The term "extrasystole" refers to a pathological condition, the course of which is accompanied by a violation of the heart rhythm. The reasons can be very diverse. Extrasystole can be both an independent disease, and testify to the progression in the body of another ailment. In all cases, if alarming signs occur, you should consult a doctor. This is due to the fact that this type of arrhythmia can lead to sudden cardiac arrest.
Pathogenesis
In the human body, the cardiac conduction system acts as a regulator of the number of myocardial contractions. It is represented by the following structures:
- Muscular paths.
- Sinus-atrial node.
- Atriventricular node and bundle.
- Interstitial atria.
In the sinus-atrial node, an impulse arises. It is the impetus for the occurrence of excitement. It, in turn, provokes the depolarization of interstitial atria. Then the excitement passes through the atriventricular node and is transmitted through the beam to the ventricles.
Under the influence of various unfavorable factors, a process of generating additional impulses is launched in some part of the conducting system. Naturally, the heart reacts to them with extraordinary contractions - extrasystoles.
Excitation always comes from an abnormally altered area. Such zones are commonly called ectopic in medicine. It is worth noting that extrasystole is a condition that is often diagnosed in practically healthy people.
Etiology
The disease is the most common type of arrhythmia. According to statistics, he is diagnosed in 65% of practically healthy people who do not show any complaints regarding their state of health. In this case, it is customary to talk about functional extrasystole.
Often an ailment is a sign of another disease. In this situation, the pathology is organic in nature and requires a comprehensive diagnosis. It must be understood that extrasystole is a condition that may indicate impaired functioning of not only the cardiovascular, but also other systems.
The main reasons for the development of functional extrasystole:
- Staying long under stress.
- Neurosis.
- Long-term use of certain medications.
- Osteochondrosis of the cervical spine.
- Cardiopsychoneurosis.
- Frequent and high-intensity physical activity.
- Smoking
- Frequent use of alcohol-containing drinks.
- Overwork.
- Intoxication process.
- Regular use of strong coffee.
- Weakening of the body after an infectious disease.
- Thyrotoxicosis.
- Uremia.
The main causes of the occurrence of organic extrasystole:
- Cardiosclerosis
- Past myocardial infarction.
- Heart disease.
- Inflammatory processes of various etiologies.
- Diseases of a systemic nature, the course of which is accompanied by damage to the heart muscle.
- Violation of ion metabolism.
- Coronary artery disease.
- Hypertension.
- Myocarditis.
- Heart failure.
- Cardiomyopathy
- Pericarditis.
It is worth noting that extrasystole is a condition that can occur regularly in any person. It is customary to talk about pathology only if more than 200 unplanned contractions per day are observed.
Regardless of the causes of extrasystole, it is impossible to delay the treatment of the disease. This is due to the fact that it can lead to the development of various complications and even death.
Classification
Depending on the zone of formation of ectopic foci, the following types of extrasystoles are distinguished:
- Ventricular. It is diagnosed in 62.6% of cases. I49.3 - ICD-10 code for ventricular extrasystole.
- Atrioventricular. It is found only in 2% of cases. The code for ICD-10 is I49.2.
- Atrial Diagnosed in 25% of cases. I49.1 - code according to ICD-10.
In isolated cases, an unplanned impulse is formed in the sinus-atrial node. There are also situations when the patient is diagnosed with a combination of several types of ailment.
The most common is ventricular extrasystole (ICD-10 code above). As a rule, it is functional in nature, but the likelihood of serious pathologies cannot be ruled out. The difficulty lies in the fact that a change in MPP (untimely depolarization) is often asymptomatic. But it is important to remember that the prognosis directly depends on the timeliness of contacting a doctor.
In the conduction system of the heart, one or more sources of excitation can form. Depending on this, extrasystoles can be:
- Monotopic. In this case, it is customary to talk about the presence of one ectopic site. On an ECG, extrasystole in this case has stable intervals.
- Polytopes. The body has several ectopic zones. On an ECG, extrasystole has different adhesion intervals.
In addition, during the diagnosis, unstable paroxysmal tachycardia can be detected. This is a condition in which several extrasystoles coming directly one after another are detected.
Currently, medicine uses several classifications. The most common is the gradation of ventricular extrasystoles according to Laun - Wolf:
- I class. The number of unplanned cuts is 30 per hour or less. Such an arrhythmia poses no threat to either health or life. Even with symptoms of extrasystole, treatment is not required.
