In recent years, there have been more patients who complain of pain in the heart area. After the examination, it turns out that most of the patients have experienced serious changes in the work of the heart muscle, and they need emergency care and urgent hospitalization. Often there is a disease such as atrial fibrillation, in which the heart wears out a lot, which subsequently leads to the development of pathologies in other body systems. One of the forms of atrial fibrillation is paroxysmal, how dangerous it is, how it manifests its symptoms, every person needs to know.
What is this pathology?
Atrial fibrillation of the paroxysmal form is a disease with serious violations of the coordination of the contractile movements of the myocardial muscle fiber. The disease is common, but as an independent condition it is very rare, most often it is an indirect sign of diseases of the heart, respiratory systems and blood vessels.
Paroxysmal atrial fibrillation is expressed inperiodic changes in the work of the sinus node, in which the atrial myocytes move in a disorderly manner, their frequency can reach up to 400 contractions per minute. As a result, only the ventricles work out of the 4 chambers of the heart, which adversely affects the work of the entire circulatory system.
Causes of paroxysmal form
Paroxysmal form of atrial fibrillation according to ICD-10:
- I 48 is atrial fibrillation and flutter;
- I 00-I 99 - diseases of the circulatory system;
- I 30-I 52 - other heart diseases.
The main and main reason for the development of the disease is one - these are diseases of the cardiovascular system:
- cardiac ischemia;
- hypertension;
- all forms of heart failure;
- all kinds of heart disorders that provoked the inflammatory process;
- congenital or acquired defects of the heart muscle;
- genetic cardiomyopathies.
But there are causes of the paroxysmal form of atrial fibrillation that are not associated with cardiac pathologies:
- Smoking and alcohol abuse, drug addiction.
- Electrolyte imbalances when there is a magnesium-potassium deficiency.
- Structural ailments of organs and tissues of the respiratory system.
- Acute form of infectious invasion.
- Post-surgery conditions.
- Diseases of the endocrinesystem.
- Treatment with adrenomimetics, cardiac glycosides.
- Chronic stress.
What are the forms of paroxysmal atrial fibrillation?
This form of arrhythmia is a malfunction in the functioning of the heart muscle, which can last an average of about 7 days. If the changes are observed longer, then cardiologists give the patient a chronic form.
Cardiologists divide the disease into several forms and types. First of all, it is taken into account with what frequency the atria contract, therefore, they are isolated:
- typical flickering at 300 beats per minute;
- demonstrative flutter no more than 200 contractions.
Despite the intensity of the work of the atria, not all impulses are conducted to the ventricles of the heart. If we classify the disease according to the frequency of contractions, then there are such forms:
- tachysystolic, in which the contraction of the ventricles is no more than 90 per minute;
- bradysystolic - less than 60;
- normosystolic or often called intermediate.
According to the clinical course, an intermediate form of pathology is considered optimal. Attacks of atrial fibrillation of the paroxysmal form can be repeated, in which case it is called recurrent.
Regarding the location of the foci of increased impulse, paroxysm can be divided into three types:
- atrial arrhythmia is when impulses are generated in the atrial node;
- ventricular arrhythmia - impulses originate in the conduction systemventricles;
- mixed type has several centers at once.
Symptoms of the disease
There are many direct and indirect causes of paroxysmal arrhythmia, symptoms may vary from patient to patient. So some patients may experience discomfort in the region of the heart, while others can be traced such manifestations:
suddenly heart starts beating faster;
- severe weakness throughout the body;
- lack of air;
- cold limbs;
- shivering in rare cases.
Also, patients may experience pallor of the skin and cyanosis of the lips. If the patient's case is complicated enough, then other symptoms may occur:
- dizziness;
- loss of consciousness;
- half faint;
- panic.
But you should not worry right away, perhaps such symptoms indicate illnesses that have nothing to do with the heart. Only an ECG can pinpoint the cause.
After an attack of paroxysmal atrial fibrillation, patients may increase the contractility of the smooth muscles of the intestine and experience increased urination. When the heart rate drops to the lower limit, the blood circulation in the brain worsens significantly. This condition can manifest itself in the form of loss of consciousness, respiratory arrest, it becomes difficult to determine the pulse. In this case, the patient should be urgently sent to intensive care.
Diagnostic methods
By frequency andrhythmic contractions of the heart determine the clinic of the disease. The main thing is to investigate the rhythm and filling of the pulse, since its deficiency is often observed in atrial fibrillation.
To accurately determine the form of paroxysmal atrial fibrillation, you need to go through a series of studies:
- myocardial auscultation - during fibrillation, an arrhythmic heartbeat is observed, atrial flutter manifests itself in the form of a loss of each subsequent beat;
- electrocardiography allows you to notice how the QRST complex changes in the ventricular variant of the disease, if the shape of the R wave is distorted and there are signs of conduction disturbance in the right leg of the His bundle with an atrial form, a change in the P wave or if it is superimposed on QRST, then this indicates to the combined form of the disease;
ECHOCG makes it possible to assess the shape and size of the atria, what is the condition of the heart valves
Before the doctor sends the patient for examination, he carefully studies the medical history (atrial fibrillation, paroxysmal form and type), learns about concomitant pathologies. If the patient is engaged in hard work, then this is a serious hindrance to the treatment of the disease. Concomitant diseases will help you choose the most effective treatment regimen.
