Sinus bradycardia - how to distinguish normal from pathological condition

May 9, 2014

 sinus bradycardia
 The normal heart rate indicator is considered to be 60 beats per minute. If there is a slowing of the rate, it is called sinus bradycardia. Not in all cases, this condition must be regarded as a deviation from the norm or disease. Noteworthy those clinical cases in which slowing of heart rate is accompanied by a major change in hemodynamic parameters (blood pressure Blood pressure - dangerous if his swing?  Blood pressure - dangerous if his swing?
 , Heart rate, heart rate variation, and others).


In some cases, aetiology is the norm

In most cases, sinus bradycardia does not lead to the development of pathological symptoms. In healthy people, the frequency rate has slowed in the daytime, when the heart rate can be from 30 to 40 beats per minute. Most often it is diagnosed in people who are engaged in various professional sports. To physically trained people is a variant of the norm, but only if due diligence and exclude the presence of disease states by the heart of the system.

Moderate sinus bradycardia may be repeated for several generations of the same family, so called family or the constitutional-hereditary. This type of bradycardia has similarities with neurogenic forms, so much importance is attached to the differential diagnosis and the study of family history. Most clearly familial aetiology describes the example of Bonaparte family.

Treatment of sinus bradycardia is necessary if detected diseases that occur with bradycardia Bradycardia - when the heart stops  Bradycardia - when the heart stops
 . At physiological bradycardia drug therapy is not carried out, it is recommended only to conduct active follow-up. Often, slowing heart rate occurs on the background of sinus arrhythmia Arrhythmia - when we hear your heart  Arrhythmia - when we hear your heart
 . Any heart rhythm abnormalities require further examination with mandatory counseling cardiologist.


ECG changes during bradycardia

To clarify the causes of bradycardia for the purpose of differential diagnosis of patients received additional types of studies, one of which is an ECG (electrocardiogram). Sinus bradycardia on the ECG change is reflected in some of the teeth and slots that used by doctors functional diagnosis when interpreting the results of the study.

Signs of pathological changes are the following figures:

  • increase PQ interval (to 0, 20-0, 22sek), but in some cases the slot may not be varied
  • QRS complex becomes wider (0 to 10 s)
  • Location ST segment contours above the bulge which faces downward

Key teeth on ECG bradycardia not changed (teeth P, T) Against a background of sinus pacemaker. Feature sinus bradycardia is to maintain consistency in the work of the atria and ventricles of the heart, so there is no change on the part of the main pacemaker (normal sinus rhythm). Change the T wave may relate to an increase in its amplitude in the chest leads (exhaust V 1 - V 4).


Clinical signs of hemodynamic instability

Any symptoms appear when the patient has a severe sinus bradycardia with a significant reduction in heart rate (less than 40 beats). This reflects the presence of underlying disease that causes damage to the sinus node and change of heart rate. It should exclude the presence of coronary heart disease or the appearance of the following complaints:

  • dizziness
  • general weakness, malaise
  • increased fatigue
  • cold sweat
  • impaired concentration
  • presyncopal, fainting (the effect of oxygen starvation)
  • Shortness of breath

Symptoms of sinus bradycardia in some cases require emergency medical care that can prevent the development of dangerous complications of cardiac and respiratory function (stopping breathing). During the development of bradycardia increases the risk of sudden cardiac arrest, which is a threatening factor for the life of the patient.

It should be borne in mind that the presence of certain clinical symptoms determined by the fact that a specific causal factor in changes in heart rate. Causes of sinus bradycardia are diverse, and the need to take into account what medicines to take a person at the time of the survey. It is known that drugs of blockers, digoxin, kordaron help reduce the heart rate.

Great importance is attached to the functional state of the thyroid gland The thyroid gland - is responsible for your hormones  The thyroid gland - is responsible for your hormones
 . If a person has a loss of function in the form of hypothyroidism, the presence of bradycardia is an important diagnostic criteria of the disease. Patients who receive thyroid drugs, marked cardiac arrhythmia, but this complication develops infrequently. Various manifestations of thyroid pathologies affecting the cardiac system, is an indication for the comprehensive examination of the patient.

Trigger the development of sinus bradycardia may be different causal factors, thus, regardless of the specific cause, there is constant basis bradycardia. Such are the foundation changes that negatively affect the process of developing sinus node pulse. Available pathological processes act as causes of bradycardia, at the same time she bradycardia itself is a pathological condition. Deal with this type of violation of the heart rate, to answer the question, what is sinus bradycardia, an expert can only be based on the study of the history of the disease, these clinical and laboratory examination.

Marina Solovyov

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  • bradycardia

Low blood pressure - can it be considered normal? - The rate of blood pressure

October 1, 2009

  • Low blood pressure - can it be considered normal?
  • The rate of blood pressure

The rate of blood pressure

Blood pressure is directly related to the vital signs such as heart rate, respiratory rate and heart rate, body temperature. Therefore it is necessary to monitor the magnitude of the pressure, because the deviation from the norm could mean disruption of vital organs. Most high blood pressure is observed at the time of the ejection of blood into the aorta; min - when the blood reaches the vena cava. There are upper (systolic) and lower (diastolic) blood pressure. For example, if the pressures are 120/80, "120" - is the upper systolic pressure, and "80" - the lower the diastolic pressure.

