Block block of the bundle of the gypsum is an obstacle or obstruction to the normal passage of the sinus pulse over the conductive cardiac system. Such an impulse forms in the sinus node, goes beyond its boundaries, thus enters the atrial system and excites at passage both auricles. During its passage, the sinus impulse undergoes a considerable physiological delay, reaching the antrioventricular junction and entering the small conducting system of the ventricles.
Features of the ailment
Blockage of the left or right leg of the bundle is a dangerous disease associated with a violation of the cardiac pulse necessary for normal heart function.
- Very rarely, the disease is diagnosed in young people and about 0.1% of known cases varies from general indicators.
- The older the person, the more often this disorder is diagnosed.
- At age 40, the percentage is already 4.5%.
ICD-10 codes:
- Atrial blockades:
- I45.8 Other specified conduction faults.
- Intragastric blockades:
- I44.4 Block of the branch( front) of the left branch of the bundle.
- I44.5 Block of the branch( back) of the left leg. Block left foot, unspecified.
- I45.0 Block the feet of the right. The blockade is two-beam.
- I45.3 Three-beam blockade.
Blockade of the right branch of the bundle of the GIS
Species and forms
Based on the anatomical structure of the blockade
. According to the anatomical structure, the bundle bundle block is divided into:
- single-beam;
- two-beam;
- three-beam.
Single-beam blockade - the defeat of only one leg: blockade of the right leg, left foot of the front and legs of the left posterior. Two-beam blockade - when two branches of the bundle are hit simultaneously( branches of the back and front left leg, right leg and left anterior branch, branches of the posterior left and right legs).Three-beam blockade - the defeat of all three branches of the bundle of His.
By the degree of impulse conduction violations
The blocks of the legs of the Guis are also subdivided according to the degree of impulse conduction violations:
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The opinion of doctors. .. & gt; & gt;
- incomplete;
- complete.
Incomplete blockade - impairment of pulse propagation along a single stem of the bundle. The function of the second leg or branch is not disturbed. The excitation of the ventricular myocardium in this case, occurs more slowly than it should, and is provided by healthy branches.
- With a slow process of passing the pulse along the branches, they say incomplete blockade of the heart of the 1 st degree.
- In the case when only some impulses reach the ventricles, cardiac arrest of the 2nd degree( incomplete) takes place.
- Blockade of the 3rd degree or complete blockade is determined by the total impossibility of passing cardiac impulses into the ventricles. Because of this, the latter are reduced independently, having a speed of 20 to 40 beats per minute.
More useful information on the incomplete blockade of the bundle's foot is contained in the following video:
For the duration of the
Foot blocks are:
- transient( intermittent);
- constants( irreversible).
In rare cases, impaired pulse transmission begins to develop with changes in heart rate. For example, with tachycardia or bradycardia.
Reasons for the occurrence of
To provoking factors, conduction disturbances of the bundle of Guiss include:
- previous myocardial infarction;
- heart valve defects;
- hypertension;
- chronic airway disease with obstruction;
- blunt chest trauma;
- neoplasms on the heart;
- progressive muscular dystrophy;
- overdose with certain medicines;
- pathology of the myocardium;
- high potassium content in the blood.
Hereditary factors:
- stenosis of the orifice of the pulmonary artery;
- inferior development of the right bundle branch segment;
- defects of interventricular and interatrial septa;
- heart defects, resulting in increased stress on the right ventricle.
Symptoms of
Incomplete isolated blockages of the right and left leg of the bundle of the Hyis show little of itself. It can be accidentally detected by ECG. Clinical symptoms of the disease can manifest themselves only when the right leg is completely blocked. In a third of patients, there may be signs of impairment in normal listening to the heart.
Possible symptoms include:
- dizziness, pre-syncope, fainting;
- rapid fatigue, weakness;Shortness of breath and shortness of breath.
Diagnosis
The diagnosis is made based on the patient's complaints, his examination and listening to the heart. Also, ultrasound of the heart is prescribed and the ECG is obligatory for revealing a complete, incomplete blockade of the left or right leg of the bundle. The examination does not make it difficult to establish a diagnosis, such violations are identified by a comprehensive study of the patient.
About the methods of treatment of full or incomplete blockade of the right / left branch of the bundle of the Hyis read on.
More details on how the ECG occurs in the event of a blockage of the right / left branch of the bundle Hisa, will tell the following video:
Treatment
Blockade of the left( right) leg usually does not mean any treatment. The emphasis is on the disease, which provokes such violations.
Medication
Prescribe medicines vitamin and fortifying, diet with the exception of sugar and fats. The emphasis in food is placed on the consumption of fresh vegetables and fruits.
If cardiac conduction is impaired by angina pectoris, heart failure, hypertension, therapy is performed with:
- nitrate;
- cardiac glycosides;
- antihypertensive drugs.
Surgical
Produced in ineffectiveness of drug therapy and with frequent fainting, as well as in malignant processes.
With AV blockade, it is possible to consider indications for implantation of the pacemaker. In the case of a bundle bundle blockage, which occurs without obvious clinical manifestations, a dynamic observation is carried out.
Prevention
To preventive measures include:
- mode of the day, a full and restful sleep;
- rejection of fried, canned and spicy food;
- consumption of foods with a high fiber content: fresh fruit-vegetables, greens;
- avoidance of stressful situations;
- refusal from alcohol and tobacco smoking;
- taking medications only prescribed by a doctor and under his supervision;
- timely diagnosis and treatment of diseases of all organs, not just the heart;
- obligatory consultation with a doctor if symptoms of the disease appear.
To what effect the full and incomplete blockage of the right / left leg of the bundle of His can result, read on.
Complications of
The following are the main consequences of the disease:
- sudden lethal outcome;
- myocardial infarction;
- stroke;
- worsening of the course of the blockade caused by the disease;
- heart failure;
- thromboembolic disorders.
Below you will find a prediction for a full or incomplete blockage of the right / left branch of the bundle.
Forecast
In young people without serious organic diseases of the cardiac and vascular systems, the prognosis is favorable. It is known that an isolated blockade of the right leg, never grow into a complete blockade.
The overall prognosis will depend on the underlying disease. In turn, such a violation of conduction of the heart adds to the risks of sudden death, as well as the development of various distant complications. The development of AV blockade, heart failure, conduction defect, hypertension and cardiomegaly also increases the risk of an unsuccessful outcome.
All parents whose children have undergone the blockade of the right / left branch of the bundle of His and other concomitant diseases should watch the following video: