Arrhythmias are a group of cardiac arrhythmias or conduction of its impulses, manifested as a change in the frequency and strength of heart contractions. Arrhythmia is characterized by the occurrence of early contractions or occurring outside the usual rhythm, or changes in the sequence of excitation and contraction of the heart.
The causes of arrhythmias are changes in the main functions of the heart:
- automatism (the ability of the rhythmic contraction of the heart muscle when exposed to an impulse formed in the heart itself, without external extraneous influences);
- excitability (the ability to react by the formation of an action potential in response to any external stimulus);
- conduction (the ability to conduct an impulse along the heart muscle).
Violations occur for the following reasons:
- Primary heart damage: coronary heart disease (including after myocardial infarction), congenital and acquired heart defects, cardiomyopathies, congenital pathologies of the conduction system, trauma, use of cardiotoxic drugs (glycosides, antiarrhythmic therapy).
- Secondary damage: consequences of bad habits (smoking, alcohol abuse, drug use, strong tea, coffee, chocolate), unhealthy lifestyles (frequent stress, overwork, chronic lack of sleep), diseases of other organs and systems (endocrine and metabolic disorders, renal disorders) , electrolyte changes in the main components of blood serum.
■ coronary heart disease;
■ congestive heart failure;
■ cardiomyopathy (heart muscle disease);
In about a third of patients suffering from a common form of arrhythmia – atrial fibrillation, it is not possible to identify any objective cause of cardiac arrhythmias ..
The next step in the diagnosis of arrhythmia is the refinement of causal factors.
■ Laboratory tests – determination of potassium, magnesium and calcium levels in the blood. Deviations in the content of these trace elements can lead to arrhythmias. The study of the level of thyroid hormones and cardiotropic enzymes also helps to clarify the causes of arrhythmia.
■ Stress tests – ECG recording when performing certain physical exercises is an additional method for the diagnosis of coronary heart disease. This method can also be used to provoke arrhythmias. When performing such tests, the ECG is recorded while walking on a treadmill.
■ Echocardiography – a method of visualizing the heart using ultrasound, which allows to identify the pathology of the heart valves as the cause of arrhythmia.
■ Coronary angiography – may be performed if coronary heart disease is suspected. Coronary angiography is a study used to diagnose heart diseases that can lead to arrhythmias. This method allows you to evaluate the flow of blood to the secondary muscle and the pressure in its cavities.
What conditions can cause cardiac arrhythmias?
Not always the presence of deviations from normal heart rhythm is a pathology. So, for example, in people during a night’s sleep, there is a moderate slowdown in the heart rhythm, that is, bradycardia, due to the prevailing vagal effects on the heart (the vagus nerve slows heart rate, night – “the kingdom of the vagus”).
In conditions such as psycho-emotional stress, stress, physical exertion, tachycardia develops. This is due to an imbalance in the functioning of the autonomic nervous system and the release of the stress hormone adrenaline, which stimulates heart contractions, to better supply blood to the muscles and brain.
Changes in the electrolyte composition of the blood (imbalance in sodium, potassium and magnesium), changes in blood viscosity cause a deterioration in the functioning of the heart and blood vessels. Feverish conditions accompanying inflammatory processes in the body, overheating or hypothermia, food poisoning, anemia, blood loss, shock, collapse, dehydration due to vomiting or diarrhea can lead to such changes.
Rhythm disturbances arising from the described conditions, as a rule, are transient, disappearing when the cause is eliminated, and treatment is not required.
More dangerous are rhythm disturbances that occur with an overdose of drugs. For example, with glycoside intoxication (digoxin, strophanthin, korglikon), an overdose of antiarrhythmics (propafenone, ethmosin), beta-adrenergic agonists (salbutamol, berodual), frequent ventricular extrasystole, paroxysmal tachycardia can develop.
Risk factors for the development of arrhythmias include old age, burdened heredity, overweight, bad habits.
The causes of arrhythmia are usually divided into 2 parts: natural and pathological.
