Cardiac arrhythmia (or irregular heartbeat) is a disease of the cardiovascular system, which is characterized by any abnormal heart rhythm. The phenomenon is associated with a change in the regularity, frequency and sequence of heartbeats, the heartbeat can be either too frequent (development of tachycardia) or too slow (development of bradycardia). Some cases of arrhythmia can lead to cardiac arrest. Arrhythmia occurs at any age, in the upper and lower chambers of the heart, the atria and ventricles, respectively. Some types of illness are subtle, while others are more dramatic and fatal. Cardiac arrhythmia is considered one of the most common causes of death.
Mechanism of normal heart rate
To understand what an arrhythmia is, the reasons for its appearance, you should understand how myocardial contraction generally occurs. The mechanism of normal heart rhythm is provided by the cardiac conduction system, which isaccumulation of special highly specialized cells. These cells create electrical impulses and conduct them along special fibers that bring the heart muscle to work. Despite the ability of each node of the system to generate impulses to the heart muscle, the sinus node remains the main link here, which sets the necessary rhythm. It is located in the upper part of the right atrium. The impulses generated by the sinus node, like the rays of the sun, propagate from it in all directions. Some impulses are "responsible" for the contraction or excitation of the atria, while others help slow down contractions so that the atria have time to send the next portion of blood to the ventricles. This ensures the normal rhythm of our heart. Its violation can be caused by two problems:
- violation of the process of formation of impulses;
- violation of the conduction of generated impulses in the cardiac system.
For problems like these, the next node in the chain takes "responsibility" for keeping the heart rate working, but the heart rate slows down. This is how arrhythmia develops, the causes of which we will consider a little later.
Types of arrhythmia
Doctors classify arrhythmias depending not only on the place where they occur (atria or ventricles), but also on the rate of heart contractions. A fast heartbeat with a heart rate (HR) greater than 100 beats per minute is called tachycardia, and a slow heart rate with a heart rate of less than 60 beats per minute is called bradycardia. The causes of cardiac arrhythmias directly depend on the type of disease.
Not always tachycardia or bradycardia implies heart disease. For example, during physical exertion, a fast heartbeat is considered the norm, since an increase in heart rate allows oxygen to be provided to the body's tissues. During sleep or deep relaxation, the heart rate tends to be slower.
If the tachycardia occurs in the atria, then the disorder is classified as follows:
- Atrial fibrillation is a rapid heartbeat caused by chaotic electrical impulses in the atria. These signals result in rapid, uncoordinated, or weak contraction of the heart muscle. The causes of atrial fibrillation are the convulsive chaotic activity of the ventricles, which usually occurs against the background of other cardiovascular diseases. A phenomenon such as atrial fibrillation can cause serious complications, such as a stroke.
- Flutter - Similar to atrial fibrillation, the electrical impulses are more organized and rhythmic than in fibrillation. Fluttering also leads to stroke.
- Supraventricular tachycardia, or supraventricular tachycardia, which includes many forms of arrhythmia originating above the ventricles.
Tachycardias that occur in the ventricles are divided into the following subspecies:
- Ventricular tachycardia - is a fast regular heartbeat with abnormal electrical signals to the ventricles. This prevents complete filling of the ventricles and interferes with effectivepump blood.
- Ventricular fibrillation is an arrhythmia caused by inefficient pumping of blood due to ventricular tremor. This is a fairly serious problem and is often fatal if the heart cannot return to normal within a few minutes. Most people who experience ventricular fibrillation either have serious heart conditions or have experienced a serious injury, such as being struck by lightning.
Not always a low heart rate means that a person is developing bradycardia. If you are in good physical shape, then the heart is able to pump enough blood for 60 beats per minute at rest. Certain medications can also lower heart rate. However, if you have a slow heart rate and your heart is not pumping enough blood, you may have one of several types of bradycardia.
- Sinus arrhythmia, the causes of which are due to the weakness of the sinus node.
- Blockade of excitation of electrical impulses between the atria and ventricles. In this case, the patient may experience missed beats of the heart muscle.
- Premature heartbeat - occurs in the ventricles between two normal beats.
Causes of cardiac arrhythmias
A he althy person hardly ever suffers from such problems. When cardiac arrhythmia occurs, its causes are determined by various negative factors for the body. These can be changes in the heart muscle, ischemic disease,electrolyte imbalance in the blood, injuries after a heart attack, healing processes after heart surgery, and others. Heart rate is also associated with anxiety, physical activity, and medication.
