Cardiac extrasystole is the most common type of heart rhythm disorder. A little less than 1000 extrasystoles are diagnosed for a person without any visible consequences a day. In fact, this is a physiological state, in which the pacemaker gives an extra impulse for contraction of the ventricles or atria. Special treatment and correction with drugs is required only if the number of extrasystoles exceeds 1000 for 24 hours of Holter monitoring.
Causes of heart extrasystole and rhythm disorders
Heart extrasystole can occur at any age without any apparent cause. However, most often for extrasystole and rhythm disturbance, there are certain pathophysiological factors that can pose a threat to human life.
The main causes of extrasystole include:
- functional disorders of the central nervous system( there may be a rhythm disturbance with exacerbation of osteochondrosis in the thoracic spine, vegetative-vascular dystonia, against hormonal failure);
- organic lesions of myocardial tissue and its muscular walls( coronary heart disease, consequences of myocarditis and endocarditis, coronary artery atherosclerosis);
- toxic effects on the nerve endings of tissue bundles responsible for the conductivity of the electrical impulse;
- chemical stimulation after taking large amounts of caffeine in tea and coffee;
- effects of alcohol intoxication;
- hemodynamic disorder during pregnancy.
At a young age, the rhythm disturbance by type of extrasystole can develop against the background of excessive physical exertion and after the transferred infectious diseases with dehydration of the body. In the latter case, the balance of the content of magnesium, potassium and sodium in the blood is disturbed, which causes the suppression of the electric pulse and the violation of the heart rhythm.
Types of extrasystole
To facilitate diagnosis and the appointment of adequate treatment, it is necessary to take into account the localization and other characteristics of cardiac rhythm disturbance. Types of extrasystole are divided into frequent and single, ventricular and supraventricular. A separate group is allocated supraventricular extrasystoles, which can occur in a rather severe form of cardiac decompensation.
Frequent and single extrasystole
To clarify the diagnosis and assessment of the patient's condition, it is important that a frequent extrasystole occurs or is a single element that may be a consequence of temporary changes in the human body. For a full study, multiple functional tests and repeated ECG photographs are needed.
A single extrasystole usually does not pose a particular hazard to human health and life. It is easily amenable to correction with the help of non-medical methods of exposure. In exceptional cases, potassium and magnesium preparations "Asparcum" and "Panangin" can be used. As a rule, these are monotrophic( arising at one site) and monotonous extrasystoles that are monotonous in morphology, which can occur against emotional excitement, after exercise, or in women during hormonal changes( for example, during menstruation or during pregnancy).
Frequent extrasystole usually has a heterotopic etiology( originating from different areas of excitation in the myocardium, which are located chaotically and can change their location).Requires utmost attention to the patient's condition, since such a frequent extrasystole may provoke paroxysmal arrhythmia in the nature of unstable tachycardia. This condition is characterized by a deterioration in well-being and the stealing of brain structures with oxygen and nutrients.
Supraventricular atrial and supraventricular extrasystole
Supraventricular extrasystole may not cause any symptoms for a long time. However, in the case of damage to the myocardial muscle layer, it can provoke a sharp deterioration in the state, provoke fainting and vascular collapse. Therefore, even a single supraventricular extrasystole requires constant monitoring and drug correction, including stimulating pharmacological drugs.
Nadzheludochkovaya extrasystole can arise from different parts of the myocardium, which is located both in the atrium itself and in the supraventricular septum. It differs by a rare transition to an allotopic form. At physical exertion can cause a tachycardia with a frequent extrasystole. This causes cardiac dyspnea, dizziness, muscle weakness in the upper and lower extremities. It is only diagnosed with the help of ECG.
Ventricular extrasystole is the most clinically significant form of cardiac arrhythmia. At the patient early enough the complex of characteristic symptoms on which the primary diagnosis can be established is formed. Later the data are confirmed with the help of ECG and ultrasound of the myocardium.
The risk of ventricular extrasystole lies in its propensity to change into the form of allorhythmia. There is compensatory diastole, which leads to the development of heart failure in a small circle of blood circulation.
Allorrhythmy by type of ventricular extrasystole can lead to the development of several ectopic foci of impaired conductivity of the electrical impulse. This forms stable prerequisites for the emergence of bigemini, which is characterized by a doubling of each pulse of the pulse wave. In the myocardium, this causes a pathological double contraction of the ventricles, during which there is not complete emptying of their internal cavity.
An even more severe form of cardiac rhythm disturbance is trigeminia, characterized by a triple pulse of the pulse wave. Ventricular emptying in this form occurs with triple consecutive reduction of their muscular walls. Very rarely occurs quadrugemia. With this form of ventricular extrasystole, the patient's condition is severe and requires immediate placement in a specialized cardiac hospital to restore the heart rate.
