The term "extrasystole" refers to a pathological condition, the course of which is accompanied by a violation of the heart rhythm. The reasons can be very diverse. Extrasystole can be both an independent disease and indicate the progression of another disease in the body. In all cases, if there are warning signs, you should consult a doctor. This is because this type of arrhythmia can lead to sudden cardiac arrest.
Pathogenesis
In the human body, the conduction system of the heart acts as a regulator of the number of myocardial contractions. It is represented by the following structures:
- Muscular pathways.
- Sinoatrial node.
- Atriventricular node and bundle.
- Internodal atria.
An impulse is born in the sinoatrial node. He is the impetus forthe occurrence of arousal. It, in turn, provokes depolarization of the internodal atria. Then the excitation passes through the atrioventricular node and is transmitted through the bundle to the ventricles.
Under the influence of various unfavorable factors, the process of generating additional impulses is started in some part of the conducting system. Naturally, the heart reacts to them with extraordinary contractions - extrasystoles.
Excitation always comes from an abnormally changed area. Such zones in medicine are called ectopic. It is worth noting that extrasystole is a condition that is often diagnosed in practically he althy people.
Etiology
The disease is the most common type of arrhythmia. According to statistics, it is diagnosed in 65% of practically he althy people who do not make any complaints about their state of he alth. In this case, it is customary to talk about functional extrasystole.
Often an ailment is a sign of another disease. In this situation, the pathology is organic in nature and requires a comprehensive diagnosis. It must be understood that extrasystole is a condition that may indicate a malfunction of not only the cardiovascular, but also other systems.
The main reasons for the development of functional extrasystole:
- Long exposure to stress.
- Neuroses.
- Long-term use of certain medications.
- Cervical osteochondrosisspine.
- Neurocirculatory dystonia.
- Frequent and vigorous exercise.
- Tobacco smoking.
- Frequent consumption of alcoholic beverages.
- Overwork.
- Intoxication process.
- Regular drinking of strong coffee.
- Weakening of the body after suffering an infectious disease.
- Thyrotoxicosis.
- Uremia.
Main causes of organic extrasystole:
- Cardiosclerosis.
- Past myocardial infarction.
- Defect of the heart.
- Inflammatory processes of various etiologies.
- Diseases of a systemic nature, the course of which is accompanied by damage to the heart muscle.
- Impaired ion metabolism.
- Ischemic heart disease.
- Hypertension.
- Myocarditis.
- Heart failure.
- Cardiomyopathy.
- Pericarditis.
It is worth noting that extrasystole is a condition that can occur regularly in any person. It is customary to talk about pathology only if there are more than 200 unscheduled contractions per day.
Regardless of the causes of extrasystole, it is impossible to delay the treatment of the disease. This is due to the fact that it can lead to the development of all kinds of complications and even death.
Classification
Depending on the zone of formation of ectopic foci, the following types of extrasystoles are distinguished:
- Ventricular. It is diagnosed in 62.6% of cases. I49.3 - ICD-10 code for ventricular extrasystole.
- Atrioventricular. It is found only in 2% of cases. ICD-10 code - I49.2.
- Atrial. It is diagnosed in 25% of cases. I49.1 - ICD-10 code.
In isolated cases, an unscheduled impulse is formed in the sinoatrial node. There are also situations when a patient is diagnosed with a combination of several types of illness.
The most common is ventricular extrasystole (ICD-10 code, see above). As a rule, it is functional in nature, but the possibility of serious pathologies cannot be ruled out. The difficulty lies in the fact that the change in MPP (untimely depolarization) is often asymptomatic. But it is important to remember that the prognosis directly depends on the timeliness of the visit to the doctor.
One or more sources of excitation can form in the conduction system of the heart. Depending on this, extrasystoles can be:
- Monotopic. In this case, it is customary to talk about the presence of one ectopic site. On the ECG, the extrasystole in this case has stable intervals.
- Polytopic. There are several ectopic zones in the body. On the ECG, the extrasystole has different clutch intervals.
In addition, during the diagnosis, non-sustained paroxysmal tachycardia can be detected. This is a condition in which several extrasystoles are detected, going directly one after another.
Currently, several classifications are used in medicine. Mostcommon is the gradation of ventricular extrasystoles according to Laun - Wolf:
- I class. The number of unscheduled cuts is 30 per hour or less. Such an arrhythmia does not pose a threat to either he alth or life. Even if symptoms of extrasystole are present, treatment is not required.
