Heart rhythm disorders: types, causes, signs, treatment. The nature and causes of failure of the heart rhythm

Violation of the heart rhythm is a clinical manifestation, which in most cases indicates the course of a disease in the body. Both adults and children can face a similar manifestation. Gender also does not play a role. A large number of factors that are not always associated with pathologies of the heart can lead to the occurrence of such a symptom. In addition, there is a group of completely harmless reasons.

The clinical picture will be determined by the condition that led to a change in rhythm, an increase or slowdown in heart rate. The main symptoms are considered to be shortness of breath, dizziness, fluctuations in blood pressure, weakness and pain in the region of the heart.

It is possible to identify the causes of heart rhythm disturbances using laboratory and instrumental methods of examination. Therapy will be individual in nature, but the basis is medication and treatment with folk remedies.

Heart rhythm disturbance in the International Classification of Diseases is encoded by several values. ICD-10 code - І49.0-І49.8.

Etiology

Clinicians identify a huge number of causes of cardiac dysfunction, both pathological and physiological.

Pathologies from the cardiovascular side, which entail the appearance of the main symptom:

malformations and character;
hypertrophy of the ventricles of the heart;

and other conditions that are characterized by impaired cerebral circulation;
neoplasms of any genesis in the brain;
traumatic brain injury.

Causes of heart rhythm disturbances associated with other internal organs:

low or high levels of thyroid hormones;
damage to the adrenal glands;
a wide range of diseases of the respiratory system;
or .

Physiological sources of this symptom:

- the most common cause of development in adolescent girls;
prolonged influence of stressful situations or nervous strains;
the period of bearing a child - during pregnancy, an increase in heart rate is often observed;
abuse of bad habits;
malnutrition, in particular, the use of large amounts of coffee;
insufficient amount of sleep;
prolonged hypothermia or overheating of the body.

In addition, uncontrolled intake of certain groups of drugs can cause heart rhythm disturbances, for example:

diuretics;
hormonal substances;
antidepressants;
antibiotics;
caffeinated drugs.

Violation of the heart rhythm in children, and in some cases in adolescents, may be due to:

congenital heart defects;
genetic predisposition;
severe food poisoning;
drug overdose;
dysfunction of the central nervous system;
the course of diseases of an infectious nature;
pathologies of other internal organs mentioned above.

It is worth noting that the main risk group includes people who are prone to obesity and people over the age of forty-five.

In some cases, the causes of such a symptom cannot be found out.

Classification

In medicine, it is customary to distinguish the following types of cardiac arrhythmias:

sinus tachycardia is a condition in which the heart rate reaches one hundred and fifty beats or more per minute. In a healthy person, it can occur against the background of stress or strong physical exertion;
sinus bradycardia - in such cases, there is a completely opposite situation compared to the previous one. The heart rate drops below sixty beats per minute. A similar disturbance occurs in healthy adults during sleep;
- Heart rate varies from one hundred and forty to two hundred beats per minute, provided that the person is at rest. This condition requires urgent first aid;
- a violation is characterized by the fact that some parts of the heart are reduced out of time. It is formed with any problems with the heart, in cases of overdose of drugs, drugs or alcohol. It should be noted that in children, extrasystole can be fatal;
- differs from extrasystole in that the contraction of some groups of cardiac muscles occurs in a chaotic manner. The frequency of contractions of the ventricles can reach one hundred and fifty beats per minute, and the atria at this time may not contract at all;
idioventricular heart rhythm, which has the opposite direction of the impulse - from the ventricles to the atria;
nodal form of rhythm - is a rather rare type of heart rhythm disturbance, but in most cases it is observed in children.

Symptoms

The danger of arrhythmia lies in the fact that it may not manifest itself at all, which is why a person may not even suspect that he has such a violation. It is for this reason that cardiac arrhythmias are very often detected during preventive examinations.

However, in some cases, failures in the rhythm of heart contractions are accompanied by the following symptoms:

, which appears either with minor physical exertion, or at rest;
sensation of "bumps" in the chest;
intensive;
decreased visual acuity or;
causeless and;
the child does not show the usual activity and interest in surrounding things or people;
in the region of the heart. Such a manifestation may have a different character, for example, stabbing or pressing;
irradiation of pain in the left arm and the area of the scapula;
change in the behavior of the patient;
feeling of lack of air;

It should be noted that these are not all signs of cardiac arrhythmias, their presence and intensity of manifestation will differ from patient to patient.

In cases of the appearance of one or more symptoms, the victim must be given first aid. First of all, it is worth calling an ambulance, and while they are waiting, follow the first aid rules:

calm the patient and lay him down so that the upper body is higher than the lower extremities - with a rapid heart rate, with a rare pulse, the position of the person should be opposite;
ensure the flow of fresh air into the room;
release the patient from narrow and tight clothing;
measure blood pressure and heart rate every fifteen minutes, write them down for subsequent presentation to visiting doctors;
Give the patient a sedative to drink. If the attack does not develop for the first time, then give those medications that are intended to normalize the condition, but on condition that they are prescribed by the attending physician.

Diagnostics

To identify the causes and type of heart rhythm disturbance, the doctor must:

to study the medical history and anamnesis of the patient's life - sometimes he can point out the factors leading to a violation of the heart rhythm;
conduct an objective examination - to determine the increase or slowdown in heart rate, as well as to measure blood pressure;
carefully interrogate the patient, if he is conscious, for the frequency of occurrence of arrhythmia attacks, the presence and severity of symptoms.

Among the instrumental methods of examination in violation of the heart rhythm, it is worth highlighting:

ECG, including daily monitoring;
treadmill test and bicycle ergometry;
transesophageal ECG;
dopplerography;

Among laboratory tests, specific blood tests have diagnostic value, thanks to which inflammatory damage to the heart can be determined.

If the frequency and regularity of heartbeats do not correspond to generally accepted norms, you may be diagnosed with cardiac arrhythmia. In essence, this is an organic lesion, which is the result of intoxication, functional failures of the nervous system, or violations of the water-salt balance.

Is cardiac arrhythmia dangerous and how can it be dealt with? We have to study the causes, symptoms and methods of treatment of this disease.

