Paroxysmal Tachycardia Management
Categories: UncategorizedSources: Disturbances Of The Heart
There is no specific treatment for paroxysmal tachycardia. What is
of value in one patient may be of no value in another; in fact,
drugs are rarely successful in ameliorating or preventing the
condition. Patients who are accustomed to these attacks often learn
what particular position or management stops the attack.
Sometimes a patient rises and walks about. Sometimes an ice-bag over
the heart will stop t
If there is no serious illness present, and no serious cardiac
disease causing the condition, and a patient is known to have an
overloaded stomach or bowels, an emetic or a briskly acting
cathartic is the best possible treatment. The attack often
terminates as suddenly as it begins, without leaving any knowledge
as to which particular treatment has been beneficial. A patient who
is well and has an attack of tachycardia should be allowed to assume
the position which he finds to give him the most comfort, and to use
the means of stopping his attack which lie has found the most
successful. In the absence of his success or of his knowledge of any
successful treatment, a hypodermic injection of 1/6 or even 1/4
grain of morphin sulphate is often curative. Atropin should not be
given, as it may increase the cardiac disturbance. If an attack
lasts more than an hour or so, one of the best treatments is the
bromids, which should be given either by potassium or sodium bromid
in a dose of 2 or 3 gm. (30 or 45 grains) at once. Sometimes one
good-sized dose of digitalis may be of benefit, but it is often
disappointing, and unless there is a valvular lesion with signs of
broken compensation, it is rarely indicated. It should also be
remembered that, if the patient is receiving digitalis in good
dosage for broken compensation, tachycardia may be caused by an
overaction of the digitalis. Such overaction would be indicated by
previous symptoms of nausea, vomiting, intestinal irritation, a
diminished amount of urine, headache and a tight, bandlike feeling
in the head, cold hands and feet, and a day or two of very slow
pulse. If none of these symptoms is present, though a patient has
received digitalis for broken compensation, a tachycardia occurring
might not contraindicate digitalis, as much of the digitalis on the
market is useless; and a patient may not actually have been
obtaining digitalis action.
If the tachycardia occurs in a patient with arteriosclerosis,
especially if there is much cardiac pain, nitroglycerin is of
advantage; also warm foot-baths. If there is prostration and a
flaccid, flabby abdomen, a tight abdominal bandage may be of
benefit.
Gastric flatulence, while perhaps not a cause of the tachycardia, is
liable to develop and be a troublesome symptom. Anything that causes
eructations of gases is of benefit, as spirit of peppermint,
aromatic spirit of ammonia or plain hot water. If there is
hyperacidity of the stomach, sodium bicarbonate or milk of magnesia
will be of benefit.
The ability of some patients to stand a rapid heart action without
noting it or being incapacitated by it is astonishing. It may
generally be stated that a rapid heart is noted, and a pulse above
120 generally prostrates, at least temporarily, a patient who is
otherwise well, provided the cause is anything but hyperthyroidism.
A patient who has hypersecretion of the thyroid will be perfectly
calm, collected, often perhaps not seriously nervous, and, with a
heart beating at the rate of 140, 150, 160 and even 200 per minute,
will state that she has no palpitation now, although she sometimes
has it. A heart thus fast, with a patient not noting it and not
prostrated by it, is almost diagnostic of a thyroid cause.
Some patients, both men and women, cannot take even a small cup of
tea or coffee without an attack of paroxysmal tachycardia. Such
patients, of course, quickly learn their limitations.
