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Types of arrhythmias
What is bradycardia and tachycardia? This question arises in those happy people who have not faced heart disease closely. These are two polar rhythm disturbances. Tachycardia is called an increase in the number of contractions of the heart over a hundred beats per minute. There is another type of arrhythmia - extrasystole. It is characterized by premature contractions of the heart. Answering the question, what is bradycardia, we can say that this is a decrease in the number of heart contractions to 55 and below. As a rule, such a violation of the rhythm in the early stages has no clinical signs and is detected during the scheduled examination.
If you are interested in what is sinus bradycardia of the heart, and counting the pulse, found that it is below 50, do not panic and call an ambulance. For those people involved in sports or physical labor, bradycardia is not uncommon. However, they do not experience any discomfort, that is, the volume of blood flowing to the brain does not decrease. This is due to the fact that, due to the constant load, their respiratory and cardiovascular systems are more developed than in the average person. Thus, the question of what is bradycardia loses its relevance for them. Its appearance in a healthy person is possible in a stressful situation, with extreme fatigue and after a long stay in the cold or in a hot and humid climate (or, for example, in the steam room). Moderate sinus bradycardia (what it is, we'll talk more about below) can be triggered by a tight tie or collar. Such conditions do not represent a danger to human health and do not require special treatment.
Bradycardia resulting from inhibition of pacemaker activity
Analyzing what bradycardia is and why it is dangerous, it should be mentioned that the pathological decrease in heart rate can be caused by several reasons. And one of them is the oppression of the pacemaker. This is due to a drop in the tone of the sympathetic nervous system or increased excitation of the vagus nerve. In turn, the cause of these phenomena can be such humoral factors as high blood levels of bile acids, low levels of thyroid hormones. The development of bradycardia in this case can be provoked by the following factors:
- vascular dysfunctions,
- high intracranial pressure
- taking certain medications
- high levels of potassium in the blood,
- infectious diseases.
Decrease in rhythm due to blockades
Speaking of what bradycardia is, the following should be noted: it can also be caused by heart block (impulse transmission to various parts of the organ is disrupted). However, it can be sinoauricular. There is a violation of the transmission of the pulse in the atria, when the currents are transmitted from the sinus node to the myocardium through time. It can also be atrioventricular. In this case, the impaired impulse transmission occurs in the ventricles? and some of their cuts just fall out of the rhythm of the heart. In the development of such blockades, there are three degrees. With the first, there is a slight decrease in the rate of impulse transmission to the ventricles, with the second, not all of them reach, and with the third, the number of contractions decreases, caused by the blockade of the conducting system.
Symptoms of bradycardia
Well, finally we got to the most important. Answer the head questions: "Sinus bradycardia - what is it and what are its symptoms?" It should be noted that in most cases this pathology proceeds unnoticed and is detected by chance, during preventive examinations. Only in the transition to the chronic form of the disease begins to actively manifest itself. This is due to the fact that as a result of reducing the frequency of contractions, the volume of blood decreases, as well as the amount of oxygen and glucose entering the brain. In the early stages of the disease manifests itself weakness, dizziness, cold sweat. Disturbed sleep and memory. Patients complain of anxiety, heart failure, shortness of breath. Despite the apparent insignificance of the symptoms, in order to understand sinus bradycardia - what it is and what real danger it poses, it is enough to consider the symptoms that appear when the process goes into the acute stage. Here, signs of cerebral hypoxia are pronounced heart failure. In addition, the patient may pursue pain in the heart (angina), darkening of the eyes, frequent moments of confused consciousness (semi-constipation). Severe bradycardia may be complicated by a symptom of Morgagni-Adams-Stokes. It is manifested by loss of consciousness, sharp pallor of the skin, respiratory failure, convulsions. It must be remembered that if the interval between ventricular contractions exceeds 15 seconds, cardiac arrest and clinical death is possible.
Moderate bradycardia is considered if heart rate indices are between 55 and 45 beats per minute. As a rule, it is asymptomatic or manifested by small autonomic disorders. The cause of it most often becomes an increase in the tone of the vagus nerve, which is responsible for the contractile function of the heart. Clinically moderate bradycardia may manifest as increased fatigue, dizziness, shortness of breath.
Bradycardia in children: causes
Sadly, this disease can occur at any age, and the diagnosis of sinus bradycardia in children is often noted. We understand what it is in adults, but in small patients the pathology will have slightly different criteria. The child's heart beats more often, so the indicators change. Diagnose "bradycardia" in children is possible in the following cases:
- if the heart rate of a newborn baby is below 100 beats per minute,
- children from one to six years - less than 70,
- adolescents - from 60 and below.
As a rule, such deviations from a normal rhythm, even if they do not have any external manifestations, do not lead to anything good and in the future may cause the development of many pathological conditions. Therefore, the faster bradycardia is detected, its cause is determined, and treatment is prescribed, the more chances to avoid complications that can be caused by brain hypoxia. The causes of this pathology are also different. Often it can be caused by such ordinary things as holding your breath, fear or impressions that have accumulated during the day (for many children the heartbeat in the evening is an order of magnitude lower than in the morning). In addition, bradycardia can cause:
- neurosis, endocrine disorders in adolescents,
- fetal hypoxia,
- increase intracranial pressure
- infectious diseases,
- fast growth,
- lead poisoning, nicotine,
What is bradycardia and how to treat it? These questions are vital for those who have been given a similar diagnosis. It should be noted that this pathology refers to those diseases that require drug therapy only in the case of pronounced clinical manifestations. If you have been given a similar diagnosis, but there are no significant abnormalities in the functioning of the body, treatment is not performed. If the patient's condition worsens, frequent fainting, dizziness are observed, symptoms of heart failure increase, and therapy consists in taking one of the following drugs:
- "Atropine" - three hours intravenously at 2 milligrams or subcutaneously at 0.5-1.0 milligrams,
- "Isoproterenol" - intravenous drip to 4 milligrams,
- "Alupent" - infusion (10 milligrams per 500 milliliters of saline),
- extracts of eleutherococcus or ginseng,
- preparations of belladonna.