Classification of pathology

Before discussing the essence of pathology, it is necessary to study its varieties. There are several groups of factors that lead our body to a state of arrhythmia. Each type of this disease has its own symptoms. The disease can be based on calcium and magnesium imbalance, industrial and bacterial conditions, bad habits (nicotine, alcohol), oxygen deficiency.

The defeat of the endocrine organs in the future may affect the work of the heart muscle. Side effects from a number of drugs can also cause disease. Types of arrhythmias are based on violations of certain cardiac functions. Four varieties of this disease are known:

sinus tachycardia.

Sinus bradycardia

A slow heart rate is one of the key symptoms of sinus bradycardia. This pathology affects the sinus node, which serves as an inductor of electrical impulses. The heart rate drops to 50-30 beats/min. Pathology is quite dangerous - it is often found in outwardly "healthy" people undergoing a routine medical examination.

The reasons are different, but most of them lie in the field of congenital genetic anomalies (reduced nodal automatism).

The risk group includes professional athletes. Constant training changes their blood circulation and energy metabolism. However, the reasons for the change in rhythm are very diverse. Let's list them:

starvation;
imbalance of the nervous system (vegetative department);
hypothermia;
nicotine and lead intoxication;
infectious diseases (typhoid fever, jaundice, meningitis);
increased intracranial pressure in tumors and edema of the brain;
consequences of taking certain drugs (digitalis, beta-blockers, verapamil, quinidine);
sclerotic changes in the myocardium;
thyroid dysfunction.

The heart rate increases sharply, exceeding 90 beats / min. The sinus node sets the rhythm, and the heart rate rises to 160 beats. This indicator decreases gradually. Usually a rapid rhythm is a consequence of physical activity, this is a normal phenomenon. Pathology manifests itself in the fact that the patient feels an abnormal heartbeat at rest.

It is not considered an independent disease. Pathology develops against the background of various ailments and an unhealthy lifestyle. This disease is dangerous because the disturbed blood supply is reflected in various systems of our body. We list the main causes of tachycardia:

vegetative imbalance;
fever;
anemia;
abuse of tea and coffee drinks;
a number of drugs (calcium channel antagonists, vasoconstrictor anti-cold tablets);
hyperthyroidism and pheochromocytoma;
heart failure;
heart defects and pulmonary pathologies.

With sinus arrhythmia, the sinus node continues to induce impulses, but gives them a variable frequency. A disturbed heart rhythm is developed, which is characterized by slowdowns and accelerations. In this case, the heart rate will fluctuate within the normal range - 60-90 beats. In healthy people, sinus arrhythmia is associated with breathing - the heart rate changes with inhalation / exhalation.

When might sinus arrhythmia be treated? It will not be possible to determine the "fatal line" on your own - for this you need to contact a professional cardiologist. When recording an ECG, the doctor asks the patient to hold their breath. In this case, the respiratory arrhythmia disappears, and only sinus arrhythmia remains. The pathological form of the disease is rare - it is a sign of heart disease.

Paroxysmal tachycardia

Heart contractions in this disease become more frequent / slow down suddenly - in attacks. The correct rhythm is maintained for a long period, but sometimes anomalies occur. The source of failures can be localized in different areas of the heart - the heart rate directly depends on this.

The pulse of adults often accelerates to 220 beats, in children - up to 300. The duration of paroxysms also differs - attacks disappear in a matter of seconds or stretch for hours.

The causes of tachycardia lie in the launch of a focus of increased automatism and pathological circulation of the electrical impulse. The disease can be based on myocardial damage - sclerotic, necrotic, inflammatory and dystrophic. Symptoms may include nausea, dizziness, and weakness.

Here are the main factors that affect the clinical picture:

condition of the contractile myocardium;
heart rate;
the duration of the heartbeat;
localization of the ectopic driver;
seizure duration.

Causes of heart failure in atrial fibrillation

We did not mention another form of the disease - atrial fibrillation, also called. The atria in this case flutter, and the ventricles receive 10-15 percent less blood. The state of tachycardia already discussed above sets in. The patient fully learns what cardiac arrhythmia is - heart rate increases to 180 beats.

Irregular heartbeats can take other forms. The pulse drops to 30-60 beats - the doctors state bradycardia. Similar symptoms are fraught with the use of a pacemaker.

We list the main causes of atrial fibrillation:

hormonal disorders (Hashimoto's thyroiditis, nodular goiter);
heart failure;
heart disease or its valves;
increased blood pressure;
diabetes mellitus and concomitant obesity;
pulmonary diseases (bronchial asthma, bronchitis, tuberculosis, chronic pneumonia);
excessive alcohol consumption;
a number of medications;
wearing tight clothing;
diuretics.

Risk factors

The causes of all forms of pathology are quite similar. Most of them are the result of some diseases, the patient's wrong lifestyle, or are hereditary. After analyzing the sources of heart failure, the doctors deduced the main risk factors.

Here they are:

genetic predisposition;
high blood pressure;
thyroid disease;
electrolyte disturbances;
diabetes;
the use of stimulants.

Most of these factors have been discussed above. Improper nutrition can lead to electrolyte disturbances - calcium, sodium, magnesium and potassium must be present in food.

Forbidden psychostimulants include primarily caffeine and nicotine - thanks to them, extrasystole develops. Subsequently, ventricular fibrillation can cause sudden cardiac death.

How to recognize arrhythmia - symptoms of the disease

Symptoms of tachycardia and bradycardia have a number of minor differences. Cardiac arrhythmia at first develops in a latent form, without showing itself in any way. Subsequently, symptoms are found that indicate arterial hypertension, cardiac ischemia, brain tumors and thyroid pathologies. Here are the main signs of arrhythmia:

dizziness;
general weakness;
dyspnea;
fast fatiguability;
darkening in the eyes;
borderline states of the brain (it seems to the patient that he is about to lose consciousness).

If you have prolonged loss of consciousness, lasting about 5-10 minutes, you can "cut off" bradycardia. Such fainting is not inherent in this form of arrhythmia. The symptoms of tachycardia look a little different and at first look like a general malaise. They look like this:

dyspnea;
cardiopalmus;
fast fatiguability;
general weakness.

