What is chronic venous insufficiency. Chronic venous insufficiency: causes, symptoms and treatment. Treatment of venous insufficiency of the lower extremities

Normal heart activity is called contractions in the range of 60-80 beats per minute. The pulses must go at regular intervals. Such work is given to cardiomyocytes by pacemaker cells. Under the influence of certain reasons, their function changes. Violation of the heart rhythm manifests itself in the form of various options. When an arrhythmia occurs, patients are concerned about symptoms, the severity of which is determined by the severity of the condition.

Why does heart rhythm disturbance occur and what is it? The term "arrhythmia" refers to changes accompanied by a disorder in the sequence and regularity of myocardial contractions. The beats per minute will be variable.

The heart rate becomes different from sinus. It is observed normally in a healthy person. Any cause that provokes arrhythmia can lead to a violation of the vital functions for which the heart is responsible.

The classification of rhythm disturbances according to Zhuravleva and Kushavsky from 1981 has received the greatest distribution. It includes the following options for the pathology of the cardiovascular system:

Change in automatism in the sinus node (nomotopic arrhythmia):
1. sinus bradycardia;
2. sinus tachycardia;
3. weakness of the conduction of the sinus node;
4. sinus arrhythmia.
Ectopic rhythm (heterotopic arrhythmia):
1. atrial heart rate;
2. atrioventricular (nodal) rhythm;
3. dissociation of function of the atrioventricular type;
4. idioventricular rhythm (ventricular);
5. migration of the supraventricular pacemaker;
Rhythm disturbance associated with changes in myocardial excitability:
1. paroxysmal variant of tachycardia;
2. extrasystole.
Rhythm disturbances by type of conduction and excitability changes:
1. flickering (fibrillation, flutter) of the ventricles;
2. atrial fibrillation (atrial fibrillation);
3. atrial flutter;
Rhythm disturbance associated with a change in conduction:
1. interatrial blockade;
2. sinoatrial blockade.
Atrioventricular blockade:
1. premature excitation of the ventricles;
2. blockade of the ventricles (branches of the bundle of His).

Each disease from the listed classification has its own causes, treatment. Symptoms of cardiac arrhythmia are expressed depending on the severity of the condition and the therapy.

Causes of irregular heart rhythm

When failures of the heart rhythm appear, the main importance is given to finding the cause. Many variants of arrhythmia are similar. You can figure out what type of disorder the patient has with the help of a comprehensive examination.

Endogenous factors

Some diseases pose a danger to the cardiovascular system. These include the following causes of heart rhythm disturbances:

Chronic diseases of the cardiovascular system. When symptoms of arrhythmia appear, the main importance is attached to ischemic processes in the myocardium, myocarditis, myocardial infarction, congenital and acquired defects. In people over 40, atherosclerosis plays an important role. The deposition of cholesterol in the form of plaques on the walls of blood vessels does not allow them to retain their elasticity properties.
Pathology of the nervous system.
Violation of metabolic processes in the form of hypokalemia or hyperkalemia.
Hormonal changes associated with thyroid diseases (hypothyroidism and thyrotoxicosis).
Violation of the heart rhythm as one of the manifestations of cancer pathology.

In some cases, patients with glomerulonephritis or pyelonephritis also complain of interruptions in the work of the heart. For this reason, it is important to remember that pathology from other organ systems can disrupt the normal rhythm.

Exogenous factors

Some environmental factors (or active human activity) negatively affect the body. They cause a heart rhythm disturbance, the symptoms of which may not bother a person for a long time. External factors include:

Age over 40 years. Most often, people in this category begin to feel unpleasant symptoms in the region of the heart, which are characteristic of arrhythmias.
Tobacco smoking, drinking alcohol. Toxic substances adversely affect blood vessels and myocardium.
Traumatic brain injuries lead to damage to the central or autonomic nervous system. Any symptom can have a negative effect on the heart.
It is not recommended to drink more than 3 cups of coffee. Due to the content of a large amount of caffeine, acceleration of contractions is noted, blood pressure rises. Changes in the state of the cardiovascular system can lead to arrhythmia.
Under the influence of anesthetics, the load on the myocardium increases. This becomes one of the reasons for the disruption of his work.

In some cases, the cause cannot be determined. If the factor is not fully understood, then it is idiopathic. Predisposing phenomena are considered a violation of the regime of work and rest, obesity, a sedentary lifestyle.

Both an adult and a teenager can get sick. The main causes of arrhythmia in a child at an early age are defects, diseases and poor heredity. In pediatrics, they give individual recommendations, depending on age.

Diseases in which rhythm disturbances occur

Not only the pathology of the cardiovascular system leads to a disorder of the functions of the heart. The appearance of signs of the disease is possible if the patient has:

atherosclerosis;
myocarditis;
congenital anomalies of the structure;
dystrophic processes in the myocardium;
heart attack;
heart failure;
pheochromocytoma;
arterial hypertension;
hernia in the esophageal opening of the diaphragm;
cardiomyopathy.