In severe cases, treatment is carried out in the hospital and is aimed at stabilizing hemodynamics and eliminating the causes of bradycardia. The dose of drugs is determined by the doctor for each patient individually.
In those cases where bradycardia is associated with the natural aging of the body or it cannot be stabilized with the help of drug therapy, pacing is prescribed. Indications for this intervention is a reduction in heart rate to 30-40 beats per minute, frequent loss of consciousness, symptoms of MAS, signs of heart failure. The procedure is performed using a probe, which is injected through the subclavian vein into the heart cavity. At the same time cardiostimulation can carry both temporary (in case of acute disorders) and permanent. A permanent procedure is carried out using a pacemaker implantation. Modern models are a device that is no larger than a wrist watch and weighs less than 100 grams. Under local anesthesia, it is implanted just below the collarbone. This allows the patient to simulate a heart rhythm. For example, with constant bradycardia, the device also works continuously, and if it is transient, the pacemaker turns on only during an attack, and after it ends it turns off. In addition, there are now rhythm-adaptive stimulants that can independently increase heart rate with increased physical activity. Thus, the patient gets the opportunity to forget about what is bradycardia.
Modern medicine is able to withstand many dangerous diseases. But, despite all its possibilities, heart pathologies rank first in terms of mortality. To avoid such a sad outcome, be more careful about your health. Eliminate bad habits, and if you feel unwell - do not delay the visit to the doctor. Then the question of how bradycardia manifests itself, what it is and how to treat this disease will lose relevance for you.
Bradycardia - the mechanism of formation
Bradycardia belongs to the class of cardiac arrhythmias, since the heart rate is below normal. A correct, normal and healthy heart rhythm should be sinus, uniform and have a certain number of contractions per minute. If the rhythm becomes uneven, that is, between two heartbeats does not pass the same period of time, then this is an arrhythmia. Arrhythmia also includes a condition in which the heart beats evenly, but the number of its contractions per minute is less than the norm. Thus, speaking of bradycardia, doctors imply one of the options for arrhythmia. And since the correct heart rhythm is the key to the normal functioning of all organs and tissues, any option of arrhythmia is very carefully analyzed and, if possible, adjusted. Bradycardia reflects the violation of such properties of the cardiac conduction system as automatism.
To understand the classification of arrhythmias, including bradycardia, it is necessary to understand how an electrical impulse is formed that causes the heart to contract regularly and evenly.
In the thickness of the muscular wall of the heart is the so-called sinus node, or the pacemaker, as it is called in the medical literature. It is in this sinus node that excitation develops regularly, which is transmitted along the nerve fibers to the muscles of various parts of the heart, causing them to contract. Sinus node provides regularity, sufficient strength, automatism and constancy of electrical impulses, forcing the heart to contract. The sinus node operates completely autonomously, independent of signals from the brain. It constantly, with a well-defined and measured frequency, generates electrical impulses, transmits them through the cardiac conduction system, causing it to beat. If heart contractions are triggered by a sinus node, the rhythm is called sinus, or right.
However, a single sinus pacemaker cannot transmit an electrical impulse to all the muscles of the heart, causing them to contract evenly and harmoniously. To do this, there are several other nodes in the heart that conduct the signal from the sinus pacemaker to the heart muscles. From the sinus node, the impulse is transmitted to the sinoatrial node. Farther from the sinoatrial to the atioventricular node, from which, in turn, the electrical impulse is transmitted through structures called the Giss bundle to all parts of the heart muscle, causing the heart to contract. If a disturbance occurs in the process of transmitting an electrical impulse from one node to another, then the heart begins to contract incorrectly, first of all, slowly - that is, bradycardia develops. In such a situation, the rhythm is still correct, but the impulse is transmitted weakly, as a result of which the heart contracts more slowly than it should.
However, if for any reason the sinus node is suppressed (for example, due to senile changes in the tissues of the heart, the appearance of scar tissue after a heart attack, taking certain medications, etc.), then it will generate impulses slowly, because of for which bradycardia will arise. Such bradycardia, combined with the correct rhythm, is called sinus. If the sinus node generates electrical impulses with a normal frequency and force, but their conduction in the sinoatrial or atrioventricular nodes is impaired, then bradycardia is not sinus, but associated with blockade of conduction of the excitation.
Bradycardia - symptoms, signs
Bradycardia Pulse calculated in the same way as normal, and is less than 60 beats per minute.
ECG signs of bradycardia are characterized by lengthening the P – Q (R) interval by more than 0.12 s (from 0.15 to 0.20 s), while the P wave remains unchanged. At not sinus bradycardia on an ECG the extended Q — T intervals, expanded QRS teeth and a negative tooth of T are visible.