Natural causes may include, for example, a slowdown in heart rate during sleep. This condition is called bradycardia. At this time, sinus arrhythmia, atrioventricular block of the first degree, single extrasystoles of individual parts of the heart can form. An interesting variant of natural bradycardia is often observed in well-trained people, such as athletes. Their heart beats normally at intervals of 50 beats per minute.
With stress and other psycho-emotional stress, as well as with too high physical exertion, tachycardia can develop. This occurs from an imbalance in the autonomic nervous system and a sharp release of adrenaline.
A similar situation can be created by consuming large doses of alcohol, nicotine and caffeinated drinks. As a result, tachycardia and extrasystole usually appear. The regular use of all these substances in large quantities can lead to the appearance of paroxysms of atrial fibrillation and supraventricular tachycardia.
Unbalanced elements such as sodium, potassium and magnesium can cause serious consequences. As a result of this imbalance, the viscosity of the blood changes, which negatively affects the functioning of the heart and blood vessels. In addition, arrhythmia is possible in the following cases:
- inflammatory process;
- sun and heat stroke;
- food and drug poisoning;
- severe blood loss;
- severe dehydration.
In these cases, arrhythmia is a rapidly passing phenomenon that does not require special treatment.
However, poisoning, especially medication, is a great danger.
The danger of the negative consequences of arrhythmia increases significantly in old age, with overweight, severe chronic diseases, alcoholism, drug addiction.
All human diseases in relation to the work of the heart can be divided into 2 parts: provoking arrhythmia and not directly affecting the work of the heart.
The risk factors include the following:
- hemodynamic heart defects;
- coronary ischemia;
- hypertensive disease;
- heart failure;
- intoxication of the body of any genesis;
- any viral infections;
- hormonal imbalance;
- surgical intervention in the lungs and heart;
- transitional age;
- cervical and thoracic osteochondrosis;
- heart defects;
- heart attack;
- left ventricular hypertrophy;
- any forms of rheumatism;
- vegetative-vascular dystonia;
- brain tumors and injuries;
- decreased or increased activity of thyroid hormones;
- adrenal gland tumor;
This extensive list cannot be called complete. Any disease or trauma that affects several body functions can change the heart rhythm. In chronic pathologies, it is necessary to purposefully begin treatment of heart rhythm.
It is represented by a whole complex of pathological conditions, united by the mechanism of conduct, functional features and the formation of an electrical impulse.
Arrhythmia attacks can occur against the background of ischemic disease and the clinical syndrome of myocardial damage, acquired and congenital heart defects, in connection with a functional disruption of the mitral valve, which ensures blood flow into the left ventricle and aorta.
Such factors as a change in water-electrolyte and acid-base balance, endocrine disorders, which are a source of rhythm disturbance and cardiac conduction, should not be ruled out. In rare cases, this group includes diseases of the biliary system, hematopoietic system and digestive system, ulcerative lesion of the duodenum.
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 postpartum period. In adolescent girls, there is an increased pulse in the transition period.
Improper intake or exceeding the indicated dosage of antiarrhythmic, diuretic and plant-based heart glycosides drugs and psychotropic substances has a negative effect on heart rate.
Bad habits like smoking, alcohol, drugs and even coffee, an abundance of greasy, preservative-containing food can also affect the heart. Frequent stresses and autonomic disorders, mental disorders, hard physical work and intense mental activity.
Arrhythmia can occur due to organic damage to the heart muscle, the causes of which are:
- Ischemia of the vessels of the heart.
- Congenital and acquired heart defects.
- Heart failure.
- Strong intoxication of the body when taking certain drugs, alcohol and the influence of certain chemical compounds.
- Imbalance in the hormonal balance of the body.
- Infectious diseases.
- Trauma and surgical treatment of the heart muscle.
Varieties of arrhythmias
If a rhythm disturbance occurred in the direction of its fall, bradycardia is recorded. If towards acceleration, tachycardia is diagnosed. However, the classification of arrhythmias is based on a more accurate indication of the place of origin or other features. For example, “sinus tachycardia” means a failure in the sinus node. It is there that the cells that generate the impulse (pacemakers) are located.
There is also a conditional classification of these conditions by type, which divides arrhythmias into those that appear due to a violation of a function. For example, an autowave.
