The bundle of the Hypos is a site in the conduction system of the heart, it is also called the atrioventricular. Consists of a trunk and two legs( left and right) and provides innervation between the parts of the organ, transferring the pulse from the right atrium to both ventricles.
The latter due to this decrease according to the rhythm of the atria. If the nerve impulse is disturbed for one reason or another, then it is a diagnosis such as a bundle block blocking the bundle of His.
What is it?
The conductive system coordinates the contraction of the ventricles and atria, providing a normal heart rhythm. If conductivity in nerve fibers is disturbed, then it causes a malfunction in the activity of the heart. Incomplete blockade of the right leg of the bundle of His is more often detected in males over the age of 45, and further with age, the risk of its development increases.
The left leg of the Guiss consists of two branches( back and front), and the right one only. There are three types of conductivity blockade:
- is one-beam, it involves the right leg or one of the left branches;
- is two-beam, when the left bundle is completely or one of its branches and the right leg;
- three-beam - affects both legs.
Each of these types of conductivity malfunction is complete or incomplete, constant or periodic, that is, occurring at different time intervals. The latter may appear and disappear on one ECG record and even be recorded not at every examination.
The following factors are capable of disturbing the impulse conduction in the atrioventricular bundles:
- myocardial infarction;
- lung diseases that cause the development of a "pulmonary" heart - the blood stagnates in the right heart, these areas are hypertrophic and expand( emphysema, bronchial asthma and others);
- inflammatory lesions of the heart walls due to rheumatism or infection( endocarditis and myocarditis);
- intoxication due to cardiac glycosides;
- heart disease;
- thromboembolism of one of the pulmonary arteries;
- myocardial hypertrophy due to chronic hypertension;
- cardiomyopathy and myocardial dystrophy of different etiology( due to alcoholism, anemia, obesity, rheumatoid arthritis, diabetes, thyrotoxicosis).
A congenital anomaly of the heart structure, for example, the presence of an additional septum in the left ventricle, can cause the incomplete blockade of the right leg of the bundle in the childhood. If there is no organic damage to the organ, a partial right blockade is considered as a physiological norm.
Failure in the impulse in the left leg due to acquired cardiac pathologies is not considered normal and requires therapeutic measures and constant monitoring of the patient.
- 1 Is blockade dangerous?
- 2 Symptoms of the right bundle leg blockade
- 3 Diagnosis
- 4 Tactics of treatment
- 4.1 Is it acceptable to exercise?
Is blockade dangerous?
Incomplete blocking of the right leg of the bundle of the His is not dangerous as the disturbed conductivity of the left. The latter is fraught with the development of heart failure and atrioventricular impulse failures. Partial blockade of the right leg does not go into full shape, and its prognosis, if there is no disease of the lungs or heart, is favorable.
With complete blockade, which develops as a concomitant of a heart attack, death occurs in almost half of the patients. In this case, the prognosis is unfavorable with the lesion of both the right leg and both.
Blockade in the atrioventricular bundle is called a condition only conditionally. It is considered as a manifestation of a particular cardiac pathology or physiological condition and is detected by an electrocardiogram and by clinical symptoms. Often develops against a background of neurosis. The consequences of the problem depend on the illness that caused it.
Symptoms of the right bundle leg blockade
With the right blockade, the symptomatology is often absent, and the disorder is detected accidentally during the passage of the ECG.If the clinical manifestations are, for example, pain in the heart, shortness of breath, arrhythmia, fatigue, then this is due to the presence of the disease. When the blockade touched only one of the branches in the left leg, the symptomatology is also present only in the presence of a pathological cause.
In the absence of serious pathologies, the incomplete blockade of the right leg and the tachycardia can be combined. In many cases this is not dangerous, but with a steady increase in the pulse rate it is recommended to undergo a thyroid examination and regularly do an ECG to monitor the condition of the heart.
Symptoms of complete blockade:
- Disturb pain in the heart;
- The head is often dizzy;
- The palpitation is felt.
These manifestations are caused by marked changes in the left ventricular muscular layer( myocardium), for example, with thyrotoxicosis, severe anemia, and infarction. Because of the complete dissociation between the ventricles and atria, the rhythm is reduced to 20-45 beats per minute, which causes the release of insufficient volume of blood into the aorta.
In this case, not only irregular heartbeats, but also fainting due to a violation of the blood supply to the brain. This can cause sudden cardiac arrest.
Conduction of a standard ECG with incomplete blockade of the right leg of the bundle of His is the main diagnostic method. Further examination depends on what type of blockade is detected:
- Incomplete right - without the presence of heart disease is considered as a physiological norm.
- Two-beam - requires more thorough diagnosis.
- Complete left or three-beam - require immediate hospitalization to find out the cause, even without the patient's complaints about certain symptoms.
Other diagnostic methods include biochemical and clinical blood analysis, urinalysis, daily ECG monitoring, echocardiography, MRI and MSCT( magnetic resonance and multispiral tomography).
Tactics of treatment of
If incomplete blockade of the right leg of the bundle of His is not accompanied by a pathology of the heart( or other systems and organs that can affect the state of the heart tissues), then treatment is not performed. If the underlying disease is, the therapy may include:
- The intake of vitamins B1, B2, PP;
- Natural soothing - motherwort, sage, Novopassit, herbage;
- Hypotensive drugs for normalization of pressure - Lizinopril, Losartan, Perindopril, Valsartan, Verapamil, Atenolol;
- Blood thinning agents( for prevention of blood clots) - Cardiomagnum, Curantil, Trombo ACC, Pentoxifylline;
- Drugs that lower cholesterol in the blood - Simvastatin, Rosuvastatin;
- Diuretics( Indapamide, Chlortalidone) and cardiac glycosides( Lanatoside, Lanicore, Carditoxin) are prescribed for heart failure.
With the development of a "pulmonary" heart due to bronchopulmonary pathologies, glucocorticosteroid agents and adrenomimetics are prescribed. If there is inflammation of the heart membranes, then antimicrobial drugs and NSAIDs are indicated.
The operative method of treatment consists in the installation of an ECS( pacemaker), which is shown with a complete impulse conduction violation( left or right).
A person with EKS should be excluded from being in close proximity to electrical appliances( less than 20 cm), whether they are mobile phones, hairdryers, televisions, electric shavers or other operating devices.
Consequences of blockade of the pedicle with a primary disease:
- ventricular tachycardia;
- heart failure;
- ventricular fibrillation;
- sudden termination of the heart.
Preventing the development of such conditions is a regular examination and visit to a cardiologist, a healthy lifestyle and compliance with all prescriptions of the doctor.
Is sport acceptable?
In case of an incomplete blockade of the right leg of the bundle, a gypsis can be practiced in sports only if there are no cardiac or pulmonary diseases that caused it. If the underlying pathology takes place, then physical exertion requires restraint.
Excluded intensive training, weightlifting and other power sports, activity should be as gentle as possible and matched with a specialist.
It is also important to avoid stress, intense emotional distress, smoking and drinking, you need a full rest and a balanced diet.