The disease can occur in two cases. First of all, it leads to a decrease in heart rate reduction sinus node activity when it generates a small electrical pulses. This is called sinus bradycardia. And there is such a situation, when the sinus node is operating normally, but the electrical impulse can not pass fully on pathways and heart rate slows.
What it is?
Under sinus bradycardia understand the change in heart rate, in which there is a decrease heart rate to 50-30 beats per minute, due to the lowering of the sinus automaticity node.
The causes of this condition are varied:
- increased tone of the parasympathetic nervous system;
- increased intracranial pressure (when brain edema, tumors, meningitis, brain haemorrhage);
- effect of drugs (digitalis, quinidine);
- sclerotic changes in the myocardium that affect sinus node;
- exposure to cold;
- lead poisoning, nicotine;
- hypothyroidism (underactive thyroid function);
- starvation, typhoid fever, jaundice and others.
Low heart rate may be a well-trained athletes and individual young healthy people (eg cyclist Miguel Indurain had a resting heart rate in the 28 beats / min. This is normal in the absence of other pathological symptoms such as fatigue, weakness, dizziness, fainting, discomfort in the chest or shortness of breath.
degrees
AV block may have three degrees of severity:
- Severe - heart rate less than 40 beats / minute
- Moderate - 40 to 50 beats / minute
- Light - 50 to 60 beats / minute
In mild and moderate bradycardia circulatory disorders not develop because the heart contracts and pushes blood sufficient force. And the expression is a violation of all organs and systems, occur numerous circulatory disorders, due to their oxygen starvation, since the amount of oxygen supplied to the tissue with blood is insufficient for normal functioning of the body person. Bradycardia is accompanied by pale skin and mucous membranes, can cause seizures and loss of consciousness.
Forms of bradycardia
The diagnosis of "bradycardia" as a symptom is always taken into account in the scheme of treatment of the underlying disease. Changes may occur and affect all levels of the process of propagation of the pulse of the heart muscle, so to distinguish the following types of bradycardia:
| sinus | It appears for violations in the sinus node, associated with its functional deficiency (starvation, vitamin deficiency, rheumatic heart muscle, coronary atherosclerosis) |
| atrioventricular block | violation nerve transmission signal from the sinus node to the ventricles in a slowing or complete cessation (scarring myocardial infarction, coronary atherosclerosis, inflammation with severe infections - myocarditis) |
| physiological | typical for persons long engaged in physical labor, and athletes, they need a longer filling phase process ventricles to provide strong cardiac output, heart rate at the same time up to 40 per minute, with good pulse |
| neurogenic | occurs when lesions of the central nervous system (brain tumor, meningitis, mental illness) |
| Associated with stimulation of the vagus nerve | when taking certain medications and diseases (mediastinal tumor, middle ear infection, gallstones, gastritis) |
| toxic | Poisoning occurs when potent toxic substances in renal and liver failure, drug overdose |
Bradycardia reflex can occur when exposed to active points: the pressure on the eyeball in the supraclavicular fossa.
Bradycardia in athletes
It is physiological, ie, reflects the norm. The fact is that during the regular trainings heart gets used to work at maximum capacity in order to increase demand for oxygen and nutrients, for which he has to pump more blood volume for a limited period time.
That is, the heart beats powerfully and strongly pushing a single blow a large amount of blood that is needed organs and tissues of the exercising person. When an athlete does not train his heart, accustomed to decrease strongly, is still a powerful incentive is pumping blood through the vessels.
Due to the good forces of contraction of the heart may be less likely to fight. Indeed, one powerful enough cuts that give a strong impetus to the blood, and it is a relatively long time to flow through the vessels. Therefore, due to the strength and power cuts to the heart pumping enough blood to beat less often.
The symptoms of bradycardia
The physiological form of this disease has no distinct clinical manifestations.
Main bradycardia symptoms arise in chronic forms. It - dizziness, weakness, slow heart rate and a feeling that the heart stops, sleep problems and memory.
- In the event of an acute form of bradycardia caused by sinus block, there is heart failure, accompanied poluobmoroke and angina. In severe cases, a person can lose consciousness. In this case it is disturbed breathing, seizures occur. Such a state is called an attack of MAC (the first letters of the names of the doctors who worked on the study of their Morgagni syndrome - Adams - Stokes). It causes a decrease in cerebral oxygen supply (hypoxia).
- With a significant slowing of ventricular contractions (atrioventricular block) cerebral blood flow is disrupted. This may cause a general anxiety and sudden severe dizziness, slight dimming of consciousness. By increasing the pause between heartbeats to 15 seconds, can occur a complete loss of consciousness or seizure MAC. Sometimes it causes heart failure, which can cause sudden death.
To identify what caused the slowing of heart rate, function or heart block, is an injection of atropine. At physiological bradycardia, this procedure causes the heart rate to normal. Lack of effect means that the cause of the disease is in the abnormal impulse conduction disturbances.
The more dangerous the bradycardia?
