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Incomplete blockade of the right bundle of His

The bundle of His is a site in the cardiac conduction system, also called atrioventricular. It consists of a trunk and two legs (left and right) and provides innervation between parts of the organ, transmitting impulse from the right atrium to both ventricles.

Thanks to this, the latter are reduced according to the atrial rhythm. If the conduction of a nerve impulse is disturbed for one reason or another, then we are talking about such a diagnosis as blockade of the bundle of the His.

What it is?

The conduction system coordinates the reduction of the ventricles and atria, ensuring a normal heart rhythm. If the conduction in the nerve fibers is disturbed, then it causes a malfunction of the heart. Incomplete blockade of the right bundle of His is more often detected in males older than 45 years, and further with age the risk of its development increases.

Incomplete blockade of the right bundle of His

The left leg of Hisa consists of two branches (back and front), and the right leg of only one. There are three types of conduction blockade:

  • odnopuchkovaya, it involves the right leg or one of the branches of the left;
  • double-bunched, when the left bundle is hit completely or one of its branches and the right leg;
  • trekhpuchkovaya - affects both legs.

Each of these types of conduction failure is complete or incomplete, permanent or periodic, that is, arising with different time intervals. The latter can occur and disappear on one ECG record and even register not with every examination.

The following factors can disturb the conduction of impulses in the atrioventricular bundles:

  • myocardial infarction;
  • pulmonary diseases that cause the development of a "pulmonary" heart - blood stagnates in the right parts of the heart, these areas hypertrophy and expand (emphysema, bronchial asthma and others);
  • inflammation of the heart walls due to rheumatism or infection (endocarditis and myocarditis);
  • CHD;
  • intoxication due to the intake of cardiac glycosides;
  • cardiosclerosis;
  • heart defects;
  • thromboembolism of one of the pulmonary arteries;
  • myocardial hypertrophy due to chronic hypertension;
  • cardiomyopathy and myocardiodystrophy of various etiologies (due to alcoholism , anemia, obesity, rheumatoid arthritis , diabetes, thyrotoxicosis).

The cause of the incomplete blockade of the right bundle of His's bundle in childhood can be a congenital anomaly of the heart, for example, the presence of an additional septum in the left ventricle. If there is no organic damage to the organ, then the partial right block is considered as a physiological norm.

Failure in the conduction of the impulse in the left leg, due to acquired heart pathologies, is not considered normal and requires therapeutic measures and constant observation of the patient.

Content

Is blockade dangerous?

The incomplete blockade of the right bundle of His is not dangerous, as is the broken conduction of the left. The latter is fraught with the development of heart failure and atrioventricular pulse failures. Partial blockade of the right leg does not turn into full form, and its prognosis, if there are no diseases of the lungs or heart, is favorable.

With a complete blockade, developing as the presence of a heart attack, death occurs in almost half of the patients. In this case, the prognosis is unfavorable for the lesion of both the right leg and both.

Blockade in the atrioventricular bundle is called a disease only conditionally. It is considered as a manifestation of a cardiac pathology or physiological state and is detected using an electrocardiogram and on clinical symptoms. Often develops on the background of neurosis. The consequences of the problem depend on the disease that caused it.

Symptoms of blockade of the right bundle of the bundle

When the right blockade symptoms often do not exist, and the violation is detected randomly during the passage of the ECG. If there are clinical manifestations, for example, pain in the region of the heart, shortness of breath, arrhythmia, fatigue, this is due to the presence of the disease. When the blockade affected only one of the branches in the left leg, the symptoms are also present only if there is a pathological cause.

In the absence of serious pathologies, incomplete blockade of the right leg of His and tachycardia may 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 make an ECG to monitor the condition of the heart.

Symptoms of complete blockade:

  • Concerned about the pain in the heart;
  • Often dizzy;
  • Heartbeat is felt.

These manifestations are caused by marked changes in the muscle layer of the left ventricle (myocardium), for example, in thyrotoxicosis, severe anemia, and heart attack. Due to the complete separation between the ventricles and the atria, the rhythm is reduced to 20-45 beats per minute, which causes the release of insufficient blood volume into the aorta.

At the same time, there are not only interruptions of the heart rhythm, but also fainting due to the blood supply to the brain. This can cause sudden cardiac arrest.

Diagnostics

Conducting a standard ECG with incomplete blockade of the right bundle of His bundle is the main diagnostic method. Further examination depends on the type of blockade detected:

  1. Incomplete right - without the presence of heart disease is considered as the physiological norm.
  2. Two-beam - requires more thorough diagnosis.
  3. Full left or trehpuchkovaya - require immediate hospitalization to find out the cause, even without patient complaints about those or other symptoms.

Other diagnostic methods include biochemical and clinical blood tests, urinalysis, daily ECG monitoring, echocardiography, MRI and MSCT (magnetic resonance and multispiral tomography).

Treatment tactics

Tactics of treatment of the blockade

If an incomplete blockade of the right bundle of His is not accompanied by pathology of the heart (or other systems and organs that can affect the state of the heart tissues), then treatment is not carried out. If the underlying disease is, then therapy may include:

  1. Reception of vitamins B1, B2, PP;
  2. Natural sedatives - motherwort, sage, Novopassit, herbs;
  3. Antihypertensive drugs for the normalization of pressure - Lisinopril, Losartan, Perindopril, Valsartan, Verapamil, Atenolol;
  4. Blood thinners (for the prevention of blood clots) - Cardiomagnyl, Curantil, Thrombotic ACC, Pentoxifylline;
  5. Drugs that reduce cholesterol in the blood - Simvastatin, Rosuvastatin;
  6. Antioxidants;
  7. Diuretics (indapamide, chlorthalidone) and cardiac glycosides (lanatozid, lanikor, carditoxin) are prescribed for heart failure.

With the development of "pulmonary" heart due to bronchopulmonary pathologies, glucocorticosteroid agents and adrenomimetics are prescribed. If there is inflammation of the heart membranes, antimicrobial agents and NSAIDs are indicated.

The operative method of treatment consists in installing an EKS (pacemaker), which is indicated in case of complete impairment of the conduction of the impulse (left or right).

A person with an EKS should not be in the immediate vicinity of electrical appliances (less than 20 cm), be it a mobile phone, a hairdryer, a TV, an electric shaver or other working devices.

Consequences of the blockade of the His foot in the presence of a primary disease:

  • ventricular tachycardia;
  • heart failure;
  • ventricular fibrillation;
  • stroke;
  • thromboembolism;
  • sudden cessation of heart function.

Preventing the development of such conditions is a regular examination and visit to a cardiologist, a healthy lifestyle and compliance with all doctor's instructions.

Are sports acceptable?

In the case of an incomplete blockade of the right bundle of the His branch, it is permissible to engage in sports only if there are no heart or lung diseases that caused it. If the main pathology takes place, then physical loads require limitation.

Intensive training, weightlifting and other strength sports are excluded, activity should be as gentle as possible and selected with a specialist.

It is also important to avoid stress, strong emotional experiences, smoking and drinking alcohol, proper rest and a balanced diet are necessary.

Interesting

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