Clinical symptoms of bradycardia following:
- Indefinite sensations of discomfort in the heart,
- Feeling short of air,
- Lowering blood pressure
- Pallor of skin and mucous membranes,
- General weakness
- Fast fatiguability,
- Short episodes of visual impairment,
- Absent-mindedness, low concentration of attention,
These symptoms of bradycardia may have varying degrees of severity. Moreover, with bradycardia, all of the listed clinical symptoms, as well as some, may develop. Symptoms are not specific, and therefore often perceived by people as signs of aging, fatigue, etc.
Usually when bradycardia 40 - 59 beats per minute a person has no clinical symptoms. When bradycardia 30 - 40 beats per minute, weakness, fatigue, memory and attention disorder, shortness of breath, dizziness, swelling, blurred vision, pale skin and palpitations appear. If the pulse becomes less than 30 beats per minute, then the person may develop convulsions or fainting. Loss of consciousness on the background of severe bradycardia is called Margagni-Adams-Stokes fit. With the development of such a state, a person must provide urgent medical assistance so that breathing does not stop, followed by death.
Classification, types of bradycardia and their general characteristics
Depending on the mechanism of development, bradycardia is divided into the following types:
1.Sinus bradycardiacaused by a decrease in the activity of the sinus node of the heart,
2.Non-sinus bradycardiaassociated with the blockade of conducting electrical impulses between the nodes of the heart:
- Violation of the impulse between the sinus and sinoatrial nodes,
- Impaired impulse conduction between the sinoatrial and atrioventricular nodes.
For a person suffering from bradycardia, there is absolutely no difference whether it is sinus or non-sinus, since their manifestations are the same. This classification is important for doctors, because it allows you to choose the optimal treatment. The rest of sinus bradycardia is no different from non-sinus, so in the following text we will describe both types of HR reduction, without specifying their type depending on the mechanism of development.
Depending on the reason that provoked the decrease in heart rate, bradycardia is divided into three large groups:
- Physiological bradycardiawhich is often observed in healthy people. Especially often physiological bradycardia is present in athletes or simply in people who are physically well developed and trained. Approximately 25% of healthy young men have physiological bradycardia.
- Pharmacological or drug bradycardiawhich develops on the background of the use of certain drugs.
- Pathological bradycardiawhich develops on the background of pathology and is the symptoms of various diseases of the heart and other organs and systems.
Pathological bradycardia can be acute or chronic, depending on the specific causative factor. Acute bradycardia develops abruptly, simultaneously in various conditions that directly or indirectly traumatize the heart, for example, poisoning, myocarditis, or heart attack. Chronic bradycardia exists for many years and is associated with severe, long-lasting diseases of the heart or other organs and systems.
In addition, pathological bradycardia is traditionally divided into intracardiac and extracardiac. Intracardiac bradycardia occurs in various pathologies of the heart. Extracardiac bradycardia is provoked by diseases and dysfunctions of other organs that can indirectly affect the functioning of the heart.
Depending on the severity of the contraction of the heart rate, bradycardia is divided into the following types:
- Severe bradycardiain which the heart rate is less than 40 beats per minute
- Moderate bradycardiaat which the heart rate is 40 to 50 beats a minute,
- Light bradycardiain which the heart rate is from 50 to 60 beats per minute.
In moderate and mild bradycardia, circulatory disorders do not develop, as the heart contracts and pushes the blood with enough force. But with severe bradycardia, numerous circulatory disorders develop, especially in the system of intracranial arteries. Due to circulatory disorders in humans, the skin and mucous membranes turn pale, the loss of consciousness and convulsions develop.
Bradycardia in children - age norms and possible causes
In children, heart rate is normally higher than in adults. And in various age categories own norms. So, for children from birth to one year, a pulse of 100 beats per minute or more is considered normal. Therefore, for an infant up to one year old, a pulse of less than 100 beats per minute will be considered as bradycardia. A child from one year to six years old is considered a normal pulse from 70 to 80 beats per minute. This means that in a child aged 1–6 years the heart rate is less than 70 beats per minute. In children older than 6 years, the pulse rate becomes the same as in adults, that is, from 60 to 70 beats per minute, therefore, bradycardia for this age group is a pulse of less than 60 beats / min.
The classification and varieties of bradycardia in children are exactly the same as in adults. The causative factors of bradycardia are also associated with various diseases of the heart or other organs, active training, hard physical work, medication or just physiological features. If a child feels well, does not complain of fatigue, shortness of breath, abundant cold sweat, weakness, fainting, or chest pain, then bradycardia is a physiological variant of the norm, that is, an individual feature of the growing organism. If the child complains of any of the listed symptoms, then this indicates pathological bradycardia, which is a sign of another serious disease.
Bradycardia in a child can develop against the background of the following diseases and conditions:
- Increased intracranial pressure
- Metabolic disease,
- Infectious diseases,
- Increased body temperature
- Overdose of drugs
- Lead poisoning,
- Heart diseases, including congenital,
- The rapid growth of a child
- Insufficient functioning of the thyroid gland (hypothyroidism),
- Disorders of cerebral circulation.
Bradycardia for children is much more dangerous than for adults, because the adaptive mechanisms of the child’s body are not yet developed, and therefore cannot provide redistribution of blood to fully meet the needs of all organs and tissues. This means that bradycardia can provoke a sudden loss of consciousness, exhaustion and even the death of a child. Because of this, bradycardia in children requires compulsory treatment by a cardiologist.