Physiological, easy and mild bradycardia, generally do not lead to complications. The main risk of bradycardia and MES seizures are asystole (cardiac arrest) and clinical death due to cerebral ischemia. In addition, the probability of the development of thromboembolic complications - pulmonary thromboembolism, ischemic stroke or myocardial infarction.
Due to disturbances of the pulse frequent ventricular premature beats may occur during bradycardia or paroxysmal ventricular tachycardia, which is fraught with the appearance of ventricular fibrillation and lethal outcome.
Diagnostics
Diagnosis bradycardia includes anamnesis, examination of the patient: heart rate determination, auscultation of heart sounds, respiratory arrhythmia determination (if available).
Instrumental examination involves performing an electrocardiogram, as well as daily monitoring of an electrocardiogram.
In the presence of organic forms shown holding bradycardia cardiac ultrasound, ultrasonic echocardiography.
treatment of bradycardia
Physiological bradycardia does not require any treatment, as well as bradycardia, do not affect the general well-being. For treatment of pathological bradycardia commence after determination of the cause. treatment principle consists in exposing the root cause, against which the heart rate to normal.
Drug therapy is the appointment of drugs that increase the heart rate. These are medications such as:
- izadrin;
- Atropine;
- isoprenaline;
- Eufilin.
The use of these drugs has its own characteristics, and therefore they may appoint a doctor.
In the event of hemodynamic disorders (weakness, fatigue, dizziness) doctor can be attributed to a patient tonic medicines: tincture ginseng, Eleutherococcus, caffeine. These preparations accelerate the heart rate and raise blood pressure.
pacemaker
When a person is registered bradycardia and against this background develops heart failure - have resorted to implantation in the heart pacemaker. This device independently generates electrical impulses. Stable specified heart rate favors the restoration of adequate hemodynamics.
The operation is performed under general anesthesia and lasts about one hour. Via the subclavian vein under the control of the X-ray machine is introduced dual electrode in the right ventricle and atrium. Stimulator filed in the subclavian area or under the skin on the abdomen.
The patient spends in the surgical department for no longer than a week.
How to treat bradycardia folk remedies?
Currently, the proven efficacy in the treatment of bradycardia have following traditional methods:
- A mixture of honey, garlic, and lemon. For its preparation should wash the lemons and scalded with boiling water, and then squeeze the juice from them. Then clean 10 medium heads of garlic and grind them to a state of pulp. The finished garlic pulp mixed with lemon juice until a homogeneous, smooth. Then, to the weight of garlic citric add one liter of honey, and the whole was well mixed. Ready mass in a sealed container in the refrigerator and put infuse for 10 days. Then eat to 4 teaspoons daily before meals.
- A decoction of yarrow. For its preparation should be 50 g of dry grass pour 500 ml of warm water and then bring it to the boil. Boil for 10 minutes, then press for one hour. Ready broth strain and take one tablespoon three times a day.
- Walnuts, which should be eating every day. Nuts should be present in the human diet every day. It is best to eat nuts for breakfast.
Generally, treatment is prolonged bradycardia, and folk methods can be used indefinitely.
Lifestyle with bradycardia
Mild to moderate bradycardia does not require a fundamental change in the usual physical activities or activities of daily living. It is enough to observe the principles of a healthy lifestyle, the basics of good nutrition and develop adequate work and rest mode.
In severe bradycardia with attacks MES patient should avoid excessive stressful situations, significant physical exertion.
Both categories of patients is useful to know that if bradycardia is desirable to eat foods such as walnuts, a mixture of Honey, lemon and garlic and broth yarrow, since these products have a beneficial effect on the contractility of the heart muscles. All persons with cardiovascular diseases - cardiovascular system to get rid of bad habits, a diet with the consumption of low-calorie foods, and often rest in the fresh air.
If bradycardia occurs in a pregnant woman's ability to bear a child depends on the underlying disease. Usually mild to moderate bradycardia does not affect the supply of the fetus with oxygen. If the expectant mother takes any medicines, it must agree with the possibility of receiving the attending obstetrician.
Forecast
Adversely affects the prognosis of bradycardia presence of organic heart lesions. Significantly burden the possible consequences of the occurrence of bradycardia attacks of Morgagni-Adams-Stokes without a decision on the carrying out of electrical stimulation. The combination of bradycardia with heterotopic tachyarrhythmias increases the likelihood of thromboembolic complications. Against the backdrop of persistent decrease in the rhythm may develop patient disability.
When the physiological form of bradycardia or moderate satisfactory prognosis.
Do take into the army if bradycardia?
The list of diseases when the recruit is considered to be unfit for the passage of conscription, bradycardia is missing, because it is not a disease, and diagnostic sign abnormalities of the heart.
When the diagnosis of bradycardia, the young person must go through the CAS survey, and only on the basis of detected / not detected the disease is solved the question of the suitability of the service. According to Art. 42-48 unfit for service recognized the young man with the disease - AV block and sick sinus syndrome. In the absence of these pathologies inductee is not exempt from military service.
