From this article you will find out what diseases can cause a low pulse at normal pressure. Is it always a pathology, as it manifests itself. Methods of performing the diagnosis while slowing the pulse. Treatment and prognosis for the disease.
Contents of the article:
- Types of low heart rate
- Causes of low heart rate at normal pressure
- Characteristic symptoms
- Diagnosis
- Treatment methods
- Forecast
A low pulse, or bradycardia, in medical practice is a condition where the number of heart muscle beats falls below 60 per minute. The normal pressure ranges from 110-140 to 70-90 mm Hg. Art.depending on the age category.
Reduction in heart muscle contraction frequency can be of several types:
| Type of bradycardia | Who and why |
|---|---|
| Physiological | For professional athletes who regularly perform cardio training In healthy people at night, due to some predominance of the parasympathetic nervous system In Vagotonics( people,in which the parasympathetic activity of the nervous system is more pronounced) |
| Pathological | Violation of the formation of the excitation energy pulse in specialized cases(pacemakers) Pathology of excitation wave propagation along the nerve fibers of the cardiac divisions |
Conducting heart system through which excitation is transmitted, with its main center - the synadrial node Physiological reduction in the frequency of contractions of the heart muscle is a norm option: it does not have pathological consequences for the bodyand does not require medical correction.
With rare heart beats, the manifestations of the disease are associated with insufficient blood flow to the main organs: the heart muscle itself, the brain, the lung.
Any stress in the physiological conditions leads to an acceleration of the heart to maintain the normal function of all systems. If there is a disturbance in the formation of the pulse and( or) the excitation of the myocardium, this does not happen - the tissues experience oxygen starvation, which is extremely dangerous for the cerebral cortex of the brain and heart. In cases of prolonged lack of blood, irreversible changes develop in them( the degeneration of active cells into connective tissue elements), worsening the course and prognosis of the disease.
Pathological low pulse with pressure figures within the age limit is one of the types of bradycardia. Most often, all types of bradyarrhythmias take place in the initial phase of the disease, when pathological changes only have arisen and the body is still coping with disorders.
It is possible to determine how much the loss of heart rate is dangerous only after determining the cause of cardiac deceleration:
- Physiological and pathological asymptomatic species do not affect the habitual life rhythm and require only periodic examinations with a specialist so as not to miss the development of serious pathology.
They are not dangerous to life. - Clinical manifestations of low pulse of a periodic or permanent nature limit the physical capabilities of the patient and require treatment, follow-up with a doctor.
If the reduction in the frequency of myocardial contractions is associated with non-cardiac causes - this condition can be cured. Pathological changes in the heart muscle itself are usually irreversible, it is necessary to correct the rhythm frequency constantly. Such types of bradyarrhythmia can endanger life.
Therapists, cardiologists, arrhythmologists and vascular surgeons are engaged in monitoring, determining the necessary complex of examinations and directly treating the loss of pulse.
Type of electrocardiogram for bradycardia Types of low heart rate
| Flowing | By manifestations | By degree pulse shortening per minute | Style disorders |
|---|---|---|---|
| Periodic Permanent | Asymptomatic symptomatic | First - 50 second - 40 third - less than 40 | Dysfunction main pacemaker or sinus Block for carrying out the excitation wave from the ventricles to the atria( atrioventricular blockades, blocked forms of atrial tachyarrhythmia) |
Causes of low heart rate at normal pressure
| Factor category | Certain types of |
|---|---|
| Pathological changes in myocardium | Chronic and acute forms of changes in blood flow in cardiac vessels( IHD) Changes in normal structure and function of heart cells( cardiomyopathies) Inflammation in cardiac muscle( myocarditis) Replacement of muscular and nerve cells with myocardium connective tissuecardiosclerosis) Surgical heart interventions |
| Metabolic changes | Disturbance of evacuation of bile to the bowel( cholestasis) Low level of hormones thyroid(hypothyroidism) High content of calcium and potassium in blood |
| Vagotonia | High level of intracranial pressure Volume and inflammatory diseases of larynx, esophagus |
| Action of medicines | Drugs for normalization of pressure, myocardial contraction frequency Cardiac glycosides Narcotic analgesics Soothing andpsychotropic substances |
| Other | Congenital disorders of the structure and function of sinus and atrioventricular nodes Without cause |
The use of certain medicines( eg digoxin) can lead to bradycardia( low heart rate) Characteristic symptoms of
Symptoms depend on the degree of reduction of heart beat:
- At the first degree, 90% of the patients have no complaints and a low pulse is an accidental finding.
- The second and third degree manifests itself immediately in 40-55% of patients, in others the first time the symptoms are absent, but as the compensatory possibilities of the myocardium decrease, the clinical picture of the disease occurs in all. Danger to life represents a decrease in the rhythm below 40 per minute - a high risk of sudden cardiac arrest.
