Wolff-Parkinson-White Syndrome: Causes and Treatment

Wolff-Parkinson-White Syndrome: Causes and Treatment Overview In a normal heart, the electrical impulses that signal the heart to beat only flow in one pathway, which begins in the sinoatrial node, or SA node, located in the right atrium. When the SA node fires, the single is spread through the right and left atria causing the chambers to contract. The impulses then travel through the atrioventricular node, AV node, which is the bridge that allows the impulses to flow from atria to the ventricles. The AV node slows down the electrical signal before sending it to the ventricles. This slight delay allows the ventricles to fill with blood. When electrical impulses reach the muscles of the ventricles, they contract, causing them to pump blood either to the lungs or to the rest of the body. When the electrical signal reaches the ventricles, the chamber them to contract. In wolf-Parkinson-white syndrome, also known as WPW, an extra conduction pathway to the ventricles reaches the chambers quicker the normal. This is because impulses travel through the extra pathway as well as the normal AV node system. The impulses travel in a circular pattern. This circular pattern causing the heart to beat unusually beating patterns called arrhythmia. The arrhythmias are conserved an electrical abnormalities called pre-excitation syndromes, and they are in many forms. In Wolff-Parkinson-White syndrome, the most common form of arrhythmia is known as paroxysmal supraventricular tachycardia. Many people with WPW also experience atrial fibrillation, an irregular rapid heart rhythm. Wolff-Parkinson-White syndrome is present at birth, but the first symptoms often first appear in teens. WPW is one of the most common causes of fast heart rate in infants and children. The syndrome affects about 1 to 3 people in 1,000 people worldwide, but many do not everyone experience symptoms. IN China 70 percent of cases of abnormal heart, rhythm is due to WPW. The extra electrical pathway in the heart doesnt necessarily cause a fast heartbeat. However, this condition makes it possible for other processes to increase the heartbeat, including: Looped electrical impulses, Disorganized electrical impulses Looped electrical impulses. The problem with a fast heartbeat usually occurs in Wolff-Parkinson-White syndrome because electrical impulses travel down one pathway and up the other one, creating a loop of signals. This condition, called AV reentrant tachycardia, sends impulses to the ventricles at a very rapid rate. The ventricles, as a result, pump very quickly. Disorganized electrical impulses. If electrical impulses dont begin correctly in the right atrium, they may travel across the atria in a disorganized way, causing them to beat very quickly and out of step with each other. This condition is called atrial fibrillation. These disorganized signals also increase the pumping rate of the ventricles to some extent. If theres an extra electrical pathway, as with Wolff-Parkinson-White syndrome, the ventricles can beat even faster. The ventricles dont have time to fill up with blood and dont pump enough blood to the body. This less common condition can be life-threatening. History In 1930, Wolff, Parkinson and White described a distinct electrocardiograph (ECG) pattern in healthy young people with short bursts of tachycardia. In 1933, other doctors noted the reason for this irregular rhythm was a faster passage of impulses traveling through the ventricles. In 1944, doctors confirmed the presence of extra pathways. Causes The extra electrical pathway of Wolff-Parkinson-White syndrome is present at birth. Little known to why the extra pathway delopes, but can be caused by sporadic occurrence, and is linked abnormal gene and inheritance, which accounts for a small a small percentage of cases. In most cases, the cause of Wolff-Parkinson-White syndrome is unknown. Most of WPW occurs randomly in the general population, occurring in about 0.1 to 3.1 per 1,000 persons. men have a higher incidence of WPW than women do, for uknown reasons A small percentage of Wolff-Parkinson-White syndrome is caused by a mutation of the PRKAG2 gene. The mutation of the gene is also linked to hypertrophic cardiomyopathy, a form of heart disease that enlarges and weakens the cardiac muscle of the left ventricle. The PRKAG2 gene codes for a protein that is part of the AMP-activated protein kinase (AMPK) enzyme. AMPK is believed to be involved in the development of the heart before birth, as well helps mangae the energy demands within the heart. Researchers are uncertain how PRKAG2 mutations lead to the development of WPW, but is due to the altered activity of AMP-activated protein kinase in the heart. It is unclear if the changes cause overactivate enzyme or reduce enyme activity. It is know though that the AMPK mutation allows glycogen to build up abnormally within cardiac muscle, as well as being related to changes in the regulation ion channels in the heart, which play critical roles in maintaining the hearts normal rhythm. Most cases of Wolff-Parkinson-White syndrome occur in people with no apparent family history of the condition, and accounts for only a small percentage of all cases of this condition. The inheritory disorder typically has an autosomal dominant pattern of inheritance. Some cases of WPW are inherited. Parents who have accessory pathways may pass them on to their children. Research has indicated that incidence of preexcitation in first-degree relatives could be as high as 5.5 per 1,000 persons. About 7 to 20 percent of patients with WPW also have congenital defects within the heart. Symptoms The extra connection in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and move from the atria to the ventricles faster than usual. The accessory pathway also can transmit electrical impulses abnormally from the ventricles back to the atria, causing an additional contraction of the atria, leading to an abnormally fast heartbeat, called