Sinking heart causes dangerous

Reasons that can disrupt the coordinated work of the heart and reward a person with arrhythmia. Arrhythmia is a condition of a pathological nature in which there is a violation of rhythm or heart rate. There are several reasons for the development of this disease. The most common ones are:

  • Congenital heart pathologies, today, doctors strive to cope with such pathologies in early childhood by performing operations on an unborn child, but, unfortunately, it is still far from complete victory over this cause;
  • Cardiovascular disease;
  • Arterial hypertension;
  • Malfunction of the thyroid gland;
  • Changes in the hormonal background – true for women during menopause;
  • Stress, nervous and physical overwork, lack of sleep;
  • Excess weight;
  • Smoking, alcohol, uncontrolled use of narcotic substances;
  • Intoxication of the body, including drugs.

As you can see, the list is by no means small, although not complete. Only the most common causes that cause arrhythmia are given. And if it’s difficult for us to influence some without the intervention of doctors: a congenital heart disease, then excluding others is entirely within our power.

The heart can behave abnormally (pound, jump out of the chest, freeze) after physical exertion and in a state of nervous excitement in absolutely healthy people. But at rest, disturbances in cardiac activity always occur only if there is a disease. First of all, it can be pathological changes in the heart:

  • Coronary artery disease, in which the myocardium is not properly provided with oxygen.
  • Arterial hypertension, accompanied by a significant overload of the left heart.
  • Cardiological malformations, which are characterized by a serious violation of hemodynamics and, as a result, improper distribution of the load on the heart chambers.
  • Inflammation of the heart muscle.
  • Cardiomyopathy is a structural and functional lesion of the myocardium (often of unknown nature), in which the heart cavity either expands or narrows.

In addition, interruptions in the work of the heart can occur with non-cardiac ailments:

  • With diseases of the endocrine system. First of all, the thyroid gland and adrenal glands.
  • With severe anemia.
  • With autonomic disorders. The patient may experience autonomic crises.
  • With pathologies of the neuropsychic sphere – psychosis, neurosis, prolonged stress, etc.
  • With electrolyte imbalance (in particular, with hypokalemia).
  • With dehydration.
  • With osteochondrosis. Pinched nerve roots in this disease can appear discomfort in the heart.

A small amount of extrasystoles is almost always in a healthy person, and he can also sometimes experience a feeling of interruptions at rest.

First you need to understand what types of arrhythmias are, since for some reasons one of them is characteristic.

  1. Tachycardia. This is called too fast beating, the number of strokes per minute exceeds 90. This condition can be a natural response to an emotional or physical load, therefore, it can occur even after eating, increasing body temperature. However, tachycardia may indicate that the heart muscle experiences constant stress and malfunctions. If the heart rate is constantly accelerating, for example, every day, then the heart does not have time to relax and rest, which increases the risk of a heart attack or coronary heart disease.
  2. Bradycardia In this case, the heart, on the contrary, beats too slowly, less than 60 beats in one minute. This is a natural state if the system of the heart and blood vessels is well trained, for example, in athletes when they are at rest. However, too slow a rhythm of the heart always threatens to faint, oxygen deprivation of the brain, and even cardiac arrest.
  1. Atrial fibrillation. It manifests itself in the absence of an effective reduction in the entire myocardium of the atria. Atrial fibrillation is a sign of diseases of the cardiovascular system.
  2. Extrasystole. This is an extraordinary contraction of the heart muscle, which in most cases is a response to the too active use of alcoholic beverages, strong tea, coffee, nicotine, can also be a dangerous signal of active myocardial damage.

In diseases of the spine, for example, osteochondrosis, the vertebral artery, which runs along the spinal column, is impaired. Cramped muscles or bone osteophytes compress the vessel, which increases the intravascular pressure. A pathological condition leads to the development of tachycardia. In order for the blood to be pumped well through a squeezed vessel, the body and, of course, the heart have to exert more efforts, which leads to an increase in heart contractions, so there are interruptions in the heart.

Tachycardia in osteochondrosis is permanent, that is, it exists even at rest. When a person changes posture, it becomes more pronounced. Ultimately, if osteochondrosis is treated, tachycardia will be reduced. But the effect will be noticeable after effective treatment.