Currently, the method of CTG (cardiotocography) allows you to record the heart rate of the fetus during pregnancy. The lower limit of the fetal heart rate is 110 beats per minute. If the fetal heartbeat is less than 110 beats per minute, then we are talking about bradycardia. Usually, bradycardia is indicative of intrauterine hypoxia, impaired cerebral circulation, or any other pathology of the fetus. For bradycardia alone, it is impossible to establish exactly what developmental abnormalities are present in the fetus, since additional detailed examination with ultrasound, Doppler measurement, possibly genetic analysis, etc. is necessary. Therefore, fetal bradycardia is a signal for subsequent examination, the purpose of which is to identify any violations it has.
Currently, many pregnant women are concerned about fetal bradycardia in early pregnancy and ask many questions about this. However, you should know that the information content of measuring heart rate to assess the condition of the fetus occurs no earlier than 20-22 weeks of pregnancy. From this period it makes sense to do CTG and calculate the fetal heart rate. Any measurement of the fetal heart rate before 20–22 weeks of gestation is not informative. Until the 20th week of pregnancy, the only information that can be obtained about the fetal heartbeat is whether it is or not. That is, to fix - a living child or died. If there is a heartbeat, then the child is alive, if it is not heard, then the fetus has died in utero. No information about the status of the fetus his heart rate before the 20th week of pregnancy does not carry. This means that women can not worry about fetal bradycardia at 5, 6, 7, 8. 19th week of pregnancy, because it means nothing, except for the fact that the baby is alive, growing and developing.
Bradycardia during pregnancy
Bradycardia is extremely rare in women during childbearing, if it did not exist before the onset of pregnancy. Bradycardia can be physiological or pathological. Physiological bradycardia is a variant of the norm and is usually noted if, before the onset of pregnancy, a woman led an active lifestyle, trained, physically worked, etc. In this case, bradycardia does not pose any danger to the fetus or to the woman herself.
Pathological bradycardia during pregnancy is usually triggered by the following pathologies:
- Thyroid disease,
- Kidney and liver disease,
- Diseases of the heart and blood vessels
- Violations of regulation by the central nervous system.
In the presence of pathological bradycardia, a pregnant woman should receive treatment, the purpose of which is to eliminate the diseases that caused the reduction of heartbeat. Pathological bradycardia can be dangerous for the mother and fetus.
About the disease and its danger
In bradycardia, the sinus rhythm, controlled by the sinus node, that is, the “driver” of the entire heart rhythm, is disturbed. Heartbeats, more precisely, their number is reduced to half a hundred beats (and less) in one minute.
By the way, athletes bradycardia - a normal phenomenon, because the heart needs rest. But if you do not play sports, it is not normal, because bradycardia can cause poor health and weakness, disturb cerebral circulation, lead to fainting. But that's not all that bradycardia is dangerous for. Slowing of heart rate can provoke blood stasis, which leads to the formation of blood clots in various chambers of the heart (most often the left atrium suffers), and blood clots appear.
Blood clots themselves are not very pleasant, but if they come off, they can get into the coronary vessels and provoke a heart attack. If the thrombus enters the carotid artery, it will end with a cardioembolic stroke. In addition, a thrombus may enter the blood vessels supplying the intestines, and this will lead to necrosis of certain parts of this organ and peritonitis. If a blood clot brings blood to the vessels of the legs, critical ischemia (i.e., their poor blood supply) and even leg necrosis are possible. But even if you are lucky and there are no blood clots, bradycardia leads to a lack of blood supply to many organs and, accordingly, disruption of their work.
Bradycardia can be a symptom of such diseases and a consequence of such problems as:
- Vegetative dysfunction and neuroses associated with it,
- wearing a tight collar or tie that puts pressure on the carotid sinus,
- increased intracranial pressure caused by swelling or brain tumors, as well as meningitis or injuries,
- ulcers of the stomach and intestines,
- myocardial infarction,
- myocardial dystrophy,
In addition, slowing the pulse can cause the effects of intoxication in typhoid fever, sepsis, hepatitis, uremia. Bradycardia also occurs as a result of poisoning with morphine, quinidine, antispasmodics, substances with organophosphorus components, cardiac glycosides, hyperkalemia and hypercalcemia. This symptom may also accompany jaundice, renal colic, diaphragm or esophagus tumor, intubation, hypothermia.
Any reduction in heart rate to 60 beats per minute is considered critical, but bradycardia itself is different.
Sinusoidal bradycardia appears if the sinus node is impaired, bradycardia in heart blocks can be sinoarterial and atrioventricular, it can also be functional, physiological and pathological, neurogenic, organic, toxic, etc.
With a slight slowdown in heart rate, there may be no symptoms. If the slowdown is within forty blows per minute, dizziness and weakness are possible, as well as fainting or faint state.
Fatigue, difficulty breathing, impaired attention and memory, chest pain, visual disturbances, pressure fluctuations are also possible. Hypoxia caused by a strong reduction in the frequency of cardiac oscillations provokes convulsions and loss of consciousness. That is why first aid for bradycardia should be urgent and should be to avoid stopping breathing.
Bradycardia in children and adolescents
In adolescents and babies, this symptom is frequent, but the norms and indicators are different. For an infant, the heart rate will be less than a hundred beats per minute. For kids from one to six, this figure is less than 70 strokes. Next are adult indicators. Symptoms are shortness of breath, fatigue, not typical of the child, fainting, cold sweat, chest pain. For children, this symptom is dangerous in that the child’s body has not yet developed adaptation mechanisms, which means that blood redistribution is impossible.