Methods of diagnostic studies

Symptoms of a suspected arrhythmia need to be carefully checked. Alarming signs include not only palpitations, but also sudden fading of the heart, pressure drops, weakness, interspersed with drowsiness.

If you have the above symptoms, it is time to see a doctor and undergo a full diagnosis. You should contact a cardiologist - first of all, he will begin to check the thyroid gland and identify possible heart diseases.

Many methods have been developed to diagnose arrhythmia. Be sure to record an electrocardiogram - it can be short and long. Sometimes doctors provoke an arrhythmia in order to record readings and more accurately determine the source of the problem. Thus, diagnostics is divided into passive and active. Passive methods include:

Electrocardiography. The electrodes are attached to the patient's chest, arms and legs. The duration of the phases of contraction of the heart muscle is studied, the intervals are fixed.
echocardiography. It uses an ultrasonic sensor. The doctor receives an image of the heart chambers, observes the movement of the valves and walls, and specifies their dimensions.
Daily ECG monitoring. This diagnosis is also called the Holter method. The patient carries a portable recorder with him at all times. This happens during the day. Physicians receive information about heart rate during sleep, rest and activity.

In some cases, passive research is not enough. Then doctors induce arrhythmia by artificial means. Several standard tests have been developed for this. Here they are:

mapping;

electrophysiological study;

tilt table test.

First aid

Attacks of arrhythmia can proceed independently and begin suddenly. The attack ends just as unpredictably. If the patient has the first attack, immediately call an ambulance. Often the orderlies drive slowly, so you should worry about the health of the victim. Do this:

calm the patient, suppress the manifestations of panic;
create rest conditions for the patient - lay him down or seat him in a comfortable chair;
try to change the position of the victim's body;
sometimes you need to induce a gag reflex - do it with two fingers, irritating the larynx.

What happens next is up to the medical staff. Medicines for cardiac arrhythmia will be prescribed by the cardiologist later - when the patient is "pumped out" and a preliminary diagnosis is made.

Seeing the symptoms of arrhythmia, try to interrupt any physical activity.

Permissible use of sedatives:

motherwort;
valerian;
corvalol;
valocordin (within 40-50 drops);
elenium.

Complex of therapeutic and preventive measures

It is impossible to give an unambiguous recommendation about which pills will help to cope with cardiac arrhythmia. This disease develops against the background of various lesions of the heart muscle (organic and functional). For example, changes in automatism lead to sinus tachycardia, arrhythmias, or bradycardia. If there are chronic / acute cardiac pathologies, they must be urgently treated.

When a specific form of arrhythmia is identified, secondary prevention is prescribed. This type of treatment is not practiced for bradycardia. But with tachycardia, you will have to drink medicines. You will be prescribed antirhythmic drugs:

calcium antagonists (Diltiazem, Verapamil);
adrenergic blockers (Atenolol, Anaprilin, Egilok);
Sotalex;
Cardarone;
Propanorm;
Allalinin.

It is strictly forbidden to take these substances without a doctor's prescription. Strict supervision is necessary, as misuse of drugs is fraught with consequences. For example, new forms of arrhythmias may arise. So don't take unnecessary risks.

Likely consequences

The main consequences of arrhythmia are heart failure and thromboembolism. Poor contraction of the heart muscle leads to heart failure - internal blood supply is disturbed. Various organs suffer from a lack of oxygen, systemic disorders begin. This leads to a number of serious illnesses and even deaths.

With an arrhythmia, the blood is not just pumped, it begins to "churn" in the atria. This can lead to thromboembolism. In some areas of the heart, blood clots form - over time they tend to come off. A severed blood clot blocks the heart, which leads to disastrous consequences:

heart attack;
angina;
fatal outcome;
brain stroke.

Ways to strengthen the heart

To get rid of the impending disaster, it is not necessary to absorb pills in batches. Prevention comes down to the right diet and the rejection of some addictions.

According to statistics, smokers are at risk - among them the disease occurs much more often. In addition to giving up nicotine, there are other preventive measures:

shaping;
fitness;
evening runs;

Interesting article, thanks. After another such attack with a strong heartbeat, I went to the doctor, did an ECG, passed the tests, fortunately they did not reveal anything very serious, but to strengthen the heart and reduce the elevated cholesterol rate, I take Cardioactive Taurine. There were no more problems with the heart rhythm, and the cholesterol slowly went down.

Heart rhythm disorders: types, causes, signs, treatment

The human heart under normal conditions beats evenly and regularly. The heart rate per minute in this case is from 60 to 80 contractions. This rhythm is set by the sinus node, which is also called the pacemaker. It contains pacemaker cells, from which excitation is transmitted further to other parts of the heart, namely to the atrioventricular node, and to the His bundle directly into the ventricular tissue.

This anatomical and functional division is important from the standpoint of the type of a particular disorder, because a block for impulse conduction or an acceleration of impulse conduction can occur in any of these areas.

Irregularities in the rhythm of the heart and it are called and are conditions when the heart rate becomes less than normal (less than 60 per minute) or more than normal (more than 80 per minute). Also, arrhythmia is a condition when the rhythm is irregular (irregular, or non-sinus), that is, it comes from any part of the conduction system, but not from the sinus node.

Different types of rhythm disturbances occur in different percentages:

So, according to statistics, the lion's share among rhythm disturbances with the presence of underlying cardiac pathology are atrial and ventricular, which occur in 85% of cases in patients with coronary artery disease.
In second place in frequency is the paroxysmal and constant form of atrial fibrillation, which occurs in 5% of cases in people over 60 years of age and in 10% of cases in people over 80 years of age.

Nonetheless, even more common are violations of the sinus node, in particular, and that have arisen without heart pathology. Probably every inhabitant of the planet experienced, caused by stress or emotions. Therefore, these types of physiological abnormalities have no statistical significance.

Classification

All rhythm and conduction disorders are classified as follows:

Heart rhythm disorders.
Conduction disorders in the heart.