If the heart muscle can not cope with the increased load, extrasystole begins to develop. With osteochondrosis, it manifests itself in the later stages. At first, frequent heartbeats are short-lived. If osteochondrosis is localized in the lumbar region, a strong influence is exerted on organs that are located in the abdominal cavity.

VVD is another reason why a person may feel disturbances in the heart. VVD has various symptoms that can complicate a person’s life, but it is not fatal. For many patients with VVD, it seems as if their motor freezes and starts again. Often it really only seems. There were patients who claimed that their heart stopped for 10 minutes and even half an hour, but this was impossible.

There are times when a person after measuring the pulse came to the conclusion that he has about 200 strokes per minute, although in fact they are 70-80, that is, within the normal range. There was even a study of patients with VVD, which showed that in almost half of patients, the heart beats normally and even well every day, that is, there are no rhythm disturbances.

Of course, interruptions in the heart, shortness of breath, weakness, abnormal pulse values ​​in patients with VVD can be real symptoms of a serious disease that is not connected with the autonomic system, especially if these symptoms are felt day after day. Therefore, timely diagnosis is very important not only for those with VSD, but also for everyone who has encountered such symptoms.

Interestingly, arrhythmia can occur in humans after eating. Moreover, the number of people who are faced with this is growing. To understand why some people lose their heart rate after eating, it is important to remember that the intensity of the heartbeat of a vital motor depends on the state of the body and the conducting system.

The digestion process leads to the fact that the activity of the vagus nerve increases, therefore, the function of the sinus node is inhibited, namely, impulses are formed in it that form the contractions of the heart.

How does the heart react to this? His response is frequent heartbeats, but the contractions are uneven due to the load.

When considering arrhythmias recorded after eating, it is important to remember that seizures can be triggered by the use of alcoholic beverages. Studies have shown that alcohol leads to paroxysms of atrial fibrillation, which in severe cases can cause death.

These are common causes that cause heart rhythm disturbances. Heart failure is caused by the following factors:

  • stress;
  • diseases of the thyroid gland, nervous system, lungs, gastrointestinal tract, heart;
  • anemia;
  • oncology;
  • atherosclerosis;
  • inflammation of the heart muscle;
  • viral infections;
  • heart defects.

The most common cause of sinking hearts is caffeine abuse. Therefore, start by limiting caffeine. Enough of one cup per day, and it is advisable to drink it until 16.00. It doesn’t matter if there will be coffee with or without milk. Remember that you should also limit tea (especially green!), Dark chocolate, energy drinks, any kinds of drinks with cola. If you still drank more coffee than necessary, you will need as much water as possible. This will speed up the removal of caffeine from the body.

The second most common cause of a sensation of a sinking heart is low blood sugar. If this is not a violation of carbohydrate metabolism, but simply a consequence of an incorrect lifestyle, then you will not need to see a doctor. Eat at the same time, 4-5 times a day, and for breakfast you can and should eat slowly digestible carbohydrates: oatmeal, buckwheat porridge or lentils.

Often the heart misses a beat during a stressful situation. Of course, it’s not just your emotional state. Most often, stress-freezing is associated with a deficiency of potassium. It’s difficult to get enough of this trace element from food, so it’s cheaper and more efficient to pick up potassium tablets, for example, Panangin. This product is sold without a prescription and is not harmful if you do not try to consciously take an excessive dose.

  • aging;
  • coronary heart disease;
  • connective tissue diseases;
  • congenital diseases, including weakness of the atrioventricular node;
  • muscular amyloidosis;
  • surgical trauma (valve bioprosthetics, heart transplantation);
  • contagious diseases (diphtheria, rheumatic heart disease, blood poisoning, typhoid fever).

clinical picture

Regardless of the number of times how much the heart froze in the chest, it is necessary to make an appointment with a cardiologist. Do not entertain yourself with the illusions that the problem will go away by itself. There are many reasons for this ailment, so the patient needs to undergo a diagnostic course. At the initial stage, signs of the disease are not always noticeable. Only on the basis of the obtained ECG results, the doctor has the opportunity to conclude on the patient’s condition.