Among patients, arrhythmia is more common, the main cause of which is a dysfunction of the cardiovascular system.

Myocarditis

Myocarditis is inflammation of the muscle. This occurs after the defeat of cardiomyocytes by infection. Violation of the heart rhythm occurs under the influence of toxic substances released by microorganisms.

The clinical picture depends on the degree of change in the walls of the organ and the severity of the process. The onset may be asymptomatic. Based on pathophysiology data, even slightly affected heart cells cause arrhythmias.

myocardial infarction

Violation of the blood circulation of the coronary vessels leads to myocardial necrosis. In the local area, foci are formed that cease to be active. In some cases, with spasm of the arteries, the same outcome occurs. A properly selected algorithm of emergency care reduces the risk of complications.

One of the consequences of the post-infarction state is a violation of the heart rhythm. Necrotic areas in the myocardium can be large and small.

Pheochromocytoma

Education is a tumor with localization in the adrenal medulla. It is found in early childhood, adolescence and adulthood. Cells begin to produce large amounts of catecholamines. These include epinephrine and norepinephrine. In rare cases, the tumor becomes malignant. This type of cell spreads through the bloodstream to other organs.

Pheochromocytoma always occurs with an increase in blood pressure. During a crisis provoked by catecholamines, it increases sharply. In the interictal period, it remains stable at high numbers, or may decrease. With the formation of even a small tumor, the heart rhythm changes. At the prehospital stage, assistance is provided to normalize pressure. The patient is taken to the hospital and operated on after the examination.

Manifestations of cardiac arrhythmias

Manifestations and signs of arrhythmia depend on the variant of the disease according to the classification. Some patients feel satisfactorily and in rare cases there are unpleasant signs in the heart area. Prolonged asymptomatic course adversely affects the myocardium, and such a condition is difficult to detect at an early stage.

When the normal function of the atrioventricular node is disrupted, an imbalance occurs between the atria and ventricles. Impulse conduction becomes difficult, and the heartbeat slows down. The frequency of myocardial contractions is about 25-45 per minute. The following symptoms are characteristic:

severe weakness on the background of bradycardia;
dyspnea;
dizziness;
darkening in the eyes;
fainting;

For atrioventricular blockade, episodes of loss of consciousness are characteristic. The fainting lasts for about a few seconds.

Atrial fibrillation (flicker)

This variant of arrhythmia is more common than others. She was assigned the ICD code - I 48. The heart rate can be up to 600 beats per minute. The process is not accompanied by the coordinated work of the atria and ventricles. Patients describe a sharp deterioration in well-being. Some of them indicate the minutes of such changes.

It all starts with sensations of a strong heartbeat, interruptions and weakness. Gradually joins the lack of air, a feeling of fear and pain in the chest. When atrial fibrillation occurs, the condition worsens dramatically. Everything takes a matter of minutes. During this time, the feeling that "the heart will soon jump out of the chest" does not leave.

Sick sinus syndrome

This variant of arrhythmia is associated with a disorder in the formation of an impulse in the sinus node and further conduction in the atria. Bradycardia appears in the norm and in healthy people who are athletically trained.

People feel pauses during the work of the heart, and the pulse is harvested. With a pronounced syndrome, there is a tendency to fainting, which is preceded by darkening in the eyes or a feeling of heat.

Extrasystole

Under the influence of various factors, the conduction system of the heart generates extraordinary contractions of the myocardium (extrasystoles). Single manifestations are not life-threatening and are rarely felt by people. When there are a lot of them or they become group, patients begin to complain. They experience a strong heartbeat, and between individual beats there is a pause, which is described by people as a fading.

Diagnosis of pathology

Before starting to treat the patient, a complete examination is carried out. It includes the implementation of laboratory and instrumental methods. After receiving the conclusion, the doctor determines the further tactics of managing the patient, depending on the individual characteristics.

Blood analysis

This survey option is one of the most accessible methods. It includes parameters by which the probability of an inflammatory process is determined. This can be done by assessing the level of leukocytes in the blood and the erythrocyte sedimentation rate (ESR). It is important to study and biochemical analysis. The electrolyte composition plays an important role for the normal functioning of the myocardium. An imbalance of potassium and magnesium in the bloodstream leads to arrhythmias.

Lipid profile

This type of examination is necessary for all patients. If the rhythm is disturbed, it is necessary to assess the state of the vascular wall. Based on the results obtained, the doctor begins treatment. If there are very few high-density lipids, and the limits of bad cholesterol exceed the allowable values, therapy is necessary.

ECG (electrocardiography)

The instrumental method is considered one of the main methods for determining cardiac arrhythmias. Any disorders occurring in the myocardium will be reflected on the film. Electrocardiography (ECG) detects the following:

The source of rhythm, whose task is to generate impulses.
Heart rate.
Impaired conduction from the atria to the ventricles.
Possible extraordinary contractions of the myocardium.
Fibrillation or flutter of the ventricles and atria.

