Diagnosis of tachycardia

A doctor can diagnose the tachycardia based on your answers to some questions about your symptoms, physical examination and a series of surveys and analyzes. Common tests include the following studies:

• Electrocardiography (ECG)

This is the main method of diagnosis of tachycardia. ECG small sensors (electrodes) are placed on the chest and arms to record electrical signals passing through the heart. ECG reflected averaging all vectors of action potentials occurring at some point in the heart. On ECG the doctor can determine the type of tachycardia, as well as to understand how disorders of the heart can affect the acceleration of the heart rate. The doctor may also ask you to use portable ECG devices at home, to get more information about the contraction of the muscles of the heart. These portable devices are - Holter monitor and logger.

• Holter Monitor

The study is a continuous recording of ECG for 24 hours or more. ECG recording is performed using a special handheld device - recorder (recorder), which the patient carries with him (at the shoulder strap or belt). For contact with the body of the patient use disposable adhesive electrodes. During the study, the patient leads a normal life (working, going for a walk), noting in a special diary time and circumstances that are experiencing the unpleasant symptoms of the heart. This study gives the physician the opportunity to get a full symptomatic picture.

• Registrar

This portable ECG device is designed to monitor the functioning of the heart for a few weeks or several months. It needs to include only when symptoms of tachycardia heart rhythm. This study allows the doctor to determine how the heart rate at the onset of symptoms.

• Electrophysiological study

The doctor also may prescribe electrophysiological study to confirm the diagnosis and determine the source of problems in the cardiac conduction system. During the study, blood vessels of the heart at different points administered thin flexible probe (catheter) to the electrode tips. When electrical stimulation electrodes accurately determine the path of the electrical impulses of the heart with each heartbeat and identify anomalies and defects in the conduction system.

• Orthostatic

Orthostatic test is used to determine the cause of the episodes of loss of consciousness and their relationship with tachycardia. Under the supervision of a doctor the patient is taking a drug that causes an attack of tachycardia. The test is in a quiet lying on the bed with slopes under different angles (30-60 degrees) for certain periods of time, while a variety of devices recorded blood pressure Blood pressure - dangerous if his swing? , The electrical impulses of the heart and blood oxygen saturation. Orthostatic test is carried out in a special room, which is called the electrophysiology laboratory.

Additional studies

Cardiologist may prescribe additional studies for the diagnosis of the underlying disease, promoting tachycardia and to determine the general condition of the heart.

• Treatment and medication

Tachycardia treatment is aimed at reducing the heart rate, preventing future episodes of tachycardia and to minimize complications.

• Decrease heart rate

Heart palpitations can be normalized without any interference, but you can slow down the heart rate using simple physical exercises. However, in some situations, you may need medication or other specialized treatment to slow the heartbeat. Known methods to slow the heartbeat:

• Reflex effect on the vagus nerve

During episodes of palpitations can perform a reflex effect on the vagus nerve, which helps regulate the heartbeat. These effects include a cough reflex, trying to stretch the muscles (as in defecation) and the application of cold (such as ice packs) to the patient's face.

• Drug treatment

If a reflex effect on the vagus nerve will not help to slow the rapid heartbeat may require administration of antiarrhythmic drugs to restore normal heart rhythm. Injections of the drug made in a hospital. The doctor also may prescribe oral anti-arrhythmic drug, such as flecainide (Tambokor) or propafenone (Ritmol).

• Cardioversion

To attach the chest of the patient electrodes through which electrical current to stimulate the heart. Electric discharge affects the electrical impulses in the heart and restore normal heart rhythm. This procedure is performed in a hospital when you need emergency care, or when other treatments have failed.

Ventricular tachycardia: a violation of the heart

Ventricular tachycardia - accelerated rhythm is ventricular contractions, continued for more than 30 seconds. Ventricular tachycardia usually accompanies some form of structural damage to the heart, most often, chronic ischemic heart disease, which leads to myocardial infarction Myocardial infarction - the most formidable diagnosis . In some cases, ventricular tachycardia occurs with minimal symptoms, but more often this type of arrhythmia is accompanied by palpitations, dizziness, fainting, and even can lead to cardiac arrest and sudden death.

These symptoms occur because the ventricular tachycardia impairs the ability of the heart to effectively pump blood. The pumping function of the heart during ventricular tachycardia deteriorates for two reasons. Firstly, the heart rate during an episode of ventricular tachycardia may increase so (often more than 180 or 200 beats per minute), that the efficiency of the heart greatly reduced. Secondly, ventricular tachycardia can lead to a disruption of the normal, orderly, coordinated contractions of the heart muscle rhythm. For these two reasons ventricular tachycardia refers to particularly dangerous heart rhythm abnormalities.