In the first case, as a rule, there is an acceleration of the heart rate and / or irregular contraction of the heart muscle. In the second, the presence of blockades of varying degrees with or without a slowing of the rhythm is noted.
Generally the first group includes a violation of the formation and conduction of impulses:

The second group of conduction disorders includes blocks () on the path of impulses, manifested by intra-atrial blockade, 1, 2 and 3 degrees and blockade of the legs of the bundle of His.

Causes of heart rhythm disorders

Rhythm disturbances can be caused not only by a serious pathology of the heart, but also by the physiological characteristics of the body. So, for example, sinus tachycardia can develop when walking or running fast, as well as after playing sports or after strong emotions. Respiratory bradyarrhythmia is a variant of the norm and consists in an increase in contractions during inhalation and a decrease in heart rate during exhalation.

However, such rhythm disturbances, which are accompanied by atrial fibrillation (atrial fibrillation and flutter), extrasystole and paroxysmal types of tachycardia, in the vast majority of cases develop against the background of diseases of the heart or other organs.

Diseases that cause rhythm disturbances

Pathology of the cardiovascular system, occurring against the background of:

, including acute and transferred ,
, especially with frequent crises and long-term,
(structural changes in the normal anatomy of the myocardium) due to the above diseases.

Extracardiac diseases:

Stomach and intestines, for example, gastric ulcer, chronic cholecystitis, etc.,
acute poisoning,
Active pathology of the thyroid gland, in particular hyperthyroidism (increased secretion of thyroid hormones into the blood),
Dehydration and electrolyte disturbances in the blood,
Fever, severe hypothermia,
alcohol poisoning,
Pheochromocytoma is a tumor of the adrenal glands.

In addition, there are risk factors that contribute to the appearance of rhythm disturbances:

Obesity,
Bad habits,
Age over 45 years old
Concomitant endocrine pathology.

Are heart rhythm disturbances the same?

All rhythm and conduction disturbances clinically manifest themselves differently in different patients. Some patients do not feel any symptoms and learn about the pathology only after a planned ECG. This proportion of patients is insignificant, since in most cases patients report obvious symptoms.

So, for rhythm disturbances accompanied by a rapid heartbeat (from 100 to 200 per minute), especially for paroxysmal forms, a sharp sudden onset and interruptions in the heart, lack of air, and pain in the sternum are characteristic.

Some conduction disorders, such as beam blockade, do not manifest themselves in any way and are recognized only on the ECG. Sinoatrial and atrioventricular blockades of the first degree proceed with a slight decrease in the pulse (50-55 per minute), which is why clinically they can manifest only slight weakness and increased fatigue.

Blockades of 2 and 3 degrees are manifested by severe bradycardia (less than 30-40 per minute) and are characterized by short-term attacks of loss of consciousness, called MES attacks.

In addition, any of the listed conditions may be accompanied by a general severe condition with cold sweat, intense pain in the left side of the chest, low blood pressure, general weakness and loss of consciousness. These symptoms are caused by a violation of cardiac hemodynamics and require close attention from an emergency doctor or clinic.

How to diagnose pathology?

Establishing a diagnosis of rhythm disturbance is not difficult if the patient presents with typical complaints. Before the initial examination by a doctor, the patient can independently calculate his pulse and evaluate certain symptoms.

However directly the type of rhythm disturbances is established only by the doctor after, since each species has its own signs on the electrocardiogram.
For example, extrasystoles are manifested by altered ventricular complexes, tachycardia paroxysm - by short intervals between complexes, atrial fibrillation - by irregular rhythm and a heart rate of more than 100 beats per minute, sinoatrial blockade - by lengthening of the P wave, which reflects the conduction of an impulse through the atria, atrioventricular blockade - by lengthening of the interval between atrial and ventricular complexes, etc.

In any case, only a cardiologist or therapist can correctly interpret the changes on the ECG.. Therefore, when the first symptoms of rhythm disturbance appear, the patient should seek medical help as soon as possible.

In addition to the ECG, which can be performed already upon the arrival of the ambulance team at the patient's home, additional examination methods may be needed. They are prescribed in the clinic if the patient was not hospitalized, or in the cardiological (arrhythmological) department of the hospital, if the patient had indications for hospitalization. In most cases, patients are hospitalized because even a mild dysrhythmia can be a harbinger of a more serious, life-threatening dysrhythmia. The exception is sinus tachycardia, since it is often stopped with the help of tablet preparations even at the pre-hospital stage, and generally does not pose a threat to life.

Of the additional diagnostic methods, the following are usually shown:

during the day (according to Holter),
Tests with physical activity (walking up the stairs, walking on a treadmill - treadmill test, cycling -),
Transesophageal ECG to clarify the localization of rhythm disturbance,
in the case when a rhythm disturbance cannot be registered using a standard cardiogram, and it is necessary to stimulate heart contractions and provoke a rhythm disturbance in order to find out its exact type.

Cardiac MRI may be required in some cases, for example, if a patient has a suspected cardiac tumor, myocarditis, or a scar after a myocardial infarction that is not reflected on the cardiogram. A method such as is a mandatory research standard for patients with rhythm disturbance of any origin.

Treatment of rhythm disorders

Therapy for rhythm and conduction disorders varies depending on the type and the cause that caused it.

So, for example, in the case of coronary heart disease, the patient receives nitroglycerin (thromboAss, aspirin cardio) and drugs to normalize elevated blood cholesterol levels (atorvastatin, rosuvastatin). With hypertension, the appointment of antihypertensive drugs (enalapril, losartan, etc.) is justified. In the presence of chronic heart failure, diuretics (lasix, diacarb, diuver, veroshpiron) and cardiac glycosides (digoxin) are prescribed. If the patient has a heart defect, he may be shown surgical correction of the defect.

Regardless of the cause, emergency care in the presence of rhythm disturbances in the form of atrial fibrillation or paroxysmal tachycardia consists in administering rhythm-restoring (antiarrhythmics) and rhythm-reducing drugs to the patient. The first group includes drugs such as panangin, asparkam, novocainamide, cordarone, strophanthin for intravenous administration.

In case of ventricular tachycardia, lidocaine is administered intravenously, and in case of extrasystole, betaloc in the form of a solution.

Sinus tachycardia can be stopped by taking anaprilin under the tongue or egilok (Concor, Coronal, etc.) orally in tablet form.