- II class. The number of unscheduled cuts is 31 per hour or more. In this case, it is customary to talk about a slight deviation from the norm. This condition does not lead to the development of complications. The decision on the advisability of prescribing medications should be made by the doctor, based on the history and diagnosis.
- III class - polymorphic extrasystoles. A lot of unplanned heart contractions are diagnosed on the ECG. To avoid the development of negative consequences, it is necessary to take medicines.
- IV-a class. These are paired extrasystoles that follow directly one after another. In this case, it is customary to speak of a class of high gradation, which often leads to complications.
- IV-b class. These are salvo extrasystoles, that is, those that seem to shoot 4-5 at once. In this case, doctors talk about a class of high gradation, which leads to irreversible changes. Moreover, this condition poses a danger not only to he alth, but also to the life of the patient.
- V class - early extrasystoles. This is the most severe condition that leads to cardiac arrest.
Thus, regardless of the severity of the symptoms and causes of extrasystoles, treatment should not be delayed. Ignoring warning signscould cost lives.
Clinical picture
The difficulty lies in the fact that the disease has no specific symptoms. Moreover, it often proceeds without any symptoms. According to statistics, in 70% of cases this type of arrhythmia is detected randomly during a preventive medical examination.
The intensity of symptoms directly depends on the following factors:
- The state of the cardiovascular system.
- Age of the person.
- Type of disease.
- The degree of reactivity of the organism.
If a person is relatively he althy, there is a high probability that he will not feel the symptoms of extrasystoles. In the presence of serious pathologies, the following clinical manifestations occur:
- Pain in the heart area.
- The appearance of a feeling of anxiety for no apparent reason.
- Feeling that the heart is beating hard against the chest.
- Excessive sweating.
- Heart sinking.
- Feeling very short of breath.
- Pale skin.
- Weakness.
- Hot flashes.
- People suffering from cerebral atherosclerosis experience frequent episodes of dizziness.
Patients compare the sensations that arise with the signs of a panic attack. It seems to them that their heart has stopped and death is near. But this state lasts only a couple of seconds.
Regardless of the severity of the symptoms of extrasystole, it is better not to delay the treatment of the disease. This is duethe fact that in severe cases the heart can really stop one day.
Diagnosis
When the first warning signs appear, you need to contact a cardiologist. The doctor will be able to suspect the presence of extrasystoles already at the stage of collecting anamnesis and physical examination.
The following information is clinically relevant to the clinician:
- Circumstances of discomfort.
- Whether the patient is taking any medication.
- How often do you worry about signs of arrhythmias.
- What diseases the patient had in the past. It is important to remember that extrasystole is such an ailment that can be a complication of many pathologies.
During the examination, it is fundamentally important to find out the etiology of the disease. Only after that the doctor will be able to understand how to treat extrasystole of the heart.
During the palpation of the pulse (this is done on the radial artery), the cardiologist can fix a sudden wave and the pause following it. And this already indicates insufficient filling of the ventricles.
An important study is auscultation of the heart. During its conduct with extrasystole, premature I and II tones can be heard. At the same time, the first one is strengthened, which is a natural consequence of insufficient filling of the ventricles. The second tone is weakened, this is due to the fact that the volume of blood entering the aorta and pulmonary artery is reduced.
Most often, the diagnosis of "extrasystole" is confirmed after a standard anddaily ECG. The disease is often detected during these studies, when the patient has no complaints.
Electrocardiographic signs of pathology:
- Untimely occurrence of the P wave. It appears earlier than it should. On the ECG, you can notice a shortening of the interval between the wave that reflects the main rhythm and the one that indicates the occurrence of an extrasystole.
- The presence of expansion, deformation and high amplitude of the QRS complex. A similar condition is characteristic of ventricular extrasystoles.
- After an unscheduled impulse, a compensatory pause follows.
Holter ECG monitoring is a study that involves recording electrocardiographic data during the day. At this time, a special apparatus is fixed on the patient's body. In addition, the patient should keep a diary in which he needs to reflect all his feelings. Holter ECG monitoring is prescribed for all patients suffering from cardiopathologies, regardless of whether they have signs of extrasystole or not.
It happens that the disease is not detected during the ECG. To confirm their suspicions, the doctor may order the following tests:
- Bicycle ergometry.
- MRI.
- Ultrasound of the heart.
- Load test.
Only based on the results of the diagnosis, the doctor will be able to provide information regarding how to treat extrasystole.
Therapy
The choice of patient management tactics is carried outcardiologist. Many patients wonder whether it is necessary to treat cardiac extrasystole at all. As mentioned above, episodically occurring arrhythmia, which is functional in nature, does not pose a danger to either he alth or life. In this regard, this condition does not require therapeutic measures.
