Extrasystole is a fairly common disorder, especially when it comes to elderly patients. This condition is accompanied by a violation of the normal heart rhythm. And today more and more people are interested in questions about what causes such a problem, how dangerous it can be for he alth.
Extrasystole - what is it?
Today, many clinic patients face a similar problem. So what is extrasystole? This is a disorder that is associated with certain heart rhythm disturbances. With such a disease, extraordinary contractions (systoles) of either the whole myocardium or its individual parts (for example, atria, ventricles) are observed.
Extrasystole - the norm or a threat to he alth?
Of course, today many people are faced with a similar problem. So just how dangerous can these disorders be? In fact, extraordinary contractions can occur and, in fact,In other words, they occur at any age. For example, often young people complain about the feeling of a strong heart attack, this is extrasystole. Moreover, according to statistics, about 80% of people over fifty suffer from periodic "unscheduled" shocks from time to time.
What causes systole? With some disorders of the heart and blood vessels, the conduction system changes: the so-called ectopic foci, areas of increased activity, are formed in it. Most often, such a disorder appears in the conduction pathways of the ventricles, atria, and atrioventricular node. It is these ectopic foci that generate impulses that trigger the mechanism of heart contraction in the phase of its relaxation (diastole). This is what an extrasystole looks like. This, by the way, can be extremely dangerous.
Of course, occasional impulses do not pose a serious threat to human he alth. Nevertheless, they signal the presence of a particular problem, experts recommend that such patients pay more attention to their lifestyle, monitor nutrition and undergo regular examinations.
On the other hand, too frequent extrasystoles affect the work of the whole organism. Indeed, as a result of multiple extraordinary contractions, the release of blood decreases, which leads to a decrease in blood flow in the brain and coronary vessels. In such cases, extrasystole of the heart is extremely dangerous, as it can lead to damage to the myocardium, fainting, or even sudden death of a person.
Irregular heart rhythm: causes
In fact, there are many factors under the influence of which an extrasystole attack may occur. For example, an abnormal heart rhythm can be associated with exposure to certain chemicals in the body, including certain foods, alcoholic beverages, drugs, even strong tea or coffee. Smoking is also a risk factor. Functional extrasystole of the heart can also occur in women during menstruation.
In addition, the causes include some diseases, including osteochondrosis of the spine (especially the cervical), as well as vegetative dystonia, neurosis of various origins and others.
There are other factors under the influence of which there is a violation of the rhythm of the heart. The reasons may be associated with organic lesions of the myocardium and the conduction system. For example, seizures often occur in patients with various defects, as well as against the background of cardiosclerosis, cardiomyopathy, coronary disease, inflammatory diseases (myocarditis, pericarditis). Diseases such as hemochromatosis, sarcoidosis, and amyloidosis are also considered risk factors, since in such conditions the risk of heart damage is high.
An attack of extrasystole often occurs against the background of a severe fever. In addition, certain drugs can cause the same effect, including those drugs that contain caffeine, ephedrine, aminophylline, novodrine, as well as tricyclic antidepressants, diuretic drugs and glucocorticoids.
Severe stress, physical overexertion, violation of contentminerals in myocardial cells - all this can provoke an attack of increased contraction of the heart muscle.
Classification of violations
Of course, today there are many classification systems that make it possible to understand what constitutes extrasystole - for example, depending on the location of the ectopic focus. Most often, rhythm failures are observed in the ventricles, more than 60% of patients go to the doctor with this diagnosis.
Atrial extrasystole is observed in 25% of cases. Much less often, foci of rhythm disturbance occur in the atrioventricular junction, in such cases they are called atrioventricular. In addition, various combinations of the above forms are observed.
In some cases, the main sinus rhythm is maintained simultaneously with the formation of an ectopic focus, such a violation is called parasystole. Violations are also classified according to the number of foci of excitation, they can be either mono- or polytopic.
If extrasystoles go two in a row, then they are called paired. If extraordinary contractions follow the “more than two in a row” pattern, then this is a volley extrasystole. In addition, such disorders are divided into groups depending on the moment of their occurrence during cardiac contraction (these are early, middle and late). If we take into account the frequency of occurrence of extrasystoles, then they can be rare (extraordinary contractions less than 5 per minute), medium (from 6 to 15) or frequent (for example, frequent ventricular extrasystole is accompanied by morethan 15 extraordinary ventricular contractions per minute).