Bradycardia and blockade require a completely different treatment. In particular, prednisolone, aminophylline, atropine are administered intravenously to the patient, and at a low level of blood pressure, mezaton and dopamine, along with adrenaline. These drugs speed up the heart rate and cause the heart to beat faster and harder.

Are complications of cardiac arrhythmias possible?

Heart rhythm disturbances are dangerous not only because the blood circulation throughout the body is disturbed due to improper functioning of the heart and a decrease in cardiac output, but also the development of sometimes formidable complications.

Most often, in patients against the background of a particular rhythm disturbance, they develop:

Collapse. It is manifested by a sharp drop in blood pressure (below 100 mm Hg), general severe weakness and pallor, pre-syncope or fainting. It can develop both as a direct result of rhythm disturbance (for example, during an attack of MES), and as a result of the administration of antiarrhythmic drugs, for example, procainamide during atrial fibrillation. In the latter case, this condition is treated as drug-induced hypotension.
Arrhythmogenic shock- occurs as a result of a sharp decrease in blood flow in the internal organs, in the brain and in the arterioles of the skin. It is characterized by a general grave condition of the patient, lack of consciousness, pallor or cyanosis of the skin, pressure below 60 mm Hg, and a rare heartbeat. Without timely assistance, the patient may die.
occurs due to increased thrombus formation in the cavity of the heart, since with paroxysmal tachycardia, the blood in the heart is “whipped”, as in a mixer. The resulting blood clots can settle on the inner surface of the heart (parietal thrombi) or spread through the blood vessels to the brain, blocking their lumen and leading to severe ischemia of the brain substance. It is manifested by abrupt speech disorders, unsteady gait, complete or partial paralysis of the limbs.
occurs for the same reason as a stroke, only as a result of clogging of the pulmonary artery by blood clots. It is clinically manifested by severe shortness of breath and suffocation, as well as blue discoloration of the skin of the face, neck and chest skin above the level of the nipples. With complete obstruction of the pulmonary vessel, the patient experiences sudden death.
Acute myocardial infarction due to the fact that during an attack of tachyarrhythmia, the heart beats with a very high frequency, and the coronary arteries are simply not able to provide the necessary blood flow to the heart muscle itself. Oxygen deficiency occurs in the heart tissues, and a site of necrosis, or death of myocardial cells, is formed. It is manifested by sharp pains behind the sternum or in the chest on the left.
Ventricular fibrillation, and clinical death. More often they develop with a paroxysm of ventricular tachycardia, which turns into ventricular fibrillation. In this case, the contractility of the myocardium is completely lost, and an adequate amount of blood does not enter the vessels. A few minutes after fibrillation, the heart stops, and clinical death develops, which, without timely help, flows into biological death.

In a small number of cases, the patient immediately develops rhythm disturbance, any of the complications and death. This condition is included in the concept of sudden cardiac death.

Forecast

The prognosis of rhythm disturbances in the absence of complications and in the absence of organic pathology of the heart is favorable. Otherwise, the prognosis is determined by the degree and severity of the underlying pathology and the type of complications.

Extrasystole is a fairly common disorder, especially when it comes to elderly patients. This condition is accompanied by a violation of the normal heart rhythm. And today more and more people are interested in questions about what are the causes of such a problem, how dangerous it can be to health.

Extrasystole - what is it?

Today, many patients of clinics face a similar problem. So what is extrasystole? This is a disorder that is associated with certain disorders. With a similar disease, extraordinary contractions (systoles) are observed either of the whole myocardium or of its individual parts (for example, atria, ventricles).

Extrasystole - the norm or a threat to health?

Of course, today many people are faced with a similar problem. So just how dangerous can these disorders be? In fact, extraordinary contractions can occur and, in fact, occur at any age. For example, often young people complain about the feeling of a strong heart attack, this is extrasystole. Moreover, according to statistics, about 80% of people over fifty suffer from periodic "unscheduled" shocks from time to time.

What causes systole? With some disorders of the vessels, the conducting system changes: the so-called ectopic foci, areas of increased activity, are formed in it. Most often, such a disorder appears in the conduction pathways of the ventricles, atria, and atrioventricular node. It is these ectopic foci that generate impulses that trigger the mechanism of heart contraction in the phase of its relaxation (diastole). This is what an extrasystole looks like. This, by the way, can be extremely dangerous.

Of course, occasionally occurring impulses do not pose a serious threat to human health. Nevertheless, they signal the presence of a particular problem, experts recommend that such patients pay more attention to their lifestyle, monitor nutrition and undergo regular examinations.

On the other hand, too frequent extrasystoles affect the work of the whole organism. After all, as a result of multiple extraordinary contractions, the release of blood decreases, which leads to a decrease in blood flow in the brain and coronary vessels. In such cases, extrasystole of the heart is extremely dangerous, as it can lead to myocardial damage, fainting, or even sudden death of a person.

Heart rhythm disturbance: causes

In fact, there are many factors under the influence of which an extrasystole attack can occur. For example, abnormal heart rhythms can be associated with exposure to certain chemicals in the body, including certain foods, alcoholic beverages, drugs, even strong tea or coffee. Smoking is also a risk factor. Functional extrasystole of the heart can also occur in women during menstruation.

In addition, some diseases, including osteochondrosis of the spine (especially the cervical region), as well as vegetovascular dystonia, neuroses of various origins, and others, are also attributed to the causes.

There are other factors, under the influence of which there is a violation of the heart rhythm. The reasons may be associated with organic lesions of the myocardium and the conduction system. For example, seizures often occur in patients with various defects, as well as against the background of cardiosclerosis, cardiomyopathy, coronary disease, inflammatory diseases (myocarditis, pericarditis). Risk factors also include diseases such as hemochromatosis, sarcoidosis, amyloidosis, since in such conditions the risk of heart damage is high.

An attack of extrasystole often occurs against a background of severe fever. In addition, the same effect can be caused by taking certain drugs, including those drugs that contain caffeine, ephedrine, aminophylline, novodrine, as well as tricyclic antidepressants, diuretic drugs and glucocorticoids.