Very often, women complain that episodes of irregular heart rhythms bother them a few days before menstrual bleeding. This condition is also a variant of the norm and does not require correction.
In persons suffering from vegetovascular dystonia, extrasystole manifests itself very pronouncedly. If the arrhythmia causes severe discomfort, it is necessary to reduce the intensity of physical activity, abandon stimulants, avoid getting into stressful situations and include foods that contain magnesium in the diet.
In the presence of serious pathologies (heart defects, ischemic heart disease, etc.), complex treatment is required. This is due to the fact that the abnormal rhythm aggravates their course, which can lead to negative consequences.
In all other cases, the expediency of therapeutic measures is assessed by the doctor. The specialist takes into account the form of the disease and its severity.
Information on how to treat extrasystoles should be provided by a cardiologist. The classical scheme of therapy is as follows:
- The primary task is to reduce the number of unplanned layoffs. Antiarrhythmic treatment can significantly improve the quality of lifepatients. Prescribed for extrasystole drugs of the first, second or third generation. The most effective means are Kordaron and Amiodarone. The indicator of their effectiveness is more than 70%. The second generation drugs include: "Bisoprolol", "Atenolol", "Metoprolol". The effectiveness rate of these beta-blockers varies between 50-70%. Third generation drugs: Panangin, Diltiazem, Verapamil, Carbamazepine. They are less than 50% efficient.
- Control over the functioning of the gastrointestinal tract and organs of the endocrine system. If pathologies are detected, appropriate treatment is carried out.
- Correction of the diet. In the presence of pathologies of the cardiovascular system, it is imperative to include foods rich in magnesium in the menu. The diet should include: beans, seaweed, apples, bananas, all kinds of cereals, prunes, raisins, dried apricots, persimmons, nuts, lettuce.
- Adjusting the degree of physical activity. In the presence of extrasystole, high-intensity training is contraindicated. Swimming, cycling and walking at a moderate pace is recommended.
- If, against the background of extrasystoles, patients experience a decrease in working capacity and sleep disorders, the doctor prescribes sedatives or tranquilizers.
This scheme can be adjusted by the doctor based on the medical history and diagnostic results of a particular patient.
Possible Complications
Almost everyonethe patient is interested in the question regarding what is dangerous extrasystole. And the disease really poses a threat not only to he alth, but also to life. The danger of the disease lies in the fact that it very often leads to the development of all kinds of complications.
Consequences of extrasystole:
- Paroxysmal tachycardia.
- Atrial fibrillation.
- Chronic insufficiency of coronary, renal and cerebral circulation.
The most dangerous is ventricular extrasystole. According to statistics, it is she who most often leads to sudden death.
Forecast
The outcome of the disease directly depends on its type and the timeliness of going to the doctor. The most favorable prognosis is considered if episodes of extrasystole occur in practically he althy people. In this case, the arrhythmia does not in any way affect the quality of life and activity score.
The effectiveness of the therapy largely depends on the state of the cardiovascular system. The most unfavorable prognosis is considered if the development of extrasystole was provoked by the progression of myocarditis, acute myocardial infarction or cardiomyopathy. In this case, most often there are complications that can lead to death. That is why it is necessary to consult a doctor at the first warning signs.
Prevention
In order to prevent the development of pathology, several important rules must be observed. They arerefer to activities carried out as part of both primary and secondary diagnostics.
What to do:
- Regularly undergo preventive examinations and promptly treat all detected diseases, especially pathologies of the cardiovascular, circulatory, endocrine and nervous systems.
- Do not take any medication that is not approved by your doctor. This is especially true for hormonal drugs, sedatives and tranquilizers.
- Follow the principles of a he althy lifestyle. Physical activity should be moderate, and the diet should be balanced. In the presence of any violations of the functioning of the heart muscle, it is necessary to include foods rich in magnesium in the menu.
Extrasystole is an ailment characterized by a relapsing course. In this regard, the treatment of the underlying disease should be complete. In addition, it is necessary to regularly visit a cardiologist in order to prevent the development of various complications.
In conclusion
Extrasystole is a pathology, the course of which is characterized by the occurrence of unplanned contractions of the heart. The disease, depending on the localization of ectopic areas, has several types. The most dangerous and common is ventricular extrasystole. If you experience anxiety symptoms, you should contact a cardiologist. The doctor will issue a referral for a comprehensive diagnosis, based on the results of which he will draw up the most effective treatment regimen.
