Dysrhythmias & EKG Interpretation Q 4 - Gyan Darpan : Learning Portal
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Friday 29 April 2022

Dysrhythmias & EKG Interpretation Q 4

The adaptations of a client with complete heart block would most likely include:
     A. Nausea and vertigo
     B. Flushing and slurred speech
     C. Cephalalgia and blurred vision
     D. Syncope and slow ventricular rate

Correct Answer: D. Syncope and slow ventricular rate

In complete atrioventricular block, the ventricles take over the pacemaker function in the heart but at a much slower rate than that of the SA node. As a result, there is decreased cerebral circulation, causing syncope. Patients with third-degree blocks can have varying clinical presentations. Rarely, patients are asymptomatic. Usually, they may present with generalized fatigue, tiredness, chest pain, shortness of breath, presyncope, or syncope. They may have significant hemodynamic instability and can be obtunded.

Option A: The physical exam is usually remarkable for bradycardia. JVP examination often demonstrates cannon A-waves owing to the simultaneous contraction of the atria and ventricles. Thus a very large pressure wave is felt up against the vein.
Option B: Especially with heart rates below 40/min, patients might also present with features consistent with decompensated heart failure, respiratory distress, and hypoperfusion such as diaphoresis, tachypnea, altered mental status, retraction, cool skin, and decreased capillary refill.
Option C: Patients with complete AV-block accompanying an acute myocardial infarction often have ischemic symptoms of chest pain or dyspnea. The past medical history will often include the presence of cardiovascular disease and/or its risk factors, including diabetes mellitus, hypertension, dyslipidemia, and smoking, etc.

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