It is important to understand that when a person has an arrhythmia, the causes and treatment of the disease for each age category of patients will be different. In children, for example, the disease occurs due to some factors, in adults - others. For a disease such as cardiac arrhythmia, general causes can be identified in the list:
- Disorders that damage the heart and valves (endocarditis, myocarditis, rheumatism).
- Thyroid disorders.
- Hereditary factors.
- Dehydration or lack of body potassium or other electrolytes.
- Damage to the heart due to a heart attack.
- Healing process after heart surgery.
The risk of getting sick increases with smoking, stress, excessive consumption of caffeine or alcohol, age, high blood pressure, kidney disease, and more.
Cardiac arrhythmia in children
In children, the disease is classified according to the location of the disturbance in the transmission of impulses, i.e. in the ventricles or atria. If an arrhythmia occurs in children, the causes of it should be looked for very carefully in order to increase the child's chances of recovery. Pediatric atrial arrhythmias include the following:
- premature atrial contractions;
- supraventricular tachycardia;
- atrial fibrillation;
- atrial flutter;
- gastric tachycardia;
- Wolff-Parkinson-White syndrome (a condition in which an electrical impulse can arrive at the ventricle too quickly).
Ventricular dysrhythmias in childhood include:
- premature contraction of the ventricles (early or extra heart beats);
- ventricular tachycardia (a life-threatening condition in which electrical signals are sent from the ventricles at a variable rate);
- ventricular fibrillation (irregular, disorganized heartbeats).
The following disorders are characteristic of pediatric bradycardia:
- sinus node dysfunction (cardiac arrhythmia in children, the causes of which are due to a slow heart rate);
- heart block (delay or complete block of the electrical impulse from the sinus node to the ventricles).
Symptoms of arrhythmia depend on the degree of maturity of the child. Older children can tell themselves about dizziness or a fluttering sensation in the region of the heart. In infants or toddlers, irritability, pallor of the skin, and lack of appetite are noted. Some common arrhythmia symptoms include:
- weakness, fatigue;
- violation of the heart rhythm and pulse;
- dizziness, fainting or pre-fainting conditions;
- pale skin;
- chest pain;
- shortness of breath, sweating;
- lack of appetite;
-irritability.
If cardiac arrhythmia develops in childhood, the causes of the disease are determined by the following factors: infectious diseases, taking certain medications, fever, fever. More serious causes include congenital malformations. In most cases, arrhythmias in children are harmless. However, when a change in heart rate occurs while the child is at rest, outside of play or exercise, parents should seek professional medical attention at a he alth facility.
Adolescent cardiac arrhythmias
If an arrhythmia occurs in adolescents, the causes may vary depending on sinus rhythm. In adolescence, the body is subject to multiple changes, which often causes various disorders. Such a phenomenon rarely becomes a pathology, changes rather occur at the physiological level and disappear over time. However, this does not mean that arrhythmias in adolescents should not be given importance. At the initial stage of the disease, a teenager needs a regular examination by a doctor who will monitor the dynamics of arrhythmia. If the symptoms of the disease do not disappear within 1-2 years, then the teenager certainly needs treatment.
The most common type of arrhythmia in adolescence is bradycardia. The disease is fraught with the fact that the child's brain does not receive the necessary amount of oxygen, which entails a deterioration in intellectual abilities, academic performance, slow reactions,inability to fully engage in sports and other problems.
The causes of arrhythmia at this age are not always associated with diseases of the cardiovascular system. The disease can be provoked by endocrine disorders, stress, nervous strain, hormonal changes in a teenager, pulmonary or bronchial diseases, colds accompanied by fever, and so on. With vegetative-vascular dystonia, the disease is most often phantom in nature, therefore, in the treatment of such children, it is important to prescribe sedatives and consult psychologists.
Cardiac arrhythmia in women
Women as a group present an interesting set of challenges for a cardiologist who specializes in cardiac arrhythmias. There are monthly changes in certain arrhythmias in which palpitations are a source of discomfort and concern for female patients, and there are certain risks when a woman is diagnosed with a cardiac arrhythmia. The causes, treatment of the disease and its symptoms depend on many different factors that should be considered.
Women have a higher prevalence of sick sinus syndrome, sinus tachycardia, atrioventricular nodal tachycardia and other types of disease. Causes of arrhythmia in women are associated with heart rhythm disturbances:
- ventricular tachycardia (comes from the lower chambers of the heart);
- supraventricular tachycardia (occurs in the upper chambers of the heart);
- premature atrial contractions (occur in both upper andlower chambers of the heart).
