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Heart block by zafran faraz

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Heart block by zafran faraz

  1. 1. HEART BLOCKS AND PACEMAKER PRESENTERS: ZAFRAN FARAZ SHABANA SYED PRESENTED TO: SHAHIDA ABBASSI LECTURER IN PGCN HAYATABAD PESHAWAR
  2. 2. OBJECTIVE • Discuss Normal A&P of the Heart. • Define heart block and Explain types of Heart block. • Describe Nursing Management of Heart Block. • Define and Explain Pacemaker. • Explain Nursing Management of Pacemaker.
  3. 3. Understanding Heart block and pacemaker through video
  4. 4. Cardiovascular Anatomy & Physiology • Heart is shaped like “Cone” • “top” of the heart is the base • “bottom” is the apex • Heart size = clenched fist • The heart has 4 valves: The mitral valve and tricuspid valve, which control blood flow from the atria to the ventricles
  5. 5. CONT... The aortic valve and pulmonary valve, which control blood flow out of the ventricles • Atria are tilted slightly toward the back and ventricles extend to left and toward anterior chest wall.
  6. 6. Cardiovascular: Blood Flow • Less oxygenated Blood: • Superior Vena Cava & Inferior Vena Cava • R Atrium • Tricuspid valve • R Ventricle • Pulmonic Valve • Pulmonary Artery to lungs (gets oxygenated) • Oxygenated Blood: • Pulmonary veins • L Atrium • Mitral Valve • L Ventricle • Aortic Valve • Aorta • Body
  7. 7. ELECTRICAL SYSTEM OF THE HEART • SA node (called the pacemaker of the heart) sends out an electrical impulse. • upper heart chambers (atria) contract. • AV node sends an impulse into the ventricles. • lower heart chambers (ventricles) contract or pump.
  8. 8. Cont.. • SA node sends another signal to the atria to contract, which starts the cycle over again.
  9. 9. DEPOLARIZATION AND REPOLARIZATION AND FORMATION OF ECG WAVES
  10. 10. HEART BLOCK DEFINATION Heart block is an abnormal heart rhythm where  the heart beats too slowly (bradycardia).  In this condition, the electrical signals that tell  the heart to contract are partially or totally blocked  between the upper chambers (atria) and the lower  chambers (ventricles).
  11. 11. TYPES OF HEART BLOCK • They are further classified as, 1) First degree heart block ( first degree AV block) 2) second degree heart block (second degree AV  block) 3) third degree heart block (third degree AV block)
  12. 12. First degree heart block • Electrical impulse moves more slowly than  normal through the AV node but it still  conducts each signal. • Common in highly trained athletes.
  13. 13. Cont... • Caused by drugs, particularly those that slow  electrical impulse conduction through the AV node,  such as beta-blockers, diltiazem, verapamil, digoxin  and amiodarone.
  14. 14. 1st degree, AV block is indicated on the ECG
  15. 15. Second Degree Heart Block • Two types: • Mobitz Type I (Wenkebach) • Mobitz Type II
  16. 16. Mobitz Type 1 • Less serious form of second-degree heart block. • Electrical signal goes slower and slower until the  heart actually skips a beat. • PR Interval prolongs with each beat until a dropped  beat is seen • The PR Interval is NOT constant
  17. 17. Cont.. • After each dropped beat, the PR interval is  normal and the cycle starts again 
  18. 18. Mobitz type 1 PR PR PR DROPPED BEAT
  19. 19. CONT... • Clinical Significance • Slight symptoms e.g.. Lethargy, Confusion • Treatment • Pacemaker if during day &/or symptoms • No treatment if at night. • Note – this can progress to 3º Heart Block
  20. 20. Mobitz TYPE 2 • Electrical impulses are unable to reach the ventricles.  • Less common than Type I, and is more serious.  • Doctor will recommend a pacemaker to treat type II  second degree heart block, as it frequently progresses  to third degree heart block. 
  21. 21. CONT... • Clinical significance – this is more significant disease  • Treatment – pacemaker • Note – this can progress to 3º Heart Block
  22. 22. THIRD DEGREE HEART BLOCK • Also called complete heart block, • None of the electrical impulses from the atria reach the ventricles. • When the ventricles (lower chambers) do not receive electrical impulses from the atria (upper chambers), they may generate some impulses on their own, called junctional or ventricular escape beats.
  23. 23. Cont... • Ventricular escape beats, the heart’s naturally occurring backups, are usually very slow..
  24. 24. SIGNIFICANCE • Clinical significance: • Symptoms LOC, Confusion, Dizziness, Low BP • Can lead to standstill, VF • Treatment - pacemaker
  25. 25. Ecgs of Hearts Blocks
  26. 26. NURSING MANAGEMENT Monitor ECG of the patient. Assess the family history of heart disease. Assess the history of smoking and alcoholism. Monitor lab values frequently especially serum cholesterol levels.
  27. 27. Cont... Assess for CAD. Monitor vital signs. Instruct to avoid high fat and oil rich diet.
  28. 28. SHABANA SYED
  29. 29. PACEMAKER Pacemaker is an electronic device that provides electrical stimuli to the heart muscle.
  30. 30. Pacemaker Design • Pacemakers consist of two components: 1)electronic pulse generator 2) wires (leads, or electrodes) — that's placed under the skin in your chest to help control your heartbeat.
  31. 31. FUNCTION OF PACEMAKER • It produces the electrical impulses that stimulate your heart to beat. • The generator is connected to your heart through tiny wires that are implanted at the same time.
  32. 32. Cont... • The impulses flow through these leads to your heart and are timed to flow at regular intervals just as impulses from your heart's natural pacemaker would
  33. 33. COMPLICATION OF PACEMAKER USE • Following complication may arise from pacemaker: • Local infection at the entry site of the leads for temporary pacing, or at the subcutaneous site for permanent generator placement.
  34. 34. Cont... • Bleeding and hematoma at the lead entry sites for temporary pacing or at the subcutaneous site for permanent generator placement.
  35. 35. CONT.. Movement or dislocation of the lead placed transvenously (perforation of the myocardium).
  36. 36. NURSING MANAGEMENT • Patient’s heart rate and rhythm are monitored by ECG. • Device’s settings are noted and compared with the ECG recordings to assess the device’s function.
  37. 37. Cont... • Cardiac output and hemodynamic stability are assessed to identify the patient’s response to pacing and the adequacy of pacing.
  38. 38. Cont... • The appearance or increasing frequency of dysrhythmia is observed and reported to the physician.
  39. 39. CONT... • Incision site where the generator was implanted is observed for bleeding, hematoma formation, or infection. • The patient may complain of continuous throbbing or pain. • These symptoms are reported to the physician.
  40. 40. Summary • Cardiovascular system A&P. • Heart Block And Types Of Heart Block. • Pacemaker
  41. 41. Refference
  42. 42. Refference • https://my.clevelandclinic.org/health/articles/hear t-block/heart-block-types • http://www.hrsonline.org/Patient- Resources/Heart-Diseases-Disorders/Heart- Block • https://www.nhlbi.nih.gov/health/health- topics/topics/hb/types • https://en.wikipedia.org/wiki/Heart_block • http://www.hrsonline.org/Patient-Resources/The- Normal-Heart/Electrical-System
  43. 43. Title • Text

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