In a number of patients, with the help of this examination, it was possible to detect changes that did not manifest themselves in any way.

Holter ECG

With the help of a modern research method, it is possible to detect changes that an electrocardiogram has detected. The advantage is that it can be done within 24 hours. All this time, a sensor is attached to the patient, which takes all indicators of cardiac activity.

The patient is advised to lead a normal life. So that he does not miss any little thing related to activity, a diary is started. On its pages, the subject fixes his workload, stress and other parameters that the doctor will recommend. The next day, he returns to his cardiologist to evaluate the results.

Event monitoring

This type of study is carried out using a portable device for recording an electrocardiogram. The convenience of the method lies in its use only when necessary. The indications are:

pain in the region of the heart;
strong heartbeat;
feeling interrupted;
feeling of fading;
the appearance of dizziness and a sharp headache;
pre-fainting state.

After recording the data at the right time, the patient can use the sound sensor to transmit information to his doctor by phone.

During physical activity in the usual mode or with severe tension, patients experience pain. Sometimes it is difficult to evaluate the indicator, and for this reason stress tests are prescribed.
The patient gets on the treadmill, and the doctor sets the required pace.

If there are no changes, then the angle of its inclination is changed, the speed is increased. If pain, interruptions and other unpleasant sensations occur, the procedure is completed and the data obtained is evaluated. When a violation of the heart rhythm is confirmed, treatment is prescribed.

Tilt test

This procedure is a variation of the one described above. Its essence lies in carrying out an orthostatic load. Before the start of the study, the patient is placed on a special table. It is fixed with straps and transferred from a horizontal to a vertical position. In the process of implementation, the following indicators are evaluated:

blood pressure level;
ECG changes;
cerebral hemodynamics.

If fainting occurs, the cause is determined using a tilt test.

EchoCG (echocardiography)

The study makes it possible to assess the state of the structural elements of the heart, the level of blood flow, pressure in the vessels. In the presence of changes associated with age or infectious disease, even minor deviations can be considered.

Electrophysiological research method

To assess the state of the heart, an electrode is inserted through the nasal passage into the esophagus (transesophageal echocardiography). If it is impossible to perform it in the indicated way, the procedure is done intravenously. The sensor enters the cavity, and the doctor gives a slight impulse. It provokes an attack of arrhythmia.

The presented method is assigned to each patient with arrhythmia. The reason for this condition may be due to an altered thyroid function. If the patient has it reduced, then bradycardia and blockade occur, which is easy to detect using an ECG. With hyperthyroidism, tachycardia and extrasystoles are noted.

Treatment of cardiac arrhythmias

The choice of the method of therapy is based on the causes of arrhythmia, clinical manifestations, concomitant diseases. It includes several options:

medication;
non-drug.

In the absence of effect, the treatment of cardiac arrhythmias is carried out by cardiac surgeons.

Medical method

To choose the right tool, a comprehensive examination is carried out. Under the control of electrocardiography, the results of treatment with antiarrhythmic drugs are evaluated. The following classes of drugs are prescribed (depending on the indications):

Drugs that stabilize cell membranes (class 1) - Lidocaine, Quinidine, Propafenone.
Beta-blockers (grade 2) - "Metoprolol", "Atenolol".
Potassium channel blockers (grade 3) - Amiodarone, Sotalol.
Calcium channel blockers (grade 4) - Verapamil, Diltiazem.

The patient is under the control of the doctor, if necessary, he must take tests. Depending on the psychosomatics and the patient's attitude to his health, a consultation of other specialists is prescribed. Additional funds may be required as indicated. They should go well with arrhythmia pills.

Non-drug treatment

If the therapy is successful and the condition returns to normal, then folk remedies can also be prescribed. For this, medicinal herbs are used, which are mixed in a certain ratio. Valerian root, lemon balm, motherwort and anise are widely used. The ingredients are combined, poured with boiling water and insisted for about half an hour. Then the resulting infusion is taken at a dose of ½ cup three times a day.

One of the healing methods is the right lifestyle and nutrition. It is necessary to give up tobacco, alcoholic beverages and junk food. To maintain a healthy heart, it is recommended to drink water (1.5-2 liters per day). If there is swelling, then this issue is resolved with the attending physician.

The diet should contain a lot of fresh vegetables and fruits. For the myocardium, bananas, dried fruits and baked potatoes are considered especially useful. They are richer than other foods in potassium, which is needed for heart function.

In the absence of dynamics from treatment at home, the patient is referred for surgical intervention. The most common and effective are:

cardioversion;
setting an artificial pacemaker;
ablation;

Cardioversion is indicated for patients with ventricular arrhythmias. The method is based on the application of a discharge of electricity. It is important to make a correct differential diagnosis. If the form of conduction disturbance turns out to be atrial, then the procedure will be contraindicated. This is due to the high likelihood of blood clots.

