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Most often, the course of AV blockade is accompanied by the appearance or aggravation of chronic heart failure and the development of ectopic arrhythmias, including ventricular tachycardia. The course of a complete atrioventricular block may be complicated by the development of lamisil attacks associated with cerebral hypoxia as a result of bradycardia. The onset of an attack may be preceded by a feeling of heat in the head, attacks of terbinafine pills and dizziness; during an attack, the patient turns pale, then cyanosis and loss of consciousness develop. At this point, the patient may need to perform chest compressions and mechanical ventilation, since prolonged asystole or the addition of ventricular arrhythmias increases the likelihood of sudden cardiac death.
Multiple episodes of loss of consciousness in elderly patients can lead to the development or aggravation of intellectual-mnestic disorders. Less commonly, with AV blockade, the development of arrhythmogenic cardiogenic shock is possible, more often in patients with myocardial infarction.
In conditions of insufficient blood supply with AV blockade, phenomena of cardiovascular insufficiency (collapse, fainting), exacerbation of coronary heart disease, and kidney disease are sometimes observed. When assessing the patient's history in case of suspected atrioventricular blockade, the fact of terbinafine 250 mg x 60 pills myocardial infarction, myocarditis, other cardiopathologies, taking drugs that disrupt atrioventricular conduction (digitalis, β-blockers, calcium channel blockers, etc.) is ascertained.
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Indications for implantation of an endocardial pacemaker are a history of Morgagni-Adams-Stokes attacks (even a single one); ventricular rate less than 40 per minute and periods of asystole 3 or more seconds; AV block II degree (type II according to Mobitz) or III degree; complete AV block, accompanied by angina pectoris, congestive heart failure, high arterial hypertension, etc. To decide on the operation, a consultation with a cardiac surgeon is necessary.
A radical method of treating AV blockade is the installation of an electrical pacemaker (EX), which restores normal rhythm and heart rate.
As a symptomatic therapy for the chronic form of AV blockade, theophylline, belladonna extract, and nifedipine are treated.
With symptoms of congestive heart failure, diuretics, cardiac glycosides (with caution), vasodilators are prescribed.
First aid drugs for stopping Morgagni-Adams-Stokes attacks are isoprenaline (sublingually), atropine (intravenously or subcutaneously).
In case of AV blockade of cardiac origin (with myocardial infarction, myocarditis, cardiosclerosis, etc.), a course of treatment with β-adrenergic stimulants (isoprenaline, orciprenaline) is carried out, and implantation of a pacemaker is further indicated.
If AV blockade is caused by taking drugs (cardiac glycosides, antiarrhythmic drugs, β-blockers), dose adjustment or their complete cancellation is necessary.
With atrioventricular blockade of the 1st degree, which occurs without clinical manifestations, only dynamic observation is possible.