Electromechanical separation phenomenon

Introduction

Introduction Electromechanical separation refers to the loss of effective cardiac output due to pathophysiological processes of different nature, but the electrocardiogram can be normal or close to normal syndrome. This syndrome can result in secondary heart failure due to a sudden and severe decrease in the preload of the left ventricle, or loss of contractile response to normal electrical excitation due to primary myocardial failure. It is divided into primary and secondary electromechanical separation. Broken heart can also cause electromechanical separation.

Cause

Cause

This syndrome can result in secondary heart failure due to a sudden and severe decrease in the preload of the left ventricle, or loss of contractile response to normal electrical excitation due to primary myocardial failure.

Examine

an examination

Related inspection

Electrocardiogram EEG examination

(1) Insufficient preload: internal bleeding and acute pericardial tamponade.

(2) Insufficient afterload: such as acute outflow tract obstruction, pulmonary embolism.

(3) Cardiac inhibition or pumping failure: acute myocardial infarction and cardiomyopathy.

The above factors cause the heart to contract ineffectively, so that sufficient mechanical work cannot be accomplished. The electro-mechanical separation often manifests as a downward shift of the pacing point, that is, the pacing function of the sinus node is gradually replaced by the atrium, and then replaced by the atrioventricular junction, followed by ventricular rhythm, and eventually ventricular arrest Beat.

Diagnosis

Differential diagnosis

Electro-mechanical separation is one of the common causes of cardiac arrest. It can account for 70% of all clinically dying patients. The causes include cardiac rupture, acute myocardial infarction, cardiomyopathy, pulmonary embolism, acute pericardial tamponade, intracardiac hemorrhage, hyperkalemia, severe heart failure, massive mitral regurgitation secondary to papillary muscle rupture, and transient left ventricular dysfunction Left heart dysfunction caused by blood, paroxysmal ischemic paralysis of the left ventricle, and antiarrhythmic drugs including lidocaine and beta-blockers can cause electro-mechanical separation. Should pay attention to identification.

(1) Insufficient preload: internal bleeding and acute pericardial tamponade.

(2) Insufficient afterload: such as acute outflow tract obstruction, pulmonary embolism.

(3) Cardiac inhibition or pumping failure: acute myocardial infarction and cardiomyopathy.

The above factors cause the heart to contract ineffectively, so that sufficient mechanical work cannot be accomplished. The electro-mechanical separation often manifests as a downward shift of the pacing point, that is, the pacing function of the sinus node is gradually replaced by the atrium, and then replaced by the atrioventricular junction, followed by ventricular rhythm, and eventually ventricular arrest Beat.

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