Heart rhythm disturbances are divided into certain forms according to their course and cause of development. Their brief classification is as follows:
- Bradycardia In this case, we are talking about its sinus variety. She is characterized by a decrease in heart rate to 55 and below. Patients often complain of chest pain, general weakness, and dizziness. Heart rhythm disturbances caused by bradycardia mainly occur due to arterial hypotension and pathologies of the heart and thyroid gland.
- Tachycardia (sinus). Such a failure of the heart rhythm is manifested by an increase in heart rate up to 95 beats per minute and higher. At the same time, the patient feels how his heart beats, feels discomfort in the chest area. Sinus tachycardia is caused by stress, physical and mental overload, colds and infections, as well as diseases of the cardiovascular system.
- Paroxysmal (paroxysmal) tachycardia. It represents the correct rhythm of the heart muscle, but is too rapid. For paroxysmal tachycardia, a heart rate of 140-220 beats per minute is characteristic. During an attack, the patient feels a loss of strength. Sometimes, increased heart rate and sweating may be observed. Relief of the general condition occurs as suddenly as the appearance of an attack. The causes are identical to sinus tachycardia.
- Atrial fibrillation . It is also called atrial fibrillation due to chaotic contraction with a frequency of 300-600 beats per minute of individual sections of muscle tissue. Such a heart rhythm failure is manifested by incomplete atrial contraction and irregular contraction of the ventricles, which causes serious problems with blood circulation. During an attack of atrial flutter, their contraction rate may exceed 300 beats per minute. But if there is no violation of atrial ventricular conduction, the heart rhythm does not go astray. Flutter and atrial fibrillation may alternate. The patient feels shortness of breath and discomfort in the chest area, during a severe attack, death is possible due to the termination or serious violation of blood flow. Atrial fibrillation develops due to defects and diseases of the heart and thyroid gland, as well as alcoholism.
- Respiratory arrhythmia. This type of heart rhythm disturbance is manifested by an incorrect alternation of contractions. This problem mainly concerns children. The course of therapy is not prescribed, since respiratory arrhythmia does not affect health.
- Extrasystoles. In this case, an extraordinary contraction of the heart occurs ahead of time. At the same time, the patient feels a strong blow in the chest or fading. Sometimes they appear in a completely healthy person or are caused by internal pathologies and an incorrect lifestyle.
- Cardiac blockade. They are characterized by a failure of the heart rhythm caused by a complete cessation or distortion of the conduction of the pulse along the myocardium. The main manifestation of the blockade is the paroxysmal disappearance of the pulse. A person due to this malfunction may lose consciousness or suffer from cramps. If the impulse blocking is complete, then heart failure develops and deaths often occur.
- Idiopathic heart rhythm disturbance. It manifests itself quite sharply even in people who do not have health problems. The essence of the idiopathic form of arrhythmia is to distort the conductivity of the pulse. A problem arises due to the influence of various external and internal factors.
The above characteristic will help to understand what arrhythmia is. However, the attending physician should make a diagnosis and prescribe treatment, focusing on the results of the examination. Self-medication can lead to an aggravation of the condition and death.
Arrhythmias can affect both the upper chambers of the heart (atria) and the lower (ventricles). There are two main types of arrhythmias: tachycardia, in which the heart rate is too high, and bradycardia, in which it is too low. Specific types of arrhythmias include the following conditions.
- Atrial fibrillation is the most common heart rhythm anomaly in which a rapid heartbeat is accompanied by an absolutely irregular rhythm. This condition may be persistent or paroxysmal and is more common in older people.
- Supraventricular tachycardia is a fast but regular heart rhythm, more typical for young people.
- Ventricular fibrillation – in this type of heart rhythm disturbance, a pathological stimulus comes from the ventricles, which can result in the development of a severe form of arrhythmia requiring emergency treatment.
- Complete heart block – electrical impulses from the atria do not enter the ventricles. The heart rate decreases sharply.
- Wolf-Parkinson-White Syndrome is a rare congenital disorder that causes very fast heart rhythms.
