Contents
Who is
2 Who happens to 3 Causes and risk factors 4 Classification and types 5 Symptoms and signs 6 Diagnosis and first aid 7 Tactics of treatment 8 Rehabilitation 9 Prognosis, complications and consequences 10 Relapse prevention and prevention What is this?
Extrasystoles occur due to the appearance of an ectopic( abnormal) focus of trigger activity in the myocardium( heart membrane) or its parts. Depending on the area of excitation, supraventricular( supraventricular - atrial and atrioventricular septum) and ventricular extrasystole are distinguished.
The term "supraventricular" means that an additional reduction occurs in the upper - supraventricular - part of the heart, that is, in the atrium or septum between the atria and ventricles( an antiventricular septum).
Who happens to Supraventricular extrasystole( SE) occurs in 60-70% of people. Normally, it can occur in clinically healthy patients.
does not say that the person is sick.
SE more often is registered in adults and older children , because young children are not yet able to describe their feelings and do not really understand what is happening to them.
In newborns and small children, supraventricular extrasystole is detected during ECG during clinical examination, general examination or in connection with an alleged cardiac dysfunction( congenital malformations, severe deterioration of the child's condition in the absence of external factors).
Causes and risk factors Nadzheluduchkovaya extrasystole can be idiopathic, that is, there is no apparent cause. It occurs in practically healthy people of any age.
In middle-aged people, the main cause of SE is functional:
stress; tobacco and alcohol; abuse of tonic drinks, especially tea and coffee. SE of organic origin appears due to damage to the myocardium as a result of coronary heart disease( CHD), inflammation, dystrophy and manifestations of cardiosclerosis.
In elderly , the organic cause of SE is more common because of the increased incidence of coronary heart disease, cardiosclerosis and other heart diseases with age. In such patients, there are profound changes in the heart muscle: foci of ischemia, dystrophy or necrosis, sclerotized areas, which causes an electrical heterogeneity in the cardiac muscle.
Organic causes can be divided into 5 groups:
Cardiac diseases:
acute myocardial infarction; IHD; heart defects are congenital and acquired; high blood pressure; chronic heart failure; myocarditis of the heart( what is this?); cardiomyopathy. Endocrine system diseases: adrenal disease; hyperthyroidism or thyrotoxicosis; diabetes mellitus. Prolonged intake of cardiac drugs , including: glycosides; medication for cardiac arrhythmia; diuretics. Electrolyte imbalance in the body - imbalance of sodium, potassium and magnesium. Insufficient oxygen intake of for bronchitis, anemia, asthma, nocturnal apnea. In young children, supraventricular extrasystole is more likely to develop due to congenital heart disease and endocrine diseases. In adolescence, they are added to stress, poisoning with tobacco, drugs and alcohol.
Classification and types of Nadzheludochkovye extrasystoles differ in several features.
At the location of the foci of excitation:
atrial - are in the atria, i.e.upper parts of the heart; antrioventricular - in the antrioventricular septum between the atria and ventricles. According to the frequency of the extrasystoles per 1 minute:
single( up to 5 additional abbreviations); multiple( more than 5 per minute); group( several extrasystoles one after another); doubles( 2 in a row). The number of foci of excitation:
monotopic( 1 focus); polytopic( more than one hearth). On appearance:
early( occur at the time of atrial contraction); averages( between contraction of the atria and ventricles); late( at the time of contraction of the ventricles or with complete relaxation of the heart). By order:
ordered( alternation of full-blown abbreviations with extrasystoles); is unordered( lack of regularity). Symptoms and signs Often supraventricular extrasystole is asymptomatic , especially if its origin is due to organic causes.
Patients may complain of severe heartbeats and strokes, a sense of fading in the chest and a feeling of a stopped heart.
For extrasystoles of functional origin neuroses and vegetative disorders of are characteristic: a feeling of lack of air, anxiety, sweating, fear, pallor of the skin, dizziness, weakness.
In children supraventricular extrasystole often occurs without symptoms. Older children complain of fatigue, dizziness, irritability, a sense of "upheavals" of the heart.