More
-
Of Whitlow
The lunar caustic is very useful in the treatment of this painful affection. Patients seldom apply to the surgeon before suppuration has taken place. It is then, I think, the best plan to open the abscess freely, to apply the caustic well within the... Old Ulcers
Take the A D current. If torpid, treat with mild force. Treat the sore with N. P., while P. P. is held upon some healthy part, and usually at a higher point. Treat five to ten minutes, three or four times a week. If high inflammation be present, thi... On The Adherent Eschar
It appears scarcely necessary to describe the immediate and well known effects of the application of the lunar caustic to the surface of a wound or ulcer. It may, however, be shortly observed that the contact of the caustic induces, at first, a whit... On The Treatment By Eschar And Poultice
In many cases in which it is impossible to adopt either the mode of treatment by the adherent or the unadherent eschar, it is of great utility to apply the caustic first and then a cold poultice made without lard or oil: this plan is particularly us... On The Unadherent Eschar
The eschar is generally adherent in cases of recent injuries, and in small ulcers, when they are nearly even with the skin and attended by little inflammation. In other cases the eschar is too apt to be unadherent, and this arises from the formation... On Ulcers
From the preceding observations it would naturally be concluded that the lunar caustic would afford a remedy for the treatment of ulcers. This conclusion is perfectly just. Yet there are many circumstances which render the mode of treating ulcers by... One's Self
TO be truly at peace with one's self means rest indeed. There is a quiet complacency, though, which passes for peace, and is like the remarkably clear red-and-white complexion which indicates disease. It will be noticed that the sufferers from thi... Onion Cases
All too many of my cases are what I privately refer to as onion cases. By this I mean the opposite of a simple case. There are multiple complaints. I call them onion cases because these people get better in layers, like pealing an onion. As each ski... Operating Room
All endoscopic procedures should be performed in a somewhat darkened operating room where all the desired materials are at hand. An endoscopic team consists of three persons: the operator, the assistant who holds the head, and the instrument assista... Opium
As so many times repeated, real pain must be stopped, and morphin, either by the mouth or hypodermically, should be used to the point of stopping such pain. If the patient is a young child, codein sulphate or the deodorized tincture of opium may be ... Other Bad Symptoms
These symptoms may present themselves with the rash standing out; but most frequently they occur when there is little or no eruption, or when it fades, becomes livid, or disappears altogether. A sudden disappearance of the rash, before the sixth day... Other Forms Of Rest
DO you hold yourself on the chair, or does the chair hold you? When you are subject to the laws of gravitation give up to them, and feel their strength. Do not resist these laws, as a thousand and one of us do when instead of yielding gently... Other Kinds Of Cancer
There seem to be many other kinds of cancer, at least if you believe the medical doctors. They divide up cancers and their treatments by their location in the body and by the type of cancer cells present. I do not see it that way. To me, a cancer is... Other Lesions
Tricuspid insufficiency, except as rarely found in the fetus, is generally due to a relative insufficiency rather than to an actual disease of the tricuspid valve. In other words, if the right ventricle dilates the valve may be insufficient. Tricusp... Other People_
HOWEVER disagreeable other people may be,--however unjust they may be, however true it may be that the wrong is all on their side and not at all on ours,--whatever we may suffer at their hands,--we can only remedy the difficulty by looking f... Other Sequels Dropsy &c
Beside the ulceration of glands and deafness, some of the sequels of scarlatina are white swelling of one or more of the joints, usually the knee, chronic inflammation of the eyes and eyelids, and partial paralysis. These chiefly occur in scrofulous... Others
HOW to live at peace with others is a problem which, if practically solved, would relieve the nervous system of a great weight, and give to living a lightness and ease that might for a time seem weirdly unnatural. It would certainly decrease the inc... Our Feet
The Living Arches of the Foot. One of the most important things to look after, if we wish to have an erect carriage and a swift, graceful gait, is the shape and vigor of the feet. Each foot consists of two springy, living arches of bone and sinew, w... Our Relations With Others