- Cardiac arrest is the complete inability of the heart muscle to contract.
1. Impairment of impulse formation. If pulses are generated in the sinus node, but too often, sinus tachycardia develops (heart rate above 90 per minute), if rarely, sinus bradycardia (heart rate less than 60 per minute). Another type of disturbance is sinus (respiratory) arrhythmia.
If impulses arise from lower sections of the conducting system, an ectopic (located in the wrong place) source of excitation is formed. Such a focus can be located in the atria, atrioventricular node or ventricles, and can send impulses both above and below its location.
This type of rhythm disturbance includes slow slipping and accelerated ectopic (non-paroxysmal tachycardia) rhythms, extrasystole and paroxysmal tachycardia. Each of these disorders can be atrial, atrioventricular, and ventricular. Also, due to the existence of ectopic foci, flickering (fibrillation) and atrial flutter, ventricular fibrillation and flutter can develop.
2. Cardiac conduction disorders are called blockages. An impulse conduction block can occur on any part of the conducting system, therefore, sinoatrial, intraatrial, atrioventricular blockade, blockade of the bundle of the bundle of His are distinguished. In addition, the same group includes Wolff-Parkinson-White syndrome (ERW – syndrome), shortened PQ syndrome, asystole of the ventricles (cardiac arrest).
3. Combined species – parasystole, atrioventricular dissociation, ectopic rhythms with blockade of exit. These are conditions in which an additional, ectopic pacemaker works parallel to the sinus pacemaker, but they are separated by a blockade. In the heart, double rhythm formation occurs, that is, the atria work in their rhythm, and the ventricles in their own.
Arrhythmia is divided into the following categories:
- Incorrect impulse formation. If the pulse formation is too frequent, a sinus tachycardia (90 or more beats per minute) may develop in the sinus node. If this impulse is rarely formed, sinus bradycardia may develop (60 or less beats per minute). Sinus respiratory arrhythmia is also in this category. Such pulses can form at lower points in the system. This forms a focus of excitement, which is usually called ectopic, that is, located in an unnatural place for this process. This process can form in the atria, atrioventricular node, and in the ventricles. Such disorders include slow slipping out or, conversely, accelerated ectopic rhythms. Both extrasystole and paroxysmal tachycardia belong to the same category.
- Blocks can form within the heart itself. Blockades can occur in any part of the system, so they are divided into many small options. For example, sinoatrial, atrioventricular block, as well as ventricular asystole (in fact, this is cardiac arrest).
- Atrioventricular dissociation, ectopic rhythms with blockade are also distinguished. These are the so-called combined species. With such processes, a double or parallel rhythm formation occurs in the heart.
A controversial and controversial question remains how to correctly classify and determine cardiac arrhythmias, to distinguish their main types. Today, there are several factors that are taken into account in order to distinguish between types of possible heart rhythm disturbances.
First of all, the pulse is associated with a change in the automatic, natural formation of the pulse, 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 of up to 90 strokes, can cause cardiac arrest. This also includes the lower atrial, atrioventricular, and idioventricular rhythm.
The source, driver of the heart pulse is not the sinus node, but the lower parts of the conductive 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 conduction system disorder is expressed by a congenital anomaly, WPW syndrome, with premature ventricular excitation and the so-called blockade. Among them, sinoauricular, intraatrial, AB, blockade of the legs of the bundle of His is noted.
A mixed or combined type of arrhythmia is separately considered. Flutter and fibrillation, atrial fibrillation and ventricular fibrillation. The heart rate reaches 200-480 beats.
Pathogenesis of the development of the disease
Not in all cases, malfunctions in the heart rhythm are the result of a developing pathological process. For example, during sleep, the intensity of heart contractions decreases.
This is due to the influence of the vagus nerve. The minor manifestations of the following failures during sleep are considered quite natural:
- blockade of the first degree;
- single extrasystoles;
- sinus type arrhythmia.
Due to the transferred stresses and disturbed psycho-emotional background, the heart rate increases. The problem arises as a result of failures in the autonomic (autonomous) section of the central nervous system, as well as due to the active synthesis of adrenaline, which gives the heart a signal to contract intensely. Among the other causes of temporary malfunctions in the rhythm of the heart, the most common:
- Bad habits and caffeine speed up the heart rate, contributes to the development of extrasystoles.
