Heart rhythm disturbance is always an indicator of malfunctions in the cardiovascular system. Frequent seizures lead to serious consequences. Pathology requires timely treatment. Next, we consider what constitutes paroxysmal tachycardia, what is the danger of the disease, and what therapy is required.
What is this disease
The code, according to ICD-10, paroxysmal tachycardia has 147. The disease is an increase in heart rate, which develops suddenly. The attack resembles extrasystole in its etiology, therefore, with repeated repetitions, we can talk about tachycardic paroxysm.
It is important to consult a doctor in a timely manner to avoid unpleasant consequences, including heart failure.
Disease development
The heart muscle works as a result of impulses in the muscle itself. An electrical signal travels through the fibers and causes alternating contractions of the atria and ventricles. If he meets an obstacle in the way, then the rhythm is broken. Muscle fibers are reduced over the existing barrier, which leads to the return of the impulse and the formation of the focus of excitation.
Against the background of an attack of paroxysmal tachycardia, the time to restore the heart muscle is reduced, the process of ejection of blood into the aorta is disrupted. It does not go unnoticed for the functioning of the brain and other internal organs.
What happens during an attack
In the absence of any pathologies, the heart muscle begins to contract as a result of impulses that occur in the main pacemaker - the sinus node. Their frequency is normal 60-90 per minute. If more, then they talk about the development of tachycardia.
The paroxysmal form has some of its own characteristics:
- In the role of a pacemaker is a pathological section of the heart muscle, which should be engaged in conducting impulses.
- Heart rate is maintained.
- The attack occurs suddenly and also stops.
- Paroxysm is not the norm, even in the absence of other symptoms.
It is important to distinguish between sinus tachycardia and paroxysmal. For this, several signs are taken into account:
- Heart rate. In both forms, an increase is observed.
- Heartbeat. The correct sequence of contractions of the atria and ventricles is maintained.
- The impulse source in sinus tachycardia is the main pacemaker, and in case of paroxysmal pathological focus in the heart.
- The course of pathology. Sinus tachycardia develops gradually and also slowly fades away, and the paroxysmal is sudden.
- Importance for the body. The sinus form may be a variant of the norm, but the paroxysmal is always an indicator of pathology.
Disease classification
In medicine, classification is approached by various factors.
If you take into account the localization of the attack of paroxysmal tachycardia (ICD 10 assigned the disease code 147), then the following forms are distinguished:
- Atrial The center of additional excitation develops in one of the atria. It begins to replace the sinus department. The heart rate is stable, but high.
- Atrioventricular Excitation develops in the area above the ventricle. There are fewer contractions than in the previous form, but impulses follow from the atria to the ventricles and vice versa.
- Ventricular paroxysmal tachycardia. The heart rate is not stable, the ventricles contract more often than the atria. It is considered the most dangerous form, as it quickly leads to the development of heart failure.
The first type of disease and the second can be combined into one form. In such cases, they talk about supraventricular paroxysmal tachycardia.
The pathology can also not proceed the same, given this fact, allocate:
- Sharp shape.
- Chronic
- Recurrent.
Depending on the mechanism of development of supraventricular paroxysmal tachycardia, there are:
- Ectopic form. There are lesions in the heart muscle.
- Reciprocal.
- Multi-focus.
Given the form and course of the pathology, the doctor selects the treatment tactics.
Causes of the disease
It is difficult to determine exactly what served as a trigger for the development of an attack, but several reasons can be identified that significantly increase the risk of paroxysmal tachycardia.
If a person does not have a history of heart disease, then an attack can be triggered:
- Excessive exercise.
- Mental overstrain.
- Alcohol abuse.
- Smoking.
- Eating spicy foods.
- Strong coffee or tea.
- Pathologies of the thyroid gland.
- Abnormalities in the work of the kidneys.
- Disorders in the gastrointestinal tract.
- The use of toxic drugs, especially cardiac glycosides or antiarrhythmic.
These reasons can be attributed to external, but there are also internal, among which:
- Hereditary predisposition.
- The presence of myocardial infections.