- II class. The number of unplanned cuts is 31 per hour or more. In this case, it is customary to talk about a slight deviation from the norm. This condition does not lead to the development of complications. The decision on the advisability of prescribing medications should be made by the doctor based on the history and diagnosis.
- Class III - polymorphic extrasystoles. On the ECG, a lot of unplanned heart contractions are diagnosed. To avoid the development of negative consequences, it is necessary to take medicines.
- IV-a class. These are paired extrasystoles that follow directly one after another. In this case, it is customary to talk about a class of high gradation, which often leads to complications.
- IV-b class. These are volley extrasystoles, that is, those that seem to shoot 4-5 at once. In this case, doctors talk about a class of high gradation, which leads to irreversible changes. Moreover, this condition is a danger not only to health, but also to the life of the patient.
- V class - early extrasystoles. This is the most serious condition that leads to cardiac arrest.
Thus, regardless of the severity of symptoms and causes of extrasystole, treatment should not be delayed. Ignoring warning signs can cost a living.
Clinical picture
The difficulty is that the disease does not have specific symptoms. Moreover, it often proceeds without any signs. According to statistics, in 70% of cases, this type of arrhythmia is detected randomly during a routine physical examination.
The intensity of symptoms depends on the following factors:
- The state of the cardiovascular system.
- Age of a person.
- Type of disease.
- The degree of reactivity of the body.
If a person is relatively healthy, there is a high probability that he will not feel the symptoms of extrasystole. In the presence of serious pathologies, the following clinical manifestations occur:
- Pain in the heart.
- The appearance of anxiety for no apparent reason.
- The feeling that the heart is beating strongly against the chest.
- Excessive sweating.
- Fading of the heart.
- A feeling of severe lack of air.
- Pallor of the skin.
- Weakness.
- Hot flashes.
- In people suffering from cerebral arteriosclerosis, frequent episodes of dizziness are noted.
Patients compare the sensations with signs of a panic attack. It seems to them that their heart has stopped and death is near. But this state lasts only a couple of seconds.
Regardless of the severity of symptoms of extrasystole, it is better not to delay the treatment of the disease. This is due to the fact that in severe cases, the heart can really stop once.
Diagnostics
If the first alarming signs occur, you need to contact a cardiologist. The doctor will be able to suspect the presence of extrasystole already at the stage of collecting an anamnesis and physical examination.
The following information is clinically significant for the doctor:
- The circumstances of the occurrence of uncomfortable sensations.
- Is the patient taking any medications?
- How often disturbed are signs of heart rhythm disturbance.
- What diseases the patient suffered in the past. It is important to remember that extrasystole is such an ailment that can be a complication of many pathologies.
During the examination, it is crucial to determine the etiology of the disease. Only after this, the doctor will be able to understand how to treat cardiac extrasystole.
During palpation of the pulse (this is done on the radial artery), the cardiologist can fix a sudden wave and a subsequent pause. And this already speaks of insufficient filling of the ventricles.
An important study is auscultation of the heart. During its conduct with extrasystole, you can hear premature I and II tones. The first is reinforced, which is a natural consequence of insufficient filling of the ventricles. II tone is weakened, this is due to the fact that the volume of blood entering the aorta and pulmonary artery is reduced.
Most often, the diagnosis of extrasystole is confirmed after a standard and daily ECG. The disease is often detected during these studies, when the patient has no complaints.
Electrocardiographic signs of pathology:
- Untimely occurrence of tooth R. It appears earlier than necessary. On the ECG, you can notice a shortening of the interval between the tooth, which reflects the main rhythm, and the one that indicates the occurrence of extrasystole.
- The presence of expansion, deformation and high amplitude of the QRS complex. A similar condition is characteristic of ventricular extrasystole.
- After an unplanned impulse, a compensatory pause follows.
Holter ECG monitoring is a study that involves recording electrocardiographic data during the day. At this time, a special apparatus is fixed on the patient's body. In addition, the patient should keep a diary in which he needs to reflect all his feelings. Holter ECG monitoring is prescribed for all patients suffering from cardiopathologies, regardless of whether they have signs of extrasystole or not.
It so happens that the disease is not detected during the ECG. To confirm his suspicions, the doctor may prescribe the following studies:
- Bicycle ergometry.
- MRI
- Ultrasound of the heart.
- Load test.
Only on the basis of the diagnostic results, the doctor will be able to provide information regarding how to treat extrasystole.
Therapy
The choice of patient management tactics is carried out by a cardiologist. Many patients wonder about whether cardiac extrasystole should be treated at all. As mentioned above, episodic arrhythmia, which is functional in nature, poses no danger to health or life. In this regard, this condition does not require therapeutic measures.