If the heart cannot cope with the problem on its own, then an artificial pacemaker is installed under the skin. When an arrhythmia focus is detected, a catheter is inserted, the task of which is to destroy it - ablation. This method of treatment will return the patient to a full life.

The appearance of interruptions in cardiac activity against the background of neurological diseases present. It is more pronounced in females. It is characterized by a functional disorder in the rhythmic work of the heart. With a pronounced clinic, appropriate treatment is prescribed. Preparations are selected by a neurologist.

Pulmonary arrhythmia

This definition often denotes a heart rhythm disorder that has developed against the background of a hypertrophied right ventricle. The disease is mainly associated with increased pressure in the pulmonary artery. Also, arrhythmia contributes to the stretching of the walls of the right ventricle. It is difficult to treat due to the chronic process.

Atrial fibrillation

Very rapid and erratic contraction of the atria, in which there is a contraction of more than 300 times per minute. Pathology is extremely dangerous for human life and requires immediate intervention of medical personnel. The risk of developing pathology increases with age, which is facilitated by organic lesions of the myocardium.

Ventricular extrasystole

An important type of arrhythmia for diagnosis, in which there is an untimely contraction of the ventricles. The signal for extraordinary depolarization comes from an additional (ectopic) focus of excitation. To prevent the development of serious complications, it is necessary to carry out timely treatment of ventricular extrasystole.

Atrial fibrillation

This type of arrhythmia is characterized by the appearance of chaotic contractions of the atrial muscles with an increase in heart rate up to 500-600 beats per minute. Pathology can cause a serious lack of blood circulation, because of which a person is threatened with death. It is often a complication of cardiac diseases that have been started or improperly treated.

sinus arrhythmia

Violation of the normal activity of the heart, in which sinus rhythm is maintained. May present with increased, slow, or irregular heartbeats. This type of arrhythmia is divided into pathological sinus arrhythmia and functional, which does not require treatment. The concept is considered general and refers to a number of diseases, each of which is manifested by specific clinical signs.

Sinus bradycardia

Violation of the normal functioning of the sinus node, in which a slow heartbeat develops. In this case, the heart rate is up to 50 beats per minute. In trained people, it is considered as a variant of the norm. If the pathology brings inconvenience to a person, then drug treatment is prescribed.

Paroxysmal tachycardia

An attack of arrhythmia, characterized by the occurrence and termination for no apparent reason. During a heartbeat, the heart rate can reach 300 beats per minute. There are ventricular, atrial and nodal (atrioventricular) forms of the disease. Almost all manifestations of pathology require medical correction.

A form of arrhythmia with a supraventricular location, resulting from the accelerated work of the sinus node. Manifested in adults with a heart rate of 100 beats per minute, in children from 120 beats per minute. Depending on the severity of clinical manifestations, it can be considered physiological and pathological. Treatment of sinus tachycardia is required in violation of the normal lifestyle of a person.

Valvular arrhythmias

It is a clinical definition of cardiac disorders that occur with insufficiency or stenosis of the valvular apparatus. Especially often appear with mitral valve prolapse. Due to the presence of organic pathology, surgical intervention is often required.

Pancreatic arrhythmias

They may appear to patients as one disease, although in fact arrhythmia is a violation of the heart rhythm. Since the pancreas is anatomically close to the heart, some of its diseases cause interruptions in cardiac activity, clinically defined as “pancreatic arrhythmias”. They cannot be ignored, therefore, consultations are held with a cardiologist, followed by the appointment of antiarrhythmic treatment.

Intestinal arrhythmia

In some situations, intestinal diseases are combined with arrhythmias (interruptions in the work of the heart), which significantly complicates the general condition of the patient. In particular, palpitations occur during infectious processes in the intestines, acute poisoning, and after injury. In each case, specific treatment in the form of antiarrhythmic drugs is required.

Intercostal neuralgia

Violation of the heart rhythm, which in neurology can be combined with intercostal neuralgia. In addition to muscle pain, the main clinic is supplemented by heart failures. Therefore, antiarrhythmic drugs are added to the general treatment.

Heterotopic arrhythmias

A group of automatism disorders not associated with the main pacemaker - the sinus node. This includes ventricular, atrial, and junctional rhythms. Excitation of the heart muscle occurs with acceleration or deceleration, which is manifested by the corresponding clinic. Often they take the form of paroxysmal tachycardia, which develops in one or another part of the heart.

Vagal arrhythmia

It is an irregular heart rhythm, directly related to the influence of the parasympathetic nerve (vagus). It develops in 90% of cases in men after taking alcoholic beverages or fatty foods in large quantities. It may not cause significant discomfort and quickly pass after the elimination of the irritating factor. In other cases, therapeutic intervention is required.

Systolic arrhythmia

It is manifested by a disturbed heart rhythm as a result of improper contraction of the ventricles. Belongs to the group of extrasystoles. Depending on the cause, organic and functional types of disorders are distinguished. In the second case, most often the patients are women. In the presence of damage to the heart muscle, they can contribute to the occurrence of more complex conditions (fibrillation, flicker).