Severe stress, physical overstrain, violation of the content of minerals in myocardial cells - all this can provoke an attack of increased contraction of the heart muscle.

Classification of violations

Of course, today there are many classification systems that make it possible to understand what extrasystole is - for example, depending on the location of the ectopic focus. Most often, rhythm failures are observed in the ventricles, more than 60% of patients go to the doctor with this diagnosis.

In 25%, atrial extrasystole is observed. Much less often, foci of rhythm disturbance occur in the atrioventricular junction, in such cases they are called atrioventricular. In addition, various combinations of the above forms are observed.

In some cases, the main sinus rhythm is preserved simultaneously with the formation of an ectopic focus, such a violation is called parasystole. Violations are also classified according to the number of foci of excitation, they can be both mono- and polytopic.

If extrasystoles go two in a row, then they are called paired. If extraordinary contractions follow the “more than two in a row” pattern, then this is a volley extrasystole. In addition, such disorders are divided into groups depending on the moment of their occurrence during cardiac contraction (these are early, middle and late). If we take into account the frequency of occurrence of extrasystoles, then they can be rare (extraordinary contractions less than 5 per minute), medium (from 6 to 15) or frequent (for example, frequent ventricular extrasystole is accompanied by more than 15 extraordinary contractions of the ventricle per minute).

Naturally, there is a system by which extrasystole is classified depending on its origin. For example, cardiac arrhythmias may be associated with organic or toxic tissue damage, physiological disorders.

How is extrasystole manifested?

In fact, not all patients have signs of heart disease; sometimes rhythm disturbances are determined by chance during a planned electrocardiogram. Moreover, there are many factors that can influence the number and intensity of traits present. For example, patients with organic myocardial lesions can endure extrasystole attacks quite easily, while the clinical picture in people with vegetovascular dystonia looks much more difficult.

Most often, subjectively, an extrasystole is felt as a strong push, even a heartbeat against the chest from the inside. In some cases, patients note that they feel as if the heart is “turning over” or even “somersaulting”. Such sensations are associated with a strong, energetic and sharp contraction of the myocardium.

In some patients, an attack of extrasystole is somewhat reminiscent of the symptoms of coronary disease or angina pectoris. Extrasystole, which is associated with functional changes, is often accompanied by other signs. For example, patients complain of increased sweating, a feeling of lack of air, hot flashes, severe, sudden weakness, and discomfort. Sometimes there is inexplicable even fear.

There are other signs of heart disease. For example dizziness. Frequent atrial or ventricular extrasystole is accompanied by a decrease in blood ejection, which causes this symptom. In patients with cerebral atherosclerosis, such rhythm disturbances can lead to circulatory disorders, which is accompanied by paresis, fainting, aphasia, and other disorders. In any case, with the manifestation of such conditions, you should immediately consult a doctor, since the consequences can be extremely dangerous and severe.

Extrasystole in childhood

In fact, extrasystole in children is diagnosed quite often. A child of any age can suffer from it, sometimes such a disorder is recorded even during fetal development. According to statistics, more than 75% of children in varying degrees suffer from heart rhythm disturbances. Moreover, over the past decade, the number of babies with similar disorders has increased significantly.

What are the main causes of heart rhythm disturbances in children? First of all, it is worth noting congenital malformations and cardiomyopathy. In addition, the most common include infectious myocarditis, rheumatic heart disease, genetically determined diseases.

In some cases, the disease is associated with some disorders of the endocrine and nervous system. For example, hypothyroidism or diabetes mellitus can lead to the appearance of extrasystole. On the other hand, chronic inflammatory and infectious processes, as well as beriberi and deficiency of certain elements, too much physical or emotional stress are important. In any case, such a disorder needs proper treatment. As for the prognosis, the average or rare extrasystole, which is not accompanied by organic lesions of the heart, is considered a relatively safe form of the disease.

Modern diagnostic methods

Naturally, there are many diagnostic methods, including ECG. Extrasystole in such a study, as a rule, is clearly visible. However, the diagnostic process does not begin with this. To begin with, the doctor is required to conduct a complete examination, which begins with the collection of information. The patient should tell the specialist what symptoms he has, how intense his attacks are, how often they occur.

It is extremely important to determine the cause of the heart rhythm disturbances. For this purpose, an anamnesis is collected, the doctor should be aware of the presence of other diseases, taking medications. The fact is that the choice of effective methods of treatment largely depends on the cause and nature of lesions of the conduction system of the heart.

After that, the doctor, as a rule, palpates the pulse on the radial artery. With extrasystole, a specialist can replace a pulse wave that occurs prematurely. Sometimes, on the contrary, extrasystole is accompanied by episodes of "falling out" of the pulse, which is observed when the ventricles are insufficiently filled during diastole.

Then it is carried out. When listening, you can notice the presence of premature І and ІІ tones. By the way, with such a disease, the first tone is increased, which is associated with a small filling of the ventricles. But the second tone, on the contrary, is weakened, since the release of blood into the aorta and pulmonary artery is much less.

After that, the doctor will probably send the patient to do a cardiogram of the heart. This is one of the most accurate research methods. In some cases, a so-called Holter ECG is performed. What is this procedure? A special portable device is attached to the patient's body, which records the heart rate for 1-2 days. Along with this, the patient keeps an activity diary in which he describes his feelings and the actions taken. Such a study is used if it is necessary to find out what provokes an attack of extrasystole.

If heart rhythm disturbances are not observed at rest, additional tests are carried out - this is a bicycle ergometry and a treadmill test. Such studies make it possible to measure indicators (blood pressure) and make an ECG during physical exertion (for example, walking on a treadmill, exercising on an exercise bike). If organic myocardial damage is suspected, patients are advised to do an ultrasound and MRI of the heart.

How is extrasystole treated?

As already mentioned, the treatment of extrasystole of the heart directly depends on the causes of its occurrence. For example, if a rhythm disorder is associated with taking some medications, then, of course, they must be canceled. If the causes lie in the disorder of the digestive or cardiovascular systems, then they should be treated first of all, and the attacks of extrasystoles will disappear along with the primary disease.