- The constant use of alcohol in large doses provokes the occurrence of attacks of atrial fibrillation and supraventricular tachycardia.
- Violation of the water-salt balance has a bad effect on the cardiovascular system. Among the reasons for the development of these phenomena, one can distinguish overheating or hypothermia, fever, inflammatory processes, poisoning, anemia (anemia), blood loss, shock, and collapse. In more rare cases, the problem occurs due to dehydration caused by a violation of the stool (diarrhea) or frequent vomiting.
The influence of the described factors causes temporary disturbances. They usually resolve themselves after eliminating the cause. However, there are cases of malfunctions in the rhythm of the heart, which can be more dangerous, for example, caused by an overdose of medications. Because of them, extrasystoles and attacks of tachycardia are manifested. Basically, this applies to the following groups of drugs:
- cardiac glycosides;
- beta adrenomimetics.
Heart rhythm malfunctions often occur due to the following aggravating factors:
- genetic predisposition;
- advanced age (after 50 years);
- excess body weight;
- smoking and alcohol abuse.
People who belong to one or more risk groups should be examined annually. If the problem could not be prevented, then you can find out what to do only with a cardiologist.
Arrhythmia is often triggered by various diseases. Basically, they relate to the cardiovascular system:
- heart defects;
- left ventricular hypertrophy;
- heart attack;
- heart failure;
- inflammatory heart diseases (myocarditis, pericarditis).
Pathologies of the nervous system have a huge impact on heart rate. It:
- vegetative dystonia;
- acute cerebral blood flow disorders;
- neoplasms in the brain;
- head injuries.
Failures in the endocrine (hormonal) balance often provoke an increase or slowdown of the heartbeat:
- low or high levels of thyroid hormone synthesis;
- menopause and especially the menstrual cycle in women.
Due to diseases of the internal organs, stomach and intestines, the patient experiences malfunctions in various systems, including the cardiovascular system. This applies to inflammation of the pancreas or gall bladder and diaphragmatic hernia.
Non-cardiac muscle causes usually cause these forms of heart rhythm malfunction:
- sinus type tachycardia and bradycardia;
- ventricular and atrial premature beats (insignificant);
- blockade of 1-2 degrees;
- on the ventricular tachycardia.
You need to be afraid of severe pathological processes that affect the heart. Serious organic damage usually causes complete blockade, atrial fibrillation, and regular attacks of ventricular tachycardia.
Features of the treatment of children
In children, arrhythmias are diagnosed, usually of a congenital nature. These include ventricular tachycardia, for example, Brugada syndrome, of the “pirouette” type. These cardiac arrhythmias in children are considered life-threatening, since they differ in the risk of sudden death. That is why early diagnosis is important if the child has relatives with similar pathologies. Among childhood arrhythmias, tachycardia and extrasystole are most often diagnosed, and less commonly, bradycardia.
In the case of an acute attack of tachycardia in a child (you can read more about tachycardia in children here), the following symptoms are observed:
- a sharp change in state;
- heart palpitations;
- shortness of breath, darkening in the eyes;
- the appearance of a coma in the throat;
- pulse up to 250 beats / min.
The presence of even some of the listed signs should be the reason for an urgent call of ambulance. It is important to remember that a sharp failure in the work of the heart in children can lead to fainting, sudden death during physical exertion (jumping, climbing, running, active play). The same applies to adolescents and adults.
Violation of the heart rhythm in children is congenital, in half the cases it is asymptomatic. The pediatrician should go in for treatment; go to the pediatric cardiologist. The basic rule in the preparation of a course of therapy remains unchanged – you need to eliminate the root cause of the disease. For example, if rheumatism is an irritating factor, then you need to remove the foci of infection.
Functional arrhythmia does not require drug therapy at all. It will be enough to change the lifestyle of the child:
- adjust the mode of rest and work;
- balance your diet;
- saturate the body with useful substances;
- make sure that the child receives minimal physical activity.
