Система Orphus

Symptoms of disease - violation conductivity of the heart

Violation of the conductance and heart rhythm - changes the normal order of the abbreviations of the heart due to the disorder of the functions of automaticity, excitability, and conduction sokratimosti.

Arrhythmia constitute a violation of the conductivity or heart rate, which can be shown by changing the frequency and force of heart contractions, the occurrence of premature or extraordinary reductions or altering the sequence of excitement and reduction of the Atria and ventricles of the heart.

In order to fully understand the possible mechanisms of arrhythmias, we consider it necessary to dwell on some of the anatomic and physiological features of the heart.

Normal contractile heart work is provided by the event system. It represents the combination of specific nodes, beams and fibre, which have the ability to generate and conduct electrical impulses to all muscular elements of the heart. Although all elements of the conducting system able to generate electrical impulses, the main node, overwhelming and controlling the function of the remaining elements of the conducting system, is the sinus node, which is called the driver rhythm. Generated in him through equal intervals of time (with a frequency of 60 to 70 times per minute) electrical impulses are at the heart muscle (myocardium) fibrillation and to the next node, called the mitral or atrioventricular (AB). From intra-auricular node impulse travels on the right and left feet beam Guisa and Purkinje fibers to myocardium of the right and left ventricles, respectively.

The work of the conducting system of the heart is built in such a way that in the beginning there was a reduction of the Atria, and then the ventricles of the heart. In addition, because of the very high speed of propagation of pulses of the simultaneous excitation and subsequent reduction of all muscle fibers.

Violations of the conductance and heart rhythm

The levels of violations:
1. a failure in the functioning of the sinus node:
- increased or slowing of the heart rate (accordingly, tachycardia and bradycardia)
syndrome weakness of the sinus node (when episodes of tachycardia replaced by bradikardiei)
2. violation of conduction of impulses within the Atria, from the Atria to the ventricles or within the ventricles (intraatrial blockade AV blockade blockade feet beam Guisa)
3. the occurrence of any division of myocardial lesions that can generate pulses to the contraction of the heart, in addition to the sinus node
4. availability of additional beams to conduct impulses.

In addition to accounting localization defeat of the conducting system of the heart, arrhythmia are classified depending on the pre-emptive destruction of cardiac function and clinical manifestations.

Which diseases there is violation conductivity of the heart

The reasons for violations of the conductance and heart arrhythmias

1. heart disease: coronary heart disease (including postinfarction arrhythmia), heart diseases, cardiomyopathy, congenital heart defects (syndrome of prolonged Q-T), injury of the heart, some drugs used for the treatment of diseases of the heart (cardiac glycosides, and antiarrhythmic drugs)

2. exocardial:
the harmful habit of Smoking, drug abuse (especially Coca), stress, alcohol, coffee and caffeine-containing products (including chocolate)
- violation of the modes of life: stress, lack of the duration of sleep
reception of certain drugs: the traditional means when you have a cold, reducing body weight, some of phytopreparations, have stimulating influence on the cardiovascular system (ginseng, ephedra, etc.)
- diseases of other organs and systems of organism (endocrine pathology, system diseases of connective tissue, diseases of kidneys and etc).
- electrolyte disorders (changes in the ratio of the levels of potassium, sodium, calcium, magnesium in intra - and extracellular space): long term use of diuretic drugs, loss of electrolytes through the gastrointestinal tract (prolonged diarrhoea, vomiting), a disease characterized by the human intake of electrolytes.

The severity of clinical manifestations of arrhythmias in a greater degree is caused by the reason which led to their development and varies widely from asymptomatic forms, to life-threatening.

Typical complaints of patients with disorders of the conductivity of the heart are:

- heartbeat (strong and rapid heart beats)
- the periodic loss of another reduction
- interruptions in heart activity
- dizziness, or fear, as a result of insufficient receipts in the brain blood
- pain in the heart area (often according to the type of stenocardia)
- shortness of breath

Given that the causes of the violation of the conductance and heart rhythm often remain unknown, arrhythmia conveniently divided by the frequency of cardiac contractions.

1. Tachycardia (heart rate of more than 90 beats per minute):

1.1. Sinusova tachycardia - regular tachycardia, at which impulses are in sinus node, but with a higher frequency. It may be a reaction of the organism to physical exercise, stress, accompanied by fever, hemorrhage, increased production of the thyroid hormones (thyrotoxicosis), anemia, low blood pressure level, myocarditis and heart failure.

1.2. Tachycardia, associated with the emergence of the pathological centers, suppress the function of the sinus node. Depending on the location of the hearth tachycardia share on supraventrikuliarnae (with its localization in the Atria and the AV-node) and ATP, but specify the localization is only possible with the help of advanced methods of diagnostics. Depending on the duration of the infringement of a rhythm of their share in the paroxizmale and permanent. Paroxizmalnaya tachycardia, the sudden increase in heart rate to 180-240 beats per minute. The duration of attack varies from a few seconds to several days, shall also be terminated abruptly as it begins, often without outside interference. Usually the occurrence of this type of rhythm disturbance due to the presence of cardiac disease (cardiosclerosis, heart defects, etc.), although in rare cases may be associated with increased nervous excitability. Patients make complaints to the attack of sharp heartbeat, discomfort in the chest, weak. More dangerous is the attack of paroxysmal ventricular arrhythmia because of the higher risk transfer it to life-threatening arrhythmia. Constant tachycardia, is characterized by a constant (more than 6 months) tachycardia

