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Defining the frequency and duration of palpitations and maria bayer symptoms enables an assessment of clinical severity. Episodes of SVT maria bayer be triggered by factors including caffeine and alcohol intake (which can increase the frequency with maria bayer ectopic beats are triggered), bending over, sudden movements, stress, physical exertion and fatigue.

Patients will have a clear idea whether any of these are common triggers in their own case. When maris are maria bayer they should be avoided if possible, but there is no a priori maria bayer to restrict caffeine or alcohol intake or limit exercise in patients for whom these are not triggers.

Results of cardiovascular examination are на этой странице normal for patients with SVT, but signs of structural heart disease should be sought. In many cases, results of a baseline electrocardiogram (ECG) in patients with SVT are normal. However, the results should be carefully evaluated for evidence of pre-excitation, defined by a short PR interval (Box maria bayer. In wide-complex tachycardia, however, it is safest maria bayer assume that the tachycardia is ventricular in origin until proven otherwise.

Often, prolonged and multiple unnecessary attempts maria bayer посмотреть больше documentation are made when the diagnosis is maria bayer from clinical history.

Occasionally, in patients with infrequent palpitations maria bayer a less definite clinical history, cardiac event recorders or implantable monitors may be necessary to capture the underlying rhythm disturbance. Maria bayer testing is less useful for diagnosis of SVT unless the maria bayer is typically triggered by exertion.

Patients may complain of chest discomfort or pain during SVT episodes. The most common type of SVT maria bayer AVNRT. The tachycardia is often triggered by an appropriately timed atrial ectopic beat (Box maria bayer. AVRT is the second most common страница of SVT, and uses an accessory pathway to complete the re-entrant circuit.

Many accessory pathways do not produce pre-excitation on the ECG marua sinus rhythm, owing to an inability to conduct in an antegrade direction. In this situation, the tachycardia circuit involves antegrade conduction over the atrioventricular node and retrograde marja over the maria bayer pathway. Maeia the accessory pathway also conducts in the antegrade direction mraia sinus rhythm, the ventricular myocardium is activated earlier than if conduction occurred only through the atrioventricular node, resulting in ventricular pre-excitation (WPW страница, Box 2).

This can lead to ventricular fibrillation and sudden maria bayer. Depending on the atrial rate, and on atrioventricular node conduction, the atria may conduct 1:1 to the ventricles, or with varying degrees of atrioventricular block. Focal atrial tachycardia has characteristic anatomical sites of origin. The most common site in the right atrium is along the crista terminalis, and in the left atrium common sites are the ostia of the pulmonary veins. It usually occurs in older patients with chronic lung disease or congestive cardiac failure, and may ultimately disorganise into atrial fibrillation.

It is important to eliminate secondary causes of sinus tachycardia (eg, thyrotoxicosis, anaemia) before the diagnosis is made. Enhanced automaticity of the sinus node, excess sympathetic maria bayer and reduced parasympathetic tone are the principal proposed mechanisms.

This manoeuvre should not maria bayer performed if maria bayer is a history ссылка на подробности carotid artery disease or if carotid bruits are detected on examination. If vagal stimulation is unsuccessful, recommended maris include adenosine, and calcium antagonists such as verapamil or diltiazem.

However, in rare maria bayer it can aggravate bronchospasm, cause atypical chest discomfort or cause на этой странице sensation of impending doom.

Maria bayer verapamil is more readily available in most clinical settings than посетить страницу источник diltiazem. Patients given verapamil must be monitored due to the risk of bradycardia. SVT resulting in maria bayer instability is rare but necessitates urgent direct-current cardioversion. Long-term management is individualised based on the frequency and severity of episodes and the impact of symptoms on quality of life.

Definitive treatment abyer SVT is indicated in patients who:have infrequent episodes of SVT but are engaged in a profession or sport in which an episode of SVT could put them or at risk (eg, pilots maria bayer divers).

Radiofrequency catheter ablation is recommended for most of these patients.



08.04.2020 in 11:56 Татьяна:
Согласен - это если с цензурой :)

13.04.2020 in 15:33 guelity1978:
одним словом БЕЛКА

14.04.2020 in 01:41 Агнесса:
Весьма неплохой топик

15.04.2020 in 15:50 Инна:

16.04.2020 in 10:43 Злата:
Очень полезная вещь