If arrhythmia is caused by internal pathologies, including the heart, then medication and surgery may be included in the treatment. Drug treatment is based on:
- normalization of electrolyte balance in the heart;
- the use of antiarrhythmic drugs;
- restoration of good nutrition of the heart.
Sometimes drug treatment does not bear the necessary fruits. In this situation, surgery is used to stabilize the heart rhythm. This is radiofrequency ablation or implantation of a pacemaker and defibrillator.
Irregularities in the heart rhythm have many features, depending on their shape. They are caused due to external and internal factors. Particular attention to the causes of arrhythmias should be given to people who are at risk. They should be screened annually to monitor heart function. If abnormalities are found, it is necessary to consult a cardiologist.
For reference. The only similarity between childhood and adult arrhythmias is that the disease can be asymptomatic and come to light only during a routine electrocardiographic study.
The first symptoms of childhood arrhythmia are:
- the presence of dyspnea;
- pale skin;
- anxiety state for no apparent reason;
- lack of weight;
- poor appetite.
In adolescents, heart rhythm disturbance manifests itself in the form of:
- frequent fainting;
- discomfort in the chest;
- exercise intolerance;
- excessive fatigue.
Factors that provoke the development of childhood arrhythmia:
- a variety of heart defects;
- genetic predisposition;
- intoxication of the body with drugs;
- abnormalities of the development of the heart;
- inflammation in the organ;
- diseases of the internal organs;
- impaired functioning of the nervous system.
Attention: In about a quarter of cases, in pediatric patients, there is an interruption in cardiac pulsation, and this process proceeds without any consequences. This is due to the fact that the autonomic nervous system is still being formed and undergoes changes. This phenomenon is completely normal and cannot be treated.
However, there are quite dangerous forms of arrhythmias in children, such as extrasystole and tachycardia. The seriousness is that babies do not feel any discomfort in their body for a long time.
Very important! The most serious heart rhythm disturbances in children are those caused by myocardial diseases and congenital malformations. The most dangerous arrhythmias are tachycardia, atrial fibrillation and absolute heart block. Lack of timely therapy is fraught with disability and the possibility of death of the child.
Diagnose the disease using electrocardiographic studies, Holter monitoring, electrophysiological examination through the esophagus. Sometimes they use testing on simulators in order to assess the functional state of the heart during exercise.
Therapy of childhood arrhythmia is carried out taking into account the form and stage of the disease. If the doctor has determined that arrhythmia is temporary, drugs are not prescribed. In this case, the child needs to ensure peace, reduce physical activity and try to avoid emotional stress.
With a more severe type of pathology, medications are prescribed that help to eliminate the causes of the development of the disease. Very rarely, an operation is required – to install a pacemaker.
Signs of a lost rhythm
Signs of cardiac arrhythmias are:
- An increase in heart rate (HR) above 90 or a decrease below 60 beats per minute.
- Heart rhythm failure of any origin.
- Any ectopic (originating not from the sinus node) source of impulses.
- Violation of the electrical impulse along any part of the conduction system of the heart.
