Second degree, Type 2 block - Essay Example

Second degree heart block: Mobitz type II Introduction Second degree heart block was ified into types I and II by Mobitz. Type II is usually as a result of a block below the AV node in the His bundle and is identical to Wenckebach block in that particular arterial impulses are transmitted to the ventricles without the occurrence of progressively lengthened PR interval. During diagnosis, it is usually a challenge to differentiate between a Wenckebach and a Mobitz type II block. The distinction between the two types of second degree heart blocks depends on whether or not there is progressive PR lengthening , this determination is however impossible to make with a 2:1 ratio in which other QRS complex is dropped.

Story of a hypothetical Mobitz type II ScenarioWhile on duty as a paramedic in New York City’s Brooklyn borough, a call came on the radio that a 56 year old man about ten blocks from my station had collapsed in his bedroom floor after experiencing recurrent dizziness. He had earlier complained to his wife about should and thigh pains and weaknesses but assumed that all these were as a result of a flu that he had earlier suffered. Upon reaching his residence and interviewing the wife, it was established that he had a history of hypertension and hypercholesterlaemia and had the following prescriptions: 75 mg of aspirin daily, 80mg simvastatin and 10 mg amlodipine daily.

Upon physical examination of the patient, it was revealed that he had a heart rate of 45bpm and BP 138/85 mmHg. Short, soft mid systolic murmur could be heard at the apex and he also had moderate leg oedema.As we tried to resuscitate him, on our way to the nearest health facility just 5 blocks away, we could see the patient gasping for air and suspected that it could be the case of second degree heart block. Further tests at the hospital revealed Hb 13.2g/dL for blood count; white cell count of 9,000/uL; T420.1’TSH 1.3 IU/L, The resting ECG had to be closely examined to have a clear diagnosis of the possible block and upon thorough examination , it was diagnosed as Mobitz type II( Pečnik et al, 2004)1Treatment options: Paramedics’ treatment patient who is suffer from second degree heart block: Mobitz type 2Being the first experts on most scenes, paramedics are of great significance in determining the life or death of a second degree heart block victim.

The most visible symptoms for type II second degree AV block is excessively slow heart like in the case of symptomatic sinus bradycardia (Habel, & Media, 2001)2. The use of a standby cardiac pace maker and temporary cardiac pacing is a treatment that paramedics can administer for symptomatic patients as they seek elaborate diagnosis and further treatments.Doctors’ treatment patient who is suffer from second degree heart block: Mobitz type 2 for in hospitalUpon precise diagnosis of type II AV block, doctors can administer Atropine to reverse the condition (Aforismo, 2004)3.

They could also implant pacemakers as a treatment option to the condition, these pacemakers van either be temporary or permanent depending on how severe the condition is (Awtry et al, 2007)4.Is there a medication after patients leave hospital? Upon leaving the hospital, patients must be subjected to medication and at present, atropine is the most recommended.Are there any recommendations by the doctors of the patient after discharge from the hospital?Yes, after discharge, patients must make changes to their lifestyles and adopt eating and living healthy.

Light exercises and low cholesterol foods are recommended. One should adopt diet choices that are vegetarian in nature to minimize the risk of further clogs (Higgins & Ali, 2011)5.BibliographyAforismo, J. F. (2004). Role of aldosterone blockage in managing heart failure: new and emerging treatment options. Bethesda, MD: American Society of Health-System Pharmacists.Awtry, E., Khan, M. F., & Sokolove, J. B. (2007). SOAP for cardiology. Philadelphia: Lippencott Williams & Wilkins. Habel, M., & Media (2001).

Heart block & ventricular dysrhythmias. Irvine, Calif.: Concept Media, Inc.Higgins, J. P., & Ali, A. (2011). Clinical questions: cardiology. New York: McGraw-Hill. Pečnik, A., Furlan, S., Maraspin, V., Cimperman, J., Logar, M., Jurca, T., et al. (2004). Electrocardiographic findings in patients with erythema migrans. Philadelphia: Potomac Books.