Medical arrhythmia

Appears to be an abnormal heart rhythm or heart rate caused by drugs. Most often develops after exceeding the dose of cardiac glycosides and diuretics. With timely assistance, it does not lead to the development of complications.

Ischemic arrhythmia

Interruptions in the work of the heart associated with a lack of oxygen supply to the heart muscle (myocardium). With the disease, an irregular, frequent, or slow heartbeat may be observed. For diagnosis, ECG, coronary angiography are used to identify ischemic areas. In difficult cases, surgery may be required.

supraventricular arrhythmia

Also known as supraventricular extrasystole. Premature impulses originate in the atria. Irregular heartbeats appear, disrupting the normal functioning of the muscular organ. Medical correction is relevant in case of presentation of complaints to patients, reduced ability to work. Without a pronounced clinic, the treatment of pathology is not carried out.

Vascular arrhythmia

It is an additional symptom complex of vegetative-vascular dystonia, characterized by abnormal heart rhythm, its acceleration or deceleration. It is not easy to treat due to the main cause of development - disorders of the nervous system. Therefore, it is often necessary to consult a psychotherapist along with the use of antiarrhythmic drugs.

Hypertensive arrhythmia

Irregular heartbeats, with fast or slow heart rate. Manifested against the background of hypertension. May develop as a result of a hypertensive crisis. This type of arrhythmia is considered a complication of the underlying disease, so timely treatment is necessary.

Respiratory arrhythmia

Mostly diagnosed in teenagers. It is manifested by an increase in the number of heartbeats on a deep breath, while on exhalation, the heart rate decreases. Often there are no clinical manifestations, therefore, pathology is detected during a general examination of the patient. With age, the likelihood of its occurrence may decrease.

cardiac arrhythmia

This type of arrhythmia is a group of heart diseases, including various rhythm disturbances with an increase or decrease in heart rate. A heart impulse against the background of arrhythmia can be formed or conducted in a pathological manner. The form of the disease is diagnosed using an ECG, after which the most appropriate antiarrhythmic agent is prescribed.

ventricular fibrillation

With this pathology, the ventricles contract chaotically with a heart rate of 250 to 500 beats per minute. Cardiac arrest is possible due to the lack of its coordinated work. It develops against the background of various heart diseases, the main of which is myocardial infarction, hypertensive crises, angina pectoris, cardiomyopathy.

Ventricular tachycardia

Frequent contraction of the ventricles of the heart, in which there is a heart rate of 120 times per minute or more. Also known as paroxysmal tachycardia. It can be considered as a physiological state (after physical exertion, against the background of emotional and mental stress) and pathological (it develops at rest). It can be complicated by fibrillation, therefore, in any form, it is necessary to undergo treatment with antiarrhythmic drugs.

Failure of the heart rhythm has the corresponding name in medicine - arrhythmia. Pathology is a failure in the frequency, regularity of the body, a violation of electrical conductivity. Sometimes the disease occurs against the background of fainting, dizziness caused by air deficiency and pain in the region of the heart. Diagnosis can be made with the help of instrumental and physical examination. In the process of therapy, cardiosurgical techniques and drugs are involved.

Many are concerned about the question of what to do if the heart rhythm fails? A brief overview of this heart disease will help to understand. Arrhythmia, or failure of the heart rhythm, is a general term indicating a disorder in the generation and transport of an electrical impulse. Pathology is very dangerous, has negative consequences.

Rhythm disturbance is manifested against the background of a failure in the conduction of the cardiovascular system, which regenerates regular and coordinated contractions. Functional, organic factors should be considered as the cause of heart rhythm failure. Arrhythmia can provoke dangerous changes. Not even a heart attack is ruled out. The characteristic of the disease indicates the appearance of a strong pulse, the fading of the organ and an interruption in its work. Sometimes there are fainting, pain in the chest, difficulty breathing, weakness and dizziness.

If you do not make a timely diagnosis and do not start timely, competent treatment, then symptoms of angina pectoris may appear. With this disease, there is a risk of cardiac arrest or swelling of the lungs.

Impaired cardiac conduction and rhythm cause death in both a child and an adult in 15% of all cases. The causes of the pathology and the treatment of heart rhythm failure are determined by the cardiologist.

Forms of arrhythmia:

bradycardia;
atrial fibrillation;
tachycardia;
extrasystole.

The specific rhythm, frequency, sequence of contractions are controlled by the conduction system. In case of its defeat, signs of arrhythmia develop. If the bundles of His are hit, then a blockade appears, namely, a failure in conduction. The consequence of this is incorrect coordination of the functioning of the ventricles, atria.

Reasons for development

Before you learn how to treat a pathology, you should consider its description and origin. The causes of heart rhythm failure may lie in other diseases. Their attending physician determines, for which a detailed diagnosis is carried out.

