Peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapy

Atrial fibrillation in old people is one of the most common causes of cardiac decompensation. It can also lead to sudden cardiac death and thromboembolism of vital organs. Comorbidities such as diffuse cardiosclerosis, myocarditis or cardiomyopathy, congenital or acquired defects of the valvular app...

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Main Authors: Tatyana Hlavatskikh, Irina Shop, Tatiana Deriyenko, Anna Kartvelishvili
Format: Article
Language:English
Published: V. N. Karazin Kharkiv National University 2020-12-01
Series:Journal of V. N. Karazin Kharkiv National University: Series Medicine
Subjects:
Online Access:https://periodicals.karazin.ua/medicine/article/view/16515
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spelling doaj-f99c0061ddce4dd2922e5a8d78dab6842020-12-14T08:49:34ZengV. N. Karazin Kharkiv National UniversityJournal of V. N. Karazin Kharkiv National University: Series Medicine2313-66932313-23962020-12-0140125133https://doi.org/10.26565/2313-6693-2020-40-15Peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapyTatyana Hlavatskikh0https://orcid.org/0000-0001-8368-1363Irina Shop1https://orcid.org/0000-0002-2027-3335Tatiana Deriyenko2Anna Kartvelishvili3Assistant of the Department of Internal Medicine, School of Medicine, V. N. Karazin Kharkiv National UniversityPhD, Associate Professor, Department of Internal Medicine, School of Medicine, V. N. Karazin Kharkiv National UniversityPhD, Associate Professor, Department of Internal Medicine, School of Medicine, V. N. Karazin Kharkiv National UniversityPh.D., doctor of the 1st cardiology department of the Kharkiv clinical hospital on railway transport No.1 of the Branch "Center for Health Protection" of PJSC "Ukrainian Railway"Atrial fibrillation in old people is one of the most common causes of cardiac decompensation. It can also lead to sudden cardiac death and thromboembolism of vital organs. Comorbidities such as diffuse cardiosclerosis, myocarditis or cardiomyopathy, congenital or acquired defects of the valvular apparatus of the heart, pathology of the endocrine system, chronic obstructive diseases of the bronchopulmonary apparatus, malignant course of arterial hypertension or its refractoriness to therapy, uncontrolled intake of antiarrhythmic drugs, can complicate the course of atrial fibrillation the addition of a transverse atrioventricular block, which is called Frederick’s syndrome. This article presents a case of clinical observation of an uncontrolled course of atrial fibrillation with the subsequent development and progression of severe circulatory failure against the background of the addition of complete atrioventricular block. Such an important factor as adherence to medical recommendations can compensate for various pathological conditions for a long time without causing significant harm to health, which was neglected by the patient from the clinical case under consideration. The launched course of arterial hypertension probably launched a cascade of morphological changes in the structures of the heart, which subsequently led to the formation of atrial fibrillation, the development of heart failure, and the addition of complete atrioventricular block. The appearance of rhythm in the heart rate, which is characteristic of this conduction disturbance, is often perceived as an erroneous restoration of the rhythm in case of pre-existing atrial fibrillation; this can complicate the timely diagnosis of pathology, especially in the absence of syncope conditions characteristic of complete atrioventricular blockade. The risks of thromboembolic complications and sudden cardiac death are as high as those associated with isolated atrial fibrillation. During the examination of the patient, the absolute indications for transplantation of an artificial pacemaker were determined. Subsequently, an increase in the minute volume of blood and cardiac output, as expected, led to an improvement in the clinical course of the disease and well-being, however, the pre-existing hemodynamic disorder of a long-term nature in this patient led to irreversible decompensation of cardiac activity, which adversely affects the long-term prognosis for life.https://periodicals.karazin.ua/medicine/article/view/16515atrial fibrillationatrioventricular blockelectric pacemakerheart failure
collection DOAJ
language English
format Article
sources DOAJ
author Tatyana Hlavatskikh
Irina Shop
Tatiana Deriyenko
Anna Kartvelishvili
spellingShingle Tatyana Hlavatskikh
Irina Shop
Tatiana Deriyenko
Anna Kartvelishvili
Peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapy
Journal of V. N. Karazin Kharkiv National University: Series Medicine
atrial fibrillation
atrioventricular block
electric pacemaker
heart failure
author_facet Tatyana Hlavatskikh
Irina Shop
Tatiana Deriyenko
Anna Kartvelishvili
author_sort Tatyana Hlavatskikh
title Peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapy
title_short Peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapy
title_full Peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapy
title_fullStr Peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapy
title_full_unstemmed Peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapy
title_sort peculiarities of the clinical course of frederick's syndrome on the background of comorbid pathology in the absence of adequate therapy
publisher V. N. Karazin Kharkiv National University
series Journal of V. N. Karazin Kharkiv National University: Series Medicine
issn 2313-6693
2313-2396
publishDate 2020-12-01
description Atrial fibrillation in old people is one of the most common causes of cardiac decompensation. It can also lead to sudden cardiac death and thromboembolism of vital organs. Comorbidities such as diffuse cardiosclerosis, myocarditis or cardiomyopathy, congenital or acquired defects of the valvular apparatus of the heart, pathology of the endocrine system, chronic obstructive diseases of the bronchopulmonary apparatus, malignant course of arterial hypertension or its refractoriness to therapy, uncontrolled intake of antiarrhythmic drugs, can complicate the course of atrial fibrillation the addition of a transverse atrioventricular block, which is called Frederick’s syndrome. This article presents a case of clinical observation of an uncontrolled course of atrial fibrillation with the subsequent development and progression of severe circulatory failure against the background of the addition of complete atrioventricular block. Such an important factor as adherence to medical recommendations can compensate for various pathological conditions for a long time without causing significant harm to health, which was neglected by the patient from the clinical case under consideration. The launched course of arterial hypertension probably launched a cascade of morphological changes in the structures of the heart, which subsequently led to the formation of atrial fibrillation, the development of heart failure, and the addition of complete atrioventricular block. The appearance of rhythm in the heart rate, which is characteristic of this conduction disturbance, is often perceived as an erroneous restoration of the rhythm in case of pre-existing atrial fibrillation; this can complicate the timely diagnosis of pathology, especially in the absence of syncope conditions characteristic of complete atrioventricular blockade. The risks of thromboembolic complications and sudden cardiac death are as high as those associated with isolated atrial fibrillation. During the examination of the patient, the absolute indications for transplantation of an artificial pacemaker were determined. Subsequently, an increase in the minute volume of blood and cardiac output, as expected, led to an improvement in the clinical course of the disease and well-being, however, the pre-existing hemodynamic disorder of a long-term nature in this patient led to irreversible decompensation of cardiac activity, which adversely affects the long-term prognosis for life.
topic atrial fibrillation
atrioventricular block
electric pacemaker
heart failure
url https://periodicals.karazin.ua/medicine/article/view/16515
work_keys_str_mv AT tatyanahlavatskikh peculiaritiesoftheclinicalcourseoffrederickssyndromeonthebackgroundofcomorbidpathologyintheabsenceofadequatetherapy
AT irinashop peculiaritiesoftheclinicalcourseoffrederickssyndromeonthebackgroundofcomorbidpathologyintheabsenceofadequatetherapy
AT tatianaderiyenko peculiaritiesoftheclinicalcourseoffrederickssyndromeonthebackgroundofcomorbidpathologyintheabsenceofadequatetherapy
AT annakartvelishvili peculiaritiesoftheclinicalcourseoffrederickssyndromeonthebackgroundofcomorbidpathologyintheabsenceofadequatetherapy
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