Sinus bradyarrhythmia heart - it is a disease in which is recorded a decrease in heart rate below 60 bpm due to pathological activity of the sinus node.
GENERAL
Sinus bradyarrhythmia heart disease refers to the driver of the first order rate - the sinus node. According to statistics, this pathology does not depend on age and sex and is widespread. Interestingly, the structure of the myocardium, the algorithm contractions of the atria and ventricles do not undergo virtually no change. Sinus bradyarrhythmia may be one of the physiological rhythm of, for example, in athletes in a period of relative quiet.
CAUSES
The reasons are varied sinus bradyarrhythmias. They can be grouped into four groups:
- The pathology of the cardiovascular system.
- Somatic diseases.
- Poisoning.
- Other.
The pathology of the cardiovascular system:
- myocardial infarction;
- postinfarction proliferation of connective tissue, affecting the sinus node;
- inflammatory diseases of the muscular tissues of the heart;
- violation of the coronary blood flow.
Somatic diseases:
- brain pathology with a rise in intracranial pressure;
- decrease the functional activity of the thyroid gland;
- increasing parasympathetic nervous system;
- serious infections;
- dystonia.
poisoning:
- heavy metals;
- nicotine;
- cardiac glycosides.
Other important etiological factors include:
- general hypothermia;
- electrolyte imbalance in plasma.
CLASSIFICATION
Sinus bradyarrhythmia share on the following factors:
- etiology;
- in severity;
- by the time the debut of the disease.
Etiology release:
- neurogenic, which is based on a violation of the nervous system;
- endocrine, often associated with a reduction in exogenous thyroid function and adrenal cortex;
- toxic arising due to the nerve cells of the sinus node endogenous or external toxic substances;
- dosage;
- cardiac.
According to severity:
- moderate shape;
- expressed form.
By the time the debut of the disease:
- congenital abnormality;
- acquired pathology.
A separate item in the labeling bradyarrhythmias allocated respiratory bradyarrhythmia, whereby reduction in heart rate independent of pressure changes in the thorax for inhalation height.
SYMPTOMS
The clinical picture of sinus bradycardia depends on the degree of disease severity. In moderate bradyarrhythmia subjective symptoms may be absent. Progression of disease sinus and further decrease in heart rate is fraught with certain characteristic features.
complaints:
- weakness;
- dizziness when changing the position of the body;
- inability to perform routine activities;
- loss of consciousness;
- transient blurred vision;
- rhythm sleep disorder;
- emotional lability;
- a significant decrease in appetite.
From the foregoing it can be seen that the major changes taking place with bradyarrhythmias in the nervous system. This is due to the fact that nerve tissue cells are most sensitive to hypoxia, during the developing urezhenii heart rate. Minimum supply of oxygen and nutrients to the brain for even a short period of time in severe sinus bradyarrhythmias provokes the death of neurocytes with the development of heavy complications.
DIAGNOSTICS
In the diagnosis of sinus bradyarrhythmias preference is given to non-invasive instrumental and laboratory methods that are performed after the history and exam fee.
Anamnesis
It is important to identify the patient:
- factors, after which there is a heart rhythm disorder;
- the duration of arrhythmias;
- age of the patient, in which the onset of the disease has occurred;
- presence of comorbidities.
inspection
During the inspection itself may draw the attention of:
- pale skin;
- cold sweat;
- episodes of impaired consciousness.
Often in patients with moderate bradyarrhythmia no visible signs of the disease.
Auscultation
During auscultation recorded insufficient heart rate, but the algorithm of the atria and ventricles are not violated.
electrocardiography
This technique is the most affordable and effective for screening patients and initial diagnosis. Changes in the electrocardiogram:
- reduction in heart rate less than 60 beats per minute;
- Registration proper sinus rhythm;
- the appearance of a positive P wave in unipolar precordial leads.
For differential diagnosis of sinus bradyarrhythmias and other pathologies options options using electrocardiography:
- a load;
- from administration of drugs.
laboratory diagnosis
In addition to standard clinical and general blood analysis to eliminate thyroid dysfunction and adrenal hormones define the concentration of iron in the blood plasma. Decrease in their content may be the cause of bradycardia. Also determine the ionic composition of the blood plasma. With special techniques detect different concentrations of toxic substances.
Advanced diagnostics
To further establish bradyarrhythmias reasons may be used:
- ultrasound of the heart, endocrine organs;
- CT scan of the chest;
- Magnetic resonance imaging of the brain;
- electroencephalography.
TREATMENT
Treatment of various types of bradyarrhythmias is common approaches:
- diet therapy and exercise therapy;
- control of somatic diseases;
- drug therapy;
- pacemaker implantation.
When Bradyarrhythmias apply:
- drugs that increase the heart rate;
- cardioprotectors;
- substances that enhance cell metabolism;
- vitamin complexes;
- nootropics.
Treatment of sinus bradyarrhythmias, particularly severe form, is carried out by setting an artificial pacemaker. Such a device is capable of maintaining the physiological heart rate.
COMPLICATIONS
The disease often goes with complications. They develop on the background of decreasing heart rate, exacerbation of somatic pathology or inefficient use of, including and non-traditional health care. Folk remedies in the treatment of bradyarrhythmias have no evidence, so their use could significantly increase during the cardiac pathology.
The most serious complications include bradycardia:
- Morgagni syndrome - Adams - Stokes - brief loss of consciousness due to a significant reduction in cardiac output and cerebral ischemia;
- sudden cardiac death.
PREVENTION
To prevent the development of sinus bradycardia must adhere to the following principles:
- reduce the psycho-emotional strain;
- to refuse from bad habits;
- normalize physical activity;
- undergo an annual preventive examination;
- for symptoms to immediately consult a specialist.
FORECAST FOR RECOVERY
With early diagnosis and proper amount of therapy the prognosis of patients with sinus bradyarrhythmia rather favorable. However, the appearance of degenerative changes in the myocardium and brain symptoms insufficient trophism often lead to patient morbidity and can be fatal.
Treatment of bradyarrhythmias drugs or using a pacemaker can improve the patient's quality of life and increase its duration.
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