Paroxysm of supraventricular tachycardia is a rapid heartbeat up to 140-220 beats per minute. The attack can begin and end at any time, while the rhythm is regular. Ectopic impulses appear in the atria, ventricles, or AV junction.
This type of tachycardia is dangerous because the heart functions with a vengeance, while blood circulation is in poor condition. In addition, intermittent paroxysms of supraventricular tachycardia cause circulatory failure.
Types of paroxysmal tachycardia
Classification is made depending on the formation of impulses. That is why atrioventricular, ventricular and atrial forms are distinguished. The subpraventricular variety includes the atrioventricular and atrial types.
In accordance with the specifics of the development of the disease, there are: chronic form; acute form; manifesting continuously - especially severe, the duration of which can beendless, in connection with which there is a total lack of blood circulation and arrhythmogenic dilated cardiomyopathy.
Main causes of pathology and its symptoms
The paroxysm of supraventricular tachycardia is formed due to deviations of the nervous system or organic damage. In the first situation, with paroxysmal tachycardia, the heart muscle is subjected to nerve stimulation. Its mechanism is as follows: a pathogenic excitation area appears, causing abnormal myocardial activity. The heart rhythm is disturbed, untimely heart contractions, extrasystoles are diagnosed, supraventricular extrasystole is formed. This type of arrhythmia is the most common.
Organic causes of paroxysmal supraventricular tachycardia are as follows:
- damage to the heart muscle, cardiac pathways that occur during ischemia, heart attack, cardiopathies, myocarditis and heart defects;
- Wolf-Parkinson-White syndrome and other diseases in which additional pathways are formed;
- pathology of the heart, structural features of this organ: additional adhesions, chords, mitral valve prolapse.
Extrasystole and paroxysmal tachycardia can occur even in he althy people if there is exposure to pathogenic factors, as well as under severe stress and long-term high-efficiency exercise.
The listed reasons are called extracardiac. Among them are also bad habits of the patient,for example, alcohol abuse, smoking, addiction to products that contain too much caffeine. When atrial tachycardia is diagnosed, it is advisable to check the thyroid hormone levels. Pathologies of other organs can also cause paroxysmal supraventricular tachycardia. These include:
- renal dysfunction;
- acute and chronic pulmonary pathologies;
- diseases of the gastrointestinal tract.
Supraventricular tachycardia has a pronounced symptomatology that distinguishes it from the sinus variety. An abrupt onset of an attack and its sudden completion, the total duration can vary from one minute to several days.
The patient initially feels a significant push in the sternum, after which a pronounced rapid strong heartbeat appears. From 140 to 220 beats per minute is a lot of stress for the human body, so the patient feels the following symptoms:
- noise in the head;
- dizziness;
- squeezing the heart.
If there is no timely treatment, then in medical practice there are cases of hemiparesis and aphasia. In addition, an unstable paroxysm of supraventricular tachycardia often goes away simultaneously with the symptoms of autonomic disorders:
- excessive sweating;
- intestinal bloating;
- nausea reflex;
- mild subfebrile condition.
When the attack ends, the patient observes the release of a large amount of light urine with low valuesdensity. With the continuation of the paroxysm for a long time, blood pressure decreases, weakness appears, the person loses consciousness.
Very rarely paroxysmal supraventricular tachycardia appears on its own. Pathology is most often the result of another significant heart disease, so the patient needs a thorough examination and an accurate definition of the disease.
Emergency
It is necessary to be able to provide emergency care to a patient with paroxysmal supraventricular tachycardia (ICD-10 code - I47.1.). Especially significant is emergency qualified assistance, if a deterioration in a person’s condition is noticeable. She appears to be competent. In case of emergency, the actions should be as follows:
- Vagus samples. First, the Valsalva test is done, which is considered the most effective. The patient should tense up and stop breathing for thirty seconds. In addition, it is recommended to breathe deeply and rhythmically. Ashner's test is also done. This manipulation consists in the fact that for five seconds they press on the eyeballs. Testing is not allowed for severe heart failure, impaired conduction, stroke, discirculatory encephalopathy and glaucoma.