The manifestations of low pulse at normal pressure are non-specific and occur in other cardiovascular diseases:
| Clinical manifestation of | Its characteristic |
|---|---|
| Pain in myocardium | Occurs during physical exertion In the first stages of the disease only with significant overstrain As the heart changes progressioneven household matters cause pain in the heart |
| Temporary manifestations of blood flow disorders in the brain( transient ischemic attack) - stThe degree of manifestation and appearance depends on the affected structure | Fainting Loss of motor capacity in the limbs or half the body Convulsions Decreased pain sensitivity on body parts Changes in sight, hearing, consciousness |
| Periods of blood pressure lowering | May occur with paroxysmal form of bradyarrhythmia, especially dangerousat night - the person sleeps and does not feel any symptoms |
| Signs of cardiovascular system disability | Dyspnea and cough with physiotherapyskom voltage increasing weakness and reduced tolerance to stress swelling in the lower extremities |
Syncope - one of the possible symptoms of bradycardia Any form of slowing myocardial contractions, even with normal blood pressure figures and complete absence of clinical manifestations, requires a specialist to avoid serious pathology.
Diagnostics
| Method | What determines | |
|---|---|---|
| Initial survey and patient examination | Assessment of complaints Presence of cardiovascular disease in the past Are there other diseases affecting the number of myocardial contractions Gathering information on medications taken, their doses and periods of use The fact of the presence of a low pulse | |
| Electrocardiography( ECG) | Instrumental confirmation of bradyarrhythmia, sometimes of its kind | |
| ECG registration during the day and / or a whole week | Diagnostic of non-permanent forms of heart beat beat, their periodicity | |
| ECG with physical( velar metry) or drug( atropine, vegetative blockade) assays | Evaluation of adequacy of myocardial contractions Determination of bradyarrhythmias | |
| Ultrasonography of the heart muscle, US) | Diagnosis of cardiac causes of low heart rate | |
| Electrophysical study( EFI) of the myocardium | Evaluation of excitation sources( rhythm drivers), track(clinical analysis, hormone level, GVHD) | Diagnosis of heart beat loss |
Special electrodes-catheters are introduced for electrophysical examination of the myocardium. Using them, the cardiac conduction system is checked. Methods of treatment
Asymptomatic and physiological types of contraction of the rhythm of cardiac contractions do not require correction, only continuous monitoring due to the risk of aggravation of the degree of bradyarrhythmia. Multiplicity of examinations and the necessary volume of examination is determined by the observing cardiologist( depends on the level of disturbance of the excitation, the age of the patient and the concomitant cardiac pathology).
Secondary pathological bradycardia( not related to cardiac factors) are completely curable under the condition that the main disease is treated - the cause of rhythm disturbance.
Treatment of primary bradyarrhythmias depends on the level of damage to the conduction pathways of the heart muscle and the degree of development of the disorders.
Treatment for sinus node dysfunction
| Type of treatment | Indications |
|---|---|
| Operative: Pacemaker permanent pacemaker( | ) Symptomatic heart rate loss Asymptomatic course of the disease in patients over 70 years of age with a contraction rate & lt;55 mg per minute |
| Pharmacological: Cholinolytics( Ipratropium bromide) Xanthines( Theophylline) | Patient failure from pacemaker implantation It is not possible to perform the operation for technical reasons |
After implantation of the stimulant, the patient's standard of living is assessed as satisfactory, although there is no cure for the disease,correction of pathological disorders.
The cardiac pacemaker is disrupted when the cardiac pacemaker unit is disrupted Atrioventricular blockade
| Degree of impulse failure | Treatment |
|---|---|
| First | Does not require |
| Second, type 1 | Medication( anticholinergic) |
| Second, type 2 All types of third | Pacemaker Implantation |
The flow of blockades of 1-2 degrees is favorable, it is impossible to cure the disease, but it does not affect the quality of life.
Blockades of the third degree - more malignant course in connection with occurrence of risk of sudden death. Requires more frequent and thorough observation even after installation of PEX.
Forecast
In case of violations of the function of the main pacemaker, the percentage of survival with the condition of installing PEX is 40-60%.In such patients, a satisfactory quality of life remains, but there are restrictions on the level of physical activity.
Atrioventricular blockades of the first, second degree are distinguished by a favorable prognosis: they do not require restrictions in loads, do not threaten life. With blockades of the third degree, without installing a pacemaker, a high risk of cardiac arrest.
It is impossible to completely recover from bradyarrhythmia associated with myocardial pathology, but timely treatment allows to fully control the disease and its manifestations.