tachycardia and other arrhythmias. About 80 percent of people with symptoms first have them between the ages of 11 and 50. Complications of Wolff-Parkinson-White syndrome can occur at any age, although some individuals born with an accessory pathway in the heart never experience any health problems associated with the condition. Resulting symptoms of the arrhythmias are dizziness, a sensation of fluttering or pounding in the chest called palpitations, shortness of breath, fainting, and rarely associated with cardiac arrest and sudden death. Some people have WPW without any symptoms at all. The most common arrhythmia associated with Wolff-Parkinson-White syndrome is called paroxysmal supraventricular tachycardia. A person experiencin an tachycardia episode will have heart rate greater than 230 beats per minute and normal blood pressure. An episode of a tachycardia begin suddenly and last for a few seconds or several hours, and often happen during exercise. Wolff-Parkinson-White syndrome often occurs with other structural abnormalities of the heart or underlying heart disease. The most common heart defect associated with the condition is Ebstein anomaly, which affects the valve that allows blood to flow from the right atrium to the right ventricle (the tricuspid valve). Additionally, Wolff-Parkinson-White syndrome can be a component of several other genetic syndromes, including hypokalemic periodic paralysis (a condition that causes episodes of extreme muscle weakness), Pompe disease (a disorder characterized by the storage of excess glycogen), and tuberous sclerosis (a condition that results in the growth of noncancerous tumors in many parts of the body). Treatments Treatments for WPW depends on the type , frequency, and associated symptoms of the arrhythmias experienced. tachycardia may correct itself, but often needs treatment. The goal of treatments for Wolff-Parkinson-White syndrome is to slow a fast heart rate when it occurs and prevent future episodes. Ways to slow your heartbeat include: Vagal maneuvers. Medications, and surgerys. Whether a person will be treated with medication or with an ablation procedure depends on several factors. These include the severity and frequency of symptoms, risk for future arrhythmias and patient preference. Vagal maneuvers affect the vagus nerve, which is the same nerve that regulate heartbeats, and is usally the first treatment tried. Vagal maneuvers, which include coughing, bearing down as if you are having a bowel movement, and putting an icepack on your face, are often performed during an episode of a fast heartbeat. These actions sometimes resulting in slowed conduction of electrical impulses through the AV node. If vagal maneuvers do not stop the fast heartbeat, often medicine is needed. Often an injection of an anti-arrhythmic medication, such as adenosine, or pill versions of drugs, such as flecainide (Tambocor) or propafenone (Rythmol), may be percribed to be taken in response to episode of a fast heartbeat that doesnt respond to vagal maneuvers. Anti-arrhythmic medications may prevent a fast heart rate all together when taken regularly. Medications are usually given to people who experience frequent arrhythmias who cannot, or do not want to undergo surgery. In people with WPW, whose heart rate can not be controlled with medications, ablation can improve symptoms and cure the abnormal arrhythmias. The most common procedure used to interrupt the abnormal pathway is radiofrequency, also known as or catheter ablation. This procedure involves inserting a catheter in an incision in the groin area and running the catheter to the heart area. Electrodes at the catheter tips are heated to damage (ablate) the extra electrical pathway and prevent it from sending electrical signals. When the catheter reaches the heart, the extra electrical pathway is destroyed using radiofrequency. This procedure is highly effective with a success rate for the procedure ranges between 85 95%, and complications which can include heart injury or infection are uncommon. Successful ablation ends the need for medication. Another procedure done to elevate the symptoms of Wolff-parkinson-white syndrome is cardioversion. cardioversion is a procedure where a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and restores a normal rhythm. Its typically used when maneuvers and medications arent effective. When all other forms of treatments have not worked open-heart surgery is almost 100 percent. However, because radiofrequency catheter ablation is almost as effective and less invasive, surgery for Wolff-Parkinson-White syndrome is now rare. However, surgery is usually done only if the patient must have surgery for other reasons. Social implications A person with WPW have several Social implications they must deal with. Since Wolff-Parkinson-White syndrome often occurs with other structural abnormalities of the heart or underlying heart disease, a person monitor there heart health carefully. In Addition to this several other genetic syndromes, including hypokalemic periodic paralysis (a condition that causes episodes of extreme muscle weakness), Pompe disease (a disorder characterized by the storage of excess glycogen), and tuberous sclerosis (a condition that results in the growth of noncancerous tumors in many parts of the body) must be monitored. Common day substances of Caffeine, Tobacco, Alcohol, and Pseudoephedrine which can contribute tachycardia episoides. This makes the person monitor there exposure to these substances and avoid places of smoking if tobacco causes symptoms. With the relatively new ohio smoking ban helps eliminate this social issue with smoking. References http://www.americanheart.org/presenter.jhtml?identifier=4785 http://www.medicinenet.com/wolff-parkinson-white_syndrome/page2.htm http://www.nlm.nih.gov/medlineplus/ency/article/000151.htm http://my.clevelandclinic.org/heart/disorders/electric/wpw.aspx http://www.mayoclinic.com/health/wolff-parkinson-white-syndrome/ds00923

