Autonomic Nervous System Disorder: Postural Orthostatic Tachycardia Syndrome
When something goes wrong with the autonomic nervous system, it can cause serious problems. Postural Orthostatic Tachycardia Syndrome (POTS) is an abnormality of the autonomic nervous system, commonly defined as an inability to regulate the heart rate (Rowe 6). Patients with POTS will experience symptoms that can limit daily activity and function (Agarwal et al. 478). Although treatment can be challenging, patients with POTS that take an active role in the diagnosis and management of their care can improve their quality of life.
To understand POTS it is important to understand the role and function of the autonomic nervous system. The autonomic nervous system involves
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In a healthy individual, blood vessels contract, heart rates increase and blood pressure adjusts with little effort (Langford 23). In patients with POTS, the body does not have the ability to make appropriate adjustments. POTS patients require three times more energy to stand than a healthy person (Grubb 2). Although an abnormal heart rate upon standing is common in patients with POTS, they will also experience other symptoms such as fatigue, headaches, dizziness, heart palpitations, nausea, diminished concentration, fainting, coldness or pain in the extremities, chest pain and shortness of breath (“POTS”).
Patients with POTS will not feel better unless they are active, but they do not have the energy to be active (“POTS”). In patients surveyed, 97.2% showed fatigue as a major concern, followed by dizziness, brain fog, and heart palpitations (“POTS”). A quiet activity, such as sitting at a desk, or a small amount of physical activity can cause fatigue that can last twenty four to seventy two hours (Rowe 3). Research has shown that almost half of POTS patients will experience at least one episode of fainting which is why it is sometimes nicknamed the fainting disease
Apical hypertrophic cardiomyopathy is a disease that mainly affects the apex of the heart and does not cause any obstruction. [1] These abnormalities in the heart muscle can cause a wide variety of symptoms. As the heart becomes stiff it increases the pressure in the left ventricle which can push blood back into the lungs, causing shortness of breath in exercise. Chest pain can occur as there is not enough oxygen available to the cardiac muscle due to insufficient blood supply. Palpitations and lightheadedness, along with other conditions can occur as a result of HCM. In addition to these discomforting symptoms, the patient may develop an arrhythmias that often goes unnoticed. An arrhythmia takes place as the electrical conduction of the heart is disturbed by the abnormal scattering of myocytes. The two most common arrhythmias are atrial fibrillation causing palpitations, and ventricular tachycardia that can be life threatening causing sudden death. Both conditions can be controlled with medication. [4]
In December of 1992, my paternal grandfather suffered a heart attack. He had been hauling several 50 lb. sacks of corn up into the deer feeder on his property by himself. He got into his truck, turned the ignition, put it into drive and before he could take his foot off the brake, he was dead. He was 68 years old. I was thirteen and that seemed so old. I remember that prior to the event there were many conversations within my family about the condition of my grandfather’s heart and cardiovascular system and how he needed to make lifestyle changes. I remember him taking nitroglycerine pills. I remember him coming to Dallas to go to an appointment so that they could perform tests with names like “stress EKG.” I
Parkinson 's disease is a progressive neurologic degenerative disease of the Central Nervous system. The brain produces Dopamine and Norepinephrine, which are chemicals needed for smooth muscle movement and coordination, heart rate, and blood pressure. Dopamine and Norepinephrine are released by basal ganglions that are produced in a bundle of nerve cells in the brainstem called substantia nigra. In Parkinson 's patients, the substantia nigra are destroyed and neither of the chemicals can be released into the body. (3) The decrease in Norepinephrine causes heart arrhythmia and low blood pressure, causing the person to get dizzy upon standing or tire easily. The lack of Dopamine, the smooth muscle movement and coordination controller is now gone, or significantly decreased, resulting in the first signs of Parkinson’s disease, pill-rolling, a one handed tremor and a decreased appetite. (2)
PPS symptoms include periods of extreme muscle weakness and fatigue, muscle pain, irregular heartbeat, and in rare cases difficulty breathing or swallowing. This last can be life threatening and require a trip to the emergency room. Episodes of severe weakness in the arms and legs are the major symptom. Typically, these episodes occur during sleep, early morning, or after strenuous activity. Cold, stress, and alcohol may also produce attacks(med.nyu.edu). Some people with certain types of PPS can be at risk for hyperthermia, which is when the body fails to regulate its body temperature and it skyrockets. This can occur during surgery under anesthesia.