EVERY one will admit that our relations to others should be quiet and clear, in order to give us freedom for our work. Indeed, to make these relations quiet and happy is the special work that some of us have to do. There are laws for health,... Our Spirit-levels
The Sixth Sense. Though we usually speak of having five senses,--sight, smell, hearing, touch, and taste,--we really have also a sixth--the sense of direction, or of balance. The machine of this sense is comparatively simple, being made up of three ... Our Telephone Exchange And Its Cables
The Brain. We are exceedingly proud of our brain and inclined to regard it as the most important part of our body. So it is, in a sense; for it is the part which, through its connecting wires, called the nerves, ties together all the widely separate... Our Wonderful Coat
What the Skin Is. The skin is the most wonderful and one of the most important structures in the body. We are prone to think lightly of it because it lies on the surface, and to speak of it as a mere coating, or covering--a sort of body husk; but it... Oxygen Tank And Tracheotomy Instruments
Respiratory arrest may occur from shifting of a foreign body, pressure of the esophagoscope, tumor, or diverticulum full of food. Rare as these contingencies are, it is essential that means for resuscitation be at hand. No endoscopic procedure shoul... Painful Menstruation
Elsie was twenty. She came to see me because I had helped Elsie's mother overcome breast cancer many years earlier. Elsie began to have very painful periods with profuse bleeding and abdominal pain. Her nutrition had been generally good because her ... Painful Urination Incontinence Of Urine
_Involuntary Urination._ Where the discharge of urine produces smarting and burning of the urethra, _Cantharis_ is the remedy. Where there seems to be an over secretion of acrid urine, producing inflammation of the neck of the bladder, known by p... Palpitation Of The Heart
This is commonly a symptomatic or sympathetic affection--rarely idiopathic--and disappears on cure of the disease from which it proceeds. It usually denotes nervous weakness, and often general debility. General tonic treatment is indicated, as far a... Papilloma Forceps
Papillomata do not infiltrate; but superficial repullulations in many cases require repeated removals. If the basal tissues are traumatized, an impaired or ruined voice will result. The author designed these forceps (Fig. 29) to scalp off the growth... Papillomata
Decannulation after tracheotomy done for papillomata should be deferred at least 6 months after the discontinuance of recurrence. Not uncommonly the operative treatment of the growths has been so mistakenly radical as to result in cicatricial or ank... Papillomata Of The Larynx In Children
Of all benign growths in the larynx papilloma is the most frequent. It may occur at any age of childhood and may even be congenital. The outstanding fact which necessarily influences our treatment is the tendency to recurrences, followed eventually ... Paracelsus
THEOPHRASTUS BOMBASTUS VON HOHENHEIM, commonly known as Paracelsus, was born in 1493 at Maria Einsiedeln, near Zurich, Switzerland. When he was nine years old, his father, who was a reputable physician, removed his residence to Carinthia. Paracelsus... Paralysis
Bilateral abductor laryngeal paralysis causes severe stenosis, and usually tracheotomy is urgently required. In cadaveric paralysis both cords are in a position midway between abduction and adduction, and their margins are crescentic, so that suffic... Paralysis
Take the B D current, medium force. If the paralysis be in a lower limb, place P. P., long cord, upon the lower lumbar vertebrae, so as to reach the hypogastric plexus, and treat with the metallic brush, N. P., five to eight minutes, over all the af... Paralysis Of The Esophagus
The passage of liquids and solids through the esophagus is a purely muscular act, controlled, after the propulsive usually voluntary start given to the bolus by the inferior constrictor, by a reflex arc having connection with the central nervous sys... Paroxysm Drugs
The part the nervous system plays in this paroxysm is shown by the good result obtained from injections of morphin, even when there is no pain; hence the action of morphin is directly in line with the natural resolution of the symptoms: it quiets th... Paroxysm Management
The immediate conditions to meet are the rapid fluttering heart, the nervous excitation and cardiac anxiety, and perhaps the most important of all, the vasomotor spasm that is often so pronounced. Physically we have, then, a heart with leaking or co... Paroxysmal Tachycardia
This condition is generally termed by the patient a "palpitation," and palpitation of the heart is recognized by most physicians as meaning a too rapidly acting heart, the term "tachycardia" being reserved for an excessive rapidity of the heart. Man... Paroxysmal Tachycardia Management
