Discussion:
Congestive Heart Failure and Third-Degree Heart Block
You are a third-year medical student on the first day of your cardiology rotation. Obviously, you are nervous and want to impress the attending physician, Dr, Jackson, who has made it clear that he is a very important man who doesn't really have time to mess around with lowly medical students.
"OK," he says, "let's see if you already know anything. Take a minute to look at Mrs. Svoboda's chart, she's a textbook case of what we see around here, and then let's talk about it."
Mrs. Svoboda is an 81-year-old woman with congestive heart failure. She had smoked for 60 years, but was able to successfully quit when she received her diagnosis four years earlier. She was in the hospital because she had fainted at home. Her EKG pattern had revealed the presence of third-degree heart block and resulting bradycardia.
Use the information from this sheet and any other reliable resources available to you to answer Dr. Jackson's following questions.
Questions
1. What is congestive heart failure?
2. What is third-degree heart block? What would the EKG tracing of someone with third-degree heart block look like?
3. Why would third-degree heart block cause bradycardia?
4. What treatment would you recommend for Mrs. Svoboda?