From this article you will receive exhaustive information about the disease sinus bradyarrhythmia: what is it, the symptoms and the ways of treatment.
Contents of the article:
- The causes and causes of
- Symptoms of sinus bradyarrhythmia in children and adults
- Diagnosis
- Methods for treating sinus bradyarrhythmia
- Prognosis for life
With sinus bradyarrhythmia( or, in other words, bradycardia), the heart rate decreases( abbreviated to heart rate)less than 60 beats per minute. The mechanism of development is the violation of the sinus node, which is the main source and driver of the heart rhythm. In this case, the normal mode of functioning of all heart structures( the sequence of contractions of the atria and ventricles) is preserved.
Such a physiological condition can be observed in completely healthy people, as well as in those suffering from cardiac and vascular pathologies. Quite often bradycardia is determined in professional athletes during rest - this is explained by their fitness and high adaptation of the cardiovascular system to physical exertion.
Also, the sinus type of bradyarrhythmia can develop against the background of the underlying disease, for example, myocardial infarction, hypothyroidism, cardiosclerosis or other pathologies.
The cardiologist deals with the diagnosis and treatment of this rhythm disturbance.
Species and causes of sinus bradyarrhythmia
Sinus bradycardia for causes of occurrence differs in 6 forms:
- physiological or functional,
- organic,
- neurogenic,
- drug,
- toxic,
- bradyarrhythmia of athletes.
Further we will disassemble these kinds more in detail, and why they arise.
Causes of physiological bradycardia
- Different physiological conditions, for example, at rest or during sleep in athletes. They have a heart rate of up to 40 beats per minute, even in the daytime, not to mention the time of sleep. Because of professional sports, these people have a special regulation of the heart rhythm.
- Pressure on the heart of a malignant or benign tumor. Compression compression of a particular heart can lead to a persistent rhythm disturbance.
Causes of Organic Form
A sharp decrease in the frequency of the sinus node pulses, which cause the heart to contract, leads to irreversible damage to the heart. Sinus bradyarrhythmia of organic origin develops, i.e., caused by persistent enduring changes in the structures of the heart.
The causes of this form of pathology:
- Myocardial infarction is the necrosis of the site of the heart muscle. IsDemia is a narrowing of the heart vessels.
- Cardiosclerosis - proliferation of scar tissue from connective fibers at the site of inflammation or necrosis of the heart.
- Myocardial dystrophy is a violation of metabolic processes in the myocardium, leading to dysfunction and dystrophy of the cardiac muscle( i.e., the myocardium).
- Cardiomyopathy is a pathology of the heart, which is based on sclerotic and dystrophic changes in cardiomyocytes. Myocarditis is an inflammation of the myocardium.
Causes of neurogenic bradycardia
- Increased intracranial pressure due to meningitis, edema, bruise, brain tumor.
- Neurosis is a functional CNS disorder.
- Neurocirculatory dystonia is a disorder of the cardiovascular system due to damage to the nervous and endocrine systems.
- Ulcer of the duodenal ulcer or gastric mucosa.
Cause of dosage form
- Overdose with cardiac glycosides, β-blockers, antiarrhythmics.
The causes of bradyarrhythmia toxic
- Strong intoxication of the body against the background of a viral infection.
- Typhoid fever is an intestinal infection caused by the bacterium Salmonella typhi.
- Hepatitis is an inflammation of the liver.
- Poisoning with organophosphorus compounds. These chemicals are often used in the home, at the dacha for the treatment of trees and plants from pests, when parasites are excreted in domestic animals. They can get into the body with contaminated water, through poorly washed hands. Poisonous fumes can be inhaled by practicing in the garden.
- Sepsis - infection of blood.
The causes of bradyarrhythmia in young children and adolescents
- The main cause of bradyarrhythmia in toddlers is an increased tone of the vagus nerve. Bradycardia affected children with vegetovascular dystonia, infectious diseases, disruption of the thyroid gland, hereditary predisposition.
- In infants, because of an inferior thermoregulatory system, a bradycardia can be triggered by hypothermia - a lowered temperature. Enough short-term presence of the baby in the cold air, so that his pulse decreases.
- Respiratory bradyarrhythmia in young children and schoolchildren develops due to the fact that the sinus node is under the influence of a vagus nerve, which is irritated. With age, this influence decreases.
- The frequent cause of bradycardia in adolescents is the lack of thyroid hormones.
