In recent years, there have been more patients who complain of pain in the heart. After the examination, it turns out that most patients have had serious changes in the work of the heart muscle, and they need emergency care and urgent hospitalization. Often there is such a disease as atrial fibrillation, in which the heart is very worn out, which subsequently leads to the development of pathologies in other body systems. One of the forms of atrial fibrillation is paroxysmal, how dangerous it is, how it manifests its symptoms, every person needs to know.
What is this pathology?
Atrial fibrillation of a paroxysmal form is a disease with serious impaired coordination of contractile movements of the myocardial muscle fiber. The disease is common, but as an independent state is very rare, most often it is an indirect sign of heart disease, respiratory systems and blood vessels.
Paroxysmal atrial fibrillation is expressed in periodic changes in the sinus node, in which atrial myocytes move in random order, their frequency can reach up to 400 contractions per minute. As a result of this, only the ventricles of the 4 chambers of the heart work, which adversely affects the work of the entire circulatory system.
Causes of the appearance of a paroxysmal form
Paroxysmal form of atrial fibrillation according to ICD-10:
- I 48 - this is atrial fibrillation and flutter;
- I 00-I 99 - diseases of the circulatory system;
- I 30-I 52 - other heart diseases.
The main and main reason for the development of the disease is one - this is a disease of the cardiovascular system:
- heart ischemia;
- hypertonic disease;
- all forms of heart failure;
- all types of cardiac dysfunctions that provoked the inflammatory process;
- congenital or acquired heart muscle defects;
- genetic cardiomyopathies.
But there are causes of the paroxysmal form of atrial fibrillation, which are not associated with cardiac pathologies:
- The abuse of smoking and alcohol, drug addiction.
- Malfunctions in the electrolyte balance when there is a magnesium-potassium deficiency.
- Structural ailments of organs and tissues of the respiratory system.
- The acute form of infectious invasion.
- Conditions after surgery.
- Diseases of the endocrine system.
- Treatment with adrenergic agonists, cardiac glycosides.
- Chronic stress
What are the forms of atrial fibrillation of a paroxysmal form?
This form of arrhythmia is a malfunction in the functioning of the heart muscle, which can last an average of about 7 days. If changes are observed longer, then cardiologists give the patient a chronic form.
Cardiologists divide the disease into several forms and types. First of all, the frequency with which the atria is reduced is taken into account, therefore, they distinguish:
- typical flicker when the frequency of contractions is 300 per minute;
- indicative flutter of not more than 200 contractions.
Despite the intensity of the atria, not all impulses are carried out on the ventricles of the heart. If you classify the disease according to the frequency of contractions, then there are such forms:
- tachysystolic, in which the contraction of the ventricles is not more than 90 per minute;
- bradisystolic - less than 60;
- normosystolic or often called intermediate.
According to the clinical course, the intermediate form of pathology is considered optimal. Attacks of atrial fibrillation of a paroxysmal form can be repeated, in which case it is called recurrent.
Regarding the location of the foci of increased impulse, paroxysm can be divided into three types:
- atrial arrhythmia is when impulses are formed in the atrial node;
- ventricular arrhythmia - impulses originate in the conduction system of the ventricles;
- the mixed type has several foci at once.
Symptoms of the disease
There are many direct and indirect causes of paroxysmal arrhythmias, symptoms may vary in patients. So in some patients, unpleasant sensations in the region of the heart can be observed, and in others, such manifestations are observed:
- suddenly the heart begins to beat faster;
- sharp weakness throughout the body;
- lack of air;
- limb cooling;
- in rare cases, trembling is observed.
Also, patients may experience pallor of the skin and blueness of the lips. If the patient's case is quite complicated, then other symptoms may occur:
- dizziness;
- loss of consciousness;
- fainting state;
- panic.
But you should not worry right away, perhaps such symptoms indicate diseases that are not related to the heart. Only an ECG can pinpoint the cause.
After an attack of ciliary arrhythmia of a paroxysmal form, the contractility of the smooth muscles of the intestine may increase in patients and frequent urination is noted. When heart rate decreases to the lower limit, blood circulation in the brain significantly worsens. This condition can manifest itself in the form of loss of consciousness, respiratory arrest, it becomes difficult to determine the pulse. In this case, the patient should urgently be sent to intensive care.
Diagnostic methods
The frequency and rhythm of heart contractions determine the clinic of the disease. The main thing is to study the rhythm and filling of the pulse, since with atrial fibrillation its deficiency is often observed.
To accurately determine the form of paroxysm of atrial fibrillation, you need to go through a number of studies:
- myocardial auscultation - with fibrillation, an arrhythmic heartbeat is observed, atrial flutter is manifested in the form of loss of each subsequent stroke;
- electrocardiography allows you to notice how the QRST complex changes with the ventricular variant of the disease, if the shape of the R wave is distorted and there are signs of conduction disturbance in the right leg of the His bundle with atrial shape, P wave change or if it overlaps with QRST, this indicates a combined form of the disease;
- ECHOCG makes it possible to assess the shape and size of the atria, what is the state of the heart valves.
Before the doctor sends the patient for examination, he carefully examines the medical history (atrial fibrillation, paroxysmal form and type), learns about concomitant pathologies. If the patient is engaged in hard work, then this is a serious obstacle to the treatment of the disease. Concomitant diseases will help to choose the most effective treatment regimen.
