Ventricular flutter and fibrillation in the elderly
Introduction
Introduction to ventricular flutter and tremor in the elderly Ventricular flutter and ventricular fibrillation are severe ectopic rhythms, and ventricular loss is an effective overall contractility, but is replaced by rapid and uncoordinated tremors in the various parts of the heart. The hemodynamic effects of both are equivalent to ventricular arrest. Ventricular flutter is often a prelude to ventricular fibrillation, and is often a fatal arrhythmia before dying. basic knowledge The proportion of sickness: 0.2% Susceptible people: the elderly Mode of infection: non-infectious Complications: cardiac arrest and cardiopulmonary resuscitation
Cause
The cause of ventricular flutter and tremor in the elderly
(1) Causes of the disease
1. Coronary heart disease, especially acute myocardial infarction or acute coronary ischemia.
2. Cardiomyopathy with complete atrioventricular block.
3. Severe electrolyte imbalance, such as severe hypokalemia or high potassium.
4. Drug toxic effects, such as quinidine, digitalis, chloroquine, expectorant, phenol oxazine and other drug poisoning.
5. Electric shock, lightning strike or drowning.
6. Various ventricular tachycardias are further aggravated.
7. Pre-excitation syndrome with atrial fibrillation, misuse of digitalis drugs.
(two) pathogenesis
Most of the electrophysiological mechanisms of ventricular fibrillation are multiple micro-reentry loops. The spiral wave reentry of dominant ring reentry and central drift may play an important role. The temporary triggering factor of retinal diseased myocardium may be the mechanism of primary ventricular fibrillation. Intracellular calcium ion aggregation, fluctuations in autonomic nervous tension, metabolic changes, and free radical effects may have important effects on ventricular fibrillation that occurs during myocardial ischemia.
Prevention
Elderly ventricular flutter and tremor prevention
Early ventricular or ventricular tachycardia should be actively controlled, strict ECG monitoring, and first-aid preparations such as defibrillation to prevent the occurrence of room flutter or ventricular fibrillation. In the treatment of digitalis and antiarrhythmic drugs, the room is found to increase. The above drug dose should be adjusted or drug observation should be stopped. When using diuretics, attention should be paid to monitoring blood potassium, and timely correction should be made to pay attention to the cause of the disease, such as positively improving the coronary blood supply of patients with coronary heart disease; hypertensive heart disease should pay attention to Control blood pressure to an appropriate range; those with cardiac dysfunction should actively improve heart function and protect the heart from damage; especially those who have had room VT, ventricular fibrillation, and unclear conditions in the near future should be vigilant and re-issued if necessary. An implantable automatic cardiovercardioverter (AICD) can be placed to automatically defibrillate and pacing cardioversion when atrial flutter or ventricular fibrillation occurs.
Complication
Elderly ventricular flutter and complication Complications, cardiac arrest and cardiopulmonary resuscitation
Complications can be complicated by cardiac arrest.
Symptom
Symptoms of ventricular flutter and tremor in the elderly Common symptoms Loss of consciousness pale pale blood pressure is zero ventricular flutter ventricular fibrillation
1. Loss of consciousness, convulsions, ie Adams-Stokes syndrome.
2. The face is pale or bruising, the pulse disappears, the heart sounds are not heard, and the blood pressure is zero.
3. If you do not rescue in time, follow your breath and stop your heartbeat.
Examine
Elderly ventricular flutter and fibrillation
Blood electrolyte disorders, such as abnormalities in blood potassium, sodium, and chlorine.
ECG monitoring, abnormal heart rate.
Diagnosis
Diagnosis of ventricular flutter and fibrillation in the elderly
diagnosis
1. The electrocardiogram of ventricular flutter is characterized by rapid and regular ventricular ectopic rhythm, but the QRS wave and ST segment and T wave cannot be recognized, and the frequency is 150-250 times/min.
2. The electrocardiogram of ventricular fibrillation is characterized by the complete disappearance of QRS complex and T wave, replaced by turbulent waves of different shapes and sizes with irregular frequencies, with a frequency of 150-500 beats/min.
Differential diagnosis
Clinical should be associated with the onset of Assy syndrome, cardiac arrest and phase differentiation.