The list of reasons reveals addiction to caffeinated products. It is wrong to think that 1-2 cups of coffee a day will not harm human health. Depending on the existing hereditary predispositions and state of health, each person requires a certain amount of coffee. Even if you add milk or cream to a cup of coffee, it will not reduce the potential health hazard. If it is impossible to refuse coffee, then its last cup should be drunk up to 16 hours.

Other caffeinated drinks and products include Coca-Cola, green tea, dark chocolate and various energy drinks. It is especially difficult to refuse such liquids to adolescents, so it is important to speed up the process of removing caffeine from the body. This will help a large amount of boiled water drunk after caffeinated liquids. Other causes of sinking hearts are as follows:

  1. A sharp decrease in blood sugar due to impaired carbohydrate metabolism. In addition, this problem is caused by the abuse of harmful products or irregular nutrition. Nutritionists recommend eating 5 to 6 times a day at strictly defined times. This optimizes the body.
  2. Exposure to stress – nerve stress is always harmful to health, especially when it comes to the heart.
  3. An acute shortage of potassium – occurs against a background of improper or irregular nutrition.
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As can be seen from the above reasons, the problem arises due to not so much physiological as psychological factors. That is why a cardiologist can refer the patient for additional advice to a nutritionist or psychotherapist.

Types of arrhythmias and their features

Our heart can fail in different ways, so the medical community identifies the following types of arrhythmias:

  • Sinus tachycardia: characterized by rapid heart contraction, more than 90 beats per minute. Usually provoked by excessive physical or emotional stress, it can be caused by colds;
  • Sinus bradycardia: the frequency of contractions drops to 55 beats per minute, as a rule, it provokes poor thyroid function. With sinus bradycardia, weakness and drowsiness often occur;
  • Sinus arrhythmia: the frequency of strokes is not uniform. These types of arrhythmias are most often affected by adolescents and children. Often this disease is associated with breathing, such arrhythmia often does not require medical intervention and does not interfere with normal life;
  • Atrial fibrillation or flickering arrhythmia. The danger is that often the patient does not know about the disease, but sometimes you can feel fluttering in the chest area, as well as pain, often shortness of breath occurs. In the risk zone are people who abuse alcohol and have thyroid disease. The main symptom is a lack of heart rate, that is, the heart rate exceeds the heart rate when listening;
  • Heart block: it is possible to determine because a person periodically completely disappears a pulse. Often, a sick person suffers from fainting, and with complete blockage, a fatal outcome is possible.

From the descriptions, the main symptoms of arrhythmia can be distinguished, these include: slow or fast heartbeat, shortness of breath, chest pain and fainting. But the symptoms, for the time being, may be mild and many tend to attribute them to banal fatigue, so be careful, listen to your health.

Distinguish single-chamber, two-chamber, three-chamber stimulants. The first and second have 1 and 2 electrodes (atrial and / or right ventricular). Three-chamber devices are used for biventricular activation and have an additional conductor for the left ventricle.

With stimulation of the right atrium, the synchronization of ventricular contraction is disturbed. On the ECG during such a process, isolation of the right leg of the bundle of His is recorded. When both ventricles are stimulated, their synchronous work is preserved, and cardiac hemodynamics is much better in this case.

With stimulation of the right atrium, the synchronization of ventricular contraction is disturbed. On the ECG during such a process, isolation of the right leg of the bundle of His is recorded. When both ventricles are stimulated, their synchronous work is preserved, and cardiac hemodynamics is much better in this case.

Reasons for the development of bradycardia

  • physical fitness;
  • aggravated vagal electrotone (vasovagal blackouts; hypersensitivity of the carotid sinus);
  • drugs (beta-blockers, calcium channel blockers, digoxin, lithium, antiarrhythmic substances);
  • cocaine use;
  • hypokalemia;
  • hyperkalemia
  • neurological disorders (CNS tumors, increased intracranial pressure);
  • obstructive sleepy apnea syndrome.

For the diagnosis of bradycardia, Holter monitoring, incident counters and implantable recording instruments, as well as electrophysiological studies are used.

For the diagnosis of bradycardia, Holter monitoring, incident counters and implantable recording instruments, as well as electrophysiological studies are used.

