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Biomedical subjects

L Lemberg

Publications and source records attributed to L Lemberg.

At least 217 records · Page 12Linked to original sources
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Acute problems in the coronary care unit that do not require intervention. IV. Acute block in the A-V node.

Second- and third-degree (complete) A-V block due to an acute inferior wall myocardiac infarction does not require any treatment if the heart rate (from the junctional pacemaker) is in a range that permits an adequate blood pressure with adequate peripheral perfusion. The patient is watched carefully for any symptomatic fall in blood pressure in order to promptly correct a bradycardia-related fall in cardiac output. The clinical state of the patient with the arrhythmia is treated, and not just the arrhythmia.

Electrocardiography↗
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Cardiogenic shock.

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Shock, Cardiogenic↗
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Electrolyte imbalance.

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Electrocardiography↗
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Digitalis toxicity.

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Arrhythmias, Cardiac↗
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Supraventricular tachycardia that mimics ventricular tachycardia.

A short PR interval, a delta wave, and attacks of paroxysmal tachycardia are the principal features of the WPW syndrome. A grossly irregular rhythm with bizzare QRS complexes at rates exceeding 180 per minute is one of the paroxysmal tachycardias characteristic of the WPW syndrome. This arrhythmia deserves special attention, because it is often misinterpretated as ventricular tachycardia. The interpretation is atrial fibrillation with varying degrees of ventricular fusion and phasic ventricular aberration. Prompt electrical cardioversion is indicated because, at times, ventricular fibrillation may result. Quinidine sulfate used prophylactically because of its negative dromotropic effect on the accessory pathway promotes A-V transmission via the A-V node.

Diagnosis, Differential↗
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Supraventricular tachycardia that mimics ventricular tachycardia. Part II.

Concealed WPW is a newly described clinical entity. The existence of this syndrome can be ascertained only through specific electrophysiologic intracardiac studies. From the clinical standpoint, the existence of an accessory unidirectional A-V pathway anatomically located in the general area of the Kent bundle should be suspected in those patients with chronic BBB who have recurrent paroxysmal atrial tachycardias initiated by sinus arrhythmias or premature atrial beats. It should be noted that functional BBB can occur following a premature atrial beat. This will also set the stage for the initiation of a reciprocating tachycardia in concealed WPW. Pharmacological therapy aimed at preventing the recurrent tachycardias is disappointing. Pacemaker implantation appears to be successful by rendering one of the bundle branches refractory through concealed conduction. With chronic block of the remaining bundle branch, the natural pathway of A-V conduction is totally blocked at a critical time during the tachycardias, thus eliminating the reciprocating tachycardia.

Adult↗