환축에서 관찰된다.
또한 어떤 항부정맥제들 과 관련이 되어 나타난다. 一제2도 방실 블럭은 다른 전심질환이나 심장질환이 있어 나타나는 경우가 많다. 제2도 방실 블럭의 type-Ⅱ는 항상 심 질환에 의하며 때로는 완전 방실 블럭으로 이행되며 급성 심근경색증에서 많이 볼 수 있다.
一제3도 방실 블럭은 선천적인 결손에 의하거나 약물중독, 또는 다른 신체질환과 연결되는 경우가 많다.
5. 치료 :
一제1도 방실 블럭의 경우 예후가 양호하여 치료가 필요 없는 경우가 많다.
一제2도 방실 블럭의 typeⅠ은 증상이 없으면 특별한 치료는 필요 없고, typeⅡ는 예후는 나쁜 편이며 영구형 “인공 심박조율기” 치료가 필요하다.
제3도 방실 블럭은 영구형 인공 심박조율기 는 만성 방실 전도장애의 유일한 치료법이다.
Heart block
block blood to veins
Well that's me.Im fucked.See ya folks.Out
add english subtitle please
Thank you. Still, my GP won't help me or the cardiologist.
I just rely on God now.
Thank you !
Thank you
Thank u
Good
Thank you
Thank you