- Massage of carotid sinuses. However, such a procedure is prohibited in case of a sudden decrease in the heart rate.
- Dip your face in cold water for a few seconds. This method can also be useful in the relief of paroxysmsupraventricular tachycardia. From seizures, the following drugs are most often used: Verapamil, Aymalin, Adenosine Phosphate, Sotalol, Atenolol, Amiodarone, Procainamide, Propranolol. If such actions are ineffective, then electrical impulse therapy or transalimentary cardiac stimulation is used. Before the arrival of the ambulance staff, you need to calm the patient, lay him horizontally. It is necessary to provide the patient with an influx of fresh air. You can do vagal tests yourself.
This is the emergency treatment for paroxysmal supraventricular tachycardia.
Diagnostic features
For paroxysm of supraventricular tachycardia (ICD-10 code, see above), manifestations of an abrupt onset of an attack and an equally sudden end become typical. The attack itself is diagnosed in accordance with the rapid heartbeat, which rolls over 130 beats per minute at rest.
When comparing the supraventricular and ventricular types, we can say that they differ in the degree of increase in heart rate.
For example, the first is characterized by an excess of heart rate over 220-250, and the second is characterized by a cardiac rhythm of up to 180 beats per minute. Supraventricular tachycardia disappears when the vagal method is applied, and the ventricular variety is not affected by this procedure.
What changes can be registered using the ECG for a short paroxysm of supraventricular tachycardia?
- The P-wave polarity shape becomesother.
- The wave is placed differently relative to the ventricular component.
Atrial type is indicated by the standard placement of the P-wave before the QRS complex. When the paroxysm is due to an atrioventricular connection, the wave appears to be negative, located behind the complex, or connected to it completely. The ventricular variety well reflects the expansion of the complex component, most often the tooth is fixed in its usual form, however, ventricular extrasystoles are also visible.
In some cases, even an ECG with a paroxysm of supraventricular tachycardia is not able to clarify the situation and reveal a certain form of pathology. In this case, doctors prescribe an ECG during the day. Equipment is attached to the patient's body that registers and indicates short periods of paroxysm throughout the day, that is, within the limits of ventricular 3-5 complexes. These episodes are rarely felt by patients, but the ECG captures and stores them in memory.
If necessary, specialists use an endocardial ECG. In order for everything to be successful, you need to find a knowledgeable and experienced cardiologist in his field. Electrodes are inserted into the heart, fixed by the observation equipment, recorded by the doctor, and based on them, conclusions are drawn later, which allow the appointment of an effective and adequate treatment for the patient.
To exclude the possibility of an organic disease, it is also desirable to do an MCST, MRI or ultrasound of an organ with a pathology.
Treatmentparoxysmal supraventricular tachycardia
The patient needs hospitalization in the event that an attack does not stop on the spot or there is a lack of heart activity. Planned therapy is necessary if attacks occur more than twice a month. The disease should be treated using an integrated approach, which consists in building a daily routine, proper nutrition, the use of medications and physiotherapy procedures. The cardiologist usually prescribes beta-blockers. These drugs include Metaprolol, Anaprilin, Propranolol, Atenolol, Obzidan, Vasocardin. In addition, sedative medications, such as tranquilizers or barbiturates, are used in the treatment.
When accompanied by a paroxysm of supraventricular tachycardia with heart failure, drugs based on foxglove are used: Isoptin, Digoxin. Medicines that contain potassium are also prescribed. It must be remembered that such tools are very powerful. That is why a cardiologist should choose them, taking into account the severity of the disease, as well as the individual characteristics of the body. During the treatment, physiotherapeutic procedures are recommended that are associated with water (therapeutic baths, baths with hydromassage, circular showers). In severe situations, surgical methods are used. These include: pacemaker implantation; destruction with catheters; radiofrequency ablation.
