A patient on Warfarin develops a bleeding ulcer. He presents with tachycardia, i

Question

A patient on Warfarin develops a bleeding ulcer. He presents with tachycardia, increased respiration rate, and a BP of 80/50 mm Hg. Briefly, explain why he has these symptoms. Is there concern about perfusion of his organs? Explain 1. 2. An older woman previously had suffered a heart attack which damaged an area of her heart. This region continued to deteriorate such that her AV node is beginning to escape the override suppression of the SA node. Explain why this is dangerous. Be specific - discuss the waves and intervals of an ECG trace and how they pertain to the pumping action of the heart.

Explanation / Answer

1. Warfarin is an anticoagulant drug. It decreases clotting factors II, VII, IX and X. This predispose to uncontrolled bleeding. As the patient has developed beeding peptic ulcer so her blood volume will decrease and this lead to decreased blood pressure. Body tries to maintain normal perfusion pressure by increasing heart rate and respiration. If bleeding is not stopped then she may go into hypervolumic shock and perfusion to organs will be compromised.

2. If AV Node escapes supression by SA Node then it lead to escape beat/rhythm. As AV node firing rate is less than SA Node so heart rate may decrease. The might be dissynchrony contraction between atria and ventricle. ECG Change -

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