Naturally, there is a system by which extrasystole is classified depending on its origin. For example, cardiac arrhythmias may be associated with organic or toxic tissue damage, physiological disorders.
How is extrasystole manifested?
In fact, not all patients have signs of heart disease, sometimes rhythm disturbances are detected by chance during a planned electrocardiogram. Moreover, there are many factors that can influence the number and intensity of traits present. For example, patients with organic myocardial lesions can tolerate attacks of extrasystole quite easily, while the clinical picture in people with vegetovascular dystonia looks much more difficult.
Most often, subjectively, the extrasystole is felt as a strong push, even a heart beat against the chest from the inside. In some cases, patients note that they feel as if the heart is “turning over” or even “somersaulting”. Such sensations are associated with a strong, vigorous and sharp contraction of the myocardium.
In some patients, an attack of extrasystole is somewhat reminiscent of the symptoms of coronary disease or angina pectoris. Extrasystole, which is associated with functional changes, is often accompanied by other signs. For example, patients complain of increased sweating, a feeling of lack of air, hot flashes, severe, sudden weakness, and discomfort. Sometimesthere is also an inexplicable feeling of anxiety, even fear.
There are other signs of heart disease. For example dizziness. Frequent atrial or ventricular extrasystole is accompanied by a decrease in blood ejection, which causes this symptom. In patients with cerebral atherosclerosis, such rhythm disturbances can lead to circulatory disorders, which is accompanied by paresis, fainting, aphasia, and other disorders. In any case, when such conditions appear, you should immediately consult a doctor, as the consequences can be extremely dangerous and severe.
Extrasystole in childhood
In fact, extrasystole in children is diagnosed quite often. A child of any age can suffer from it, sometimes such a disorder is recorded even during fetal development. According to statistics, more than 75% of children in varying degrees suffer from heart rhythm disturbances. Moreover, over the past decade, the number of babies with similar disorders has increased significantly.
What are the main causes of heart rhythm disturbances in children? First of all, it is worth noting congenital malformations and cardiomyopathy. In addition, the most common include infectious myocarditis, rheumatic heart disease, genetically determined diseases.
In some cases, the disease is associated with some disorders of the endocrine and nervous system. For example, hypothyroidism or diabetes mellitus can lead to the appearance of extrasystole. On the other hand, chronic inflammatory and infectious processes are important, as well asavitaminosis and deficiency of certain elements, too much physical or emotional stress. In any case, such a disorder needs proper treatment. As for the prognosis, the average or rare extrasystole, which is not accompanied by organic heart damage, is considered a relatively safe form of the disease.
Modern diagnostic methods
Naturally, there are many diagnostic methods, including ECG. Extrasystole in such a study, as a rule, is clearly visible. However, the diagnostic process does not begin with this. To begin with, the doctor is required to conduct a complete examination, which begins with the collection of information. The patient should tell the specialist what symptoms he has, how intense his attacks are, how often they occur.
It is extremely important to determine the cause of heart rhythm disturbances. For this purpose, an anamnesis is collected, the doctor should be aware of the presence of other diseases, taking medications. The fact is that the choice of effective methods of treatment largely depends on the cause and nature of lesions of the conduction system of the heart.
After that, the doctor, as a rule, palpates the pulse on the radial artery. With extrasystole, a specialist can replace a pulse wave that occurs prematurely. Sometimes, on the contrary, extrasystole is accompanied by episodes of “falling out” of the pulse, which is observed when the ventricles are not sufficiently filled during diastole.
Next, auscultation of the heart is performed. While listening, you cannotice the presence of premature І and ІІ tones. By the way, with such a disease, the first tone is increased, which is associated with a small filling of the ventricles. But the second tone, on the contrary, is weakened, since the release of blood into the aorta and pulmonary artery is much less.
After that, the doctor will probably send the patient to do a cardiogram of the heart. This is one of the most accurate research methods. In some cases, a so-called Holter ECG is performed. What is this procedure? A special portable device is attached to the patient's body, which records the heart rate for 1-2 days. Along with this, the patient keeps an activity diary in which he describes his feelings and the actions taken. A similar study is used if it is necessary to find out what provokes an attack of extrasystole.