Complications
Frequent interruptions in the work of the heart with rapid strokes lead to the fact that the myocardium is overstressed. A paroxysmal form of heart rhythm disturbance causes serious circulatory disruptions, which can ultimately provoke blood clots and thromboembolism. That is why it is urgent to take all possible measures and begin treatment of the paroxysmal form of fibrillation as soon as possible, otherwise the patient may have the following consequences:
- state of shock - when blood pressure drops rapidly, the frequency of contractions of the ventricles decreases;
- the development of acute heart failure;
- pulmonary edema - cardiac asthma;
- arrhythmic cardiomyopathy;
- deterioration in the nutrition of brain tissue.
If the attack is unfavorable, then there is a risk of developing thromboembolism. Blood clots that can migrate to other parts of the body can accumulate in the atrial disease altered by the disease. Only two days after atrial fibrillation of a paroxysmal form, as a result of clogged arteries, a heart attack, stroke, or gangrene can develop.
First aid for atrial fibrillation
Before a patient with paroxysm of atrial fibrillation receives emergency medical care, he needs help at home. Help consists in providing mechanical action on the vagus nerve:
- Valsalva's test involves an attempt to inhale, while blocking the access of air. Nose and mouth are covered with palms and take a breath.
- Ashner's test involves pressing with your fingers on the inner corner of the eye, but you just need to do everything as carefully as possible so as not to harm.
- The Goering-Chermak test is carried out by pressing on the carotid artery to reduce oxygen supply and the number of heart beats per minute.
- Wiping with cold water will help reduce the respiratory rate and contractions of the heart muscle.
- You can stop the attack if you provoke a gag reflex.
It is very important to send the patient to the hospital immediately after the attack, otherwise it will be difficult for experienced doctors to restore the sinus rhythm two days after it.
Drug treatment
In the hospital, doctors use the following drugs:
- "Digoxin" - helps control heart rate;
- "Cordaron" has a minimum number of undesirable manifestations, which in this case is a significant plus;
- "Novocainamide" - if administered quickly, helps lower blood pressure.
All of these drugs are administered intravenously. Most patients experience relief in the first hours after such treatment.
The doctor can recommend the treatment of paroxysmal atrial fibrillation "Propanorm" in patients with seizures and to alleviate the condition, which is available in the form of tablets, so the patient can take it without any help.
Pulse treatment
If drug treatment did not bring relief to the patient, then in this case, the doctor may recommend electropulse therapy. This procedure is as follows:
- the patient is anesthetized;
- two electrodes are installed above the heart and under the clavicle on the right side;
- the doctor on the device sets the synchronization mode, this is necessary so that the discharge is fully consistent with ventricular contraction;
- the required current value is set, it can vary from 100 to 360 J;
- produces an electric discharge.
Thus, the doctor, as it were, reboots the cardiac system. The method is almost 100% effective.
Surgical intervention
The operation is recommended for patients with frequent seizures, when drug treatment of atrial fibrillation of the paroxysmal form did not give the desired result.
The operation consists in cauterizing the foci of excitation of the heart muscle with a laser. To carry out the procedure, an artery is punctured and special catheters are inserted into it. The effectiveness of the procedure by the method of radiofrequency ablation is more than 80%. If the first procedure did not give the desired effect, then it is repeated.
Traditional medicine for atrial fibrillation
Before using folk methods in treatment, you should consult your doctor so as not to harm the health that has become shaky. If there are no contraindications, then you can apply such recipes:
- Take hawthorn and its tinctures for alcohol, motherwort and valerian. You need to take three bottles of each tincture and mix in one container, shake everything well and send for the whole day in the refrigerator. After a day, you can start taking 1 teaspoon three times a day half an hour after eating.
- Take a pound of lemons, finely chop them and pour honey, add 20 apricot kernels. Eat the treatment mixture twice a day for 1 tablespoon.
- It will take 4 grams of Adonis grass, which is filled with a glass of water and boiled in an enameled container for no more than 3 minutes. After that, set aside the broth for 20 minutes in the heat. Take a decoction of one tablespoon three times a day.
The features of the paroxysmal form of atrial fibrillation are such that seizures can occur at any time, which is why the patient should always have a means in the access zone that will help him easier to transfer it. But it is better after the first attack to get qualified specialist help and do everything possible so that he is no longer there.
Prevention and prognosis of the disease
Patients who already had a malfunction in the heart or in the family have relatives with serious problems, the prevention of heart disease is necessary. In addition, you need:
- reduce or even completely eliminate the use of alcoholic beverages;
- avoid serious physical exertion, it is better to replace them with walks in the fresh air with an unhurried step;
- eat balanced, exclude everything fatty and spicy, foods rich in potassium and magnesium should prevail in the diet;
- as a prophylaxis, take sulfate, aspartate.
As for the prognosis for a patient with paroxysmal atrial fibrillation, it cannot be called unfavorable, especially if the attacks did not provoke the development of more serious pathologies. If you follow all the recommendations of a doctor, then the patient can live for more than a dozen years with such a diagnosis.
The frequency of serious pathologies in people with this diagnosis is one in 6 people, which gives a good prognosis for each patient. It is important to change your lifestyle and follow all recommendations.