Arrhythmia

a. Long QT syndrome. Associated with torsades de pointes and ventricular fibrillation. Exacerbated by exercise, sudden noise, surprise. Autosomal-dominant inheritance. Corrected QT measures > 450 msec.

b. Wolff-Parkinson-White syndrome. Manifests on ECG as delta waves and short PR interval. Atrial fibrillation or flutter can conduct rapidly to ventricles, producing ventricular fibrillation. Most likely to occur during exercise.

c. Arrhythmogenic right ventricular dysplasia. Associated with malignant ventricular arrhythmias. Myocardium in the right ventricular outflow tract is partially replaced by fibrous or adipose tissue.

d. Ventricular tachycardia. Can occur in patients with corrected or uncorrected congenital heart disease. Rare in children with structurally normal hearts in absence of conditions listed earlier in entries a or c.

e. Sick sinus syndrome (tachycardia-bradycardia syndrome). Occurs almost exclusively in pediatric patients who have undergone extensive surgery in atria.

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