In accordance with the etiological factors and the mechanism of development of the disease, two forms of arrhythmia are distinguished - functional and organic. As for the latter, it is a frequent companion of myocarditis, coronary artery disease, injuries, defects, insufficiency, VSD, complications after surgery.

If there is a failure of the heart rhythm, the reasons for this may be as follows:

In order to provide first aid for arrhythmias in time, it is advisable to know what the symptoms of a heart rhythm failure look like. Interestingly, a change in the electrolyte balance in this organ provokes the development of arrhythmias. The process significantly complicates the contractile capabilities of the muscle.

Clinical picture

During an attack, emergency medical attention may be needed. That is why it is important to know about the symptoms of heart rhythm failures and dangerous indicators.

Signs of arrhythmia:

dizziness;
severe weakness, chills;
palpitations, the presence of fading and interruptions;
angina;
suffocation;
cardiogenic shock;
fainting state;
nausea.

During an attack, everything possible should be done to alleviate the patient's condition. You need to know what kind of medicine or folk remedy will help to cope with an exacerbated disease.

Arrhythmias can be fatal. From the very first seconds, weakness, dizziness, convulsions appear. It is impossible to determine the pulse and pressure, breathing worsens. Pupil dilation is observed, clinical death may occur. If the patient has asystole, there is a risk of developing syncope. With a ciliated type of disease, a thromboembolic complication ends with a stroke.

Diagnostic and therapy methods

The initial stage of diagnosis is carried out by a therapist, a cardiologist. After that, instrumental studies are used.

Diagnosis of cardiac arrhythmia:

Ultrasound of the heart;
medical examination;
measurement of pulse rate, blood pressure;
ECG monitoring, blood pressure;
OAM, KLA, electrolytes.

Most often, the cause of the pathology is the chronic form of coronary artery disease, hypertension, heart failure. In this case, drugs and tablets are prescribed that show high efficiency in therapy.

The main medications for arrhythmia:

statins;
blockers for beta-adrenergic receptors;
diuretics;
angiotensin-preventing inhibitors;
cardiovascular drugs.

A good effect is observed with their stable use. Drugs can be prescribed only by the attending physician. Antiarrhythmic drugs help well: Sotaleks, Propanorm, Kordaron. They help to relax the heart muscle. Of great importance is prevention, which implies a healthy lifestyle, moderate physical activity, taking certain drugs.

Alternative methods of treating arrhythmia:

You can make an infusion of horsetail, you need dried leaves. Preparation: 2 tsp. brew raw materials in a glass of boiling water. Strain after twenty minutes. Take every 2 hours for a tablespoon.
Peppermint. In 200 ml of boiling water, brew a teaspoon of herbs. Infuse for half an hour, drink once a day for a year.
Fight against tachycardia: cut asparagus shoots - 1 tbsp. spoon, pour 250 ml of boiling water, wrap. Infuse for an hour, drink daily for 2 tbsp. l. about a month.
Mix equal amounts of black radish juice with liquid honey. Take 3 tsp. after meal.
Calendula. For 0.5 liters of hot water 1 tbsp. l. plant flowers. Cool down. Take 100 ml 4-5 times a day.

The course of treatment should be agreed with the doctor in order to avoid side effects and complications.

Most cases do not threaten health and life. The ciliated form of the pathology, which contributes to the development of stroke, heart failure, deserves special attention. A particular threat and negative consequences are observed with fibrillation, ventricular flutter.

Thus, failure of the heart rhythm is a dangerous disease, which is fraught with the development of many complications, as well as negative consequences. If you have any suspicious symptoms, you need to consult a doctor, undergo a preventive examination. It is strictly forbidden to self-medicate.

You may also be interested in:

Atrial rhythm: why it occurs and what to do?

Cardiac arrhythmia: what is it and how is it treated?

- any violation of the regularity or frequency of the normal heart rhythm, as well as the electrical conduction of the heart. Arrhythmia may be asymptomatic or be felt as a heartbeat, fading, or interruptions in the work of the heart. Sometimes arrhythmias are accompanied by dizziness, fainting, pain in the heart, a feeling of lack of air. Arrhythmias are recognized in the process of physical and instrumental diagnostics (heart auscultation, ECG, PECG, Holter monitoring, stress tests). In the treatment of various types of arrhythmias, drug therapy and cardiosurgical methods (RFA, installation of an electrocardiostimulator, cardioverter-defibrillator) are used.

General information

The term "arrhythmia" combines various disorders in the mechanism of occurrence, manifestations and prognosis of the origin and conduction of electrical impulses of the heart. They arise as a result of violations of the conduction system of the heart, which provides consistent and regular contractions of the myocardium - sinus rhythm. Arrhythmias can cause severe disturbances in the activity of the heart or the functions of other organs, and can themselves be complications of various serious pathologies. Manifested by a feeling of palpitations, interruptions, fading of the heart, weakness, dizziness, pain or pressure in the chest, shortness of breath, fainting. In the absence of timely treatment, arrhythmias cause angina attacks, pulmonary edema, thromboembolism, acute heart failure, cardiac arrest.