It is important to remember that irregular heartbeat is a symptom of an illness, not a diagnosis. Sometimes, when an arrhythmia appears, the causes of its occurrence can be associated with factors such as stress, nervous overexcitation, emotional distress. However, in these cases, careful diagnosis of the disease is necessary to exclude the possibility of more serious causes.
Arrhythmia during pregnancy usually occurs due to changes in the hormonal background of a woman. An increase in the level of estrogen and human chorionic gonadotropin affects the expression of cardiac ion channels, hemodynamic changes are characterized by an increase in circulating blood volume and a doubling of cardiac output. In addition, pregnancy increases sympathetic tone. All these changes in the female body contribute to the development of arrhythmias.
Cardiac arrhythmia in men
Heart disease is twice as common in men as in women. The most common forms of the disease are atrioventricular block, carotid sinus syndrome, atrial fibrillation, supraventricular tachycardia, Wolff-Parkinson-White syndrome, recurrent ventricular tachycardia, ventricular fibrillation and sudden death, and Brugada syndrome. Causes of arrhythmia in men are often associated with overweight, alcohol abuse, smoking, lack of physical activity, unhe althy diet, stress, taking certain medications.
Men with heart disease especiallyare prone to developing arrhythmias, since disturbances in the functioning of the heart muscle can cause cardiac arrest or a delay in the electrical signal from the sinus node to the ventricles. If an arrhythmia appears after eating, the causes of this condition are associated with the pressure of the stomach on the diaphragm. This causes compression of the sternum, pressure on the heart. Causes of arrhythmia in men are also associated with high blood pressure and an overactive thyroid gland, which also increase the risks.
Symptoms of the disease in adults
With a disease such as cardiac arrhythmia, the symptoms and causes of the disease are closely interrelated. So, for example, when the heart beats faster than normal, signs of illness include chest discomfort, palpitations, dizziness, headache, and hypertension. Bradycardia usually causes fatigue, dizziness, fainting or pre-syncope, low blood pressure.
Symptoms of arrhythmia in adults include general weakness, increased feeling of fatigue, heart rhythm and pulse disturbances. With slow heartbeats, the brain does not receive the right amount of oxygen, as a result of which patients report frequent dizziness, fainting or pre-fainting, they develop shortness of breath and sweating increases. The skin turns pale, covered with perspiration. With tachycardia, pain in the chest area is frequent, irritability increases, If flutters in the chest area are random, then they do not carry any danger. But if the pain in the heart becomes more frequent, and the person constantly has a feeling of weakness, the pulsebecomes irregular, it is time to see a doctor.
Arrhythmia treatment
Most forms of heart disease are considered harmless and do not require treatment. If a person has a heart arrhythmia, the causes and treatment of the disease usually depend on each other, since doctors choose the method of therapy based on the factors that provoked the disease. Treatment of the disease is usually aimed at preventing blood clots in the bloodstream in order to prevent the risk of stroke, restore a normal heart rhythm, control the heart rate in the normal range, reduce risk factors for cardiovascular disease.
If the bradycardia that occurs has no obvious cause, doctors usually resort to the use of pacemakers. A pacemaker is a small device that is placed near the collarbone. One or more electrodes with tips emanating from the device send electrical impulses through the blood vessels to the heart and thus stimulate regular heartbeats in a person.
For many types of tachycardia, the patient may be prescribed treatment to control the heart rate or restore a normal heart rhythm. Such therapy minimizes all possible complications. For atrial fibrillation, a doctor prescribes blood-thinning medications that prevent blood clots from forming in the bloodstream. In atrial fibrillation, the patient is prescribed medications withusing cardioversion to restore normal sinus rhythm.
In some cases, the patient may be recommended surgical treatment of arrhythmia. With a serious lesion of the coronary artery, the patient is offered coronary bypass surgery. This procedure improves blood flow to the heart. Radiofrequency ablation is performed in case of an increased number of heartbeats with an insufficient pulse. During the operation, the doctor makes punctures in the scar tissue, which can no longer conduct electrical impulses.
Prevention
In order to prevent heart disease, and in particular arrhythmias, you should lead a he althy lifestyle, follow the recommendations regarding proper nutrition, give up bad habits, avoid stressful situations, play sports.
