The Curious Clinicians

52 - Way Back Wenckebach

Jul 6, 2022
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ANECDOTE

Wenckebach's Discovery

  • Karel Frederik Wenckebach, a Dutch anatomist and physician, noticed an unusual repeating pattern in a patient's pulse in the late 1800s.
  • Due to color blindness, he shifted from pathology to cardiology, leading to this discovery using a smoked drum.
INSIGHT

Wenckebach's Observation

  • Wenckebach heart block involves a progressive delay between the A-wave of the jugular vein pulse and the carotid pulsation.
  • This delay increases with each heartbeat until a dropped beat occurs, and the cycle repeats.
INSIGHT

Role of the AV Node

  • The AV node is crucial for Wenckebach heart block, as slower conduction leads to longer action potentials and depolarization during the relative refractory period.
  • This prolongs the PR interval with each beat, eventually causing depolarization during the absolute refractory period and a dropped beat.
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