According to statistics, conduction and heart rhythm disorders in 10-15% of cases are the cause of death from heart disease. The study and diagnosis of arrhythmias is carried out by a specialized section of cardiology - arrhythmology. Forms of arrhythmias: tachycardia (rapid heartbeat more than 90 beats per minute), bradycardia (slow heartbeat less than 60 beats per minute), extrasystole (extraordinary heart contractions), atrial fibrillation (chaotic contractions of individual muscle fibers), blockade of the conduction system and others

Rhythmic sequential contraction of the heart is provided by special muscle fibers of the myocardium, which form the conduction system of the heart. In this system, the first-order pacemaker is the sinus node: it is in it that excitation arises at a frequency of 60-80 times per minute. Through the myocardium of the right atrium, it spreads to the atrioventricular node, but it turns out to be less excitable and gives a delay, so the atria contract first and only then, as the excitation spreads along the bundle of His and other parts of the conduction system, the ventricles. Thus, the conducting system provides a certain rhythm, frequency and sequence of contractions: first the atria, and then the ventricles. Damage to the conduction system of the myocardium leads to the development of rhythm disturbances (arrhythmias), and its individual links (atrioventricular node, bundle or legs of His) lead to conduction disturbances (blockades). In this case, the coordinated work of the atria and ventricles can be sharply disturbed.

Causes of arrhythmias

The development of organic arrhythmias is based on damage (ischemic, inflammatory, morphological) of the heart muscle. They make it difficult for the normal distribution of an electrical impulse through the conduction system of the heart to its various departments. Sometimes damage also affects the sinus node - the main pacemaker. In the formation of cardiosclerosis, scar tissue prevents the conduction function of the myocardium, which contributes to the emergence of arrhythmogenic foci and the development of conduction and rhythm disturbances.

The group of functional arrhythmias includes neurogenic, dyselectrolyte, iatrogenic, mechanical and idiopathic arrhythmias.

The development of sympathetic arrhythmias of neurogenic origin is facilitated by excessive activation of the tone of the sympathetic nervous system under the influence of stress, strong emotions, intense mental or physical work, smoking, drinking alcohol, strong tea and coffee, spicy food, neurosis, etc. Activation of the sympathetic tone is also caused by diseases thyroid gland (thyrotoxicosis), intoxication, feverish conditions, blood diseases, viral and bacterial toxins, industrial and other intoxications, hypoxia. In women suffering from premenstrual syndrome, sympathetic arrhythmias, pain in the heart, sensations of suffocation may occur.

Vagodependent neurogenic arrhythmias are caused by activation of the parasympathetic system, in particular, the vagus nerve. Vago-dependent rhythm disturbances usually develop at night and can be caused by diseases of the gallbladder, intestines, duodenal ulcer and stomach ulcers, bladder diseases, in which the activity of the vagus nerve increases.

Diselectrolyte arrhythmias develop with electrolyte imbalances, especially magnesium, potassium, sodium and calcium in the blood and myocardium. Iatrogenic rhythm disturbances result from the arrhythmogenic action of certain drugs (cardiac glycosides, β-blockers, sympathomimetics, diuretics, etc.).

The development of mechanical arrhythmias is facilitated by chest injuries, falls, blows, electric shocks, etc. Rhythm disturbances without an established cause are considered idiopathic arrhythmias. In the development of arrhythmias, hereditary predisposition plays a role.

Classification of arrhythmias

Etiological, pathogenetic, symptomatic and prognostic heterogeneity of arrhythmias causes discussions about their unified classification. According to the anatomical principle, arrhythmias are divided into atrial, ventricular, sinus and atrioventricular. Taking into account the frequency and rhythm of heart contractions, it is proposed to distinguish three groups of rhythm disturbances: bradycardia, tachycardia and arrhythmias.

The most complete classification is based on the electrophysiological parameters of rhythm disturbance, according to which arrhythmias are distinguished:

I. Caused by a violation of the formation of an electrical impulse.

This group of arrhythmias includes nomotopic and heterotopic (ectopic) arrhythmias.

Nomotopic arrhythmias are caused by dysfunction of the automatism of the sinus node and include sinus tachycardia, bradycardia and arrhythmia.

Separately, in this group, sick sinus syndrome (SSS) is distinguished.

Heterotopic arrhythmias are characterized by the formation of passive and active ectopic complexes of myocardial excitation located outside the sinus node.

With passive heterotopic arrhythmias, the occurrence of an ectopic impulse is due to a slowdown or disruption in the conduction of the main impulse. Passive ectopic complexes and rhythms include atrial, ventricular, disorders of the atrioventricular junction, migration of the supraventricular pacemaker, and jumping contractions.