Patients with with an organic cause of have less arrhythmias in the recumbent position( the patient feels better) and stronger in standing position.
Patients who have the cause of SE functional , feel better in standing position, and worse - lying down.
Diagnosis and first aid The presence of the does not indicate the presence of any heart disease .
Diagnosis is based on:
of patient complaints; general examination with listening and heart rate measurement( HR); data on lifestyle, bad habits of the patient, past illnesses and surgical interventions, heredity; laboratory blood test( general, biochemical, thyroid hormones and adrenal glands). If necessary, prescribe ECG, Holter monitoring, ultrasound examination of the heart, tests under load with ECG recording before and after the load.
Differential diagnosis of SE is carried out using ECG and electrophysiological examination of the heart( EFI), which record intracardiac potentials.
First aid with SE: calm the person, remove the outer clothing( if the attack did not happen outside in the cold season), or unbutton the collar, give a drink of water, put in a cool, quiet place.
Tactics of treatment If the patient has no complaints, hemodynamic disorders( cerebral, coronary and renal blood flow reduction) and there are no organic heart lesions, specific treatment for supraventricular extrasystole is not performed. Single extrasystoles are not dangerous for health and treatment does not require.
With frequent symptoms of supraventricular extrasystole and poor tolerability of , sedatives can be prescribed.
Antiarrhythmic drugs are prescribed by the doctor in exceptional cases due to a large number of side effects. Rare SE( dozens or hundreds of additional cuts per day) does not require such serious therapy. Therefore, if there are no clinical manifestations, disturbances of blood flow and heart diseases, it is enough to calm the patient and recommend:
Correctly to establish a diet, if possible, to exclude from the diet fatty, salty, hot. To consume more fiber, vegetables and fruits. Exclude tobacco, alcohol and energy. Spend more time outdoors. Eliminate stress and exercise. Ensure adequate sleep duration. In the presence of a marked decrease in blood flow, heart disease and AE against them, is prescribed conservative treatment with with antiarrhythmic drugs and glycosides. Medicines are chosen only by the attending physician individually to each patient.
When treating the underlying heart disease , the symptoms of SE are weakened or completely disappear.
In extreme cases, if the medications do not bring relief and the patient is severely suffering from extrasystole, surgery can be performed.
Currently, there are two options for surgical treatment of SE:
Open-heart surgery , during which ectopic sites are removed. Typically, this operation is indicated in cases of intervention in connection with prosthetic heart valve. Radiofrequency ablation of of ectopic foci. A catheter is inserted into a large blood vessel, an electrode is inserted through which an area of pathological impulses is burned. Rehabilitation Specific rehabilitation for supraventricular extrasystole is not required .
General recommendations are the same as after any heart surgery:
rest, no stress; minimum physical activity: walking, no weight; diet food; calm long-term sleep; completely eliminate smoking, alcohol, energy drinks; does not overheat( do not go out in the heat, do not visit the sauna and sauna, dress according to the season). Prognosis, complications and consequences According to some experts, frequent supraventricular extrasystole in a few years can lead to the development of heart failure, atrial fibrillation and cause a change in the configuration of the atria.
The prognosis for AE is favorable. This disease does not lead to sudden death, in contrast to ventricular extrasystole in combination with organic heart disease.
In rare cases, development of supraventricular tachycardia is possible.
Relapse prevention and prevention
Specific prophylaxis for supraventricular extrasystole is not required. Doctors advise to establish a healthy lifestyle and nutrition:
to sleep in a cool room at least 7-8 hours a day; cut in the diet to a minimum of salted, fried, hot; as little as possible to smoke and drink alcohol, it is better to clean energy completely; walk on foot in the open air for at least an hour a day, preferably 2 hours; moderate physical activity: swim in the pool, climb the stairs instead of climbing the elevator, skiing or running in the park. This is especially true for people with sedentary work. Nadzheludochkovaya( supraventricular) extrasystole occurs in people of any age. Easy cases do not require treatment. More serious can be accompanied by cardiac and other diseases and require drug therapy, and in extreme cases - surgical treatment. The main thing in this disease is to stay calm and lead a healthy lifestyle.
