Sinus bradycardia of the heart: what is it, the causes, treatment and prognosis

From this article you will learn: what is a sinus bradycardia, its kinds. Causes, symptoms, how to treat.

Sinus bradycardia is a slowing of the heart rate in the form of a decrease in the heart rate( heart rate) of less than 60 beats per minute. This condition can be physiological( a variant of the norm, a peculiarity of the organism) and pathological( it indicates violations in the body).In 90-95% of cases, the pathological type of sinus bradycardia is a manifestation of various diseases. Therefore, it can not be regarded as an independent disease or diagnosis, but only as a symptom or syndrome.

If the heart is reduced in the range of 50 to 60 times per minute, in 90-92% of cases in humans this is either not manifested at all, or accompanied by general weakness and malaise. A pronounced bradycardia( less than 50 beats per minute) causes blood circulation disorders, primarily in the brain, as a result of which a person can not perform the usual work, play sports or even walk. The frequency of cardiac contractions of less than 40 beats per minute can signal a threatening cardiac arrest.

Sinus bradycardia is easy to diagnose during normal examination( calculate heart rate), and such a simple method as ECG completely confirms its presence. Cure is possible, but for this it is necessary to find out and eliminate the cause. Primarily this problem deals with a cardiologist or therapist, and if necessary, other specialists( neurologist, infectiologist, endocrinologist).

Essence and danger of sinus bradycardia

A healthy heart shrinks on its own without any stimulating effects. This is possible due to spontaneous exciting impulses that arise in the cardiovascular cells. The largest cluster of them is called the sinus node. Its impulses are rhythmic, strong and pass through all parts of the heart, producing regular single-type contractions of the myocardium. Therefore, a healthy heart rhythm is called a sinus rhythm( its frequency per minute is 60-90 ud.)

With a sinus bradycardia, the sinus node generates few impulses, the heart shrinks less often than it should - less than 60 times per minute. This leads to a slowing of blood circulation in all organs and tissues, which is accompanied by oxygen starvation( hypoxia).The brain and the heart muscle suffer most. The more pronounced bradycardia, the heavier the violation in the body. The threat to life occurs when the heart rate slows down less than 40 / min, and the figure is less than 30 beats / min - signal of the impending cardiac arrest.

Two types of bradycardia

1. Bradycardia as a variant of

If the slowing of the heart rhythm is caused by the natural reaction of the body to the influence of environmental factors, it is called a physiological( variant of the norm).This means that these people are dominated by inhibitory effects of the nervous system on the heart.

Physiological sinus bradycardia of the heart happens:

With regular physical exertion, athletes develop physiological sinus bradycardia

The main criterion that reducing heart rate is a variant of the norm:

2. Bradycardia as a symptom of

Disease Bradycardia is considered abnormal( anomalous, a signal of the disease) if a slow heartbeat occurs:

• without explicit presuppositions( there are no factors that can cause physiological bradycardia);
• in the form of sudden seizures;
• is accompanied by a irregular heartbeat( different lengths of time intervals between contractions);
• is accompanied by a violation of the general condition or any other complaints.

Common causes of pathology - diseases manifested by bradycardia

The term pathological sinus bradycardia means that it is only a symptom of a disease, and not an independent diagnosis. The most common reasons for its appearance:

• neurocirculatory dystonia( vegetative-vascular);
• acute and chronic heart diseases( myocarditis, infarction, cardiomyopathy, sinus node weakness syndrome);
• brain disease( cranial injury, meningitis and meningoencephalitis, brain tumors);
• systematic abuse of alcohol, tobacco and drugs;
• intoxication of the body( lead, chemicals, production hazards);
• severe infections( large abscesses, abscesses, sepsis, intestinal infections, pneumonia, etc.);
• tumors of the neck and chest;
• overdose of medications slowing down cardiac contractions( eg, verapamil, amiodarone, metoprolol, aspartame);
• pathology of the endocrine system( hypothyroidism - decrease of hormonal activity of the thyroid gland, gipokortitsizm - adrenal insufficiency);
• hepatic-renal failure due to severe liver and kidney diseases. Symptoms and signs

sinus bradycardia The clinical picture can vary from no symptoms, up to a critical deterioration of the general condition. Manifestations of which it is accompanied, are described in the table:

	symptoms and manifestations of heart rate per minute
	50-59 39-49 39-30	less
complaints - weakness, dizziness, dyspnea, headache, chest pain	None or slightly expressed	Appear always, expressed	Highly expressed, patients are forced to lie
General condition	Not violated	Misdemeanor, weakness	Severe, critical
Consciousness	Not violated	Drowsiness, retardation	coma( unconsciousness)
Blood pressure	Average	Below normal	sharply reduced or absent
Pulse	Dragged down	slowed, weakened	not determined
Breath	not changed	frequently, dyspnea	Surface or missing

main symptoms of sinus bradycardia

Occurrenceand for sinus bradycardia may be sudden, paroxysmal( minutes, hours, days) as well as long, chronic( weeks, months, years).The second option is more favorable, since the body has time to adapt to slowing the heart rate, especially if it is moderate( 59-50 beats / min).Sudden rapidly progressing seizures are dangerous, most of all in cases where bradycardia is preceded by an increase in heart rate - this is a threat of cardiac arrest.

Treatment methods

It is possible to cure sinus bradycardia. The treatment consists of two stages:

1. Emergency care

Emergency treatment of bradycardia is most appropriate if the patient's general condition is disturbed against the background of a heartbeat less than 50 beats / min:

• Put the patient on his back, provide conditions for good access to fresh air( open the ventilator, remove or unfasten clothing that compresses the thoraciccage and neck).
• Assess the presence of consciousness, breathing, pulse on the arteries of the neck and palpitations. Only in their absence are shown reanimation measures - heart massage and artificial respiration.
• Taking medications( listed in the table).

Names of the preparation	Indications for use
Drops Zelenin	Ingestion for any form of a bradycardia in the case of conserved consciousness
Atropine sulfate	Administered intravenously or subcutaneously with a reduction in heart beat less than 50 beats per minute
Dopamine	Sinus bradycardia , accompanied by a decreasearterial pressure
Adrenaline	Enter subcutaneously / intravenously at a critical slowing of the rhythm( less than 30 beats per minute)( cardiac arrest)

First aid in detecting a symptomthe strong sinus bradycardia

2. Special treatment

To permanently eliminate the pathological sinus bradycardia, it is possible only by treating the causative diseases. In any case, first you need to contact a cardiologist or therapist. The specialist will decide the amount of necessary examination and consultations of other specialists( this may be a neurologist, endocrinologist, infectious disease specialist, etc.).Only after this is the optimal treatment is prescribed.

If against a background of ongoing specialized or urgent measures to restore the normal heart rate is not possible, patients are placed under the skin pacemaker - a device that produces electrical impulses, and is an artificial pacemaker.

Pacemaker

Prediction

Statistically, the complete cure for sinus bradycardia occurs in 95-97%:

• 90-95% of patients have specific medication therapy. Its duration depends on the cause of the disease: from a single injection of drugs in the first occurrence of an attack, to prolonged treatment for several months or years for chronic diseases.
• 5-10% of patients require the installation of a pacemaker. This procedure is effective in all cases, regardless of the causes of bradycardia. The rhythm is restored immediately after its installation.

If you do not treat a causative disease, you can not cure the bradycardia.