HOLTER ECG

Holter ECG:(P wave)

The P wave is the first complex seen on the ECG and represents atrial depolarization,which is an electrical and not a mechanical event.
The P wave does not reflect sinus node impulse formation but only reflects depolarization of the atrial muscle tissue once the sinus impulse reaches the atria from the node.

Holter ECG:(PR interval)

The PR interval is calculated from the beginning of the P wave to the  beginning of the QRS complex.
It represents the time it takes for the impulse to travel from the atria to the ventricles, including the normal physiological delay in the AV junction.
The PR interval should be within 0.12 to 0.20 second or no longer than one large square.

Holter ECG:(QRS complex)

The QRS complex represents ventricular depolarization and is measured from the beginning of the Q wave to the end of the S wave.
The Q wave is defined as the first negative deflection after the P wave.
The initial upright deflection or R wave is defined as the first upright deflection after the P wave.
The first negative deflection after the R wave is the S wave.It should normally return to the baseline.
Various configurations of the QRS complex may occur and the term QRS complex is used to describe this complex of ventricular depolarization regardless of the deflections present.

Memo A

1. Arrhythmia: An irregularity in the rate or rhythm of the heartbeat.
2. Palpitation: A subjective sensation of irregular or abnormal heatbeat.
3. Adams-Stokes syndrome: Slow or absent pulse as a result of atrioventricular block,causing syncope with or without convulsions.
4. Syncope: Loss of consciousness caused by diminished cerebral bllod flow.
5. Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to deficient oxygenation of the blood.
6. Cardiac arrest: Complete cessation of electrical and mechanical activities of the heart.

Memo B

1. Cheyne-stokes respiration: Periodic respiration with a gradual increase in depth followed by a gradual decrease resulting in apnea.
2. Biot respiration: An abnormal breathing pattern with continually variable rate and depth of breathing followed by apnea.
3. Hyperventilation: Increased alveolar ventilation relative to metabolic carbon dioxide production,leading to a loss of carbon dioxide from the blood.

 Editor: Shinsuke Sugaki M.T. 

SMI

Definition and Classification of the Cardiomyopathies.

• heart muscle diseases of unknown cause.
• diseases of the myocardium associated with cardiac dysfunvtion. 

Usefulness of 24 hour holter electrocardiography for the diagnosis of effort angina pectoris with coronary spastic angina.
*(Bibliography)
Japanese Journal of Medical Technology Jan 2022.

Cardio Pulmonary Resuscitation

1. Check to see if the person is conscious by tapping them on the shoulder and talking to them.
2. Check to see if he or she is breathing,and if not,perform 30 compressions to the sternium.
3. After applying pressure to the sternum,give rescue breathing. Give two breaths for one second each,and breathe with enough air to raise their chest.

Memo 

1. Conductive hearing loss: A reduction in the ability to perceive sound due to a lesion in the external auditory canal or the middle ear.
2. Sensorineural hearing loss: Hearing loss due to a lesion in the vestibulocochlear nerve or the inner ear.
3. Tinnitus: Perception of a sound in the absence of an environmental acoustic stimulus.

Important points

1. If rescue breathing cannot be performed,continue applying compressions to the sternum instead.
2. As a first step,ask someone nearby to call an ambulance or find an AED.
3. Methods of operation may differ from one AED to another.

Nervous System

1. Tremor:Rhythmic involuntary movements caused by alternate contraction of oppsing muscle groups.
2. Adie syndrome:A neurological disorder characterized by mydriasis and loss of deep tendon reflexes. 
3. Orthostatic hypotension:A drop in blood pressure upon assuming the standing position, accompanied by dizziness or syncope.

I wish all your family the best of health.

When the heart is compromised, the kidneys work hard compensate.
But eventually, the kidneys deteriorate, so the heart tries to help, but ends up overworking. In other words, when one organ declines, so does the other. Kidney function plays a very important role in heart failure. We want to extend the longevity of their hearts. For many heart failure patients with lifestyle-related diseases, existing. We believe existing treatments can help them to live as long as people without such conditions.

SUGAKI,M.T