Children in Victorian society Essay

Charles Dickens was born in Portsmouth in 1812. He lived a happy childhood. Everything was fine until 1824 when Dickens was 12 his father, John Dickens was sent to Marshalsea prison for debt. Dickens was put to work in the Warners blacking factory. When John Dickens left prison Dickens was told by his mother to stay on working at the factory. He found working there a humiliating experience but the good thing is it inspired much of his fiction in later life. Charles Dickens wrote ‘A Christmas Carol’ as a warning to London. London at the time was much divided, it was split into the poor and rich living, and there was no middle class. The rich would be VERY rich, would own masses of land, they would have extravagant clothes and foods with servants serving them their marvellous foods. Whereas the poor was VERY poor! The vast majority would be homeless, probably scavenge for food and all that they owned would be the clothes that they had on. The poor would be living on very dirty streets that were filled with disease and famine. On page 69 we get to see how bad these streets are as Dickens gives us a graphic detail of them. He describes the alleys and arches as cesspools. Cesspools were pits at the end of some (most) streets where all waste products were dumped – including human waste! This paragraph in the novel really shows us as the audience just how bad London was at the time. The warning was that: ‘If the children of today keep on growing up like they are, uneducated and neglected, the outlook for this country and its nation is a very bad one ‘ His very famous play ‘A Christmas Carol’ written in 1842 showed a great reflection of London society e. g. we had the poor and the rich – Scrooge (the main character) and tiny Tim (a disabled poor child. ) The character of scrooge was a very cold and lonely one. We can relate Scrooge to Dickens because scrooge had spent many Christmas’s alone at boarding school just like Dickens had at the factory. The boarding schools were very unpleasant places; they were lonely and very strict! Parents would send their children to them to get them out of the way until they were old enough to work; children were treated very badly in Dickens’ time. On pages 26 – 29 Dickens uses pathetic fallacy to describe Scrooge’s boarding school in his novel. Pathetic fallacy uses surroundings to create images of feelings. Dull red brick tells me that this is place is dull, boring and not the best of places to be. The whole passage uses different images to show us how truly bad this place is. He describes the place as damp, mossy, dreary – all these words are negative points. This shows us how depressing it must have been on the students e. g. Scrooge. The boarding school has had a dramatic impact in Scrooges life and has made Scrooge the way he is! His personality reflects the description of the school – the cold/upsetting environment has left Scrooge with a cold/icy personality. Dickens uses three ghosts to tell the story they show us the past, present and future of Scrooges life. The 1st ghost – Past This ghost takes us back to Scrooges time at boarding school, it shows him alone and neglected as other children go home for Christmas with their warm, loving families. Scrooge is described as a solitary child neglected by his friends (pg 26. ) The ghost also shows that after Scrooge leaves school he is very mean and because he is very lonely his only ‘friend’ is his money. We can see this in a scene with his girlfriend as he has to decide love of money, he chooses money and once again he is alone. The 2nd ghost – present This ghost introduces us to the Cratchit family waiting for Bob Cratchit and tiny Tim to get back from church. Tiny Tim is a young boy, he is very ill and likely to die soon, and this is all due to poverty not neglect because he has a very caring family! Tiny Tim is physically crippled and we see Scrooge as emotionally crippled from his childhood. The ghost then shows some of Scrooges family having a Christmas celebration without him. They are playing a guessing/description game where one person thinks of something and others have to guess what it is or who it is by asking questions. The game starts with someone describing this person as a savage animal living in London. Someone guesses it as ‘Uncle Scrooge’ He shows no emotion towards this and doesn’t care what anyone thinks of him. The ghost finally shows Scrooge two children, a boy and a girl. The boy represents ignorance and the girl represents want. Dickens sees the boy as the one to be scared of, he uses the boy to tell us that with the lack of education the boy will turn out much worse than the girl of want (poverty. ) When we are first introduced to the children, Dickens describes them as wretched objects, frightful, hideous, and miserable. From this I get the idea that Dickens is confused about what he wants to portray by these characters. Dickens then describes them as yellow, meagre, ragged, scowling, wolfish; but prostate too. He has now decided to portray both these children as frighteningly scary. These children really bring up dickens’ massage of a poor future The last ghost – future This ghost shows Scrooge some disturbing images in this stave, the stave starts off with people talking about a man who has died but people are quite happy about his death. They then see other people talking about what they have stolen from this dead man, just to get some money. Somebody has even stolen the sheets he was lying on. This shows that nobody really cares about the man that has died! This ghost shows Scrooge the Cratchit family again but they are no longer happy and cheery this is because Tiny Tim has passed away due to the poverty. Finally the ghost shows Scrooge a gravestone with his name on it, this when Scrooge realises that nobody does car about him and that he is alone. He has caused the suffering of the Cratchit’s with his evil greedy ways! Scrooge w.akes up on Christmas day and changes who he is and helps Tiny Tim and the Cratchit’s. I think that this story works very well because look where we are today, there is no longer much harsh poverty and all children are now educated in England. So I believe that this novel could have played a huge part in this transformation because I woke people up to just how bad things were going to be. Charles Dickens passed away suddenly in 1870 without finishing his final novel ‘The Mystery of Edwin Drood’