Systolic pressure represents the pressure that occurs when the blood passes through the arteries from the heart to other organs and parts of the body (heart muscles contract). Diastolic blood pressure represents the pressure in the arteries in between heartbeats (cardiac muscle relaxed).

It is considered that the normal pressure is 120/80, but many experts believe that the optimal pressure is 115/75. Overall, realize what is the optimal pressure for a specific person, rather difficult.

Nevertheless, the pressure is below 90 (systolic) and 60 (diastolic) is considered to be low. The pressure may be considered low or even lower if only one parameter is underestimated, i.e. systolic or diastolic. Therefore, the pressure of 115/50 is considered to be low.

 The rate of blood pressure | Low blood pressure - can it be considered normal?

Types of low blood pressure

Orthostatic hypotension: a sudden sharp decrease in blood pressure in people who rise sharply after prolonged sitting or lying down. The fact is that when you get up abruptly, the blood rushes to the extremities, resulting heartbeat quickens. However, this compensation mechanism does not work in humans with orthostatic low pressure. They are getting up after a sudden sharp drop in blood pressure, leading to dizziness, loss of coordination and even loss of consciousness.

  • Causes of orthostatic hypotension: dehydration, a long stay in lying position (for example, in the treatment of bed rest), pregnancy, burns, diabetes, fever, varicose veins and some neurological diseases. The most common orthostatic hypotension in people older than 65 years, but for young people it is also found.
  • Multiple system atrophy with orthostatic hypotension: sometimes low blood pressure caused by the violation of the nervous system. This disease is known as Shy-Drager syndrome (or hereditary mieloentsefalopatiya), developed by the collapse of the autonomous (vegetative) nervous system. Multiple system atrophy untreatable and leads to death of the patient within 7-10 years after diagnosis.
  • Postprandial hypotension: In rare cases, a sharp decrease in blood pressure occurs after a meal (by gravity blood rushes to the feet). Our body is "programmed" so that the effect of gravity must be compensated palpitations and vasoconstriction. People with Parkinson's disease often develops postprandial hypotension.
  • Vegetovascular hypotension (dystonia): in this case, a sharp drop in pressure occurs after long standing, especially in hot weather. It is caused by a violation of communication between the brain and the heart. When you stand for a long time, the blood rushes to your legs, but the body compensates for this by normalizing blood pressure. But in people suffering from vascular dystonia, the nerves of the left ventricle of the heart sends the brain a signal that the blood pressure is not reduced, but increased. As a result, the heartbeat slows and the pressure is reduced further. This disease is most common in young people.

So if you have low blood pressure and accelerated heart rate, you are in danger. The fact that the tachycardia pumping blood through the vessels more difficult, resulting in reduced blood flow to organs and body parts. When the heart rate exceeds 83 beats per second, you should immediately consult a doctor. But remember that after exercise heart rate increases, and that's fine.

 The rate of blood pressure | Low blood pressure - can it be considered normal?

The dangerously low blood pressure

Low blood pressure (hypotension) is often considered the norm, especially when you consider that high blood pressure (hypertension) is more harmful to the heart and circulatory system. Low pressure reduces the likelihood of developing kidney disease and stroke Stroke - a serious brain injury  Stroke - a serious brain injury

Nevertheless, low blood pressure is also associated with certain health risks. By lowering the pressure passage of blood through the blood vessels decreasing blood flow to certain vital organs such as the brain and heart, resulting in dizziness Dizziness - if the ground is slipping from under his feet  Dizziness - if the ground is slipping from under his feet
   and loss of consciousness.

Age is directly related to blood pressure.

Older people who rise sharply after meals, postprandial hypotension develops. Children and young people often develop vascular dystonia.

The likelihood of hypotension is increased in people with cardiovascular disease and Parkinson's disease Parkinson's disease - where the nerve endings are destroyed  Parkinson's disease - where the nerve endings are destroyed

 The rate of blood pressure | Low blood pressure - can it be considered normal?

Low blood pressure and pregnancy

Pregnancy often causes a temporary decrease in blood pressure during pregnancy as the circulatory system of women is growing rapidly. According to doctors, in the first 24 weeks of pregnancy, the systolic blood pressure may fall to 5-10 units, and diastolic - 10 - 15 units. As a result, pregnant women often feel dizzy or even faint. By themselves, these displays low pressure has not dangerous but they can cause a drop that already carries the risk for the fetus.

According to some doctors, dehydration can also lead to low blood pressure in pregnant women, therefore, recommended during pregnancy increase the intake of liquids (water or juice).

 The rate of blood pressure | Low blood pressure - can it be considered normal?

Treatment of low blood pressure

Low blood pressure usually does not require treatment, especially when it comes to asymptomatic hypotension. Treatment of symptomatic hypotension usually assigned depending on its cause.

To normalize the pressure is often recommended to change the diet, in particular, increase the intake of sodium.

Here are some non-pharmacological means of normalizing blood pressure:

  • Limit your caffeine intake
  • Increase your fluid intake
  • Exercise regularly (to improve blood flow)
  • Carefully stand up and lie down on the bed to keep from falling. When you get up, sit down on the bed first, and only then get up on his feet.
  • Do not take hot baths. Long-spa treatments are also contraindicated.

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  • pressure