It’s the big day of the finals and you are experiencing some anxiety. You walk in the classroom and feel like your heart is going to jump out of your chest. This is a normal response to anxiety by the body known as sinus tachycardia. The heart is like a pump and needs to be taken care of for it to work properly. The heart has its own rhythm and on an electrocardiogram (EKG) should have a synchronous pattern called sinus. The normal sinus rhythm should be around 60-100 beats per minute (LeMone, Burke & Bauldoff, 2011). There are many factors that can change the rate and rhythm of the heart. When sleeping your heart rate tends to be slower and should be slower due to the decreased work load on the heart. Something as little as being excited or exercising can cause your heart rate to increase and due to signals to your heart telling it to beat faster to supply the body with more blood and oxygen. The heart can beat over 100 beats per minute at rest, even when supine so it is important to assess for symptoms of any complications (Olhansky & Sullivan, 2013). A normal rhythm, but faster than 100 beats per minute is called sinus tachycardia (LeMone et al., 2011).
Sinus tachycardia can be caused by different factors within the body including stimulation of the sympathetic nervous system or a blocked parasympathetic system. The autonomic nervous system which controls the heart originates in the medulla oblongata. The vagus nerve is part of the parasympathetic nervous symptoms and slows the heart down. When this block of the stimulation of the nerve occurs the heart cannot slow down (Jevon, 2010). The sinoatrial or (SA) node in the heart seats the pace. With sinus tachycardia the signals are fired rapidly to the atria which in tu...
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Heart Rhythm Society (n.d.). Heart diseases & disorders. Retrieved from http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders#axzz2rryaqK3f
Jevon, P. (2010, January 22). How to ensure patient observations lead to effective management of tachycardia. Retrieved from http://www.nursingtimes.net/nursing-practice/clinical-zones/cardiology/how-to-ensure-patient-observations-lead-to-effective-management-of-tachycardia-/5010727.article
LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-surgical nursing: Critical thinking in patient care (5th ed.). Upper Saddle River, NJ: Pearson Education, Inc.
Olshansky, B., & Sullivan, R. M. (2013). Inappropriate Sinus Tachycardia. Journal Of The American College Of Cardiology (JACC), 61(8), 793-801. doi:10.1016/j.jacc. 2012.07.074
622 Y. When the AV node receives the signal, it fires and causes the ventricles to depolarize, this is known as the QRS Complex. The atria also repolarizes during this phase. Specifically in the QRS Complex, during the Q wave, the interventricular septum depolarizes, during the R wave, the main mass of the ventricles depolarizes, and during the S wave, the base of the heart, apex, depolarizes. After the QRS Complex, the S-T segment can be identified as a plateau in myocardial action potentials and is when the ventricles actually contract and pump out blood to the pulmonary and systemic circuits. The final phase of the heartbeat is the T wave and this is when the ventricles repolarize before the relax, ventricular diastole, EKG Video Notes and pg. 671 D. These phases represent the cardiac cycle, which is the time and events that occur from the beginning of one heartbeat to the beginning of the next heartbeat. In this lab, the first EKG that I took was my regular heartbeat during rest. In this recording, I was able to see the P wave, followed by the QRS Complex and the T wave as well. Everything looks pretty normal, but the T wave does go a little lower than normal and I believe this is due to the fact that I was diagnosed with sinus bradycardia
It increases during physical exercise to deliver extra oxygen to the tissues and to take away excess carbon dioxide. As mentioned at rest, the heart beats around 75 beats per minute but during exercise this could exceed to 200 times per minute. The SAN controls the heart rate. The rate increases or decreases when it receives information by two autonomic nerves that link the SAN and the cardiovascular centre in the medulla of the brain. The sympathetic or accelerator nerve speeds up the heart. The synapses at the end of this nerve secretes noradrenaline. A parasympathetic or decelerator nerve, a branch of the vagus nerve slows down the heart and the synapses at the end of this nerve secretes
It occurs because of repetitive electrical activity. This can occur in a patient with early or late heart failure, because there is damage to the heart tissue and the heart beats faster to try to supply the body with blood. Recommended treatment is elective cardioversion. Drugs used include an antidysrhythmic such as Mexitil or Sotalol (Ignatavicius &Workman, p. 728-729).
Heart rate variability (HRV) reflects the variations in the intervals between heart beats (R waves) over time. The time between two consecutive R waves is termed the R-R interval; it is measured in milliseconds, and is controlled by the autonomic nervous system 1. HRV is a non-invasive method for interpreting autonomic nervous system modulation and provides information relating to each branch of the autonomic nervous system 2. Analysis of the beat to beat variability provides an insight into the relative contributions of the sympathetic and parasympathetic components of the autonomic nervous system’s control of the heart 34. In healthy individuals it is now widely agreed that under normal resting conditions, a high HRV is an indicator that the parasympathetic pathway is dominant over the sympathetic pathway. Consequentially, a large number of various disease states for example, cardiovascular disease have been linked to a low HRV reflecting increased sympathetic activity at rest 5. Studies have reported that regular practice of physical activity improves ...