This leads to exhaustion, fainting, and even the death of a child. Also, this symptom can be observed in the fetus (heart rate less than 110). If he appeared in adolescence, it can go by itself, with the disappearance of adolescent diseases. In pregnant women, a significant slowdown in heart rate can be caused not only by vascular and heart diseases, but also by diseases of the thyroid gland, liver, kidneys, as well as disruptions in the central nervous system.
Before you treat bradycardia, you need to determine what causes it, that is, to find the underlying disease. The easiest way to detect a slowdown in the heart rate and blockade during attacks is electrocardiography. It is also possible to carry out Holter daily monitoring, that is, an electrocardiogram recording takes place all day, while the patient is doing his usual business.
Echocardiography is good because it allows you to detect an increase in heart cavities and those pathologies that caused a decrease in heart rate. A transesophageal electrophysiological study will help to study the conductive heart pathways to determine the nature of bradycardia.
Since this is only a symptom, it is most important to find out which disease caused the heart rate to slow down.
If there are no clinical symptoms of slowing the heart rate, then nothing can be done with bradycardia. If the slowing of the heart rate is accompanied by arrhythmia, fainting, heart failure, pressure drop, then individual treatment is necessary. If the slowing of the heart rate is caused by an overdose of drugs, then the dose should be immediately adjusted. Pulse can be quickly accelerated with the following medications:
- Atropine. Inject it into the veins and under the skin. Dosage - from half a milligram to two. Enter three times a day. You can slightly increase the dosage (if the result is not yet available) and add adrenaline in a dosage of up to 0.1 mg. If there is, you can enter a temporary pacemaker and monitor
- Euphyllinum is entered into a vein in a dosage up to 480 mg or is taken once inside 600 mg,
- Isadrin is also injected into the veins. Dosage - from 2 to 20 mcg per minute, diluted in glucose solution (5%),
- If the slowing down of the heart rate is insignificant, Zelenin drops can be taken. Dosage - from 35 to 40 drops three times a day.
But this will only help to remove the symptom of bradycardia, and the treatment of all major ailments is not canceled.
Popular treatment also has the right to exist, but if combined with the treatment of the underlying disease. Then you can achieve the maximum and stable result.
- Be sure to eat walnuts. Нужны они не только сердцу, но и мозгу, да и вообще организм укрепляют. Лучше есть их за завтраком и каждый день,
- Чеснок, лимон и мед. They are needed not only for colds, but also to improve and accelerate the work of the main pump in the body. Use them in a mixture. Several lemons are washed and scalded, then juice is squeezed out of them. Garlic (a dozen heads of medium size) is cleaned and blender crushed (or rubbed). It remains to mix the garlic porridge with lemon juice to a state of uniform. Now honey is added here (1 thousand ml) and everything fits in a container (it is tightly closed). Insist in the refrigerator and a half weeks. Eat a mixture of 20 g daily before each meal,
- Yarrow It needs 50 g (dry). Pour half a liter of water (hot), boil for 10 minutes and insist 60 minutes. After that, it is filtered and drunk three times a day, 25 g each.
A diet for bradycardia is also needed, but there is nothing complicated here. You just need to eat foods with a low calorie content, limit fats and alcohol. It will be useful to refuse soda, fatty meat, too fatty dairy products, cakes, pastries, canned and smoked products. Salt is used at a minimum (it is possible and sea).
It is important to include omega-6 and 3 in your diet, so fish oil and fish will be very necessary, as is linseed oil, as well as corn oil.
But meat and fish (sea), low-fat should be required. You also need to eat seafood, cottage cheese (low-fat) and generally fermented milk products, hard and low-fat cheese, buckwheat, rice, corn and oatmeal, vegetable soup and borscht, vegetables in the form, stewed, fresh and baked, dried fruit and fresh fruit. It is best to cook all food (including steamed) or stew, and eat in small portions six times a day.
We also need magnesium to help the heart muscle cells absorb energy. This element contains wheat bran, germinated grains, seeds (flax, pumpkin, sesame), nuts (pine and walnut), cocoa, beans, lentils and other legumes. Mandatory in bradycardia and an element such as potassium, that is, vitamin for the heart.
This is the main intracellular cation for the myocardium and its cells. A lot of potassium contains baked potatoes, as well as fresh cucumbers, banana, tomato, carrot, zucchini, orange and many berries (lingonberries, red currants), as well as pumpkin with melon, prunes, raisins, figs, dried apricots, nuts (peanuts, pine, almond). A lot of it in the fish, as well as liver and cottage cheese.
The danger is that this element slows down the heart impulses and their conduction, therefore, with blockages of 3 and 2 degrees of potassium, one cannot eat too much.
Calcium is also needed not only for bones, nails and teeth with hair. This element helps maintain the contractile ability of the heart muscle. Among the sources of the element are milk, fermented milk products, cabbage, all the same almonds, egg shells, etc. So, calcium products with bradycardia will also be needed every day. You can take all these elements in the form of additives.
Causes and symptoms
Sinus bradycardia occurs as a result of a disorder in the activity of the sinus node, which regulates the speed of the heartbeat. More often, it is a symptom of a serious illness that disables the cardiovascular system.
Depending on the form, there are such reasons for the occurrence of bradycardia:
Mild and moderate bradycardia (from 60 to 40 beats per minute in adults) does not manifest clinically. The first symptoms are noticeable when the pulse drops to less than 40 beats. This leads to poor circulation and organic heart disease. The initial signs of bradycardia are:
- differential blood pressure (increase / decrease),
- constant fatigue
- pain in the center of the chest,
- lack of air,
- labored breathing,
- impaired memory or attention
- temporary visual impairment.
