Random Thinking

Your heart beat is controlled by the sinoatrial (SA) node or sinus node. This is a group of cells in the right atrium which produce the electrical impulses that make your heart beat.The impulse travels from the SA node down to the ventricles. As the signal goes from the atria to the ventricles, it passes through specialized conducting tissue called the atrioventricular (AV) node.

On an electrocardiogram (EKG), a portion of the graph called the P wave shows the impulse passing through the atria. Another portion of the graph, the QRS wave, shows the impulse passing through the ventricles. As long as the impulse is transmitted normally, the heart pumps and beats at a regular pace.

AV Block is when the signal from the heart’s upper to lower chambers is impaired or doesn’t transmit. This does not mean that the blood flow or blood vessels are blocked. It means that the electrical signal is failing to transmit through the heart correctly. First-degree AV block is when the electrical impulse moves through the AV node more slowly than normal. The time it takes for the impulse to get from the atria to the ventricles (the PR interval shown in the EKG above) should be less than about 0.2 seconds. If it takes longer than this, it’s called first-degree AV block. Generally, no treatment is necessary for first-degree AV block.

So why am I bringing this up? Last night Beth was complaining about chest pains and shortness of breath. We assumed this was related to her asthma so we took her over to the local late-night pediatric center for a quick treatment. The doctor didn’t hear any wheezing so they decided to do an EKG. Then they did another one. Then another one. OK, what is going on, Michel asked. The doctor came in and told us to go to the ER because she didn’t like what she was seeing on the EKG, that she was seeing an AV Block.

So off we went to the hospital and they called the cardiologist on call (Dr. Better - really she should be called Dr. Best), who happened to be Mikey’s cardiologist. She ordered another EKG. And a bunch of blood tests. And a chest X-Ray. The ER doctor (the wonderful Dr. Petras who has taken care of Mikey many times over the last nine years) told us the computer wouldn’t let her enter an X-Ray unless she first did a pregnancy test!!! Beth couldn’t pee into the cup but they finally decided do the X-Ray anyway, damn the computer! They finally let us go home at 2:30 AM.

Today we took Beth over to see Dr. Better and she did another EKG and then decided to put Beth on a 24 hour monitor. She told us that it was most likely nothing serious as it was only a first-degree AV Block. Since this was Beth’s first EKG ever, it may be that this is normal for Beth. Anyway, we will know more after the doctor analyzes the results of the monitor.

P.S. Since Beth was such a good patient I let her buy four CD’s. And by “good patient” I mean that she didn’t kill anyone at 2:30 AM.