Paroxysmal tachycardia: treatment, symptoms, what is it?
Paroxysmal tachycardia — sudden onset of rapid heartbeat (140 to 220 beats/min and above) with preservation of cardiac rhythm. Quite dangerous as, with the rapid development and the long-threatening the patient’s life. Therefore, patients with cardiovascular diseases should know what it is, symptoms of the disease and urgent assistance measures.
Paroxysms of tachycardia: classification
Temporary (paroxysmal) replacement sinus rhythm at a pathological frequency associated with the occurrence of abnormal impulses. The development mechanism of tachycardia is:
- focal (foci of pathological impulses);
- multicentric — multiple foci of abnormal pulses;
- reciprocal — reflexive mechanism of pathological impulses the sinus node (AV nodal reciprocal form of the least dangerous, often diagnosed).
Depending on where pathological impulses diagnosed tachycardia:
- supraventricular (medical term — supraventricular) — atrial (ectopic impulses arise in Atria) and atrioventricular (pathological impulses is formed in the atrioventricular node);
- ventricular pathological impulses occurs from the ventricles (bundle branch block and his legs, Purkinje fibers).
Neparoxizmale tachycardia, unlike paroxysmal, is a constant increase in the number of heart rate (HR). In this case is different and treatment tactics.
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Causes of paroxysmal tachycardia
Tachycardia, paroxysmal developed, it may be triggered by such diseases as:
- increased activity of the sympathetic nervous system (the development of the supraventricular form);
- inflammation of the myocardium, the necrosis (infarct), degeneration and sclerotic damage to provoke ventricular tachycardia;
- heart disease, hypertension;
- ischemia of the heart;
- emotional overload (provokes paroxysms of tachycardia in children and adolescents);
- the toxic effects of chronic administration of cardiac glycosides;
- hyperthyroidism, adrenal tumors;
- pathology of the gastrointestinal tract (ulcer, cholecystitis, hepatic failure);
- kidney failure;
- the abuse of drugs, alcohol, cigarettes.
The clinical picture
Tachycardia is clearly limited in time (weak — less than 30 sec, persistent — lasts more than 30 seconds), has a sharp beginning and the same sudden end. Symptoms:
- the patient feels a sharp jolt to the heart from the rapidly increasing heartbeat (140 – 220 beats/min);
- compression of the chest;
- dizziness, noise in the ears;
- sweating, nausea, slight hyperthermia inherent supraventricular tachycardia;
- slurred speech, passing paresis (rarely recorded);
- after the attack is observed polyuria (large amounts of urine);
- long flowing attack may trigger fainting.
Heavier flows of ventricular tachycardia in the presence of concomitant cardiopathology.
Light, short paroxysms of tachycardia usually does not provoke complicating conditions. However, we should not exclude:
- chronic heart failure (formed with frequent recurrences of paroxysmal tachycardia);
- atrial fibrillation (occurs with increasing heart rate above 180 beats/min);
- angina, heart attack;
- acute heart failure (cardiogenic shock, pulmonary edema).
To diagnose paroxysmal tachycardia and to determine its form by the electrocardiogram. ECG changes the polarity of P wave and its relative position to the QRS complex recorded during a seizure:
- when atrioventricular form — heart rate to 250 beats/min, the prong R is negative, is the QRS complex;
- ventricular tachycardia — heart rate up to 180 beats/min, the prong P may be unchanged, and the QRS complex widened and deformed.
If you are not able to capture the moment of the onset of tachycardia, the patient conduct daily ECG monitoring. For the diagnosis of heart disease appointed by ultrasound, coronary angiography, MRI and testing with the load.
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During an attack of tachycardia should:
- Position the patient to measure a/d and pulse.
- To make a call to the ambulance.
- To spend vagal test — the patient inhales deeply, retching, trying to cough, press your fingers on closed eyes. Vagal sample level only supraventricular tachycardia.
- At the onset of clinical death — an indirect heart massage and artificial respiration is 15:2.
Drug withdrawal seizure holds the doctor of the ambulance. /Injected ATP, Digoxin, a combination of Mezatona and Procainamide (reduced a/d). If upon arrival, the doctor diagnosed clinical death, is cardiac defibrillation.
Hospitalization is appropriate only when the patient’s condition, if you suspect the development of complications, with persistent heart pain. Therapy is to assign individually:
- antiarrhythmics (Cardinorm, Verapamil, etc.);
- cardiac glycosides (Celanidum, Digoxin) — regular use prevents relapse of the disease;
- adrenoblokatorov (Propanorm) — reduce the risk of developing atrial fibrillation;
- antiplatelet agents (Aspirin, Thrombase).
Do not try to resolve the attacks of tachycardia folk remedies, this pathology requires urgent effective treatment.
With the ineffectiveness of drug treatment and the progression of the disease surgical intervention is performed. Modern medicine has minitrampoline techniques (radiofrequency ablation, implantation of pacemakers), fast leveling pathological impulses.
The most severe course is observed during ventricular tachycardia. It was under this form there is damage to the myocardium and, as consequence, heart attack, or threat to the flicker of the ventricles. To prevent their development, is only able to regular anti-relapse therapy or radical surgery.