Whether bradycardia is dangerous: consequences
If the symptoms of the disease do not appear, and the person does not feel discomfort, then bradycardia is not life threatening. However, its appearance indicates the presence of pathology in the body, which must be diagnosed and promptly treated. Then both bradycardia and the main disease will not progress, it will be possible to restore health.
The most frequent consequences of the disease manifest themselves in the form of:
- Chronic seizures related to the physiology of the body. Treatment in this case does not help, because the patient often has dizziness, loss in space, weakness. It is impossible to overcome the disease, because drugs for the suppression of symptoms are prescribed.
- Blood clots, the formation of which is most characteristic of people in old age with frequent attacks. Due to irregular heart rate, blood remains in the ventricle, gradually forming a blood clot. From the heart, he can get into any vessel and clog it. Such a complication leads to the most disastrous consequences, because if a patient is suspected, they are sent for examination, and then special treatment is prescribed.
- Heart failure when the left ventricle is defective. This leads to a failure of blood pressure and poor blood flow to the organs. As a result, the likelihood of myocardial infarction and ischemic heart disease increases.
If the symptoms of the disease began to appear, then there is a great danger to life. With a sharp decrease in heart rate, a person may become disabled or die.
First of all, the brain suffers from a deterioration in blood circulation: a small amount of oxygen gets into it. Hypoxia contributes to cramps and loss of consciousness. These are the most dangerous symptoms of bradycardia, which can result in lung or heart arrest, and therefore require emergency medical attention.
Methods of treatment and prevention
Self-medication for bradycardia is strictly prohibited. The person is obliged to consult with the doctor so that the treatment does not harm.
A moderate degree of illness does not require treatment. Bradycardia is a symptom, because therapy is aimed at eradicating the underlying disease. This primarily concerns the toxic, organic and extracardiac forms of the disease. Medical form requires the abolition of the drug. After that, the heart rate will recover on its own.
In severe bradycardia, when the head is spinning, general malaise is felt, blood pressure is reduced or heart failure develops, prescribing targeted treatment of bradycardia in the form of medical preparations (Ephedrine, Isoprenaline) or herbal medicine (ginseng root, belladium) is prescribed. These drugs affect the work of the heart, improving blood circulation, increasing blood pressure and heart rate. In the event of an MAS (Morgagni-Adams-Stokes) attack, a surgical intervention is performed, during which an implant is inserted into the heart, stabilizing the heart rhythm.
Prevention consists in timely treatment of the underlying causes of the disease and drug support for heart rhythm on the recommendation of the doctor. And you should also stop drinking alcohol and smoking, do not overload your body with physical exertion and eat a balanced diet, replenishing the body with essential vitamins and minerals.
What is dangerous bradycardia
If a person has no clinical symptoms of bradycardia, then it does not pose a danger to human life and health. But the presence of bradycardia indicates some pathological process in the body, and therefore is the reason for the examination and subsequent treatment, which can stop the further progression of the disease and maintain good health.
If bradycardia is combined with clinical symptoms, the danger is an unexpected syncope, during which there is a very high risk of sudden death due to cardiac arrest. In such a situation, doctors usually recommend the installation of a pacemaker.
Is bradycardia dangerous?
The risk of bradycardia depends on its form. There are types of bradycardia that are caused by internal pathologies, such as jaundice, brain tumor, or shock. This is a pathological bradycardia. It provokes changes in the body.
- The risk of death of myocardial cells or sclerotic changes in the walls of blood vessels occurs in sinus bradycardia. The vagus nerve begins to affect the sinus node, and cardiac impulses slow down sharply.
- Fainting, critical decrease in heart rate to 35 beats per minute and abrupt cardiac arrest develops with idioventricular rhythm - sinoatrial bradycardia. It is also called heart block. It occurs due to impaired transmission of electrical waves from the atria to the ventricles.
Some forms of bradycardia do not pose a threat:
- Absolute Bradycardia: pulse reduction to 50 beats / min appears in healthy people who play sports, athletics and swimming.
- Relative bradycardia: lagging pulse from high temperature. It is the body’s response to influenza and typhoid fever.
Complications after an attack of bradycardia
- Dyspnea. Occurs with little exertion - walking, abrupt change in body position. The blood is pumped more slowly than at a normal rhythm, and there is stagnation of blood in the lungs. The vessels overflow, there is a violation of oxygen metabolism in the tissues.
- General weakness, fatigue. Muscles lack oxygen. They are poorly reduced, so a person can no longer perform physical work.
- Pale skin. It is explained by low blood pressure. The body tries to compensate for insufficient blood circulation and reduces blood flow to the skin.
- Constant pain in the chest. Appear only with a serious pathology in heart rhythm - angina pectoris. Due to the lack of oxygen, myocardial cells begin to die off - this causes a feeling of stiffness in the chest.
Consequences of bradycardia with a pulse of 40 beats per minute
- Heart failure. The left ventricle does not pump blood evenly, tissues and organs suffer from oxygen starvation, blood pressure drops. There is a risk of coronary heart disease or myocardial infarction.
- The formation of blood clots. Observed with heart block and heart rhythm disturbances. Blood passes through the chambers of the heart unevenly, slowly, part of it stagnates and remains inside the ventricles. There are gradually formed blood clots. They can get into any vessel and clog it. There is a chance of a stroke.
