Fading of the heart - the treatment of this disease has recently excited the minds of many heart surgeons and other "heart" specialists. What is it connected with, what are the symptoms of this dangerous disease, how to treat it - these are just some of the issues that interest our citizens. It is no secret that a sufficiently large number of people have a diagnosis such as "sinking hearts." Symptoms, treatment with folk remedies, referral to specialized institutions, diagnoses - these concepts should be studied by everyone who has signs of the disease. Below are highlighted some relevant issues on this topic.
Fading of heart: causes and treatment
The cause of the feeling of "fading" in the work of the heart can be various disturbances in rhythm and conduction. Some of these conditions do not require medical intervention, and for other forms, a delay in detection and treatment can be fatal. Supraventricular and ventricular arrhythmias are distinguished.
Supraventricular extrasystole
This is a premature electrical activity of the heart. The reason is the source, which is located in the atria, pulmonary and vena cava, as well as in the atrioventricular junction. After such an extraordinary contraction, an incomplete or complete post-extrasystolic pause may develop. Frequent extrasystoles and a longer pause after an extraordinary contraction can give a feeling of fading, interruptions in the work of the heart.
These forms of rhythm disturbances do not have independent clinical significance, except in those cases when their appearance is the start for triggering supraventricular tachycardia, flutter or atrial fibrillation.
In the absence of structural abnormalities in the heart muscle, special treatment of supraventricular extrasystoles is not required. In cases where they are accompanied by significant subjective discomfort, beta-blockers, verapamil, sedatives can be used.
Often supraventricular extrasystoles are a manifestation of the underlying disease (vegetovascular dystonia, chronic obstructive pulmonary disease, electrolyte disturbances), then the diagnosis must be clarified and treatment of the underlying process.
Ventricular extrasystolic arrhythmia
Ventricular extrasystole is an early electrical activity of the heart in relation to the main rhythm, stimulated by an impulse that occurs in the legs or divergences of the His bundle, Purkinje orions or working myocardium. After this process, more often complete compensatory pauses develop, which, as in the case of atrial extrasystoles, are felt in the form of “fading”. Ventricular processes of any gradation without organic heart disease are not a risk factor for sudden death, therefore, they are not treated. The exception is healthy patients with hereditary syndromes (congenital lengthening or shortening of QT, Brugada syndrome, etc.).
Fading of the heart, the causes and symptoms of which are discussed here, also occurs as a result of rare heart rhythms.
Normal heart rate is determined in the range from 60 to 100 strokes per minute. Physiological slowdown of the heart can develop during sleep, with deep breathing, in athletes.
If there is a violation at any stage of the generation and conduction of a cardiac impulse, pathological bradycardia develops, which can be symptomatic, asymptomatic and most often needs treatment.
Reasons for the development of bradycardia
Distinguish between internal and external causes of bradycardia.
Internal causes include:
- aging;
- coronary heart disease;
- connective tissue diseases;
- congenital diseases, including weakness of the atrioventricular node;
- muscular amyloidosis;
- surgical trauma (valve bioprosthetics, heart transplantation);
- contagious diseases (diphtheria, rheumatic heart disease, blood poisoning, typhoid fever).
External factors in the development of bradycardia include:
- physical fitness;
- aggravated vagal electrotone (vasovagal blackouts; hypersensitivity of the carotid sinus);
- drugs (beta-blockers, calcium channel blockers, digoxin, lithium, antiarrhythmic substances);
- cocaine use;
- hypokalemia;
- hyperkalemia
- neurological disorders (CNS tumors, increased intracranial pressure);
- obstructive sleepy apnea syndrome.
For the diagnosis of bradycardia, Holter monitoring, incident counters and implantable recording instruments, as well as electrophysiological studies are used.
Bradycardia Treatment
The first step is to identify the causes of bradycardia and the possible elimination of their action (stop taking betablockers). If there is no removable reason, then drug therapy or temporary or permanent pacing may be necessary).
Drug treatment
Atropine, isoproterenol, and aminophylline are used to stimulate heart rhythm with significant reductions (longer than 3 seconds). However, taking these drugs can provoke rhythm disturbances, including life-threatening ventricular disturbances.
In patients with heart attack and bradycardia due to ischemia, anti-ischemic therapy is carried out and take a wait-and-see attitude, if necessary using pacemaking.
Patients with sinus suppression syndrome and atrioventricular blockade are evaluated to establish a temporary or permanent pacemaker.
There are developed European indications for the installation of permanent pacemakers in patients with CVD, AV block.
Varieties of Stimulants
Distinguish single-chamber, two-chamber, three-chamber stimulants. The first and second have 1 and 2 electrodes (atrial and / or right ventricular). Three-chamber devices are used for biventricular activation and have an additional conductor for the left ventricle.
With stimulation of the right atrium, the synchronization of ventricular contraction is disturbed. On the ECG during such a process, isolation of the right leg of the bundle of His is recorded.
When both ventricles are stimulated, their synchronous work is preserved, and cardiac hemodynamics is much better in this case.
Implantation
The first such device was installed in 1958. Subsequently, their evolution took place. Now these are modern, very small, high-tech devices.
At present, from 400 to 1200 stimulants per one million people are installed annually.
A cardiac device conducts electrical activation of the myocardium. The signal propagates through the heart muscle in a non-physiological way. Its prolonged exposure can cause electrical and mechanical changes in the myocardium. Therefore, the installation of a stimulant must be performed according to serious indications.
Features of stimulation modes
During stimulation of the right ventricle, an electrical impulse is applied to the apex of the left ventricle and depolarizes the slow-conducting myocardium. On the ECG, this is expressed by blockade of the left leg of the bundle of His. Such patients have a lower ejection fraction than patients without blockade. Also in this process, electrical remodeling of the heart occurs. Recently, there has been a tendency to reduce indications for the installation of these stimulants due to a significant number of adverse changes.
It is established that the lowest ejection fraction is formed when exposed to the ventricles. Medium - with activation of the atria, then the remaining parts of the heart. The highest ejection fraction is maintained when the atria and ventricles are stimulated through naturally occurring pathways.
It is proved that fibrillation develops less in patients with atrial and bicameral activation than in patients with only ventricular exposure to the device.
A two-chamber apparatus, proven by research and experimentation, is better in physically active patients.
Pacemakers are currently the gold standard in treating patients with symptomatic bradycardia. The search for the most physiological pathways for positive effects on the myocardium continues.
Conclusion
Thus, a sinking heart (when falling asleep or in other situations) is a very dangerous disease. At the first symptoms of this ailment, you should immediately contact a medical institution, conduct all tests and carefully treat yourself. The faster you start treatment and prevention, the more effective the treatment procedures will be.