Post on 23-Dec-2015
The “Befores” and “Afters” of Arrhythmias and Hypertrophic Cardiomyopathy
Brought to you by:Andy LutzkaninSara Farag
What Andy wants you to know… What is an arrhythmia? What are some warning signs? What are some complications? Two basic types of arrhythmia. How do we doctors treat arrhythmias? What can you do to prevent arrhythmias?
What is an arrhythmia?
What is an arrhythmia?
“Normal cardiac function relies on the flow of electrical impulses through the heart in an exquisitely coordinated fashion.”
Any abnormality in this rhythm of the heart is by definition an arrhythmia.
Symptoms and Signs
What kinds of things did we see with little Jimmy? Rapid heart rate, sweating, restlessnes, difficulty
breathing, passed out
Some others you may see: Dizziness, blurred vision, chest pain, palpitations
(feeling of irregular heartbeats), anxiety
So why are arrhythmias bad?
Every day problems:Uncomfortable, can fall and injure yourself
(what if you are old and frail and you fall?) Longer term problems:
Damage to heart, kidneys, brain, etc.Why?
Worst case scenario:
Ineffective pumping=poor blood flow to organs
Sudden Cardiac Death
Types of Arrhythmias
Junctional Escape Rhythm
Torsades de pointes
Sinus Bradycardia
Ectopic Atrial Tachycardia
Sinus BradycardiaParoxysmal Supraventricular Tachycardias
Atrial Fibrillation
Atrial Flutter
Atrial Premature Beats
Sinus Tachycardia
Sick Sinus Syndrome
Conduction Blocks
Ventricular Premature Beats
Ventricular Tachycardia
Multifocal Atrial Tachycardia
Paroxysmal Reentrant Tachycardias
Ventricular Fibrillation
Ventricular Escape Rhythm
Wolf-Parkinson-White Syndrome
Three Basic Types
Increased Automaticity“Too many chiefs, not enough Indians”Rob’s example: grandma at thanksgiving
Triggered Events - Not important! Reentry
“dog chasing its tail”
“Too many chiefs…”
What normally controls the heart?
SA node is automatic - this is why transplants work
Other parts of heart may become automatic
Recall Rob’s demo with grandma at the Thanksgiving table
“Dog chasing its tail”
Birth defect or damage to heart causes a loop to form in conduction system
Electrical signal will just travel through loop over and over
Loops can be big or small
Great, you have a problem. Now what? What types of treatment are there?
DrugsSurgeryShock the heart (AED or manual defibrillator) Implantable device (defibrillator or pacemaker)
Some important drugs… Epinephrine
aka adrenaline Produced in adrenal glands “fight or flight” response Causes heart to beat stronger and faster
Atropine Originally found in Jimsonweed and deadly nightshade
plants Causes SA node to fire more often Very toxic at high doses - causes ventricular fibrillation
“Individual results may vary…”
Drugs Most have dangerous side effects including causing
new arrhythmias Surgery
Not always useful Can cause further damage
Defibrillators Only fix life threatening situations Can cause further damage Sometimes unable to save
Preventing Arrhythmias
Structure important for ___________ Congenital defects - are they preventable?
Unfortunately not Damage to heart - is it preventable?
YES!!!!
What is a risk factor?
Preventing Arrhythmias Cardiac Risk Factors
SmokingHigh cholesterolHigh blood pressureDiabetes/ObesityAge Gender
Eliminate these factors, your risk of damaging the heart goes down!
What Sara wants you to know…
Hypertrophic Cardiomyopathy
(HCM)
Lifestyle Changes
Prevention
Let’s review, what is HCM again?
What are the differences between a
normal heart and one with HCM?
In Hypertrophic Cardiomyopathy…1. Asymmetric
myocardium thickening (especially in septum)
Decreased filling High outflow velocity High pressure Difficulty breathing
In Hypertrophic Cardiomyopathy…
2. Abnormal growth of muscle fibers
Messy conduction
Arrhythmias
Since HCM is genetic, there aren’t good treatments for it.
Making lifestyle changes is very important…
Children experience slow growth because the body uses up all of its calories compensating for the heart’s hard work.
HIGH calorie, LOW fat, LOW sodium diet with lots of fluids is important!
What about physical activity?
Vigorous activities should be avoided but moving around is EXTREMELY important.
How does HCM affect social life?
Teachers/nurses should be aware of condition in school
Occupation should have low physical demand
Support Groups: www.childrenscardiomyopathy.org/site/listserve.php
What can we do to catch a problem early on? Look at family history
Problems? Consider genetic screening
Blood pressure checks every 2 years 120/80 mm Hg or less is
GREAT Cholesterol checks every
5 years Total should be less than
200 mg/dL
THANK YOU!
Any questions?