- Congenital heart defect.
- Myocarditis.
- Mitral valve prolapse.
- Long stress.
- Mental overstrain.
- Rheumatism.
Attacks of paroxysmal tachycardia can worry not only older patients, but also young people and even children.
Causes of the development of the disease in children
Pathology can manifest itself in childhood. Paroxysmal tachycardia (ICD refers it to serious diseases) in children often develops against the background of the following reasons:
- Congenital diseases of the nervous system, for example, hydrocephalus, increased intracranial pressure.
- Pathology of the adrenal glands.
- Thyrotoxicosis.
- Congenital heart defects.
- Wolf-Parkinson-White Syndrome.
- Infectious diseases of the heart muscle.
- Violations of the autonomic nervous system.
Paroxysmal tachycardia, ICD code 147, in children requires urgent treatment.
Symptoms of the disease
An attack of pathology always develops suddenly. This is the difference between paroxysmal tachycardia and normal heart rhythm disturbance. The patient at this moment feels:
- A sharp push behind the sternum. This is the main symptom of paroxysmal tachycardia.
- The heartbeat is rapid and intense.
- Dizziness may appear.
- Headache.
- Lump in throat.
- Noise in ears.
- Pain in the area of the heart compressive in nature.
- Vegetative disturbances in the form of: increased sweating, an attack of nausea and vomiting, a slight increase in body temperature are possible.
After the cessation of the attack, increased urination is observed. If the attack of paroxysmal nodal tachycardia is delayed, then the following violations are possible:
- General weakness.
- Lowering blood pressure.
- Loss of consciousness.
At the time of a prolonged attack, it is important to provide a person with first aid.
Diagnosis of the disease
It is enough for an experienced specialist to listen to the patient’s complaints to suggest the presence of paroxysmal ventricular tachycardia. Next, the patient is sent for an ECG. Research will show:
- Correct sinus rhythm with an increased to 140-200 number of contractions per minute.
- P wave is visible before ventricular contraction, but in an altered form.
- The QRS complex is not expanded or deformed.
- The atrioventricular node shows a negative P wave after QRS or its absence.
Additional studies are:
- MRI
- Ultrasound examination of the heart muscle.
- ECG monitoring during the day.
- Diagnostic tests after exercise.
- Coronography
- Pulsometry
- Echocardiography. The study allows you to detect inflammatory processes in the myocardium and evaluate its contractility.
After confirming the diagnosis (paroxysmal tachycardia code 147), the doctor prescribes therapy. It may be outpatient or hospitalization is required.
Tachycardia in children
We have already met with the causes that can provoke the disease in childhood, and then we will consider the symptoms.
In children, the heart rate at the time of the attack reaches 200 per minute. Duration can be from a few minutes to 3-4 hours. If you make a cardiogram at this moment, then the specialist will notice specific changes.
The manifestations of pathology are influenced by many provoking factors, among which:
- Difficult pregnancy in a woman.
- Complex birth.
- There are cases of psychosomatic and autonomic diseases in the family, as well as disorders of the nervous system.
- Features of the conduction system of the heart muscle.
- WPW Syndrome.
Very often, the provocateur of an onset of an attack becomes emotional overstrain or increased physical activity. Most often, in children, the attack develops at night or in the evening, but it is not excluded during the day. According to statistics, if it develops for the first time, then in 90% of cases it can be quickly stopped. With repeated attacks, medical help is indispensable.
Danger of disease
Paroxysmal supraventricular tachycardia is dangerous for its negative consequences. The complications of the disease include:
- Ventricular fibrillation, which can be fatal.
- The development of acute heart failure.
- Cardiogenic shock.
- Pulmonary edema.
- Angina pectoris.
- Myocardial infarction.
- Progression of Chronic Heart Failure
The development of complications depends on the state of the heart muscle and on the presence of concomitant pathologies of the internal organs.
First aid for the patient
When symptoms of paroxysmal tachycardia appear, it is important to provide a person with first aid. It is as follows:
- Help the person sit or lie down on the sofa.