- Chronic seizures. Occur for physiological reasons. It is practically impossible to eliminate them with medicines. A person appears weak, dizzy, decreases ability to concentrate.
Can bradycardia be life threatening?
With physiological bradycardia, there is no threat to life. With pathological bradycardia - there is. Her provoke:
- high tone of the parasympathetic nervous system,
- heart diseases.
Health hazards occur when the following symptoms of bradycardia occur:
- severe dizziness, fainting, pallor of the skin - they say about circulatory disorders,
- headaches, eyeballs, ringing in the ears are an indicator of low blood pressure,
- frequent pulse reduction with chest pains,
- malaise when doing physical work,
- pulse below 40 beats per minute.
With all of the above symptoms, there is a possibility of sudden cardiac arrest or an attack of ventricular fibrillation.
How dangerous is the baby?
A child's heart rate is higher than that of an adult. A heart rate of less than 70 beats per minute is recognized as bradycardia in children under 6 years of age. It arises due to abnormalities of the heart, physical exertion, medications, or simply as a physiological feature. If a child has a normal state of health, he does not complain of fatigue, sweating and chest pain, then bradycardia is a normal condition during the period of growth.
If pathology brings discomfort, then it is a sign of internal disturbances. Bradycardia in this case symptom:
- impaired metabolism
- congenital heart disease,
- malfunction of the thyroid gland,
- insufficient blood circulation in the brain.
In adolescence, a low pulse is not dangerous, as it is the body's response to hormonal changes. Over time, the heart rate returns to normal.
Prevention is aimed at eliminating the symptoms of bradycardia. The main thing - to give up bad habits: drinking alcohol and smoking. Ethanol and nicotine poison the heart, affect its work, disable the entire circulatory system. But physical exertion should be reduced only for pain in the heart.
What principles must be observed:
- limit animal fats,
- give up alcohol
- reduce calorie intake to 1700 kcal,
- reduce salt and water intake
- add to the diet nuts and foods that contain fatty acids.
This prevents the main pathologies with a low pulse - heart failure and the formation of blood clots.
In this form, Dr. Myasnikov in the program “About the Most Important” tells about bradycardia, its impact on health, what complications can be and how to cope with them.
Bradycardia is dangerous to health if there are symptoms that bother a person. A low pulse can intensify existing heart diseases and provoke new ones. Therefore, it is necessary to listen to your body and avoid heart failure.
Bradycardia - treatment
If there are no clinical symptoms in bradycardia, then treatment is not necessary. Bradycardia therapy is indicated only if it is accompanied by fainting, hypotension (low pressure), heart failure, or ventricular arrhythmias. In this case, treatment depends on the reasons that provoked bradycardia.
If bradycardia is associated with intracardiac causes, then the best way to treat it is to install a pacemaker. If the decrease in heart rate is triggered by extracardiac factors, then it is necessary to treat the underlying disease, for example, to correct the level of thyroid hormones, eliminate brain swelling, etc. In addition to treating the underlying disease that provoked bradycardia, a symptomatic increase in the heart rate is carried out with the help of the following medicines:
- Atropine - administered intravenously or subcutaneously at 0.6 - 2 mg 2 - 3 times a day,
- Izadrin - is administered intravenously at 2 to 20 μg per minute in 5% glucose solution until normal heart rate is reached,
- Euphyllinum - is administered intravenously at 240 - 480 mg or taken orally at 600 mg 1 time per day.
However, these medications only help to temporarily increase the heart rate, so they can only be used as an emergency measure. In order to achieve a permanent cure for bradycardia, treatment of the underlying disease, which provoked a decrease in heart rate, should be initiated.
Zelenin drops in bradycardia, you can take 35-40 drops 3 times a day. This remedy is effective in moderate bradycardia.
The decrease in heart rate, depending on the cause, is divided into 2 types:
- Sinus bradycardia - occurs when the sinus node automatism fails, at which the frequency with which impulses are generated in it becomes less than 60 per minute.
- Sinoatrial and atrioventricular blockade - impaired conduction of nerve impulses between the sinus node and the atria, or between the atria and the ventricles.
Bradycardia can be:
- Physiological - during sleep, in athletes, sometimes in pregnant women.
- Pathological - if the cause is a disease.
Pathological, in turn, can occur in two forms:
- Acute - this is observed in myocarditis, myocardial infarction, some poisoning.
- Chronic - occurs mainly in chronic age-related heart diseases.
Depending on the cause, the following types of bradycardia are distinguished:
- Organic (with some lesions of the heart).
- Extracardiac (if the cause is not a cardiac pathology).
- Sinus bradycardia athletes.
Causes of Bradycardia
Extracardiac forms can develop with:
- vascular dystonia,
- increased intracranial pressure - observed in subarachnoid hemorrhage, meningitis, brain tumors, intracranial hematoma,
- gastric ulcer and duodenal ulcer,
- mechanical pressure on the carotid sinus - when wearing a tight collar or tie,
- pressure on the eyeballs.
Causes of organic genesis bradycardia:
- myocardial dystrophy,
- myocardial infarction.
These diseases contribute to the fibrous change of cardiomyocytes in the sinus node or damage to the cardiac conduction system, causing blockages and arrhythmias.
Schematic representation of the heart. An organic lesion of the source of the heart rhythm causes a pathology called the sinus syndrome. In this disease, the frequency of generated impulses decreases sharply, which leads to bradycardia or alternation of other pacemakers with the change of bradycardia to tachycardia. Complete defeat of the sinus node is fraught with complete failure of pulse generation.