1.3. Flicker (atrial fibrillation) fibrillation (atrial fibrillation) - frequent violation of rhythm, characterized by the emergence of a variety of additional centers of excitation, each of which is chaotic reduction of individual muscle fibers of the atrium with a frequency of 400-600 per minute. In connection with the accompanying violation of conductivity in the atrioventricular node, the ventricles is only part of these impulses. Only the strongest of electrical impulses come from the Atria to the ventricles, therefore reducing the ventricles coming fairly chaotic, Recalling the flicker (hence the name atrial fibrillation). Sinus node when it loses its function driver rhythm. Causes of predserdy are: ischemic heart disease, heart defects (especially defects mitral valve), thyrotoxicosis, myocarditis, cardiomyopathy, embolism pulmonary artery, acute infection, and injury. Atrial fibrillation can occur in the form of paroxysms, and in the form of a permanent form. This type of arrhythmia is not always accompanied by the increase of rhythm and can occur on the background of normal or slow heart rate.

1.4. Of atrial flutter - rhythm disturbance, always linked to the presence of organic diseases of the heart muscle and through the regular contractions of the Atria to the frequency 220-360 in a minute. At the same time to the ventricles is held only every second, third or fourth pulse of the accompanying violations conductivity pulse through the AV node.

1.5. Ventricular tachycardia, a rhythm disturbance, manifested in the reduction of the ventricles of the heart with a frequency of 150-200 per minute, due to the functioning of the pathological centers of excitation in the ventricles. The danger of this rhythm disorders is associated with a high probability of its transition to a life-threatening fibrillation (Atlas) of the ventricles. This type of arrhythmia was observed in severe defeat of the heart muscle.

1.6. Flicker (atrial fibrillation and atrial flutter fibrillation - threatening rhythm disturbance, which without rendering urgent medical assistance lead to the death of the patient. The severity of these types of arrhythmias due to the lack of full value reduction of the ventricles of the heart and, consequently, the lack of an adequate blood supply to vital organs of the body and the high risk of cardiac arrest (ventricular asystole). Such patients lose consciousness, and sharply pale, pulse and blood pressure are not defined.

2. Bradycardia (heart rate less than 60 per minute).

Sinusova aetiology is a regular slowing heart rate as a result of lower excitability of the sinus node. It can be observed in healthy, but well-trained people, under the influence of cold or be a sign of the development of a pathological condition. For example, hypothyroidism (reduced function of the thyroid gland), raising vnutricerepnogo pressure, certain infectious diseases (typhoid fever), total asthenization prolonged fasting. Not expressed aetiology does not affect the well-being of patients, while in reducing the frequency reductions of less than 40 beats per minute have been dizziness and loss of consciousness.

3. Syndrome weakness of the sinus node syndrome, characterized by the expressed violation of the sinus node, reflecting the combination of various types of violations of rhythm, including the alternation of periods of bradycardia and tachycardia.

4. The blockade of the heart constitute a violation of the conduction of the electrical impulse (see above). Depending on the level of destruction allocate intraatrial blockade AV blockade blockade feet beam Guisa, which are divided by the degrees of severity.

4.1. Intraatrial blockade AV blockade of I degree and the blockade feet beam Guisa clinically not occur and can be detected only with the help of additional methods of examination.

4.2. The more severe the degree AV blockade II and III degrees) accompanied by pronounced slowing of heart rate to 40-30 in the moment that causes dizziness, darkening of the eyes, short-term loss of consciousness.

4.3. Slowing heart rate less than 20, often in the transition partial blockade (II degree) in full (III degree), accompanied by the development of attacks Morhai-Adams-Stokes, caused by circulatory disturbance of the Central nervous system. The attack appears loss of consciousness, a sharp paling of the patient, the advent of seizures, deep breathing, sharp deceleration frequency or does the lack of a pulse.

5. Arrythmia - is a special heartfelt reduction. This is one of the most frequent types of arrhythmias. Arrythmia can occur both in healthy people, for example, when abuse of coffee, strong tea, Smoking, and on the background of various diseases. Depending on the place of ekstrasistolia as are divided into najeludockove (supraventrikuliarnae) and ATP. Single rate (up to 5 per minute) are not dangerous for life, while frequent, steam and especially ventricular are unfavorable sign.

In this classification are considered far not all types of violations of heart rhythm, however, we have tried to briefly reflect the most frequent types of arrhythmias.

Not all the episodes are dangerous and important for the prognosis of the disease. The danger caused disruptions to the patient derives like arrhythmia, so and the state, on the background of which it emerged.

Danger to life is connected, primarily, with the risk of sudden cardiac death due to cardiac arrest.

The arrhythmia may act as in the role of one of the symptoms of the disease, and in the role of complications. The most important is the development of violations of rhythm and conduction, as complications of myocardial infarction (occurrence frequency reaches 70-100%). In postinfarctne period may be any of the types of arrhythmias, but most often appears ventricular arrythmia (in the first hours-days of a heart attack at 2/3 of patients), which can be transformed in atrial fibrillation. (The significance of the arrhythmia to forecast, see the table). Treatment of arrhythmias in early postinfarction period is carried out in conditions of a hospital. The occurrence of any violation of rhythm after discharge from the hospital requires a mandatory consultation of the doctor, with a view to establishing the kind of correction or appointment of additional therapy and follow-up of the patient.

Unfortunately, there are no clear signs, in advance characterizing the aggravation of the tide and the development of a new type of infringement of a rhythm. Therefore, the appearance of new symptoms or the subjective deterioration of state of health requires reference to the cardiologist.

Which doctor should I contact if there is a violation conductivity of the heart

  • Cardiologist
  • Arrhythmologist

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