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- Sick Sinus Syndrome
- Congenital Heart Disorders – Disorders with Decreased Pulmonary Blood Flow
- Hepatic Encephalopathy
Posted: 01 Dec 2010 04:54 PM PST Sick sinus syndrome, also called sinus node dysfunction, is a group of abnormal heart rhythms (arrhythmias) presumably caused by a malfunction of the sinus node, the heart’s primary pacemaker. It is likely to affect adults older than age 70. Many people with sick sinus syndrome eventually need a pacemaker to keep the heart in a reg Types of sick sinus syndrome and their causes include:
Pathophysiology: Scar tissue from a previous heart surgery may cause Sick sinus syndrome, particularly in children. It may also be set off by medications, such as calcium channel blockers or beta blockers that are used to treat high blood pressure, heart disease or other conditions. However, in most cases, the sinus node doesn’t work properly because of age-related wear and tear to the heart muscle. Signs and symptoms:
Diagnostic Evaluation:
Medical Management: Treatment for sick sinus syndrome focuses on eliminating or reducing unpleasant symptoms. Regular checkups to monitor the condition are very important. For people who are bothered by symptoms, the treatment of choice is usually an implanted electronic pacemaker. But if you have a pacemaker and your heart rate is still too fast, your doctor may prescribe anti-arrhythmia medications to prevent fast rhythms. If you have atrial fibrillation or other abnormal heart rhythms that increase your risk of stroke, you may need a blood-thinning medicine, such as warfarin (Coumadin). Nursing Management:
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Congenital Heart Disorders – Disorders with Decreased Pulmonary Blood Flow Posted: 01 Dec 2010 04:49 PM PST Disorders with Decreased Pulmonary Blood Flow Obstruction to pulmonary blood flow decreases the flow of the blood in the pulmonary circulation. Because of the obstruction present, pressure of the right side of the heart increases. Increase pressure of the right side of the heart can open the foramen ovale at birth (Atrial Septal Defect) or ventricular septal defect (VSD) can be present. This results to the invasion of deoxygenated blood in the systemic circulation. Disorders under this classification of congenital heart disease include tetralogy of fallot or tricuspid atresia. Tricuspid valve is located in between the right atrium and ventricle. This flap of tissue opens to pressure to allow blood to be drained in the right ventricle to the pulmonary circulation. In tricuspid atresia (atresia means absence of opening), as the name implies, the tricuspid valve is absent or completely closed. This prevents the blood to enter the right ventricle. Due to the increasing pressure of the right atrium, the foramen ovale opens at birth resulting to an astrial septal defect. The blood crosses the foramen and goes directly into the atrium bypassing the step of oxygenation. Thus, blood is pumped into the systemic circulation completely deoxygenated. Blood can be shunted back to the lungs for oxygenation if the ductus arteriosus is patent. Open foramen ovale and patent ductus arteriosus can meet a child's oxygenation needs. When these structures are closed the infant will developed the following clinical manifestations:
Tetralogy of fallot presents with four cardiac anomalies namely:
Clinical Manifestations
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Posted: 01 Dec 2010 04:44 PM PST Hepatic encephalopathy is the occurrence of confusion, altered level of consciousness and coma as a result of liver failure. It occurs when the liver is no longer able to remove toxic substances in the blood. It is also It is said to be triggered by dehydration, eating too much protein, electrolyte abnormalities (especially a decrease in potassium), bleeding from the intestines, stomach, or esophagus, infections, kidney problems, low oxygen levels in the body and use of medications that suppress the central nervous system (such as barbiturates or benzodiazepine tranquilizers). Diagnostic Evaluation:
Signs and Symptoms: Early symptoms:
Intermediate stages:
More severe encephalopathy:
Severe form of encephalopathy:
Treatment: Hepatic encephalopathy is reversible with treatment. This relies on suppressing the production of the toxic substances in the intestine and so lactulose was widely used. The antibiotics neomycin and metronidazole were previously used as a treatment for hepatic encephalopathy. However, it is known that neomycin and similar aminoglycoside antibiotics may cause hearing loss and renal failure if used extensively. While Metronidazole, was also discarded because prolonged use could cause a peripheral neuropathy. A safer and probably more effective antibiotic is rifaximin, a nonabsorbable antibiotic from the rifamycin class. This is thought to work in a similar way, but without the complications attached to neomycin and metronidazole. However, whenever acute liver failure occurs, it may indicate liver transplant. Photo credits: www.lookfordiagnosis.com Related posts: |
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