Symptoms and treatment of ventricular extrasystole
Symptoms of extrasystole at supraventricular, atrial and supraventricular type of localization of the ectopic foci may be completely absent. The disease is detected randomly during a periodic medical examination. Patients thus do not feel any symptoms of the extrasystole of the heart.
The most typical clinical picture is the ventricular extrasystole, which can lead to significant disturbances in the human condition.
Major symptoms of ventricular type extrasystole:
- dizziness and a sense of fear during seizures;
- orthostatic dizziness;
- headaches after inadequate physical activity for a particular person;
- sensation of sudden tremors in the sternum;
- sensation of fading or cardiac arrest on the background of emotional stress;
- pain behind the sternum, accompanied by a sense of panic;
- shortness of breath, feeling of insufficient air intake.
When examining a patient, pathologically altered veins can be seen in the neck that can pulsate and protrude above the skin. This indicates a lack of blood circulation in a small circle. Violation of pulsation on the wrist is detected. Also, with an auscultatory listening to the rhythm of the heart, there may be a discrepancy between the heart rate tones and the pulse wave. There is a splitting according to the type of the second tone of alorhythmia.
Treatment of ventricular extrasystole begins with the normalization of work and rest. It is necessary to completely refrain from the abuse of alcoholic beverages and smoking, including passive. A special regime is appointed, whereby at least 8 hours are spent for night rest, and after every one and a half hours of work a rest break is required for 30 minutes. Special programs of physical exercises are used, which are aimed at strengthening the heart muscle.
In the diet should be present foods that contain a lot of potassium and magnesium. These are peaches, apricots, potatoes, dried apricots, watermelons, lean meat. Drinks that contain caffeine and fatty fried foods should be excluded. It is also necessary to pass a survey of the state of the gastrointestinal tract. In some cases, the correction of the acidity of gastric juice may be required to treat ventricular extrasystole. This is due to the fact that frequent heartburn can provoke a violation of the heart rhythm.
Drugs for treatment with extrasystole
Treatment of extrasystole with pharmacological drugs is used in those cases when pathology disturbs the work of the heart and causes secondary pathological changes in the structures of the brain and other internal organs. Treatment of extrasystole in severe cases is performed in a hospital with intravenous administration of drugs that contribute to the restoration of physiological heart rhythm.
In the absence of a positive effect, surgical treatment of extrasystole is performed. It consists in the catheterization through the coronary vessels for the introduction of the coagulator. With the help of this influence, the focus of ectopic signals for an extraordinary contraction of the myocardium is eliminated. The technique is used only in the case of monotrophic forms of cardiac arrhythmia.
Preparations for extrasystoles can be used from several pharmacological groups, each of which has its own purpose. A combined therapy regimen using drugs with extrasystole from different groups can be used.
The main types of drugs for extrasystole include:
- medications for the elimination of arrhythmia( "Amiodarone", "Propafenon", "Morazizin", "Bretaliy" and others);
- beta-blockers( Atenolol, Betakardin, Kordanol, Methanolol and others);
- inhibitors of ACE products( Amprilan, Pyramil, Sinopril, Enalapril, Monopril, Kapoten and others);
- blockers of isolated calcium channels( "Nifedipine", "Verapamil", "Cinnarizine", etc.
Various sedatives are widely used, including herbal products, which can be tincture of valerian, motherwort, peppermint.is carried out with more potent drugs, which are sold in the pharmacy only by prescription of the doctor. As a rule, they are the drugs of the barbiturate group.,
. The treatment with potassium and magnesium preparations is shown, "Panangin", "Asparcum" ATP, "Riborxin"Vitamin preparations
Rare extrasystoles in pregnancy
Extrasystoles during pregnancy can occur against the backdrop of hidden pathologies of the esophagus, stomach and myocardium. As a rule, the violation of the heart rhythm in a woman can occur spontaneously. This occurs in the second trimester of pregnancy. The patient begins to experience regular muscle weakness,sensations of tremors in the sternum, interruptions in the work of the heart. Several dyspnea, the development of edematous syndrome, can gradually attach.
Causes of extrasystoles during pregnancy can be a violation of hormonal balance, toxicosis, disturbance of the regime of the day and nutrition. Not infrequently, heart rhythm disturbance in pregnant women occurs against proteinuria and massive edema of the shins and face. This is due to a violation of the balance of microelements and alkalization of blood. The volume of peripheral blood sharply increases. There is an increased load on the myocardium. The ventricles can not completely empty out in one contraction, and there is a need for extrasystoles to maintain a stable blood flow.
Special treatment of rare extrasystoles during pregnancy does not require. The doctor appoints a special diet, in which foods containing potassium are added to the diet. Exercise is excluded. If necessary, preparations containing potassium and magnesium can be used. In pregnant women, these trace elements are often washed out by increasing the daily diuresis.