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1. Atrioventricular block, second degree

70세 여성 환자로, 2도 방실차단과 2:1 방실차단 진단을 받고 영구 심박동기 삽입술을 위해 입원했습니다. 환자는 과거력으로 우측 어깨 수술, 좌측 손목 골절 수술, 심실 전도 이상, 골관절염 등이 있었습니다. 입원 기간 동안 환자의 활력징후와 의식 상태가 안정적으로 유지되었고, 심박동기 삽입술 후 심박수가 정상화되는 것을 관찰할 수 있었습니다. 수술 부위 통증과 발열 등의 합병증이 발생했지만 적절한 간호 중재로 호전되었습니다. 환자는 입원 생활과 수술 전후 주의사항에 대한 교육을 받았습니다.

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1. Atrioventricular block, second degree

Atrioventricular (AV) block, second degree is a cardiac conduction disorder in which some, but not all, atrial impulses are conducted to the ventricles. This condition is characterized by a progressive delay in the conduction of electrical impulses from the atria to the ventricles, resulting in an irregular heart rhythm. In second-degree AV block, there is a partial blockage of the electrical signals between the atria and ventricles, causing some atrial contractions to be conducted to the ventricles while others are not. This can lead to a slower heart rate and an irregular heartbeat, as the ventricles do not receive a consistent number of impulses from the atria. There are two main types of second-degree AV block: Mobitz type I (Wenckebach) and Mobitz type II. In Mobitz type I, the PR interval (the time between the atrial and ventricular contractions) gradually lengthens until a ventricular contraction is dropped, resulting in a pause in the heartbeat. In Mobitz type II, the PR interval remains constant, and the dropped ventricular contractions occur in a more unpredictable pattern. The causes of second-degree AV block can include ischemic heart disease, myocardial infarction, congenital heart defects, electrolyte imbalances, and certain medications. Symptoms may include dizziness, fatigue, syncope (fainting), and palpitations. Management of second-degree AV block depends on the underlying cause and the severity of the condition. In some cases, no treatment may be necessary, and the condition may be monitored. In more severe cases, a pacemaker may be required to maintain a regular heart rhythm and prevent complications such as heart failure or sudden cardiac death. Overall, understanding the mechanisms and management of second-degree AV block is crucial for healthcare professionals to provide appropriate care and prevent potential complications in patients with this cardiac conduction disorder.

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