|Type of rhythm disturbance||ICD Code 10||Signs of Violations|
|Sinus tachycardia||I47. 1||It is characterized by increased heart rate at rest more than 90 beats per minute. This may be the norm during physical exertion, elevated body temperature, blood loss, and in the case of pathology – with hyperthyroidism, anemia, inflammatory processes in the myocardium, increased blood pressure, heart failure. Often this type of arrhythmia manifests itself in children and adolescents due to imperfection of neuroregulatory systems (neurocirculatory dystonia) and does not require treatment in the absence of clearly expressed symptoms|
|Sinus bradycardia||R00. 1||In this condition, heart rate decreases to 59-40 beats per minute, which may be a consequence of a decrease in the excitability of the sinus node. The causes of the condition may be a decrease in thyroid function, an increase in intracranial pressure, infectious diseases, and hypertonicity of n.vagus. However, this condition is normal in well-trained athletes in the cold. Bradycardia may not manifest clinically or, on the contrary, may cause deterioration of health with dizziness and loss of consciousness|
|Sinus arrhythmia||I47. 1 and I49||Often found in adults and adolescents with neurocirculatory dystonia. It is characterized by an irregular sinus rhythm with episodes of increased frequency and a decrease in the number of contractions: the heart rate rises on inhalation and decreases on exhalation|
|Syndrome of weakness of the sinus node||I49. 5||It is characterized by a significant disruption in the functioning of the sinus node and appears when about 10% of the cells that form an electrical impulse remain in it. For diagnosis, you must have at least one of the criteria: sinus bradycardia below 40 beats per minute and (or) sinus pauses for more than 3 seconds in the daytime|
|Extrasystoles||J49. 3||Rhythm disturbances by the type of extrasystole are extraordinary contractions of the heart. The reasons for their occurrence can be stress, fear, overexcitation, smoking, the use of alcohol and caffeinated products, neurocirculatory dystonia, electrolyte disturbances, intoxication, and so on. By the origin of extrasystoles can be supraventricular and ventricular. Supraventricular extrasystoles can occur up to 5 times per minute and are not a pathology. A serious problem is represented by ventricular extrasystoles, including those of organic origin. Their appearance, especially polymorphic, paired, group (“runs”), early, indicates a high probability of sudden death|
|Atrial flutter and atrial fibrillation||I48. 0||Organic myocardial damage can manifest itself in the form of a pathological atrial rhythm: flutter is recorded with regular contractions of up to 400 per minute, fibrillation with random excitation of individual fibers with a frequency of up to 700 per minute and unproductive ventricular activity. Atrial fibrillation or atrial fibrillation is one of the main factors in the occurrence of thromboembolic events, therefore, requires careful treatment, including antiplatelet and antithrombotic therapy, if indicated|
|Ventricular flutter and fibrillation||I49. 0||Ventricular flutter – their rhythmic excitation with a frequency of up to 200-300 beats per minute, occurring according to the re-entry mechanism that occurs and closes in the ventricles themselves. Often this condition goes into a more serious condition, characterized by an irregular reduction of up to 500 per minute of individual sections of the myocardium, ventricular fibrillation. Without emergency medical care for such rhythm disturbances, patients quickly lose consciousness, cardiac arrest is recorded and clinical death is recorded.|
|Heart block||J45||If the passage of an impulse is interrupted at any level of the conduction system of the heart, it appears incomplete (with a partial influx of impulses into the underlying parts of the heart) or complete (with an absolute termination of impulse intake) heart block. During sinoatrial blockade, impulses from the sinus node to the atria are impaired, intra-atrial – through the atrial conduction system, AV block – from the atria to the ventricles, blockade of the legs and branches of the bundle of His – one, two or three branches, respectively. The main diseases that cause the development of such disorders are myocardial infarction, postinfarction and atherosclerotic cardiosclerosis, myocarditis, rheumatism|
At the cardiologist’s consultation, patients most often complain of feelings of fear and anxiety when characteristic symptoms of heart rhythm disturbance appear, such as constricting pain and tingling in the chest area, shortness of breath and lack of oxygen. May occur periodically or be observed continuously.
Many people feel the rhythms in the heart suddenly freeze and resume. Cough and suffocation accompany a decrease in the working capacity of the left ventricle, sputum production is possible. During an attack of bradycardia, dizziness, impaired coordination of movements, weakness and even fainting appear.
With self-monitoring of the pulse in the wrist, an unnatural violation of the heart rate per minute is pronounced. The number of reductions, in this case, either does not reach 60, or exceeds the rate of 100 or more strokes.
Symptoms of arrhythmia.
Symptoms of arrhythmias are varied, but most often they are manifested by a sensation of a rapid or, on the contrary, a rare heartbeat, interruptions in the work of the heart, chest pains, shortness of breath, feeling of lack of air, dizziness up to loss of consciousness.
Diagnosis of rhythm disturbances is based on a thorough history, physical examination (measuring the frequency and studying pulse parameters, measuring blood pressure) and objective electrocardiography (ECG) data in 12 leads (according to indications, a larger number of leads, including intraesophageal, are used).
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