Bradycardia: what is it?
Bradycardia is diagnosed when listening to the heart on reception at the therapist/cardiologist or when an ECG. What is the bradycardia, is it worth worrying when it occurs and how to treat it — the answers to these questions you will find in this article.
Bradycardia: what is it?
Bradycardia — a condition characterized by slowing of the heart rate (heart rate) to 60 min and below. Bradycardia is physiological (athletes) and not accompanied by any painful symptoms. But it could be pathological, provoked cardiac and noncardiac pathological changes. A decrease in heart rate indicates a disruption in the cardiac conduction system at different levels: from the sinoatrial and atrioventricular nodes up to all sorts of blockades electrical impulse that causes the heart muscle to contract.
The decrease in the heart rate occurs for the following reasons:
- hereditary — genetics specific person provokes a strong predominance of the vagal activity over the sympathetic system;
- neurogenic — related to incorrect functioning of the nervous system observed in the neuroses, high intracranial pressure, subarachnoid hemorrhage, severe glomerulonephritis, gastric, renal/hepatic/intestinal colic, often at starvation, severe hypothermia and during the recovery period after severe infections;
- myogenic — caused by disorders of the heart: a myocardial infarction in the acute phase, pulmonary hypertension, arrhythmias, hypertrophy of the area of the myocardium, the sclerotic process in the heart muscle, etc.;
- endocrine — bradycardia is often accompanied by hypofunction of the thyroid gland and decreasing the work of the adrenal cortex;
- drug — bradycardia as an inappropriate response can cause a taking even small doses of blockers, certain antihypertensives (Moxonidine), cardiac glycosides, antiarrhythmic drugs, calcium antagonists (Verapamil), drug opium;
- toxic intake of toxins from the outside or their production in the organism at liver failure or uremic conditions causing the elevated levels of potassium or calcium in the blood leads to a slowing the heart rate.
Isolation is bradycardia in athletes. Heart rate at rest with skiers, cyclists and runners often does not exceed 30 – 35 per minute. If not detected organic disorders of the heart, the condition is considered physiological and do not require treatment.
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Types of bradycardia
Depending on the conditions under which decreases the heart rate, there are following types of bradycardia:
- relative — transient state, is typical for fevers, hypothyroidism, high physical exertion, infections and injuries;
- the absolute decrease in heart rate is recorded continuously, regardless of the patient’s condition (rest or exercise);
- moderate (breathing) is directly related to breathing: HR increases on inspiration, slowing in expiration.
Slight bradycardia in most cases not manifest symptomatically. Often the slow heart rate is seen only with chronic fatigue. However, in marked reduction in heart rate observed:
- General weakness, fatigue;
- cold sweat;
- pallor of the skin;
- weak, low pulse;
- darkening and flashing in the eyes;
- dizziness, frequent fainting.
Such symptoms indicates a severe decrease in heart rate and requires immediate treatment in the clinic. The lack of timely treatment has:
- syndrome Morgagni-Adams-Stokes — sudden syncope accompanied with seizures, high risk of death;
- instability the a/d, sometimes hypertension;
- ischemia of the heart with repeated strokes;
- chronic heart failure;
- a sudden cardiac arrest.
Every patient should know about life-threatening complications of bradycardia. That is why when it is the slightest symptoms, you need to consult a cardiologist or arithmology. Diagnostic complex includes such studies as:
- inspection specialist (auscultation of the heart, measurement of a/d assessment rate);
- ECG, Echo-KG;
- Holter monitoring (necessary for detecting relative bradycardia);
- laboratory tests — clinical biochemistry, the study of hormonal background;
- coronary angiography;
- stress test;
- atropinovy sample (in/in the introduction of 1 ml of Atropine at a concentration of 0.1%);
- electrophysiological study;
- the transesophageal cardioversion.
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- ECG — heart rate of 59 to 40 per minute, correct sinus rhythm in I, II, V4-V6, aVF leads of the prong R is positive;
- noncardiac slowing the heart rate — heart rate increases when conducting atropinovij samples and physical exertion, often combined with respiratory arrhythmia;
- myogenic aetiology of heart, a lack of respiratory arrhythmia and rapid heart rate after administration of Atropine, a slight quickening of rhythm during physical exertion.
Type diagnosis of TMJ and how to treat it is the prerogative of a qualified professional. Self-medication in this case is totally unacceptable. Treatment strategy depends on the causes of bradycardia:
- Physiological slowing of the heart rhythm does not require treatment.
- Specific treatment of bradycardia is not performed on noncardiac and toxic forms, treatment is symptomatic. In this case, the main goal of treatment — relevant causal therapy of the disease. Recovery of function of the damaged organ (normalizing hormone levels, eliminate toxins, etc.) leads to disengagement of bradycardia.
- Drug bradycardia requires immediate correction or replacement of the drug, triggering a slowing of heart rate.
- Symptomatic measures include intake of extract of Eleutherococcus or ginseng. The last one is recommended for individuals older than 35 – 40 years. These herbal remedies increase blood pressure and can cause insomnia when taken in the evening. Also prescribed Ephedrine and Caffeine doses are selected individually. Effective at low heart rate dosage forms with belladonna.
- Surgical methods — in the absence of results of drug therapy and in severe cases, aetiology, especially when combined with a rare heart rhythm (sinking of the heart continues for more than 2 sec, heart rate below 40 per minute) with atrial fibrillation or atrial fibrillation is the implantation of a pacemaker, taking on the function of the pacemaker. External cardioversion (catalytic plates are placed on the chest front and back) — only a temporary measure to stabilize the patient’s condition. The technological equipment allows clinics to implant a pacemaker without anesthesia crescatoare way: the introduction of electrodes inside the heart through a vein. In asynchronous work of the ventricles and the Atria is dwukierunkowy the cardioversion according to the method of the BVP.
It is worth remembering that people with a permanent pacemaker in order to avoid failure of the apparatus should exclude:
- magnetic, electromagnetic impact on the area of implantation, effects of microwave and electrical current;
- Some MRI and physiotherapy (magnetotherapy, heating);
- Ultrasound in the area of implantation of the housing of the stimulator;
- the procedure to electrocoagulation;
- blows to the chest.
The implantation of cardio devices is a drastic measure necessary in severe cardiac arrhythmias. However, timely access to a cardiologist at the first signs of disease and proper treatment often helps to avoid surgery.