The conditions and diseases listed below can cause the heart to work arrhythmically, more often, and harder:

  • excessive activity of the thyroid gland (hyperthyroidism);
  • anemia (anemia);
  • low blood sugar of the patient (hypoglycemia);
  • low blood pressure (hypotension);
  • high temperature (fever) from 38 degrees or more;
  • fluid deficiency in the body (dehydration);
  • directly heart problems.

How to recognize extrasystoles?

Recognizing extrasystoles is actually not difficult. Disruptions in the work of the heart appear. It seems to roll over, freezes due to overwork, physical or mental stress. It hurts in the heart, shortness of breath, dizziness, weakness, a feeling of lack of air appear.

Symptoms, for example, after a myocardial infarction, may be completely absent.

The heart freezes and catches a breath often in infants. Increasingly, babies with a similar pathology began to be born.

Extrasystoles are detected in patients with diabetes mellitus, suffering from disorders of the endocrine system.

An electrocardiogram shows a significant decrease in the volume of blood ejected by the heart. Patients experience a lack of oxygen due to circulatory disorders in the vessels. Extrasystoles are accompanied by renal, cerebral insufficiency.

Almost all smokers have signs of tachycardia, cardiac arrhythmias. Shortness of breath and cramping of the head appear.

The manifestation of extrasystoles occurs with physical exertion, a long stay in a sitting position, against a background of stress, severe overstrain.

Often broken heart rate in pregnant women. That heart is beating too much, it is suspiciously silent, thereby creating a nervous atmosphere. Pregnant women begin to fall into tantrums, which is not the best way affects the development of the baby. Doctors detect arrhythmia in the fetus. If extrasystoles occur more often than every 10 contractions of the heart, then this is already a deviation from the norm, the condition becomes dangerous.


Depending on the cause of the arrhythmia, in addition to heart rhythm failures, other symptoms are also observed. The most common is shortness of breath, heart pain.

Shortness of breath is rapid breathing. In a calm state, a person performs approximately 16-18 respiratory movements. If breathing quickens, a person begins to feel a lack of air, he cannot breathe to his full chest. In this state, a person can breathe heavily.

Shortness of breath is often a sign of a serious illness, especially in combination with arrhythmia. Therefore, when shortness of breath occurs, you must immediately go to the hospital.

Sometimes shortness of breath can cause another symptom, pain in the heart, which can manifest itself on its own. The pain can have a different nature and give to other parts of the body. Arrhythmia, shortness of breath and pain – these symptoms are often found together. After eating, with VVD and other conditions, weakness, dizziness, and other signs that require attention can occur along with arrhythmia.

In case of sensations of interruptions in the work of the heart, before starting treatment, it is necessary to determine what exactly causes these sensations, clarify the nature of rhythm disturbances, its potential danger to humans, try to eliminate the provoking factors, if any, and only after that the doctor prescribes therapy . Self-administration of antiarrhythmic drugs can cause significant harm to your health and is life threatening.

As symptomatic medications can be used

1 group of mambranostabilizing sodium channel blockers is divided into 3 subgroups: 1A quinidine, procainamide; 1B lidocaine; 1C propafenone, ethacyzine. 2 group beta-blockers (bisoprolol, metoprolol, propranolol) .3 group potassium channel blockers: amiodarone (cordarone), sotalol. 4 group calcium channel blockers (verapamil, diltiazem) .5 group digoxin, adenosine.

• herbal sedatives based on motherwort, valerian, peony;

• combined sedatives (corvalol, valocordin);

• metabolic drugs are prescribed to improve metabolic processes in the heart (mildronate, mexidol, omega-3 polyunsaturated fatty acids, magnesium preparations);

What tests to pass in case of interruptions in the work of the heart

The minimum examination volume for rhythm and conduction disorders includes

• clinical blood test (to exclude anemia, infection, blood diseases, inflammatory non-infectious diseases);

• urinalysis general (to assess the condition of the kidneys);

• biochemical analysis of blood (transaminases, bilirubin – assessment of the liver, creatinine, electrolytes – to assess kidney function, exclude electrolyte disturbances, glucose level);

• determination of the level of thyroid hormones (first of all, the level of thyroid-stimulating hormone is studied);

• an electrocardiogram is necessarily performed for an objective assessment of the heart rate, to evaluate the correct rhythm, and to diagnose possible cardiac causes of the development of rhythm disturbances

• chest x-ray to assess the size of the heart, the state of the lung tissue;

• performing echocardiography (ECHO-KS), which is necessary to assess structural and functional changes in the heart (condition of valves, heart muscle, pericardium, pulmonary artery diameter, pulmonary artery pressure, heart tumors, etc.).

