Tachycardia - the body to the limit? - Paroxysmal

Paroxysmal tachycardia

The manifestations of paroxysmal tachycardia depend on the duration of the attack, the location of ectopic foci of the disease and against which evolved attack.

In attacks of paroxysmal tachycardia heartbeat rhythmic, frequency of up to 120-220 beats a minute. The attack begins suddenly and may last from a few seconds to several days, and sometimes weeks, and the heart rate does not change. Just before the attack the patient has a feeling of "interruptions", "fading" of the heart.

When patients experience long bouts of common concern, the fear is sometimes dizziness Dizziness - if the ground is slipping from under his feet . At very high heart rate may fainting.

Supraventricular paroxysmal tachycardia often occurs on the background of vegetative-vascular dystonia and is accompanied by symptoms such as trembling of the body, sweating, frequent urination abundant. The heart rate at higher supraventricular tachycardia (140-220 beats / min) than ventricular (130-170 beats / min). Ventricular tachycardia is often a sign of heart disease and more severe.

Complications

Long attack of paroxysmal tachycardia can cause severe complications such as cardiogenic shock (severe disorder with disturbance of consciousness and sudden disorder of blood circulation in the tissues), or congestive heart failure Heart failure - when the heart is unable to cope with the work   with pulmonary edema (heart does not have time to pump blood and its stagnation in the lungs, liquid part of blood seeping through the walls of blood vessels, flooding the lungs).

This significantly reduces the amount of cardiac output, resulting in a decrease of coronary blood flow and (arteries supplying blood to the heart muscle), which may result in angina attacks (acute intermittent pain in the heart).

Treatment

During an attack of tachycardia important - physical and mental rest. The attack of supraventricular tachycardia can be removed reflex methods irritating the vagus nerve: natuzhivayas, squeezing the abdominal muscles, holding your breath, pushing the eyeballs, causing gagging. With the ineffectiveness of using various drugs (eg obzidan). In severe cases, to restore proper rhythm slows conduct electrical stimulation of the atria.

If ventricular tachycardia is most often injected lidocaine. If drug therapy does not work, then spend cardioversion.

Prevention

Warning paroxysmal tachycardia should take account of its shape, the frequency and the causes. When seizures rare (one in a few months or years) the patient should maintain a healthy lifestyle (no smoking and alcohol) with the exception of physical and mental stress. With frequent attacks to prevent them apply soothing and eliminating abnormal rhythm drugs.

In paroxysmal tachycardia associated with heart disease, extensive treatment of this disease.

Paroxysmal tachycardia: Types

Paroxysmal tachycardia is more frequent bouts of sudden heart rate while retaining their correct sequence. Distinguish supraventricular (occurs more frequently with nervousness, heart rate 180-260 beats per minute) and ventricular (occurs more often in diseases of the heart, 140-200 beats per minute) paroxysmal tachycardia.

The attack of paroxysmal tachycardia can last from several minutes to several days and ends as abruptly as it begins. Paroxysmal tachycardia - a fairly common disease states. Various forms of paroxysmal tachycardia detected in 20-30% of patients undergoing long-term ECG monitoring. But it should be borne in mind that this study often prescribed to patients with suspected cardiac arrhythmias.

Supraventricular paroxysmal tachycardia

Normally, the electrical impulse arises in the cells of the natural pacemaker (sinoatrial node) in the upper part of the heart (the atria). Under the influence of atrial sync pulse muscles contract and push blood into the ventricles (lower heart chambers). Next, an electrical impulse arrives at the atrioventricular node, where spreads bundle branch Purkinje fibers and ventricular myocardium on. Delay electrical impulse in the atrioventricular node provides the atria time shortened, causing blood to the ventricles. Then the pulse propagates in the ventricles, they contract and push blood into the blood vessels.

When supraventricular paroxysmal tachycardia violation conduction of electrical impulses leads to an increase in the frequency of contractions of the atria and ventricles. This phenomenon is paroxysmal in nature, since the frequency of contractions increased dramatically and chaotic. Paroxysmal supraventricular tachycardia often passes before the patient reaches the hospital. Abnormal conduction path can be formed anywhere in the atria or around the atrioventricular node.