Symptoms of sinus bradyarrhythmia in children and adults
Both in children and adults, there is a compensated and decompensated form. With compensated sinus bradyarrhythmia, the body is able to compensate for the changes occurring, therefore, it does not affect the person's health. This form is asymptomatic in both adults and children. Diagnosed in most cases with routine examinations based on ECG results.
Symptoms of bradyarrhythmia occur when the rhythm disturbance becomes pronounced( the pulse is less than 40 beats per minute), and the body is no longer able to compensate for the changes occurring.
Then decompensated bradyarrhythmia develops, manifested by the following symptoms:
- sensation of lack of air;
- dizziness, especially when changing the position of the body;
- severity, pressing pain behind the sternum;
- by pre-occlusive conditions;
- pimple skin;
- cold sweat;
- weakness;
- reduced mental activity, concentration, remembering;
- drowsiness;
- attacks of Morgagni-Adams-Stokes - short-term syncope, triggered by a severe heart rhythm disturbance and, as a consequence, cerebral circulation;
- blood pressure changes, often downward;
- loss of appetite.
Symptoms of decompensated bradyarrhythmia In children, the emergence of bradyarrhythmia symptoms indicates the presence of a complex pathology, for example, violations of the liver or kidneys, intracranial hematoma.
Diagnosis of sinus bradyarrhythmia
To identify sinus bradyarrhythmia and determine its form, a comprehensive study of the cardiovascular system is needed. But in the beginning the cardiologist conducts a general examination with measuring the pressure, collecting complaints, listening to heart tones through a phonendoscope.
With the help of a phonendoscope, a cardiologist listens to the heart sounds. Click on the picture to enlarge The following table lists the research methods used to establish the diagnosis:
| Diagnostic methods | Description |
|---|---|
| Electrocardiography | Electrocardiographic curve is used to determine the heart rate and possible pathologies |
| Holter heart monitoring | Continuous electrocardiographic recording by Holter of cardiac pulses during the day allows to detect a rhythm disturbance that is not detected by short-term ECG removal |
| Echocardiography - ultrasoundheart structures | Helps to determine the cause of the organic form of bradyeartmii, to study the structure of the heart. During the study, an increase in the size of the organ is detected, a decrease in the ejection fraction is less than 45%, sclerotic changes in the myocardium |
| Transesophageal electrocardiography | The ultrasound of the heart is done through the esophagus into which the sensor-electrode that emits ultrasonic waves is injected. The method makes it possible to determine whether changes in the structure of the heart have already occurred( organic arrhythmia) or not. |
Methods for diagnosis of sinus bradyarrhythmia Modern methods of treatment of sinus bradyarrhythmia
Moderate bradycardia, not accompanied by clinical signs, does not require treatment. Patients feel completely healthy, not guessing about changes in the work of the heart. At the child such deviation is most often temporary, well amenable to correction, and even completely independently passes with age.
Treatment is mandatory in cases of decompensation, when a decrease in heart rate is caused by a serious cardiac pathology.
Depending on the form of the rhythm disturbance, the treatment can be conservative or surgical:
- With an extracardiac, organic, toxic form, the underlying disease is treated.
- The dosage form is eliminated by eliminating or adjusting the doses of the drugs that caused it.
Taking medications
In children and adults, this therapy is aimed at treating the underlying disease, to eliminate the cause of a rare heartbeat.
To increase the heart rate prescribed anticholinergic action - Atropine, Amisil, Metacin, Mebedrol. They are used intravenously or intramuscularly for emergency help with a sharp slowing of the pulse.
Drugs for increasing heart rate Therapy will be supplemented with Panangin, Magne B6 and other drugs containing potassium.
Operation - implantation of pacemaker
The most effective way to normalize heart rate is to implant the pacemaker. It is established during a simple operation in the subcutaneous tissue of the patient in the area of the armpit, and the electrodes are conducted through the vein to the chambers of the heart. This artificial rhythm driver takes control of the pulse, producing electrical impulses with a physiological frequency. Normalization of the rhythm of the heart helps restore normal blood supply to internal organs.
Prognosis for bradyarrhythmia
Sinus bradyarrhythmia in young children usually passes spontaneously without medical intervention.
Adults need to treat the underlying disease, a prognosis for life is favorable.
The combination of bradyarrhythmia with atrial fibrillation, cardiac blockades aggravates the prognosis. The risk of thrombosis increases and spreads through the circulatory system. This can lead to a stroke, a heart attack, a pulmonary embolism and death. The solution of the problem becomes implantation of a pacemaker, after which the quality of life improves significantly, and its duration increases.