There is no specific treatment for paroxysmal tachycardia. What is of value in one patient may be of no value in another; in fact, drugs are rarely successful in ameliorating or preventing the condition. Patients who are accustomed to these attacks ... Pathologic Physiology
The development of permanent injury to one or more valves of the heart may have been watched by the physician who cares for a patient with acute endocarditis, or it may have been noted early during the progress of arteriosclerosis or other conditi... Pathology
The part of the heart most affected is the part which has the most work to do--the left side of the heart--and of this side the left ventricle and therefore the mitral and aortic valves; the most frequent valve to be inflamed and to stiffer permanen... Pathology
The pathology of arteriosclerosis is a thickening and diminishing elasticity of the arteries, beginning with the inner coat and gradually spreading and involving all the coats, the larger arteries often developing calcareous deposits or thickened ca... Pathology
If the foreign body completely obstructs a main bronchus, preventing both aeration and drainage, such rapid destruction of lung tissue follows that extensive pathologic changes may result in a few months, or even in a few weeks, in the case of irri... Penetrating Projectiles
Foreign bodies that have penetrated the chest wall and lodged in the lung may be removed by oral bronchoscopy if the intruder is not larger than the lumen of the corresponding main bronchus (see Bibliography, 43) [FIG. 90.--Schematic illustration... Pericarditis Symptoms And Signs
If there is pain or much aching in the cardiac region, it tends to disappear with the exudate, if such is to occur, in the same way as does the pain of pleurisy. If there is much exudate, the pressure on the heart of course increases, the cardiac du... Period Of Desquamation Or Peeling-off
About the sixth or seventh day, the epidermis, or cuticle of the skin begins to peal off, commencing in those places which first became the seat of the rash, and gradually continuing all over the body. In such parts as are covered with a thin delica... Period Of Efflorescence Or Standing Out Of The Rash
During the first day or two of the period of efflorescence, which lasts three or four days, the above symptoms usually continue to increase. Sometimes, however, the patient is alleviated at once on the rash being formed. This alleviation always take... Period Of Eruption Or Appearing Of The Rash
Commonly, on the second day, towards evening, sometimes on the third, and only in very bad cases later, the rash begins to make its appearance, under an increase of the above symptoms, especially of the fever and delirium, and continues to come out ... Period Of Incubation Or Hatching
The time which passes between the reception of the contagious poison into the system and the appearance of the rash, is called the period of incubation; incubation or incubus meaning, properly, the sitting of birds on their nests, and figuratively, ... Perversions In The Guidance Of The Body
SO evident are the various, the numberless perversions of our powers in the misuse of the machine, that it seems almost unnecessary to write of them. And yet, from another point of view, it is very necessary; for superabundant as they are, t... Philosophy Of Disease And Cure
In every part of the animal economy, polar derangements in the electro-vital principle are liable to occur. These derangements are always the real foundation of disease. They may be occasioned by a thousand agencies, which act as the procuring cause... Phylacteries
They ware in their foreheads scrowles of parchment, wherein were written the tenne commaundements given by God to Moses, which they called philaterias. JOHN MARBECK, Book of Notes and Common-Places: 1581. There we... Physical Care
REST, fresh air, exercise, and nourishment, enough of each in proportion to the work done, are the material essentials to a healthy physique. Indeed, so simple is the whole process of physical care, it would seem absurd to write about it at all. The... Physical Signs In Esophageal Foreign Body
There are no constant physical signs associated with uncomplicated impaction of a foreign body in the esophagus. Should perforation of the cervical esophagus occur, subcutaneous emphysema, and perhaps cellulitis, may be found; while a perforation of... Physical Signs Of Bronchial Foreign Body
In most cases there will be limitation of expansion on the invaded side, even though the foreign body is of such a shape as to cause no bronchial obstruction. It has been noted frequently in conjunction with the presence of such objects as a common ... Physical Signs Of Tracheal Foreign Body
If fixed in the trachea the only objective sign of foreign body may be a wheezing respiration, the site of which may be localized with the stethoscope, by the intensity of the sound. Movable foreign bodies may produce a palpatory thrill, and the rum... Physics Of Aortic Lesions