Complications
Frequent interruptions in the work of the heart with rapid beats lead to the fact that the myocardium is overstrained. The paroxysmal form of cardiac arrhythmias causes serious disruptions in blood circulation, which can eventually provoke the formation of blood clots andthromboembolism. That is why it is urgent to take all possible measures and start treating the paroxysmal form of fibrillation as soon as possible, otherwise the patient may have the following consequences:
- state of shock - when blood pressure drops rapidly, the ventricular rate decreases;
- development of acute heart failure;
- swelling of lung tissue - cardiac asthma;
- arrhythmic cardiomyopathy;
- deterioration of nutrition of brain tissue.
If the attack proceeds unfavorably, then there is a risk of developing thromboembolism. Blood clots can accumulate in the diseased atrium, which can migrate to other parts of the body. Just two days after paroxysmal atrial fibrillation due to blockage of the arteries, a heart attack, stroke or gangrene can develop.
Atrial fibrillation emergency
Before a patient with paroxysmal atrial fibrillation receives emergency medical care, he must be helped at home. Help is to exert a mechanical effect on the vagus nerve:
- Valsalva test involves an attempt to inhale, while blocking the access of air. Cover nose and mouth with palms and inhale.
- Ashner's test involves pressing your fingers on the inner corner of the eye, but you just need to do everything as carefully as possible so as not to cause harm.
- The Goering-Chermak test is carried out usingpressure on the carotid artery to reduce oxygen supply and heart beats per minute.
- Spongling with cold water will help slow down your breathing and heart rate.
You can stop an attack if you provoke a gag reflex
It is very important to send the patient to the hospital immediately after the attack, otherwise even experienced doctors will find it difficult to restore sinus rhythm two days after the attack.
Medicated treatment
In the hospital, doctors use the following drugs:
- "Digoxin" - helps control heart rate;
- "Kordaron" has a minimum number of undesirable manifestations, which in this case is a significant plus;
- "Novocainamide" - if administered quickly, helps to lower blood pressure.
All of these drugs are administered intravenously. Most patients experience relief within the first hours after such treatment.
The doctor may recommend the treatment of paroxysmal atrial fibrillation with Propanorm, which is available in the form of tablets, so the patient can take it without assistance.
Electropulse treatment
If drug treatment has not brought relief to the patient, then in this case the doctor may recommend electrical impulse therapy. This procedure is as follows:
- the patient is given anesthesia;
- overtwo electrodes are placed in the heart and under the clavicle on the right side;
- the doctor on the device sets the synchronization mode, this is necessary in order for the discharge to fully correspond to the contraction of the ventricles;
- the desired current value is set, it can vary from 100 to 360 J;
- produces an electrical discharge.
Thus, the doctor, as it were, resets the heart system. The method is almost 100% effective.
Surgery
Surgery is recommended for patients with frequent attacks when medical treatment of paroxysmal atrial fibrillation has not given the desired result.
The operation consists in cauterization of foci of excitation of the heart muscle with a laser. To carry out the procedure, the artery is pierced and special catheters are inserted into it. The effectiveness of the procedure by the method of radiofrequency ablation is more than 80%. If the first procedure did not give the desired effect, then it is repeated.
Traditional medicine for atrial fibrillation
Before using folk methods in treatment, you should consult with your doctor so as not to harm your he alth, which is already shaken. If there are no contraindications, then you can apply the following recipes:
- They take hawthorn and its tinctures for alcohol, motherwort and valerian. You need to take three bottles of each tincture and mix in one container, shake everything well and send it to the refrigerator for the whole day. A day lateryou can start taking 1 teaspoon three times a day half an hour after eating.
- Take half a kilo of lemons, finely chop them and pour honey, add 20 apricot pits. Eat the healing mixture twice a day, 1 tablespoon.
- You will need Adonis herb 4 grams, which is poured into a glass of water and boiled in an enameled container for no more than 3 minutes. After that, set aside the broth for 20 minutes in warmth. Take a decoction of one tablespoon three times a day.
Features of the paroxysmal form of atrial fibrillation are such that attacks can occur at any time, which is why the patient should always have a remedy in the access area that will help him to transfer it more easily. But it is better to get qualified help from a specialist after the first attack and do everything possible so that it does not happen again.
Prevention and prognosis of the disease
Patients who have already had heart failures or have relatives with serious problems in the family must be prevented from heart disease. In addition, you need:
- reduce or even completely eliminate the consumption of alcoholic beverages;
- avoid serious physical activity, it is better to replace them with leisurely walks in the fresh air;
- eat a balanced diet, exclude all fatty and spicy foods rich in potassium and magnesium;
- take sulfate, asparaginate as a preventive measure.
As for the prognosis for a patient with paroxysmal atrial fibrillation, it cannot be calledunfavorable, especially if the attacks did not provoke the development of more serious pathologies. If you follow all the doctor's recommendations, then the patient can live for decades with such a diagnosis.
The incidence of serious pathologies in people with this diagnosis is one in 6 people, which gives a good prognosis for each patient. It is important to change your lifestyle and follow all the recommendations.
