Lown-Ganong-Levine syndrome

Cardiovascular

Clinicals - History

Fact Explanation
Blackouts In Lown-Ganong-Levine syndrome, normal conduction of electrical impulses through the heart is bypassed from aberrant conduction pathway which results in heart rhythm disturbances that leads to intermittent episodes of rapid heart rates.These episodes may lead to blackouts Blackouts
In Lown-Ganong-Levine syndrome, normal conduction of electrical impulses through the heart is bypassed from aberrant conduction pathway which results in heart rhythm disturbances that leads to intermittent episodes of rapid heart rates.These episodes may lead to blackouts
Palpitations Heart rhythm disturbances that leads to intermittent episodes of rapid heart rates may lead to palpitations Palpitations
Heart rhythm disturbances that leads to intermittent episodes of rapid heart rates may lead to palpitations
Faintness/ light headedness Heart rhythm disturbances that leads to intermittent episodes of rapid heart rates lead to faintness Faintness/ light headedness
Heart rhythm disturbances that leads to intermittent episodes of rapid heart rates lead to faintness
Congenital heart defects Congenital defects in the conduction system can give rise to Lown-Ganong-Levine syndrome eg : hypertrophic cardiomyopathy, Ebstein’s
anomaly, tricuspid atresia
Congenital heart defects
Congenital defects in the conduction system can give rise to Lown-Ganong-Levine syndrome eg : hypertrophic cardiomyopathy, Ebstein’s
anomaly, tricuspid atresia

Clinicals - Examination

Fact Explanation
Tachycardia In Lown-Ganong-Levine syndrome, normal conduction of electrical impulses through the heart is bypassed from aberrant conduction pathway which results in heart rhythm disturbances that leads to intermittent episodes of rapid heart rates.These episodes may lead to tachycardia ( supraventricular tachycardia )
The diagnosis is based on identifying paroxysms of rapid heart rate
Tachycardia
In Lown-Ganong-Levine syndrome, normal conduction of electrical impulses through the heart is bypassed from aberrant conduction pathway which results in heart rhythm disturbances that leads to intermittent episodes of rapid heart rates.These episodes may lead to tachycardia ( supraventricular tachycardia )
The diagnosis is based on identifying paroxysms of rapid heart rate
Low blood pressure The presence of an anomalous conducting
pathway would account for the recurrent disorder
of cardiac rhythm, associated with hypotension
Low blood pressure
The presence of an anomalous conducting
pathway would account for the recurrent disorder
of cardiac rhythm, associated with hypotension
Accentuated first heart sound There is an accentuated first heart sound in most patients due to short PR interval Accentuated first heart sound
There is an accentuated first heart sound in most patients due to short PR interval
Normal physical examination As these changes are episodic, patient will be completely normal in between the episodes Normal physical examination
As these changes are episodic, patient will be completely normal in between the episodes

Investigations - Diagnosis

Fact Explanation
Electrocardiogram (ECG) PR interval less or equal to 0.12 second (120 ms) with normal QRS complex duration.ECG may show episodes of supraventricular tachycardia.
The tachycardia can be corrected by vagal maneuvers.
Electrocardiogram (ECG)
PR interval less or equal to 0.12 second (120 ms) with normal QRS complex duration.ECG may show episodes of supraventricular tachycardia.
The tachycardia can be corrected by vagal maneuvers.
Holter monitoring Holter monitoring may be needed in some patients to identify the paroxysms. Holter monitoring
Holter monitoring may be needed in some patients to identify the paroxysms.

Investigations - Management

Fact Explanation
Electrocardiogram PR interval less or equal to 0.12 second (120 ms) with normal QRS complex duration.ECG may show episodes of supraventricular tachycardia Electrocardiogram
PR interval less or equal to 0.12 second (120 ms) with normal QRS complex duration.ECG may show episodes of supraventricular tachycardia
Serum electrolytes To verify that the electrolytes are normal,as abnormalities in electrolytes can give rise to similar symptoms such as faintness Serum electrolytes
To verify that the electrolytes are normal,as abnormalities in electrolytes can give rise to similar symptoms such as faintness
Lipid profile The greatest harm in the care of these patients is
the frequent attribution of coronary artery
or arteriosclerotic heart disease as the cause
of the recurrent tachycardia,Thus assessing the lipid profile is important
Lipid profile
The greatest harm in the care of these patients is
the frequent attribution of coronary artery
or arteriosclerotic heart disease as the cause
of the recurrent tachycardia,Thus assessing the lipid profile is important
Lipid profile The greatest harm in the care of these patients is
the frequent attribution of coronary artery
or arteriosclerotic heart disease as the cause
of the recurrent tachycardia,Thus assessing the lipid profile is important. Recommended low-density lipoprotein cholesterol target level in people with heart disease <100 mg/dl
Lipid profile
The greatest harm in the care of these patients is
the frequent attribution of coronary artery
or arteriosclerotic heart disease as the cause
of the recurrent tachycardia,Thus assessing the lipid profile is important. Recommended low-density lipoprotein cholesterol target level in people with heart disease <100 mg/dl
Fasting blood sugar Controlling of other co morbid conditions is important as the greatest harm in the care of these patients is the frequent attribution of coronary artery or arteriosclerotic heart disease as the cause of the recurrent tachycardia Fasting blood sugar
Controlling of other co morbid conditions is important as the greatest harm in the care of these patients is the frequent attribution of coronary artery or arteriosclerotic heart disease as the cause of the recurrent tachycardia
Electrocardiogram (ECG) PR interval less or equal to 0.12 second (120 ms) with normal QRS complex duration.ECG may show episodes of supraventricular tachycardia Electrocardiogram (ECG)
PR interval less or equal to 0.12 second (120 ms) with normal QRS complex duration.ECG may show episodes of supraventricular tachycardia

Management - Supportive

Fact Explanation
Controlling other co morbid conditions The greatest harm in the care of these patients is
the frequent attribution of coronary artery
or arteriosclerotic heart disease as the cause
of the recurrent tachycardia
Controlling other co morbid conditions
The greatest harm in the care of these patients is
the frequent attribution of coronary artery
or arteriosclerotic heart disease as the cause
of the recurrent tachycardia
Avoid triggering factors Avoid emotional stresses Avoid triggering factors
Avoid emotional stresses

Management - Specific

Fact Explanation
Digoxin Reduces the heart rate Digoxin
Reduces the heart rate
Beta blockers They act by blocking the effects of catecholamines at the β1-adrenergic receptors, thereby decreasing sympathetic activity on the heart. These agents are particularly useful in the treatment of supraventricular tachycardias as they decrease conduction through the atrio ventricular (AV) node Beta blockers
They act by blocking the effects of catecholamines at the β1-adrenergic receptors, thereby decreasing sympathetic activity on the heart. These agents are particularly useful in the treatment of supraventricular tachycardias as they decrease conduction through the atrio ventricular (AV) node
Calcium channel blockers They decrease conduction through the AV node, and shorten phase two (the plateau) of the cardiac action potential Calcium channel blockers
They decrease conduction through the AV node, and shorten phase two (the plateau) of the cardiac action potential
Surgical management - pacemaker implantation, followed by radiofrequency (RF) ablation of the AV node For patients with failed medical therapy who continue to have recurrent, intolerable symptoms Surgical management - pacemaker implantation, followed by radiofrequency (RF) ablation of the AV node
For patients with failed medical therapy who continue to have recurrent, intolerable symptoms

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