If heart rhythm disturbances are not observed at rest, additional tests are carried out - this is a bicycle ergometry and a treadmill test. Such studies make it possible to measure indicators (blood pressure) and make an ECG during physical exertion (for example, walking on a treadmill, exercising on an exercise bike). If organic myocardial damage is suspected, patients are advised to undergo an ultrasound and MRI of the heart.
How is extrasystole treated?
As already mentioned, the treatment of extrasystole of the heart directly depends on the causes of its occurrence. For example, if a rhythm disorder is associated with taking some medications, then, of course, they must be canceled. If the reasons lie indisorder of the digestive or cardiovascular systems, then you need to treat them first of all, and the attacks of extrasystoles will disappear along with the primary disease.
In some cases, diagnosis helps to understand that rhythm disturbances have arisen against the background of nervous strain. Such patients are referred to a neurologist for consultation and are usually prescribed mild sedatives or sedative herbs.
Individual and rare attacks of extrasystoles do not require specific medical treatment, patients are only advised to follow the principles of a he althy lifestyle and undergo repeated examinations from time to time.
If the attacks are observed frequently, accompanied by shortness of breath, strong blows and weakness, then, most likely, the doctor will select the appropriate medicines. As a rule, so-called antiarrhythmic drugs are prescribed to eliminate violations, including lidocaine, sotalol, novocainamide, diltiazem, quinidine, cordarone, mexilene. In no case should you use these drugs on your own, since the dosage and mode of administration here are purely individual. Moreover, sometimes drugs are started during the Holter ECG monitoring, this makes it possible to understand whether the drug is really working as it should, and whether it will cause even more harm to the body.
For benign extrasystoles, drugs are taken until the attacks completely disappear, or at least their number is minimized. After that, the number of drugs is started graduallyreduce and then eliminate them altogether. As a rule, such treatment lasts several months. But in malignant forms of the disorder, patients take antiarrhythmic drugs throughout their lives.
In cases where such drugs do not work, or if the patient has an intolerance to them, other methods of treatment are used, in particular, radiofrequency ablation of the heart. By the way, the indication for this form of therapy is the ventricular form of extrasystole, which is accompanied by 20-30 thousand attacks per day. This is a minimally invasive surgical procedure. It is carried out using a special endovascular catheter that transmits high-frequency currents. Thus, the electrode acts pointwise on areas of the heart where conduction is impaired. With this procedure, you can block the transmission of pathological, "wrong" impulses and resume normal sinus rhythms.
Consequences of cardiac arrhythmias and prognosis for patients
Prognosis for patients directly depends on the course of the disease and the presence of concomitant disorders. For example, extrasystoles that develop against the background of a heart attack, cardiomyopathy and organic myocardial damage are considered the most dangerous.
In any case, the lack of qualified and timely assistance can lead to a lot of complications. Despite the fact that in most cases, extrasystole is benign, sometimes other dangerous diseases develop against its background, including paroxysm altachycardia, atrial fibrillation and atrial flutter. Such conditions can lead to sudden death of the patient.
There are some other complications that accompany extrasystoles. These are, first of all, problems with blood circulation and tissue nutrition. Indeed, with repeated extrasystoles, the volume of blood ejected by the heart is significantly reduced. This leads to oxygen starvation and disruption of normal blood circulation. Often, extrasystole leads to the development of chronic insufficiency of the renal, coronary and cerebral vessels, which entails even greater complications.
Prevention methods
Of course, a patient with such problems should be registered with a cardiologist and undergo regular examinations. The main method of preventing dangerous complications of extrasystole is the correct treatment of the primary disease. Sick people need to take the drugs prescribed by a specialist, as well as follow the schedule and regimen of treatment. In addition, regular heart rate studies are essential, as this gives the doctor the opportunity to monitor the rate of disease progression and the effect of prescribed drugs.
Surely patients will need to drastically reconsider their lifestyle. Any heart disease requires a special diet. Quitting smoking, drinking alcohol and caffeine is a must. And, of course, moderate but regular physical activity, walks in the fresh air will be useful for the work of the cardiovascular system.
Separately worth talking about first aid. Attackextrasystole, as a rule, occurs suddenly. The patient should lie down and calm down. It is also recommended to unbutton the top buttons of the shirt, loosen the tie and belt, in a word, remove all possible obstacles that interfere with breathing. If the attack was caused by stress, then it is allowed to take a small amount of a sedative. It is best to call an ambulance, as the consequences of extrasystoles can be dangerous.