In some cases, diagnosis helps to understand that rhythm disturbances have arisen against the background of nervous overstrain. Such patients are referred for a consultation with a neurologist and are usually given mild sedatives or sedative herbs.

Single and rarely occurring attacks of extrasystole do not require specific drug treatment, patients are only recommended to follow the principles of a healthy lifestyle and undergo repeated examinations from time to time.

If the attacks are observed frequently, accompanied by shortness of breath, severe shock and weakness, then most likely the doctor will select the appropriate medications. As a rule, to eliminate violations, the so-called ones are prescribed, including lidocaine, sotalol, novocainamide, diltiazem, quinidine, cordarone, mexilene. In no case should you use these drugs on your own, since the dosage and mode of administration here are purely individual. Moreover, sometimes drugs are started to be administered during Holter ECG monitoring, this makes it possible to understand whether the drug is really working as it should, and whether it will cause even more harm to the body.

For benign extrasystoles, drugs are taken until the attacks completely disappear, or at least their number is minimized. After that, the number of drugs begins to gradually decrease, and then they are completely canceled. As a rule, such treatment lasts several months. But in malignant forms of the disorder, patients take antiarrhythmic drugs throughout their lives.

In cases where such drugs do not work, or if the patient has an intolerance to them, other methods of treatment are used, in particular, by the way, the indication for this form of therapy is the ventricular form of extrasystole, which is accompanied by 20-30 thousand attacks per day. This is a minimally invasive surgical procedure. It is carried out using a special endovascular catheter that transmits high-frequency currents. Thus, the electrode acts pointwise on areas of the heart where conduction is impaired. With the help of such a procedure, it is possible to block the transmission of pathological, "wrong" impulses and resume normal sinus rhythms.

Consequences of cardiac arrhythmias and prognosis for patients

Forecasts for patients directly depend on the course of the disease and the presence of concomitant disorders. For example, extrasystoles that develop against the background of a heart attack, cardiomyopathy and organic myocardial damage are considered the most dangerous.

In any case, the lack of qualified and timely assistance can lead to a lot of complications. Despite the fact that in most cases, extrasystole is benign, sometimes other dangerous diseases develop against its background, including paroxysmal tachycardia, atrial fibrillation and atrial flutter. Such conditions can lead to sudden death of the patient.

There are some other complications that accompany extrasystole. These are, first of all, problems with blood circulation and tissue nutrition. Indeed, with repeated extrasystoles, the volume of blood ejected by the heart is significantly reduced. This leads to oxygen starvation and disruption of normal blood circulation. Often, extrasystole leads to the development of chronic insufficiency of the renal, coronary and cerebral vessels, which entails even greater complications.

Prevention methods

Of course, a patient with such problems should be registered with a cardiologist and undergo regular examinations. The main method of preventing dangerous complications of extrasystole is the correct treatment of the primary disease. Sick people need to take the drugs prescribed by a specialist, as well as follow the schedule and regimen of treatment. In addition, regular heart rate studies are mandatory, as this gives the doctor the opportunity to monitor the rate of development of the disease and the effect of the prescribed drugs.

Surely patients will need to radically reconsider their lifestyle. Any heart disease requires a special diet. Quitting smoking, drinking alcohol and caffeine is a must. And, of course, moderate but regular physical activity, walks in the fresh air will be useful for the work of the cardiovascular system.

Separately, it is worth talking about first aid. An attack of extrasystole, as a rule, occurs suddenly. The patient should lie down and calm down. It is also recommended to unbutton the top buttons of the shirt, loosen the tie and belt, in a word, remove all possible obstacles that interfere with breathing. If the attack was caused by stress, then it is allowed to take a small amount of a sedative. It is best to call an ambulance, as the consequences of extrasystoles can be dangerous.

Usually, when they talk about the pulse, the contractility of the heart, they mean sinus heart rate.

Determines and controls its frequency a small number of muscle fibers, which are located in the sinoatrial node, in the region of the right atrium.

In case of any violations or damage, this function can be performed by other parts of the conductive system. As a result, the heart rhythm fails from the norm, which in adults is in the acceptable range from 60 to 90 beats per minute, in babies up to 6 months - from 90 to 120-150.

Children from 1 year of age to 10 years of age are diagnosed with a heart rhythm disorder if its performance exceeds 70-130 beats.

In adolescents and the elderly, the pulse should be no more than 60-100. Otherwise, a thorough study of the problem and subsequent treatment will be required.

Causes of heart rhythm failure

About 15% of all diagnosed cases of diseases of the cardiovascular system that provoke heart rhythm disturbances are caused by arrhythmias.

It is represented by a whole complex of pathological conditions, united by the mechanism of conduction, functional features and the formation of an electrical impulse.

Attacks of arrhythmia can occur against the background of ischemic disease and the clinical syndrome of myocardial damage, acquired and congenital heart defects, due to a functional disruption of the mitral valve, which provides blood flow to the left ventricle and aorta.

We should not exclude such reasons as changes in the water-electrolyte and acid-base balance, endocrine disorders, which are the source of rhythm and conduction disturbances of the heart. In rare cases, this group includes diseases of the biliary tract, the hematopoietic system and the digestive system, duodenal ulcer.

In women, very often non-pathological causes and treatment of arrhythmia caused by hormonal changes are not provided. Heart rhythm disturbances are associated with premenstrual syndrome, menopause and the period after childbirth. In adolescent girls, there is a rapid pulse during the transition period.

Incorrect intake or excess of the indicated dosage of antiarrhythmic, diuretic and medicinal preparations containing vegetable cardiac glycosides and psychotropic substances has a negative effect on the heart rate.

Bad habits, such as smoking, alcohol, drugs and even coffee, an abundance of fatty foods containing preservatives, can also affect the heart. Frequent stress and autonomic disorders, mental disorders, hard physical work and intense mental activity.

Types of heart rhythm disorders

Ambiguous and controversial remains the question of how to properly classify and define cardiac arrhythmias, to identify their main types. To date, there are several factors that are taken into account in order to distinguish between the types of possible cardiac arrhythmias.

First of all, the pulse is associated with a change in the automatic, natural formation of an impulse, both in the sinus node and outside it. With sinus tachycardia, the heart rate per minute exceeds 90-100, while, as with bradycardia, the pulse decreases to 50-30 beats.