Most physicians and people who acquired the problem usually know it as A-FIB, a shorter term for atrial fibrillation. Atrial fibrillation deals with the cardiovascular system, in particular, the heart in the body. It is defined as, “the electrical signals that control this system are off-kilter. Instead of working together the atria do their own thing, causing fast fluttering heartbeat, also known as arrhythmia” (WEBMD). In a normal pumping blood of the heart the atria would squeeze first, followed by the ventricles of the heart. A-fib can be a serious issue if not treated, due to the inadequate pumping of the blood, causing a higher chance of heart failure. It is also a higher chance in getting a stroke, because improper flow of the blood can cause clots in the
With acute aortic insufficiency, pulse pressure widens as the valve deteriorates. Signs and symptoms may include a bounding pulse, atrial and ventricular gallops, chest pain, palpitations, pallor, crackles, dyspnea, and jugular vein distention, may also be present.
Porges theory recognises his important discoveries on the vagus nerve which changed previous understanding and functioning of the autonomic nervous system. Prior to this discovery, it was understood that the system operated in a balanced sympathetic/parasympathetic way. Porges research changed the outlook and understanding on the system, firstly with the vagus nerve in mammals having two branches, and secondly that the newest branch is able to prevent other nervous system activity.
Blood pressure -138/88, HR 71, Lung sounds –clear, temperature 98.8 F, radial pulse and pedal pulses +1 bi-laterally, normoactive bowel sounds. No history of smoking, drugs, alcohol use or diabetes; takes no daily medications. Surgical history: Hernia surgery September 2016 and cataract surgery September 2013. Moderately active, walks every day, sometime incorporating hand weights. Patient presents with minimal trembling unilaterally, (left side) when fingers stretched out, reports movements have been slower than normal. Patient’s wife reports “He’s been eating more slowly and it has been taking longer for him to get dressed in the morning.”. Upon examination it was determined that patient has reduced arm swing, slight stiffness in neck, difficulty rising from sitting position in the chair, masked facial features and deteriorated balance. No signs or symptoms of stroke.
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P
This is a 94 years old female resident at Derby health and Rehab. Pt have two problem seen today, impaired tissue integrity and acute pain. What I learned although pain is subjective, if a pt is in acute pain is frequently associated with anxiety and hyperactivity of sympathetic nervous (eg tachycardia, increased respiratory rate and BP, diaphoresis, dilated pupils). Also I learned impaired tissue integrity if untreated can cause risk for infection and the necrosis (dead tissue) can lead to systemic
Parkinson disease (PD), also referred to as Parkinson’s disease and paralysis agitans, is a progressive neurodegenerative disease that is the third most common neurologic disorder of older adults. It is a debilitating disease affecting motor ability and is characterized by four cardinal symptoms: tremor rigidity, bradykinesia or kinesis (slow movement/no movement), and postural instability. Most people have primary, or idiopathic, disease. A few patients have secondary parkinsonian symptoms from conditions such as brain tumors and certain anti-psychotic drugs.
For instance, while the POTS patients did experience symptoms of a panic attack that corresponded during increased orthostatic intolerance during all three stimuli’s, resolution of symptoms occurred directly after testing was completed or they were placed back into supine position (Khurana, 2006). Also, POTS patients had no prior history or family history of PD and some common cognitive symptoms of PD patients (such as fear of dying or feelings of detachment) were not reported by the patients with POTS. As expected, no symptoms were noted in any member of the control group. However, the most interesting and influential finding of this study was that personality patterns were different between the disorders, with POTS patients scoring in a normal
An dysrhythmia of the heart is an irregular heartbeat rhythm. Ventricular tachycardia is an dysrhythmia in which the lower chambers of the heart, the ventricles, beat unusually fast.
The cardiac cycle describes the coordinated and rhythmic series of muscular contractions associated with the normal heart beat.
The heart is one of the most important organs in an organism’s body, no matter if they are aquatic, amphibian, or a mammal. This super organ works automatically, able to pump massive amounts of oxygen rich blood through the body by means of electrical impulses and the opening and closing of valves within its many layers. It is what keeps us and every other creature on this earth alive; so it is only natural for one to fear when there might be a problem with one’s heart. A cardiac arrhythmia can happen to anyone, no matter the age, race, or gender, and as such, doctors and scientist have spent years trying to better understand the heart and the way it functions so that they can try to prevent these problems and save millions of lives.