Cardiac Arrhythmias – Causes, Signs, Treatment
Arrhythmia or cardiac arrhythmias (LDCs) means irregular heart function. LDCs arise when changing such characteristics in his work as automatism, excitability, conductivity.
Age and causes of arrhythmia
Throughout a man’s life, arrhythmias can be detected at any age. Sometimes they occur without any manifestations of the disease, in healthy people, are detected by chance. There are cases when cardiac arrhythmias are associated with severe pathology of the heart and other organs.
In childhood, most often detect sinus arrhythmia, tachycardia. Normally, they occur from birth. They are a reflection of the immaturity of nervous regulation, the untrained heart muscle. The muscle of the heart resembles the muscles of the skeleton in structure.
Pathological types of rhythm disturbances in children are associated, as a rule, with the presence of congenital heart defects, surgery on this subject, less often, with diseases of other systems and organs. The frequency of congenital heart defects is 6-8 per 1000 births (or about 20,000 per year). One of the causes of congenital heart defects is the use of alcohol by parents. Arrhythmias that can occur in such cases are manifold.
Adolescence and draft age
Of particular interest are arrhythmias detected in recruits. This period of life of young people is under the supervision of medical commissions of military commissariats interested in the health of military personnel. Most often, arrhythmias characteristic of children (sinus tachycardia) are detected. Their presence is explained by poor physical fitness.
Boys who spend most of their time reading books and computer activities remain physically untrained at an older age. The lack of regular physical exertion (for the heart they are needed, as for any muscle) leads to the fact that any effort causes an increase in heart rate (tachycardia). Particularly sensitive young people notice this in the form of unpleasant sensations of a heartbeat.
Other types of arrhythmias are less common, are detected by chance, they do not interfere with life (blockade of the right leg of the bundle of His, sinoauricular blockade of the 2nd degree, extrasystole). They are attributed to age-related versions of the norm. They do not manifest anything painful, do not require treatment. They do not interfere with military service (except for special military branches, where health criteria are especially strict).
Pathological arrhythmias are rare in draftees. Usually these are the consequences of operations carried out for congenital heart defects, less often others. They are successfully treated.
Middle and older age
The average age of the stronger sex is vulnerable to various diseases, heart damage. All of them can become the causes of arrhythmias.
Causes of cardiac arrhythmias in middle-aged men:
- intoxication (smoking, alcohol);
- occupational hazards;
- taking certain medications;
- coronary heart disease;
- arterial hypertension;
- thyroid disease;
- diseases of other organs.
Such rhythm disturbances require attention, treatment of the underlying disease. Some arrhythmias, with such a cause, can cause sudden death (ventricular fibrillation, ventricular tachycardia).
Older men may have the same causes of arrhythmias. More often, their heart rhythm disturbances are associated with complications of existing heart diseases and other organs. The presence of arrhythmias at this age shortens life, reduces its quality.
Changes in any electrophysiological characteristics of the heart (excitability, automatism, conduction, contractility) are accompanied by cardiac arrhythmias. Depending on which function is changed, distinguish:
- impulse formation defects;
- changes in its conduct;
- combined options. These can be extrasystoles, blockades, tachycardia, or a combination thereof.
Depending on the constancy of the presence of arrhythmias, their forms are distinguished: permanent or paroxysmal (paroxysmal).
How to understand that this is arrhythmia?
Manifestations of arrhythmias depend on their type, effects on the functioning of the heart and systemic hemodynamics (blood movement, oxygen supply of vital organs). Heart rhythm disturbances may not manifest themselves. Sometimes this is just an unpleasant sensation of its “owner”.
- Fading hearts
The most common type of arrhythmias is extrasystole . Its causes are unknown, it occurs in 80% of healthy people. A completely harmless arrhythmia for a healthy heart in a single and group form. Not all people feel it, only neurotics, which is associated with the peculiarities of the perception of “rustling” in the body.
It feels like a short cardiac arrest, “somersault”, especially a strong beat or contraction of the heart. If you do not pay attention to it, perception becomes dull, becomes invisible. In another case, when their appearance is given unreasonably increased attention, they begin to be perceived especially colorfully. There is a fear of cardiac arrest, sudden death, attacks of weakness, dizziness, sweating, and cooling of the extremities join in.
Extrasystole with sinus tachycardia is especially common in young people, as a sign of neurosis, physical untraining. The neurosis that causes such sensations progresses to panic attacks that require serious volitional efforts to overcome them. These manifestations of arrhythmias are the most common cause of young men visiting a cardiologist.
In the presence of a serious pathology of the heart, this type of arrhythmia requires attention, observation, and sometimes additional treatment. The conditions for the appearance of extrasystoles are important. At rest, they appear with neurosis, during physical exertion (usually not felt at the same time), their cause can be serious.