Causes

The normal passage of an electrical pulse may prevent a number of factors, including:

• Congenital heart anatomical pathology;
• Alcohol abuse;
• Consumption of drugs;
• Heart diseases;
• Excessive consumption of caffeine;
• High blood pressure;
• Hyperthyroidism;
• Electrolytic imbalance;
• Side effects of certain medications;
• Smoking.

In the majority of cases of ventricular tachycardia develops due to major cardiovascular disorder that causes damage to the ventricular muscle - often, coronary heart disease (CHD), heart failure, and Heart failure - when the heart is unable to cope with the work . In a weakened or damaged heart muscle appear tiny pathways that may cause reciprocating tachycardia. Thus, ventricular tachycardia often represents one of the types of reciprocating tachycardia.
  In fact, the risk of ventricular tachycardia is proportional to the degree of damage to the muscles of the ventricles - the greater the loss, the greater the risk of tachycardia.

• The best way to assess the extent of damage to the heart muscle - measurement of left ventricular ejection fraction. The smaller the ejection fraction, the greater the damage to the muscles, and therefore, the higher the risk of ventricular tachycardia.

Much less ventricular tachycardia can occur in younger people who seem perfectly healthy and do not suffer from coronary heart disease or heart failure. In this case, the arrhythmia is caused by some or congenital genetic disorders, including:

• Syndrome of extended interval QT (electrophysiological phenomenon, characterized by an abnormal elongation of interval QT, reflects the process of electrical stimulation and recovery of the heart muscle);
• Repeated (counter) monomorphic ventricular tachycardia;
• Arrhythmogenic cardiomyopathy Cardiomyopathy - the cause of the disease is unknown   the right ventricle;
• Polymorphic ventricular tachycardia.

Symptoms

When the ventricles ventricular tachycardia is a rapid generation of electrical impulses that cause heart palpitations, which prevents the normal functioning of the ventricles. Palpitations normally prevents the ventricles to fill with blood and shrink, so the heart can not pump enough blood for all body functions. This can lead to life-threatening conditions, which is quite common in ventricular tachycardia. Symptoms include ventricular tachycardia:

• Dizziness;
• Shortness of breath;
• Increased heart rate (the most obvious symptom);
• Heart rate can be as fast and chaotic, that the patient seems to be that the heart is turned in the chest;
• Fainting;
• Chest pain (angina).

These symptoms can appear and disappear suddenly, and in some cases tachycardia can occur completely asymptomatic.

Treatment

Treatment of ventricular tachycardia is aimed at reducing the high heart rate and prevent further attacks and to minimize the risk of complications. During an attack of ventricular tachycardia recommended coughing, straining the abdominal muscles and put an ice pack on your face. This method reflex action on the vagus nerve, which will help to normalize and stabilize the heartbeat pulse.

If the above steps do not help, the patient is injected with anti-arrhythmic drug that helps restore a normal heartbeat. Acute episodes of sustained ventricular tachycardia often require emergency medical care. If cardiac arrest, you should immediately apply the standard methods of cardiopulmonary resuscitation.

If a patient with persistent ventricular tachycardia in the conscious and in stable condition, you can take other measures. For example, for quick relief of acute attacks of arrhythmia often injected lidocaine and similar drugs. Also, the patient is given a sedative and spend cardioversion - the procedure for restoring normal heart rate at which the controlled current straight polarity is passed through electrodes attached to the patient's chest.

Prevention

After an attack of ventricular tachycardia was stopped and restored a normal heart rhythm, you must take care of prevention of future episodes. This is very important because the first attack of sustained ventricular tachycardia is rarely the last. Chances are that the next episode will happen in the next year or two, and any repeated attacks can be life-threatening.

In most cases this means the selection of optimal treatment for ischemic heart disease or heart failure (or both diseases). Unfortunately, even with optimal treatment of underlying heart disease, the risk of recurrent episodes of ventricular tachycardia typically remain high and, therefore, increases the risk of cardiac arrest and sudden death, and therefore it is necessary to adopt other measures for prevention.

Sometimes antiarrhythmic drugs can help in the prevention of recurrent ventricular tachycardia, but unfortunately, these drugs are often not effective. In some cases, ablation is recommended for pathways, causing ventricular tachycardia, but (unlike SVT) is the exception rather than the rule.

For these reasons, doctors strongly recommend implanting a defibrillator survivors of at least one episode of sustained ventricular tachycardia. It is also shown in patients who have suffered a sudden cardiac arrest outside the hospital.

In order to prevent ventricular tachycardia are also encouraged to make lifestyle changes to reduce the risk of heart disease. Regular fitness, proper balanced diet, maintaining a healthy weight and constant monitoring and blood pressure Blood pressure - dangerous if his swing?   cholesterol and help maintain a healthy tone of the heart muscle.