ELFH - cardiac arrhythmias - heart block treatment Flashcards
Do you treat first degree heart block?
rarely warranted
Do you treat second degree heart block?
some cases of second degree heart block
Do you treat third degree heart block?
If yes, what tx?
virtually all cases of third degree heart block require treatment with an artificial pacemaker
2 types of pacemaker?
temporary or permanent
Who would have a temporary pacemaker?
emporary pacemakers are typically used in patients with a sustained or haemodynamically compromising bradycardia.
It may be necessary to progress to permanent pacing.
Who would have a permanent pacemaker?
Permanent pacemakers are fully implanted into the body. Insertion may follow temporary pacing.
Insertion is indicated in most cases of third degree heart block.
What is bundle branch block?
occurs when there is complete or incomplete interruption to the flow of electrical current through the right or left bundle branches
What are symptoms of right and left bundle branch blocks?
rarely cause symptoms
tx for bundle branch block?
Treatment is not usually indicated in bundle branch block.
Occasionally, where patients are at risk of progression to complete heart block, a pacemaker may be indicated.
What is a heart block?
Occurs when there is a delay in the conduction of electrical current as it passes through the cardiac conduction system
What is AF?
Occurs when electrical activity within the atria becomes disordered and chaotic
Sinus bradycardia or tachycardia
What is first degree heart block?
First degree heart block involves a delay in the conduction of impulses between the atria and the ventricles.
As a dentist you may play a role in the identification of AF. What should be included in your consultation with the patient? If you suspect the patient has AF, what would make you seek medical advice?
The patient should have a thorough medical history taken. It would be beneficial if their vital signs are recorded, such as their pulse.
Many patients with AF are on warfarin. The patient’s INR must be obtained prior to any invasive procedures and if exceeding the recommended level of 4.0, then advice should be requested.
You will also need to consider the use of adrenaline with any local anaesthetic preparation, although good pain control is important to reduce the internal release of catecholamines!