With active heterotopias, the emerging ectopic impulse excites the myocardium before the impulse formed in the main pacemaker, and ectopic contractions "interrupt" the sinus rhythm of the heart. Active complexes and rhythms include: extrasystoles (atrial, ventricular, originating from the atrioventricular junction), paroxysmal and non-paroxysmal tachycardia (originating from the atrioventricular junction, atrial and ventricular forms), flutter and flicker (fibrillation) of the atria and ventricles.

II. Arrhythmias caused by dysfunction of intracardiac conduction.

This group of arrhythmias occurs as a result of a decrease or cessation of the propagation of an impulse along the conduction system. Conduction disorders include: sinoatrial, intra-atrial, atrioventricular (I, II and III degree) blocks, premature ventricular excitation syndromes, intraventricular blocks of the bundle of His bundle (one-, two- and three-beam).

III. Combined arrhythmias.

Arrhythmias that combine conduction and rhythm disturbances include ectopic rhythms with exit blockade, parasystole, and atrioventricular dissociations.

Symptoms of arrhythmias

Manifestations of arrhythmias can be very different and are determined by the frequency and rhythm of heart contractions, their effect on intracardiac, cerebral, renal hemodynamics, as well as the function of the myocardium of the left ventricle. There are so-called "silent" arrhythmias that do not manifest themselves clinically. They are usually identified by physical examination or electrocardiography.

The main manifestations of arrhythmias are palpitations or a feeling of interruptions, fading during the work of the heart. The course of arrhythmias may be accompanied by suffocation, angina pectoris, dizziness, weakness, fainting, and the development of cardiogenic shock. Palpitations are usually associated with sinus tachycardia, attacks of dizziness and fainting - with sinus bradycardia or sick sinus syndrome, fading of cardiac activity and discomfort in the region of the heart - with sinus arrhythmia.

With extrasystole, patients complain of sensations of fading, pushing and interruptions in the work of the heart. Paroxysmal tachycardia is characterized by suddenly developing and stopping heart attacks up to 140-220 beats. in min. Sensations of frequent, irregular heartbeat are noted with atrial fibrillation.

Complications of arrhythmias

The course of any arrhythmia can be complicated by ventricular fibrillation and flutter, which is tantamount to circulatory arrest, and lead to the death of the patient. Already in the first seconds, dizziness, weakness develop, then - loss of consciousness, involuntary urination and convulsions. Blood pressure and pulse are not determined, breathing stops, pupils dilate - a state of clinical death occurs. In patients with chronic circulatory failure (angina pectoris, mitral stenosis), during paroxysms of tachyarrhythmia, shortness of breath occurs and pulmonary edema may develop.

With complete atrioventricular blockade or asystole, syncope may develop (Morgagni-Adems-Stokes attacks, characterized by episodes of loss of consciousness), caused by a sharp decrease in cardiac output and blood pressure and a decrease in blood supply to the brain. Thromboembolic complications in atrial fibrillation in every sixth case lead to a cerebral stroke.

Diagnosis of arrhythmias

The initial stage of diagnosing arrhythmia can be carried out by a therapist or cardiologist. It includes the analysis of the patient's complaints and the determination of the peripheral pulse characteristic of cardiac arrhythmias. At the next stage, instrumental non-invasive (ECG, ECG monitoring), and invasive (ChpEFI, VEI) research methods are carried out:

An electrocardiogram records the heart rhythm and frequency for several minutes, so only constant, stable arrhythmias are detected by an ECG. Rhythm disturbances that are paroxysmal (temporary) in nature are diagnosed by the Holter 24-hour ECG monitoring method, which records the daily heart rhythm.

To identify the organic causes of arrhythmias, Echo-KG and stress Echo-KG are performed. Invasive diagnostic methods make it possible to artificially induce the development of arrhythmia and determine the mechanism of its occurrence. During an intracardiac electrophysiological study, catheter electrodes are brought to the heart, recording an endocardial electrogram in various parts of the heart. The endocardial ECG is compared with the result of an external electrocardiogram recording performed simultaneously.

Forecast

In prognostic terms, arrhythmias are extremely ambiguous. Some of them (supraventricular extrasystoles, rare extrasystoles of the ventricles), not associated with organic pathology of the heart, do not pose a threat to health and life. Atrial fibrillation, on the contrary, can cause life-threatening complications: ischemic stroke, severe heart failure.

The most severe arrhythmias are flutter and ventricular fibrillation: they pose an immediate threat to life and require resuscitation.

Prevention

The main direction in the prevention of arrhythmias is the treatment of cardiac pathology, which is almost always complicated by a violation of the rhythm and conduction of the heart. It is also necessary to exclude extracardiac causes of arrhythmia (thyrotoxicosis, intoxication and febrile conditions, autonomic dysfunction, electrolyte imbalance, stress, etc.). It is recommended to limit the intake of stimulants (caffeine), the exclusion of smoking and alcohol, self-selection of antiarrhythmic and other drugs.