Very often, women complain that episodes of heart rhythm disturbance disturb them a few days before menstrual bleeding. This condition is also a variant of the norm and does not require correction.
In individuals suffering from vegetovascular dystonia, extrasystole is manifested very pronounced. If arrhythmia causes severe discomfort, it is necessary to reduce the intensity of physical exertion, abandon stimulants, avoid getting into stressful situations, and include foods containing magnesium in the diet.
In the presence of serious pathologies (heart defects, coronary heart disease, etc.), complex treatment is required. This is due to the fact that the abnormal rhythm exacerbates their course, which can lead to negative consequences.
In all other cases, the feasibility of therapeutic measures is evaluated by the doctor. The specialist takes into account the form of the disease and its severity.
Information on how to treat extrasystole should be provided by a cardiologist. The classical scheme of therapy is as follows:
- The paramount task is to reduce the number of unplanned cuts. Antiarrhythmic treatment can significantly improve the quality of life of patients. In case of extrasystole, drugs of the first, second or third generation are prescribed. The most effective remedies are Cordaron and Amiodarone. Their performance indicator is over 70%. Second-generation drugs include: “Bisoprolol”, “Atenolol”, “Metoprolol”. The effectiveness indicator of these beta-blockers varies between 50-70%. Third-generation drugs: Panangin, Diltiazem, Verapamil, Carbamazepine. Their effectiveness is less than 50%.
- Monitoring the functioning of the gastrointestinal tract and organs of the endocrine system. If pathologies are identified, appropriate treatment is carried out.
- Dietary adjustment. In the presence of pathologies of the cardiovascular system, it is imperative to include magnesium-rich foods in the menu. The diet should include: beans, sea kale, apples, bananas, all kinds of cereals, prunes, raisins, dried apricots, persimmons, nuts, lettuce.
- Correction of the degree of physical activity. In the presence of extrasystole, high-intensity training is contraindicated. It is recommended that you prefer swimming, cycling and walking at a moderate pace.
- If, against the background of extrasystole, patients experience a decrease in working capacity and sleep disorders, the doctor prescribes sedatives or tranquilizers.
This scheme can be adjusted by the doctor based on the history and diagnostic results of a particular patient.
Possible complications
Almost every patient is interested in the question regarding the danger of extrasystole. And the disease is indeed a threat, not only to health, but also to life. The danger of the disease lies in the fact that it very often leads to the development of all kinds of complications.
The consequences of extrasystole:
- Paroxysmal tachycardia.
- Atrial fibrillation.
- Chronic insufficiency of coronary, renal and cerebral circulation.
The most dangerous is ventricular extrasystole. According to statistics, it is she who most often leads to sudden death.
Forecast
The outcome of the disease directly depends on its type and the timeliness of going to the doctor. The most favorable prognosis is considered if episodes of extrasystole occur in practically healthy people. In this case, arrhythmia in no way affects the quality of life and activity indicator.
The effectiveness of the therapy largely depends on the state of the cardiovascular system. The most unfavorable prognosis is considered if the development of extrasystole was triggered by the progression of myocarditis, acute myocardial infarction, or cardiomyopathy. In this case, complications most often arise that can lead to death. That is why it is necessary to consult a doctor when the first alarming signs occur.
Prevention
In order to prevent the development of pathology, it is necessary to observe several important rules. They relate to activities carried out as part of both primary and secondary diagnostics.
What do we have to do:
- Regularly undergo preventive examinations and timely treat all detected diseases, especially pathologies of the cardiovascular, circulatory, endocrine and nervous systems.
- Do not take medications whose use is not agreed with the doctor. This is especially true for hormonal drugs, sedatives and tranquilizers.
- Follow the principles of a healthy lifestyle. Physical activity should be moderate, and the diet - balanced. In the presence of any disturbances in the functioning of the heart muscle, it is necessary to include foods rich in magnesium in the menu.
Extrasystole is a disease that is characterized by a relapsing course. In this regard, the treatment of the underlying disease should be complete. In addition, it is necessary to regularly visit a cardiologist in order to prevent the development of various complications.
Finally
Extrasystole is a pathology, the course of which is characterized by the occurrence of unplanned contractions of the heart.The disease, depending on the localization of ectopic sites, has several types. The most dangerous and common is ventricular extrasystole. If alarming symptoms occur, consult a cardiologist. The doctor will draw up a referral to a comprehensive diagnosis, based on the results of which will make the most effective treatment regimen.