Anti-relapse treatment
Furtherdrug treatment is carried out in accordance with the manifestation of seizures. When there is no result from self-stopping, the patient is prescribed a long course, which includes such medications as Quinidine, Celanide, Etmozin, Digoxin, Amidaron, Desopyramid, Verapamil.
Continuous use of cardiac glycosides reduces the frequency of recurrence of attacks and alleviates the severity of the pathology. If there is no positive effect from anti-relapse therapy, surgical intervention is used, including ablation with radio frequencies, destruction of additional impulse production pathways, the use of pacemakers that have programs of one or another stimulation of cardiac activity.
Diet
Also an important part of the treatment is the right diet. That is why you need to abandon such products that cause tachycardia. Unhe althy foods are: confectionery, coffee, starchy foods, lard, fatty meats, butter, mayonnaise, sour cream, fried foods, margarine, canned food.
These foods contain too much cholesterol, which is bad for the heart. In addition, s alt intake should be minimized. It is recommended for paroxysmal tachycardia to eat low-fat and vegetable foods. The diet should contain the following foods: vegetables, cereals, dried fruits, low-fat dairy and dairy products, fruits, seafood, nuts, vegetable oil.
Eat small meals at least six times a day. Apart fromFor this, you should stop smoking and drinking alcohol. During treatment, it is necessary to avoid stressful situations and overstrain of the psyche. Adequate sleep and moderate exercise are required. Patients are monitored for cholesterol and blood sugar. You can take medicinal plants at home to cure tachycardia. The most effective remedies are from motherwort, viburnum, wild rose, lovage, hawthorn and valerian.
How to treat tachycardia with home remedies
Traditional medicines can stop an attack and alleviate a person's condition. To cure the patient, it is necessary to restore the proportion of electrolytes in the blood. Supraventricular paroxysmal tachycardia is characterized by a serious imbalance. It is necessary to restore the following substances: potassium, calcium and chlorine. This can be achieved through treatment with vegetable glycosides and herbs. These include: valerian, motherwort, mint, hawthorn and lemon balm.
You can be treated without pills with the following compositions:
- 40 g of lovage roots should be poured with a liter of hot water and strained after eight hours. Drink in small portions throughout the day until the condition improves.
- Pour three cups of viburnum berries into a three-liter container, then pour two liters of boiling water, close the container, wrap and insist for six hours. The broth is filtered, the fruits are squeezed out, 0.5 liters of honey is added, and the jar is placed in the refrigerator. Drink a third of a glass before meals for a month. Then rest for ten days and resume treatment again. Atparoxysmal arrhythmia only requires three cycles.
Pharmacy tinctures of valerian, hawthorn and motherwort are mixed, one bottle each. The composition is put in the refrigerator, you need to drink three times a day, before meals, a teaspoon.
What to do during an attack?
When an attack of paroxysmal tachycardia happened at home, you need to act like this:
- calm down, do not panic and cope with emotions;
- in case of weakness, sudden dizziness and nausea, lie down or sit comfortably;
- the patient must be supplied with fresh air, it is necessary to open the window and unfasten the clothes;
- cause irritation of the vagus nerve: hold your breath for twenty seconds, put pressure on your eyeballs and tighten your chest press;
- drink drugs prescribed by a specialist, observing the prescribed dosage;
- if you feel worse, call an ambulance.
Yoga Breathing
With paroxysmal tachycardia, yoga breathing and other similar techniques help. The methods of Buteyko and Strelnikova are also suitable. Examples of breathing exercises that are performed to relieve an attack are as follows:
- one nostril is closed with a finger, through the free one you need to inhale, then exhale through the one that was clamped before;
- inhale for three counts, do not breathe for two counts and exhale for three counts, hold for two countsbreath.
We looked at what it is - a paroxysm of supraventricular tachycardia.