After performing a standard examination volume, the doctor, as a rule, determines the causes of the development of arrhythmia. You may need to consult a specialist: a cardiologist, an endocrinologist, a gastroenterologist.

If the arrhythmia could not be fixed by the indicated methods, tests with physical activity are performed. During the test, a treadmill or exercise bike is used, during the load an electrocardiogram is recorded. Instead of exercise, medications can be used. The test with an inclined table is used in case there are unexplained loss of consciousness.

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Heart rhythm disturbance is a very serious problem that can bring patients not only discomfort, but also lead to serious complications, such as stroke, heart failure, thromboembolism of different localization. Therefore, when there is a feeling of interruptions in the work of the heart, you must seek medical help for an examination.

Cardiologist M.A. Chuguntseva

Treatment, tuning and help our motor

Any treatment begins with a diagnosis, the doctor not only takes an interest in the symptoms that bother you, but also prescribes an electrocardiogram, according to the results of which he writes out the appropriate treatment. In some cases, the doctor also prescribes an additional study such as echocardiography, which allows you to find out all the necessary information about the size of the heart, its valves and to monitor the movement of the walls during heart contractions.

The following steps are largely dependent on the cause of the problem, as well as the degree of neglect. Often resort to the help of medicines, prescribing antiarrhythmic drugs, and also, for the prevention of thrombosis, advising to take antiplatelet therapy drugs. But the doctor selects the dose and the drugs themselves individually.

One thing is for sure, the factor that triggered the development of the disease must be removed. If this is high cholesterol, then the diet will help you, if it is dehydration and heat, do not forget about the headgear and that it is good to take a bottle of clean water for long walks. Well, if these are stresses, it means that you have a good reason to think about your life and change it, eliminating stressful situations, for example, exhausting work.

The approach to treating heart failure is determined by the cause of this symptom. In some situations, conservative therapy will be effective, in others surgery may also be necessary (for example, stenting of the coronary arteries in case of severe cardiac ischemia), in the third case, doctors will limit themselves to observation and general recommendations (regarding the regimen, diet, physical activity).

The second factor determining the tactics of treating uneven heart function is the nature and potential danger of rhythm disturbances. With some of them, the patient may even stop the heart. Therefore, doctors will take active therapeutic measures and, if drug therapy is ineffective, recommend surgical intervention (for example, radiofrequency ablation of the arrhythmogenic focus in the myocardium or the establishment of a pacemaker). As for the symptomatic treatment of heart failure, it is carried out by the following groups of drugs:

  • Antiarrhythmic drugs. For each type of arrhythmia, certain drugs from this group are shown, therefore it is strictly forbidden to drink tablets that help one of the relatives get rid of the attack.
  • Sedatives – herbal or synthetic. Experience and anxiety are factors that provoke heart failure, so they must be excluded.
  • Metabolic drugs. Medicines of this group improve metabolic processes in the myocardium, which contributes to more efficient work of the heart muscle.

In addition, in case of interruptions in the work of the heart, it is very important that the patient quit drinking and smoking, start eating properly, enriching his diet with heart-friendly food, if possible refuse heavy physical work, revised the regimen of the day, devoting sufficient time to rest and sleep. Equally important is a regular visit to a cardiologist with mandatory registration of an ECG and passing the necessary blood tests.

What to do if a person discovers such unpleasant symptoms, whether they are after eating, with physical exertion or other situations? Go to the doctor immediately. It is impossible to describe the treatment, since it completely depends on the results of the examination.

If the heart beats intermittently, weakness is felt, breathing is difficult, it is necessary to calm down. You can lie down, breathe fresh air. In severe cases, you should call a doctor. Effective treatment will get rid of unpleasant symptoms, which will improve the quality of life.

The first step is to identify the causes of bradycardia and the possible elimination of their action (stop taking betablockers). If there is no removable reason, then drug therapy or temporary or permanent pacing may be necessary).