Symptoms

Supraventricular paroxysmal tachycardia is accompanied by heart palpitations, as well as the following symptoms:

• Dizziness;
• Weakness;
• Shortness of breath;
• A feeling of pressure in the chest.

When you need to see a doctor

As soon as possible, contact your doctor if:

• You often heart palpitations and other symptoms of paroxysmal tachycardia, and the symptoms do not disappear on their own after a few minutes.
• You diagnosed with supraventricular paroxysmal tachycardia, and the attack fails after a reflex effect on the vagus nerve, or palpitations accompanied by other symptoms.
• Seizures often recur.
• There are new symptoms.

Diagnostics

Diagnosis of supraventricular paroxysmal tachycardia is based on the interpretation of the data and ECG Holter monitor. Diagnosis is difficult because often the heartbeat to normal before the patient seek medical help. In these cases, conduct research using Holter monitor that the patient is at itself within 2-3 days. This little device captures every heart beat, and its indicators help determine the root cause palpitations.

If the cause of the hearth and heart rhythm disorders using Holter monitor fails, conducted a 30-day monitoring of the activity of the heart.

Treatment

Treatment of supraventricular paroxysmal tachycardia is aimed at normalizing the electrical conduction of the heart. Reflex action to stimulate the vagus nerve and normalization of heart rate - that's the first line of therapy. By reflex effects are cough, abdominal muscle strain or the application of cold to the face. For fast relief of an attack of supraventricular paroxysmal tachycardia intravenous adenosine, which normalizes the heart rate and heart rate.

In rare cases where other therapies were ineffective, used cardioversion - heart affect the discharge of electrical current generated by the defibrillator.

Prevention

There are several ways to prevent supraventricular paroxysmal tachycardia. Attacks of tachycardia is receiving stimulants - caffeine, alcohol, some OTC cold and flu containing pseudoephedrine, as well as smoking and drug use. Beta-blockers, calcium channel blockers and antiarrhythmic drugs are widely used for the maintenance of normal heart rhythm.

Electrophysiological study and helps detect abnormal pathways. This procedure is similar to the cardiac catheterization studies but no blood vessels, and on the cardiac conduction system. Often, for the destruction of abnormal pathways and to prevent attacks of paroxysmal tachycardia subsequently applied radiofrequency ablation. The aggressiveness of preventive measures depends on the frequency and severity of attacks of supraventricular paroxysmal tachycardia.

Ventricular tachicardia

At ventricular paroxysmal tachycardia focus of concern is the pulse in the conduction system of the ventricles - the bundle of His, His bundle branches or Purkinje fibers. Usually, ventricular paroxysmal tachycardia develops in the organic changes in the heart muscle, such as in acute myocardial infarction Myocardial infarction - the most formidable diagnosis   or chronic ischemic heart disease.

Paroxysmal ventricular tachycardia occurs suddenly, a feeling of palpitations and general appearance of weakness. In addition to these symptoms may occur discomfort, compression or gravity in the heart. Pulse frequent, more than 120 beats per minute. The attack of ventricular paroxysmal tachycardia usually ends as abruptly as it begins.

Diagnosis and treatment

To distinguish ventricular tachycardia paroxysmal supraventricular only by using an electrocardiogram. Symptoms are very similar to supraventricular. Paroxysmal ventricular tachycardia often docked lidocaine intravenously. With the ineffectiveness of medical treatment, as well as in the event of a collapse, shock, cardiac asthma and pulmonary edema spend cardioversion (cardioversion).

In attacks of ventricular paroxysmal tachycardia should not use techniques of stimulation of the vagus nerve, to use verapamil Verapamil - indispensable for angina and hypertension , Propranolol, ATP and cardiac glycosides because of their low efficiency.

If the attacks of ventricular tachycardia frequently, between bouts of supportive therapy with antiarrhythmic drugs.