Other signs of arrhythmia are heart attacks of various durations: from several minutes to several hours, days. They appear at any time in life. Men are more common in women.
Causes of heart attacks:
- the presence of additional pathways in the heart (when there is no function of synaptic delay of the atrioventricular node);
- alcohol intoxication;
- coronary heart disease;
- if the cause of heart attacks cannot be found, it is called idiopathic (unknown).
- Other conditions
Paroxysmal dizziness, weakness, fainting (the so-called syncope), which are caused by arrhythmias, are rare. Their “owners” are usually people of considerable age (or very young children with congenital heart defects). This is a high degree of heart block, giving pauses in work for more than 3 seconds or too high a heart rate (about 300 per minute). Such conditions do not provide full blood supply to the brain.
Methods for determining the type of arrhythmia
For the diagnosis of LDCs, the main thing (taking into account complaints) is the ECG method, its modifications. Of particular importance for analysis is the recording of an ECG at the time of arrhythmia. The determination of its type and the need for medical interventions depend on this.
ECGs can be recorded on paper or digital media using stationary or portable devices called electrocardiographs. They can be configured for continuous recording, fragmentary (after certain periods of time set by the program), “on demand” – the recording mode determined by the patient or the situation provided for by the recording program.
Hospitals use paper models, ECG recording in 12 standard leads (electrode locations). Analysis of stationary ECGs, subject to professional recording, is considered more complete. Portable models have a limited number of leads, quite sufficient to identify the type of arrhythmia.
A modification of the ECG method is Holter ECG monitoring (HMECG). Continuous ECG recording is performed in 1-2 or more days. It depends on the software of the HMECG system. There are monitors designed for very long wearing periods (months). This method is used for the quantitative analysis of the types of rhythm disturbances, registration on the ECG of syncope episodes that reveal their causes.
In some cases, when it is not possible to record an episode of arrhythmia, it is possible to provoke it with the participation of a doctor by the method of electrophysiological research (EFI). These can be methods of intracardiac or transesophageal electrostimulation of the heart with ECG recording. The properties of the conducting system of the heart, the nodes of automatism are studied. This research method is easily tolerated by children, women, a rare man treats him without fear.
Treatment and its need
Not all arrhythmias need treatment. Its need is determined by the type, subjective tolerance of cardiac arrhythmias, changes in hemodynamics.
Sometimes a man subjectively poorly tolerates even single harmless extrasystoles or tachycardia. This happens with neurosis, panic attacks. We have to recommend such patients a short-term intake of drugs that improve tolerance to arrhythmias. Usually these are sedatives of plant origin (valerian, motherwort, etc.) in the form of freshly prepared infusions.
Much less often, small doses of drugs are prescribed that reduce the heart rate. A mandatory recommendation (which is often neglected by a man) is treatment by a psychotherapist or psychiatrist. Attention is always paid to physical activity in the daily regimen, its gradual expansion leads to the elimination of manifestations of neurosis and facilitates the perception of arrhythmias.
Men, as a rule, consider taking medications sufficient. Their perception of rhythm disturbances is accompanied by depression, impaired potency, a negative attitude to physical training. It is an infrequent option when the stronger sex copes with neurosis on its own.
Other types of arrhythmias with hemodynamic disorders, for example, atrial fibrillation, paroxysms of tachycardia with a high heart rate, blockade are successfully treated promptly. There are many varieties of surgical techniques for these reasons, the choice is made by an arrhythmologist, explaining to the patient the essence of the intervention (RFA, EX). The results of surgical treatment depend on the condition of the patient, the experience of a cardiac surgeon. From 50 to 90% of operations have good results.
Some forms of paroxysms of cardiac arrhythmias are tolerated quite successfully (supraventricular tachycardia), rarely repeated (once a year or several years). Their surgical treatment may be delayed indefinitely. There are cases when the operation is impractical or the patient has no desire to be operated on.
In such situations, medication is prescribed for arrhythmia. It can have a planned character, with a long intake of prescribed doses of drugs or emergency (stationary or at home) to stop the resulting paroxysm. Men are characterized by inaccuracy in fulfilling the doctor’s recommendations on drug therapy. As a result, they have a higher frequency of emergency situations with rhythm disturbances.
With some cardiac arrhythmias it is quite possible to live without paying attention to them. Others should be well warned so as not to engage in their treatment for long and hard. For this, it is necessary to influence the reasons for their development. The most reliable principles for preventing arrhythmia coincide with a healthy lifestyle. It:
- elimination of bad habits (smoking, drinking alcohol – life without them has much more opportunities for self-realization and happy moments);
- maximum possible physical activity;
- balanced diet;
- sufficient rest;
- positive attitude to life.
In conclusion, we can add that a man of any age can prevent and manage arrhythmias if he considers himself a representative of the stronger sex.