Sick sinus syndrome is accompanied by heart failure, muscle contractions up to 90 beats, can cause cardiac arrest. This also includes the lower atrial, atrioventricular and idioventricular rhythm.

The source, driver of the cardiac impulse is not the sinus node, but the lower parts of the conduction system.

Functional changes in the excitability of the heart muscle are associated with the manifestation of extrasystole, when an extraordinary strong impulse occurs, and paroxysmal tachycardia, in which a pulse of up to 220 beats is traced.

The disorder of the conduction system is expressed by a congenital anomaly, the WPW syndrome, with premature excitation of the ventricles and the so-called blockade. Among them, sinoauricular, intra-atrial, AV, blockade of the legs of the bundle of His are noted.

A mixed or combined type of arrhythmia is considered separately. Flutter and fibrillation, atrial and ventricular fibrillation. The heart rate reaches 200-480 beats.

Accompanied by a violation of the functions and conduction, excitability of the myocardium.

Signs of a broken rhythm

At a consultation with a cardiologist, patients most often complain of a feeling of fear and anxiety, when such characteristic symptoms of cardiac arrhythmias appear, such as squeezing pain and tingling in the chest area, shortness of breath and lack of oxygen. May occur periodically or be observed constantly.

Many feel how the rhythms in the heart suddenly stop and resume. Cough and suffocation accompany a decrease in the efficiency of the left ventricle, sputum production is possible. During an attack of bradycardia, dizziness, incoordination, weakness, and even fainting appear.

With self-monitoring of the pulse in the wrist area, an unnatural violation of the heart rhythm per minute is pronounced. The number of contractions, in this case, either does not reach 60, or exceeds 100 or more beats.

Diagnostics

A single change in heart rate or a prolonged failure of heart contraction can be assessed by the attending physician, neurologist or cardiologist. Typically, the rhythm is measured in a calm state of the patient by counting the blows entering the region of the arteries for 12 or 30 seconds.

If there is a deviation from the norm, the specialist is obliged to prescribe an additional examination.

Not everyone knows what modern diagnostics using "Tilt-test" is and what it is intended for. It is carried out in the conditions of specialized cardiology clinics using a special table. During the procedure, the patient, fixed in a horizontal position, is moved to a vertical position.

At the same time, a person experiences the necessary load, which allows us to conclude how much blood pressure changes and whether the heart rhythm is disturbed.

The traditional screening test is performed by placing electrodes in the chest area during an electrocardiogram procedure. Possible cardiac arrhythmias are recorded graphically.

Modern rhythmocardiography is also widely used, followed by computer processing of the results and their analysis. Determines the affected area in the heart, projects a presumptive breakdown or complications of the disease.

This method allows you to identify the type and nature of the arrhythmia, select the appropriate treatment and make a prognosis.

Preparations for restoring the rhythm of the heart

Basic, preliminary measures to create an enabling environment include the appointment of " Sanasola” and a mixture of insulin, glucose and potassium under the supervision of a physician. Further, several groups of antiarrhythmic drugs are prescribed to begin treatment and cope with abnormal functioning of the cardiovascular system, including heart rhythm disturbances.

I class. Represents the category of quinine analogues. Widely used to treat atrial fibrillation. This also includes substitutes Lidocaine”, which do not affect the frequency of sinus rhythm, but have a local anesthetic effect. Used for ventricular arrhythmias.

« Novocainamide". Reduces the excitability and automatism of the myocardium, atria, ventricles, normalizes blood pressure. Daily intake - 0.5-1.25 grams every 4-6 hours.

« Allapinin". Reduces intraventricular conduction, has an antispasmodic and sedative effect. Dosage per day - 25 mg 3 times.

II class. Blockers of beta-adrenergic receptors stop attacks of paroxysmal tachycardia, are recommended for extrasystoles. Reduce the heart rate with sinus tachycardia and atrial fibrillation.

« bisoprolol". It inhibits conductivity and excitability, reduces myocardial contractility and oxygen demand, eliminates the symptoms of arterial hypertension. Single daily intake - 5-10 mg.

« Obzidan". Stimulates peripheral vessels, reduces the need for myocardial oxygen, and, therefore, reduces the frequency of heart contraction, increases the muscle fibers of the ventricles. The daily norm is from 20 to 40 mg 3 times.

III class. Directly antiarrhythmic intensive means of a wide spectrum of action. Do not affect heart rate, lower sinus rhythm.

« Amiodarone". Expands the coronary vessels, increases blood flow, lowers the pulse and blood pressure, provokes bradycardia. The norm per day is 0.6-0.8 grams 2 times.

IV class drugs are effective for the prevention and treatment of supraventricular arrhythmias.

« Verapamil". Reduces myocardial tone, prevents vasodilation, blocks calcium channels, suppresses the automatism of the sinus node. Daily intake - 40-80 mg no more than 3 times.

« Diltiazem". Reduces the amount of calcium in blood vessels and smooth muscle cells, improves myocardial circulation, normalizes blood pressure, reduces platelet aggregation. The norm per day is from 30 grams.

Restore blood circulation, reduce pressure in the ventricles, relieve the load on the myocardium and drugs such as ACE inhibitors, vasodilators, " Prednisolone”, magnesium sulfate. Additionally, it is advised to drink sedatives and potent sedatives that do not affect blood pressure.

Restoring the rhythm of the heart with folk remedies

Ignoring disorders associated with the functioning of the cardiovascular system and refusing to treat them is dangerous.

Severe consequences and complications that a seemingly small deviation in heart rate can entail will manifest as myocardial infarction, ischemic stroke, chronic heart failure, extensive cardiosclerosis and death.

Therefore, if the contractions of the heart are incorrect, then proven and reliable folk remedies will tell you what to do in such a situation.

Pour 200 ml of boiling water and leave for about 3 hours. Take a glass throughout the day. With tachycardia, you can use valerian root, fennel, chamomile and cumin fruits. Mix them and take 1 teaspoon of the mixture.

Pour it in a glass of boiling water. After an hour, drink in small sips throughout the day.