In a healthy individual receiving a general anaesthetic, the anaesthetist must be aware of the causes and treatment of acute onset AF, both intra-operatively and peri-operatively. Patients with AF often develop a decline in left ventricular performance and other hemodynamic instabilities including reduced diastolic filling and tachycardia mediated cardiomyopathy1, all of which can reduce cardiac output and pose difficulties for the anaesthetist.
Atrioventricular node (AV) “serves as a gate that slows the electrical current before the signal is permitted to pass down through the ventricle” (Medicine Net) that has a BPM of 40-50.
A normal heartbeats at a rate of 60-100 beats per minute. Cardiac dysrhythmia occurs when there is a disturbance in the normal rhythm of the heart. Atrial fibrillation and atrial flutter are two of the most common types of cardiac dysrhythmia. “These atrial arrhythmias may interfere with the heart’s ability to pump blood properly from its upper chambers (atria). The atria may not always empty completely, and blood remaining there too long may stagnate and potentially clot. Such clots may travel to other parts of the body, where they may cause blockages in the blood supply to the limbs, brain or heart. ("Cardiac Arrhythmias." Cardiac Arrhythmias. N.p., n.d. Web. 11 Dec. 2013, retrieved from http://www.hopkinsmedicine.org/) The American Heart Association reports that 383,000 emergency out-of-hospital treated cardiac arrests occur in the United States. A number of factors can cause cardiac dysrhythmia; smoking, heavy alcohol use, drugs (ie; cocaine or amphetamines), some prescription or over-the-counter medicines, or even too much caffeine or nicotine. Emo...
On average, the heart rate of a healthy adult is 70 beats per minute with an average resting pulse rate of 60-80 BPM. Blood entering arteries causes their walls to expand and withdraw, this process creates the pulse that can be felt close to the surface of the skin.
Individuals with AN keep their body in a state of starvation. Their body must function without the sustenance that it needs to continue functioning. Bradycardia is the most common heart arrhythmia for individuals with this disorder. As a result of the caloric deficit, the body tries to decrease cardiac work by reducing cardiac output. (Casiero & Frishman, 2006). The baroreceptor reflex is the body’s mechanism to regulate blood pressure through use of baroreceptors, which then transmits information to the brainstem. The vagal nerve receives this information, then sends impulses to the sinus node to slow the beat of the heart. (Kollai et al, 1994) A study published in the Oxford Heart Journal measured cardiac va...
Although in many occasion of heart palpitation, there can be sign of a serious, chronic underlying problem which may be like:
Critical incidents are snapshots of something that happens to a patient, their family or nurse. It may be something positive, or it could be a situation where someone has suffered in some way (Rich & Parker 2001). Reflection and analysis of critical incidents is widely regarded as a valuable learning tool for nurses. The practice requires us to explore our actions and feelings and examine evidence-based literature, thus bridging the gap between theory and practice (Bailey 1995). It also affords us the opportunity of changing our way of thinking or practicing, for when we reflect on an incident we can learn valuable lessons from what did and did not work. In this way we develop self-awareness and skills in critical thinking and problem solving (Rich & Parker 2001). Critical incidents ???
Preusser, B. (2008). 4th Ed. Winningham and Preusser’s critical thinking in nursing: Medical-surgical, pediatric, maternity, and psychiatric case studies. New York: Elsevier/Mosby Inc.
The heart is a pump with four chambers made of their own special muscle called cardiac muscle. Its interwoven muscle fibers enable the heart to contract or squeeze together automatically (Colombo 7). It’s about the same size of a fist and weighs some where around two hundred fifty to three hundred fifty grams (Marieb 432). The size of the heart depends on a person’s height and size. The heart wall is enclosed in three layers: superficial epicardium, middle epicardium, and deep epicardium. It is then enclosed in a double-walled sac called the Pericardium. The terms Systole and Diastole refer respectively and literally to the contraction and relaxation periods of heart activity (Marieb 432). While the doctor is taking a patient’s blood pressure, he listens for the contractions and relaxations of the heart. He also listens for them to make sure that they are going in a single rhythm, to make sure that there are no arrhythmias or complications. The heart muscle does not depend on the nervous system. If the nervous s...
A normal heart rhythm begins at the sinoatrial node and follows the hearts conduction pathway without any problems. Typically the sinoatrial node fires between 60-100 times per minute (Ignatavicius & Workman, 2013). When a person has Atrial Fibrillation, the sinoatrial node releases multiple quick impulses at a rate of 350 -600 times per minute. When this happens, the ventricles respond by beating around 120- 200 beats per minute, making it tough to identify an accurate heart rate. This arrhythmia can be the result of various things. During a normal heart beat, the electrical impulse begins at the sinoatrial node and travels down the conduction pathway until the ventricles contract. Once that happe...
Heart palpitations are often cause irregular heartbeats. While they can be fairly common (occurring in most people at some point in their lives) and many who experience them may not feel symptoms at all, they can be fairly troublesome to patients who do not understand them. Heart palpitations are often caused by an extra beat in the heart. There are two main types of asymptomatic palpitations: premature ventricular contractions (PVCs) and premature atrial contractions (PACs). In this paper, we will look at the difference between PVCs and PACs, how to detect them in patients who are experiencing palpitations, what can cause them, and complications they can cause.