Next in frequency to mitral insufficiency is aortic insufficiency, which occurs most frequently in men. The cavity of the heart that is most affected by this lesion is the left ventricle, which receives blood both from the left auricle, and regurgit... Physics Of Mitral Stenosis
Mitral stenosis, though less common than mitral regurgitation, is a frequent form of disease of the valves, especially in women. Often this condition is associated with regurgitation; but in a simple mitral stenosis the greatest hypertrophy is of ne... Piles - Hemorrhoids
One important matter in all cases of habitual piles, is, to keep the bowels regular. Much can be done for this purpose by diet and regimen. On rising from bed in the morning drink freely, from a gill to half a pint of cold water, at least half an ho... Plain Every-day Common Sense
PLAIN common sense! When we come to sift everything down which will enable us to live wholesome, steady, every-day, interesting lives, plain common sense seems to be the first and the simplest need. In the working out of any problem, whether... Plate V Laryngeal And Tracheal Stenoses:
1, Indirect view, sitting position; postdiphtheric cicatricial stenosis permanently cured by endoscopic evisceration. (See Fig. 5.) 2, Indirect view, sitting position; posttyphoid cicatricial stenosis. Mucosa was very cyanotic because cannula was re... Pleurisy
This is inflammation of the Pleura of one or both lungs, generally confined to one side. It is known by sharp pain in the side of the chest, increased by taking a long breath, or coughing, or by pressing between the ribs. The cough is dry and painfu... Pleuroscopes
As mentioned above the anterior commissure laryngoscope and the esophageal specula make very efficient pleuroscopes; but three different forms of pleuroscopes have been devised by the author for pleuroscopy. The retrograde esophagoscope serves very... Pleuroscopy
Foreign bodies in the pleural cavity should be immediately removed. The esophageal speculum inserted through a small intercostal incision makes an excellent pleuroscope, its spatular tip being of particular value in moving the lung out of the way. T... Pleuroscopy For Disease
Most pleural diseases require a large external opening for drainage, and even here the pleuroscope may be of some use in exploring the cavities. Usually there are many adhesions and careful ray study may reveal one or more the breaking up of which ... Pneumonia
Its Cause and Prevention. The other great disease of the lungs is pneumonia, formerly known as inflammation of the lungs. This is rapid and sudden, instead of slow and chronic like tuberculosis, but kills almost as many people; and unfortunately, un... Pneumonia
Take B D current, forceful as the patient can bear, and treat briefly--say five to seven minutes, several times a day, until relief is experienced. Place N. P., long cord, low on back of neck, and move P. P. over all the upper part of the lungs. ... Polar Antagonism
When the conducting cords are of equal length, as commonly they should be, each of the two poles or electrodes produces a polar effect in the patient directly the opposite of that produced by the other. Also, at any point in either half of the circu... Polarization
It may be proper, in this place, to spend a few words upon electrical polarization in general. Electrical polarity may be defined as a characteristic of the electric or magnetic fluid, by virtue of which its opposite qualities, as those of attrac... Polarization Of The Circuit
I have said, in effect, a little above, that, while the current is running, the entire circuit is one complete magnet, which extends from the inner or positive sides of the zinc plates, where the current commences, all the way around to the outer or... Position For Bronchoscopy And Esophagoscopy
The dorsally recumbent patient is so placed that the head and shoulders extend beyond the table, the edge of which supports the thorax at about the level of the scapulae. During introduction, the head must be maintained in the same relative positio... Positive And Negative Effort
DID you ever have the grip? If you ever have you may know how truly it is named and how it does actually grip you so that it seems as if there were nothing else in the world at the time--it appears to entirely possess you. As the Irishman sa... Positive And Negative Manifestations
Acute diseases are to be regarded as electrically positive, and chronic affections as negative. The exceptions are rare, if any at all. Malignant cholera, which is eminently acute, might by some be considered as an exception. In negative diseases, t... Practice On The Dog
Having mastered the technic of introduction on the cadaver and trained the eye and fingers by practice work on the rubber tube, experience should be had in the living lower air and food passages with their pulsatory, respiratory, bechic and deglutit...