Citation and Argumentative Research Paper

Kenned Taylor Evaluator: Angela Moore Title: Pro's and Cons of Abortion What was the thesis statement of the essay? Abortions, an unethical practice of termination should be illegal because it is considered murder, can cause physiological and medical problems, and reduces the number of adoptions. How was the introduction? Did it grab your attention? If so, how? If not, what could have been done differently? The introduction was good and it did grab my attention by showing interesting facts.Did the author make a strong case for their argument? What was the strongest argument that was made? Lacked evidence for the arguments, not strong enough arguments. What was the weakest argument made? Arguments were all kind of weak How well did the author Incorporate: Facts? Yes Anecdotes? No Quotes? There wasn't many quotes In the paper. How well did the author follow the PAP formatting and citation requirements? What could have been done differently? The PAP Format could use a little more work b ut overall it was fine.The reference page needs to be finished. How well did the author do with using correct grammar and punctuation? Were there any specific areas that he or she needs to work on for future papers? (Be specific) There were a few spelling mistakes and the sentences had much grammar (Passive 1 OFF Could you determine a Christian worldview in the paper? If yes, what was it? Yes there was a Christian world view, abortion is a sin. Did the conclusion wrap up the paper without introducing new information? Yes but you need to work on length.

The End Of The Stranger By Albert Camus - 1859 Words

At the end of The Stranger by Albert Camus, the protagonist Meursault says: For me to feel less alone, I had only to wish that there be a large crowd of spectators the day of my execution and that they greet me with cries of hate. (123). It is here that Meursault proposes a new look at the relationship between internal suffering and the external manifestation of that suffering: hateful spectators. Similarly, in Crime and Punishment, Marmeladov and Katerina have their individual miseries highlighted through both personal strife and, inevitable, their public deaths. Despite the different circumstances of their deaths, both seem to suggest that the crowd of disgusted spectators offer validation to Marmeladov and Katerina’s suffering. The†¦show more content†¦Additionally, the carriage drivers story is corroborated by three bystanders: â€Å"‘That s exactly how it was! some witness responded from the crowd. ‘he did shout †¦ another voice responded ‘everybody heard it! cried a third.† (175). This demonstrates how the audience has a vested interested in being a part of the narrative. Here, Dostoevsky uses the parallel of the coachman s three shouts with the three witnesses to show a contradiction between the motives of the two similar but distinct parties. The carriage driver attempts to distance himself from the tragedy of the event, while the crowd strives to become part of the tragedy, whether it be by encroaching on the scene, or by confirming the coachman s story. The witnesses strive to be a part of the struggle, and in doing so, it serves to highlight the magnitude of Marmeladov’s physical suffering. This interplay between sufferer and spectators culminates when Dostoevsky uses the narrator to highlight the entertainment value of a tragedy and to elaborate on the satisfaction that the audience receives from the spectacle. 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