- To unfasten the top buttons of clothes to provide free breath.
- Open the window for fresh air.
- Reassure the patient.
You can stop the attack using vagal techniques, which will reduce the effect on the heart muscle of the sympathoadrenal system. The essence of the tricks is as follows:
- Apply regular straining.
- Try to exhale sharply, but the mouth and nasal passages should be closed. This is a test of Valsalva.
- Ashner's test. Press on the inner corners of the eyeballs.
- Wipe with cold water.
- Try to induce a gag reflex.
- Press on the area of carotid sinuses in the region of the carotid arteries.
These methods do not always give the desired result, therefore, to stop the attack of paroxysmal supraventricular tachycardia, it is necessary to use antiarrhythmic drugs.
- A 10% ATP solution or 5% Glucose solution is administered intravenously, but this can be done if there is no low blood pressure.
- At low pressure, administer Novocainamide together with Metazone or Adrenaline.
- If a supraventricular form of pathology is observed, then “Amiodarone”, “Digoxin”, “Disopyramide” are used.
- In some cases, the use of b-blockers gives a positive effect.
If help did not help, paroxysmal tachycardia does not recede, then an urgent need to call a doctor.
Pathology therapy
After first aid in the event that the attack is repeated several times a month, serious treatment is required. If the ventricular form of tachycardia, then the patient is urgently hospitalized. In other cases, you can undergo therapy on an outpatient basis.
Treatment for each patient is selected individually, taking into account the frequency of seizures, the form of pathology, localization and course. Be sure to take into account concomitant pathology.
Therapy aims not only to eliminate the attacks of the disease, but also the reasons that provoked them. Sometimes for this the patient needs to undergo a series of additional examinations. The doctor most often prescribes the following list of drugs to the patient:
- Cardaron for improving heart rate.
- To block adrenaline, “A Tenolol” is prescribed.
- Verapamil is a calcium blocker.
- To restore the rhythm of "Glycine."
- As a sedative, "Valocardin" is prescribed.
- "Tincture of hawthorn."
These drugs alleviate the condition of the patient, but antiarrhythmics are required to increase effectiveness. These drugs are administered only intravenously in a hospital under the supervision of a doctor:
- Quinidine.
- Aimalin.
- "Etmozin."
If therapy does not give noticeable positive results and the seizures are repeated, then an electropulse effect is prescribed.
In severe cases, an operation is recommended, during which mechanical, laser, cryogenic or chemical destruction will be performed. It is possible that the patient will need to install a pacemaker.
Prognosis for the patient
It depends on several factors:
- Forms of paroxysmal tachycardia.
- Duration and frequency of seizures.
- The presence of complications.
- The state of the heart muscle.
If the myocardium has extensive lesions, then the risk of developing ventricular fibrillation and heart failure increases. The best prognosis is the supraventricular form. It least affects the overall health of a person, but it is almost impossible to completely get rid of it. The course of this form is most often due to the physiological characteristics of the heart muscle and the underlying disease, which has become a provocateur of the development of seizures.
A less favorable prognosis for the ventricular form, which develops against the background of cardiac pathologies. But regular visits to the doctor and taking the prescribed drugs several times reduces the likelihood of developing sudden heart failure and death.
Disease prevention
It is impossible to completely prevent the development of paroxysmal tachycardia, but it is possible to reduce the likelihood of its occurrence. To do this, some preventive measures must be observed:
- Timely engage in the treatment of any infectious diseases in the body.
- Consult a doctor if problems arise in the functioning of the heart muscle.
- Lead a healthy lifestyle.
- Eliminate smoking and alcohol abuse.
- Review the diet, on the table should only be healthy and wholesome food with lots of vitamins and the right substances.
- Avoid increased physical and mental stress.
- In the presence of increased nervous excitability, take light sedatives.
- Do not abuse strong coffee and tea.
- When prescribing therapy to prevent new attacks, you must regularly take drugs recommended by your doctor.
You can cope with the disease if you do not ignore the unpleasant symptoms and see a doctor. Timely treatment will help get rid of paroxysmal tachycardia attacks.