Thứ Hai, 13 tháng 1, 2014

Ventricular Fibrillation

Ventricular Fibrillation Ventricular fibrillation is the abnormal heartbeat in which the heart beats with erratic rhythm. This condition forces the chambers of your heart to pump and shake uselessly instead of regular work of pumping blood. There will be sudden drop in blood pressure and the blood supply to vital organs is cut off during this process. Often ventricular fibrillation occurs due to heart attack. It is an emergency condition needing immediate medical care. A person getting ventricular fibrillation will not breathe and have increased chances for getting collapsed within seconds. Cardiopulmonary resuscitation is done to save the life of the person in emergency department.


Symptoms :


An individual affected with ventricular fibrillation will faint immediately and lose conscious within minutes. There will be some signs that precede ventricular fibrillation indicating that something is seriously wrong in your heart. It will cause intense sharp chest pain, rapid heartbeat with erratic rhythm (tachycardia) and shortness of breath. The person will feel breathless and dizzy and also feel nauseated. Usually these symptoms can occur before one hour of ventricular fibrillation occurs, depending on the health condition of the person. Portable automated defibrillators are available in public places like police patrol cars, shopping malls and in many leading outlets. This will deliver electric shock to the patient that would immediately restore heartbeat normally.


What happens during normal heartbeat?


Your heart expands and contracts in rhythmic pulses driven by electrical impulses. It will follow a precise pathway pumping blood into vital organs. Any interruption (in any form) to these electrical impulses can produce irregular and erratic heartbeat (arrhythmia).


There are 4 chambers in each human heart containing 2 auricles and 2 ventricles. Auricles and ventricles are connected with pumps or valves. When the heart beats, smaller atria present in the auricle contracts thus filling the ventricles with blood. This occurs during the sinus mode when the right atrium sends electrical impulse leading to the contraction of right and left auricles.


This is immediately followed by the contraction of ventricles. The impulse originated from the right atrium will travel to the center of the heart exactly to the area that connects the atria and ventricles. Here the impulse travels into the ventricles making them to contract thus sending blood throughout the body. This process happens continuously in defined rhythms as long as you are alive. Any disruption in the electrical impulse will lead to break in pumping blood causing heart attack.


Causes :


Exact reason for ventricular fibrillation is not known. But once a person gets first attack, there will be problem in sending and receiving electrical impulses. It can arise from the scar of the heart muscle that has originated previous attack. Ventricular tachycardia VT is an abnormal or rapid heartbeat which is initiated when abnormal electric impulse travels inside the heart.


People having some form of heart disease like leakage or damage in the ventricle can cause heart attack. VT may last for 30 seconds or even less and may not produce any symptoms thus go unnoticed. Getting ventricular tachycardia or erratic heartbeat is a clear indication of heart problem. In case the VT lasts for more than 30 seconds the patient will faint or feel dizzy. Untreated VT is a major cause for ventricular fibrillation.


During ventricular fibrillation, the heart pumps rapidly or chaotic manner due to erratic electrical impulses. This in turn makes the ventricles to quiver without pumping any blood. In the absence of effective heartbeat, blood pressure will suddenly go down thus cutting off the blood supply to major organs like liver and brain. Hence the person will immediately lose consciousness when he gets ventricular fibrillation.


Who are at risk?


A person who is born with heart defect, a person who has ventricular fibrillation previously and a person who have had heart attack are prone to get VF. Any case of heart defect or muscle damage can also trigger this problem. Any sudden damage to the heart muscle like electrocution can trigger ventricular fibrillation. People who are in the habit of substance abuse like cocaine or heroin can get heart attack and VF.


Tests :


Ventricular fibrillation is a serious condition and hence can be diagnosed in emergency situations. Your doctor will monitor the heartbeat through monitor that may show no heart beat at all or beats in erratic fashion. The pulse may not be felt or it will be difficult to read the pulse.


Electrocardiogram is the best test for confirming heart attack and ventricular fibrillation. The doctor may order for blood tests to check the presence of certain heart enzymes in it. Angiogram is done for testing whether there is any block in coronary arteries. In case of any blockage your doctor will treat it using balloon angioplasty in which the tubes of coronary arteries are widened to clear the block.


Treatment :


Ventricular fibrillation needs emergency treatment to restore the normal heartbeat and blood flow into the heart. The team of doctors will have to act very quickly to prevent any damage to the vital organs like brain and kidney. Cardiopulmonary resuscitation is done to restore the normal blood flow. The doctors and trained CPR person will give rhythmic movement on your heart that resembles pumping motion of the heart. It will set right the abnormal electrical impulse and streamline the blood flow again. This treatment can be given by trained family members also to save the life of the person. In this process about 100 compressions are to be made for a minute. You have to give time for the chest to rise completely before each compression.


Defibrillation is a technique in which electric shock is sent into the wall of the heart to restore the normal rhythm. This process will often be used for resuming heart rhythm instantly. It has to be administered by trained personnel or you can use it by following the voice instructions.


In many advanced countries defibrillator devices are installed in public places like airports, shopping malls and casinos and can be used by the public. In case ventricular fibrillation has occurred due to heart attack, your doctor will give suitable medications to prevent further attacks. Anti arrhythmic medications are prescribed for people who are at the risk of cardiac arrest. ACE inhibitors, beta blockers and calcium channel blockers are usually given.


Once the person reaches stable state, the doctor will implant a small device called cardio-verter defibrillator into the left collarbone that carries wires to the veins of your heart. This device will continuously monitor the heartbeat and in case of abnormal rhythm it will deliver an electric impulse to restore normal heart rhythm.


Coronary angioplasty is done for treating severe block in the arteries in which the artery is widened to clear off the block. Coronary bypass surgery is another option in which the narrowed artery is bypassed by sewing the arteries and veins in a site that is far beyond the narrowed ones thus restoring normal blood flow. Both these surgeries will prevent future episodes of ventricular fibrillation.


Lifestyle Changes :


In case you are at the risk of getting attack of ventricular fibrillation you can purchase home automated external defibrillator in consultation with your doctor. But you have to get help from someone to grab the machine so that you can monitor the rhythm and send electric shock to restore normal rhythm.


If you are a smoker, avoid smoking completely. Monitor your blood cholesterol regularly and make necessary changes in diet and lifestyle for lowering bad cholesterol. If you have hypertension, take medicines continuously for controlling blood pressure. You should exercise regularly to improve the function of your heart and for managing healthy weight. Avoid taking foods that are rich in fat and cholesterol and manage your diet if you are overweight.


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