Если дегенеративные изменения касаются проводящей системы сердца, то некоторые сигналы из источника водителя ритма в определенном месте блокируются. Это приводит к тому, что до желудочков не доходит импульс. As a result, there is no heartbeat and blood from the cavity of the heart does not go into the vascular system of the body. Often this is another reason for the development of bradycardia.
Often, heart rate may decrease as a result of taking certain medications. These include:
- beta-blockers (Metoprolol, Anaprilin),
- cardiac glycosides (Korglikon, Digoxin),
- sympatholytic agents (reserpine),
- antiarrhythmic drugs (quinidine, Novocainamide, Amiodarone),
- calcium channel blockers (Nifedipine, Verapamil),
- narcotic analgesics (morphine).
The cause of bradycardia can also be the action of some toxins on the myocardium. Perhaps a decrease in heart rate can be observed when:
- typhoid fever,
- FOSami poisoning (phosphorus-organic compounds).
This group of bradycardia can be attributed to the decrease in the generation of the frequency of the pulse with an excess of potassium (hyperkalemia) or calcium (hypercalcemia) in human blood.
To idiopathic form of bradycardia include those cases in which it is not possible to find the cause of the decrease in heart rate. This happens during the natural aging process in the body, i.e. in old age.
Symptoms of any bradycardia
Moderate bradycardia does not affect the state of the body, because it does not cause significant circulatory disorders. Symptoms of bradycardia occur when the frequency of contractions of the heart muscle decreases to less than 40 beats per minute. Patients are usually concerned about:
- general malaise, fatigue,
- bouts of dizziness,
- blood pressure fluctuations
- chest pains
- labored breathing.
As a result of insufficient blood supply to the brain, bradycardia can cause the following symptoms:
- impaired memory, attention and concentration,
- bouts of visual impairment,
- confused thinking.
The symptoms of bradycardia always depend directly on the severity of a circulatory disorder of a particular organ. As a result of the fact that the brain first responds to this deficiency, often the only manifestations of the disease are:
- loss of consciousness,
- manifestations of Morgagni-Adams-Stokes syndrome (incoming attacks of impairment of consciousness with its independent recovery).
All these symptoms are extremely dangerous for the body and therefore require urgent assistance. The need for emergency medical supervision is due to the possible development of complications. For example, with prolonged attacks described above, respiratory arrest may occur.
Principles of treatment for bradycardia
Active treatment of bradycardia is carried out if the patient develops angina pectoris, hypotension (lower blood pressure), fainting, attacks of ventricular arrhythmia, or heart failure. In the event of frequent attacks of Morgagni-Adams-Stokes, an urgent consultation with a heart surgeon is required for an operation of implantation of an IVR (pacemaker). Such an artificial pacemaker will generate pulses with a predetermined frequency, which will eliminate the signs of hemodynamic disturbances (circulatory disorders).
Prognosis of the disease
In general, mild bradycardia has a favorable prognosis. However, with the addition of organic changes or persistent circulatory disorders without adequate treatment, the likelihood of developing syncope with all possible complications increases. Stably reduced heart rate in combination with tachyarrhythmias of various origins significantly increase the risk of thrombosis and thromboembolic complications, in particular, myocardial infarction and stroke.
Folk treatment of bradycardia
Various folk methods are a good help in the complex treatment of bradycardia, because they allow to achieve a stable effect. However, traditional methods are recommended not to use instead of drug therapy, but in combination with the latter, and then the total therapeutic effect will be maximum.
Currently, the following traditional methods have proven effectiveness in the treatment of bradycardia:
- Walnuts, which should be eaten every day. Nuts should be present in the human diet every day. Best to eat nuts for breakfast.
- A mixture of honey, lemon and garlic. To make it, wash the lemons and scald with boiling water, then squeeze the juice out of them. Then peel 10 medium heads of garlic and chop them to a slurry. Mix the finished garlic gruel with lemon juice until a homogeneous, homogeneous mass. Then add one liter of honey to the garlic-lemon mass, and mix the whole mixture well. Put the prepared mass in a sealed container in a refrigerator and leave for 10 days. After that, eat 4 teaspoons every day before meals.
- Yarrow decoction. For its preparation should be 50 g of dry grass pour 500 ml of warm water, then bring it to a boil. Boil for 10 minutes, then infuse for an hour. Ready broth strain and take one tablespoon three times a day.
Usually the treatment of bradycardia is long-term, and traditional methods can be used for an arbitrarily long time.
In addition, to normalize the heart rate, you must adhere to the following rules of life, allowing you to strengthen the heart:
- Fat-restricted diet
- Consume low-calorie foods,
- Do regular exercise,
- Stop smoking
- Limit alcohol intake.
Are they taking to the army with bradycardia?
In the Schedule of Diseases, on the basis of which the recruit is declared unfit for military service, the diagnosis of bradycardia is absent. This means that if bradycardia is present, the recruit undergoes an examination of the heart and vascular system, and the question of whether or not the service is suitable for service is decided on the basis of an identified disease of the cardiovascular system.
According to Articles 42 - 48 The disease schedules are unfit for military service as adolescents suffering from the sick sinus syndrome (SSS) or AV blockade. If these pathologies do not exist, then bradycardia is not a reason for exemption from military recruitment. Consequently, in most cases with bradycardia take the army.
Author: Nasedkina A.K.Specialist in conducting research on biomedical problems.