Atropine, isoproterenol, and aminophylline are used to stimulate heart rhythm with significant reductions (longer than 3 seconds). However, taking these drugs can provoke rhythm disturbances, including life-threatening ventricular disturbances. In patients with heart attack and bradycardia due to ischemia, they conduct anti-ischemic therapy and take a wait-and-see attitude, using cardiac pacing, if necessary.

Patients with sinus suppression syndrome and atrioventricular block are evaluated for the installation of a temporary or permanent pacemaker. There are developed European indications for the installation of permanent pacemakers in patients with CVD, AV block.

Patients with sinus suppression syndrome and atrioventricular block are evaluated for the installation of a temporary or permanent pacemaker. There are developed European indications for the installation of permanent pacemakers in patients with CVD, AV block.

What to do in such a situation?

  • Treat the underlying disorder that caused heart rhythm disturbances.
  • If the heart beats intermittently, what to accept? First of all, to correct bradycardia with drugs (anticholinergics, xanthines). Suitable Trental, Agapurin, Atropine.
  • If there is a big risk of cardiac arrest, install a pacemaker (pacemaker).

The choice of tactics is determined by the stage of the disease and the presence of the clinic. With interruptions in the rhythm due to myocardial damage, complete recovery will not occur.

Physiological bradycardia in athletes and trained people does not require treatment, as well as bradyarrhythmia without symptoms.

Treatment aimed at eliminating heart rhythm disturbances should be comprehensive and depend on the reasons that influenced it. Prevention and therapy are prescribed by a specialist based on diagnostic results. Measures may include the use of drugs and a special diet. In some cases, surgery is required.

Sometimes after drinking, the heart beats intermittently.

Therapeutic Techniques

Treatment lasts longer if the cause is hidden in a psychological or anatomical plane. It is necessary to understand the underlying factors that led to the disruption of the natural rhythm. The emphasis is not so much on drugs, but on psychological unloading. In some cases, it is necessary to teach the patient techniques for the correct reaction to external stimuli.

As mentioned earlier, the primary cause of rhythm disturbance is VVD. As it develops, the “motor” works intermittently, the duration and frequency of occurrence of which is different. That is why drugs are prescribed that normalize the situation. This means that treatment should not be interruptions in the work of the heart, but the situation that causes them.

As soon as the VSD becomes less pronounced, the heart rate will return to normal. Strict implementation of the recommendations of the doctor and related specialists is the key to health. Under no circumstances should you stop the course of medication prescribed by your doctor. It is impossible to cure VVD, but there are effective methods to reduce the intensity of the manifestation of the clinical picture.

Risk group

If a person has close relatives experienced arrhythmia, it is advisable to be examined regularly by a cardiologist. Also at risk include:

  • patients with congenital diseases of the heart and blood vessels;
  • women in menopause;
  • adolescents;
  • patients who are overweight;
  • men after 45 years;
  • patients who have thyroid abnormalities.

In addition, the heart beats intermittently in people whose activities are associated with increased intellectual or physical stress.


A healthy lifestyle is perhaps the panacea, if not for all diseases, then for the most part. But it’s easy to say: a healthy lifestyle, but you have to get used to it, and it’s not so simple. It is impossible to completely rebuild your life in one day. Therefore, let’s talk about good habits, the introduction of which into the daily schedule will benefit the heart and help you forget about problems with it:

  • Moderate physical activity: walking, swimming, water aerobics. Just remember, your doctor should allow you the load. It is not worth appointing them yourself;
  • Refusal of bad habits: smoking and alcohol. One glass of good red wine does not count, on the contrary, it can even be useful, but do not abuse;
  • Lack of stress, positive emotions;
  • Diet, the fight against obesity, but remember, it is contraindicated to starve, you just have to give up harmful products.
  • Phototherapy – taking infusions of herbs, do not get carried away and consult your doctor better, but, nevertheless, this method can not be discounted, infusions of herbs can tarnish your heart.

A preventive measure is to maintain a healthy lifestyle. It is necessary to abandon salted, fatty foods, as well as bad habits. An essential condition is sports. However, one must remember the moderation of physical activity.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.