Author Ольга Кияница
Extracardiac bradycardia is a pathological condition that develops without organic damage to the heart against diseases of other systems and organs. Often associated with various disorders of the central and peripheral nervous system.
In extracardiac bradycardia, only the frequency of cardiac contractions often changes, which in adults can be 50 ug / min or lower. In this case, the rhythm remains correct, the main driver is the sinus node.
The diagnosis of the pathology does not present any particular difficulties and the preliminary diagnosis can be established at the first medical examination. More time will be needed to determine the cause of arrhythmia. A similar is done with the purpose of the appointment of effective treatment of extracardiac bradycardia and the underlying disease.
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Description of extracardial bradycardia
Under the influence of various factors, certain mechanisms of slowing down the heart rate are triggered. Most often, bradycardia develops as a result of weakening of the sinus node activity. Similar is observed when the sympathetic nervous system decreases or, on the contrary, increases - parasympathetic.
The second mechanism of development of rhythm disturbance is hormonal imbalance. For example, in hypothyroidism, inadequate amounts of thyroid hormones are synthesized, which negatively affects the activity of the heart.
The main types of danger represented by bradycardia below 40 beats / min:
- The myocardium receives insufficient oxygen.
- In the central nervous system pathological changes begin to occur.
- There are various uncomfortable feelings that noticeably decrease the productivity of a person.
- In severe cases, bradycardia is complicated by threatening conditions in the form of myocardial infarction, stopping of breathing or ending heart activity.
Extracardiac bradycardia refers to the classification of sinus bradycardia due to development, so its mention in the diagnosis indicates the presence of another, the main disease, as well as complications in the form of arrhythmia.
Symptoms of extracardiac bradycardia
The disease may be asymptomatic and determined on a regular examination by a doctor. In other cases, there is a chronic, not very pronounced clinic, which manifests itself by the following symptoms:
- decrease of working capacity;
- fast fatigue;
- noise in the ears, flies in front of the eyes;
- shortness of breath
If adults can show these or other complaints, children are not always able to accurately characterize their well-being.Therefore, in the case of frequent whims of a baby or poor school performance in older children, a pulse should be measured, which, depending on the age of the bradycardia, is determined by the following values:
- in the first months after birth - less than 100 beats / min;
- up to six years - less than 70 a / min;
- to 16 years old - less than 60 beats / min.
Changes in cardiac activity in children are normal, and therefore, extracardiac bradycardia should be distinguished from respiratory arrhythmias, which disappears during physical exercises. If the lower pulse is observed constantly and at the same time there are signs of other diseases (infection, endocrine pathology), then you should not delay your visit to a doctor.
Causes of extracardial bradycardia
In the development of the pathological state, various diseases can take part. The only thing, and it's important, is not related to the organic damage to the heart.
The main factors provoking the appearance of extracardiac bradycardia:
- Activation of parasympathetic nerves, which is often caused by squeezing the carotid sinus (with a tightly tied tie) or eyeballs (some patients have a bad habit of rubbing their eyes often).
- Violation of the activity of various parts of the nervous system, most often vegetative, which is often expressed in neuroses, neuralgia, osteochondrosis, etc.
- Traumatic and tumorous lesions that lead to an increase in intracranial pressure.
- Inflammatory and ulcerative diseases of the stomach or duodenum.
- Thyroid dysfunction, manifested in hypothyroidism, that is, the inadequate production of thyroid hormones.
In the development of rhythm disturbance without visible causes, that is, there are no cardiac and extracardiac factors, then speak of idiopathic bradycardia. But such a pathology occurs quite rarely.
Diagnosis of extracardiac bradycardia
Begins at the reception of the doctor, where the patient is listened to the stethoscope and make a preliminary conclusion. At insignificant clinic during the medical examination there are no significant violations, except for the reduction of heart rate. In severe cases, the poor condition of the patient is objectively noted, a preliminary failure of the heart rate is made.
An important method for diagnosing any form of arrhythmia is electrocardiography. This available study allows us to determine the following signs of extracardiac bradycardia:
- unchanged teeth P, T, ventricular complexes QRS;
- reduction in heart rate below 60 beats / min (in adults);
- the presence of the correct sinus rhythm;
- absence of signs of organic heart disease.
Before the start of therapy, as a rule, Holter monitoring is performed. With its help the functional capabilities of the heart are evaluated. In order to exclude cardial pathology, ultrasound of heart cells is performed. If additional differentiation is required between different diseases, then load tests are assigned.
Treatment and prevention of extracardiac bradycardia
The weakly manifested violation of the rhythm is not corrected by medication. If there are indications in the form of fatigue, marked weakness, heart rate decrease to 40 beats / min and less, the following drugs are prescribed:
- Atropine - intravenous administration every 3 hours.
- Isadrin - is administered in vest with glucose intravenously drip.
- Alupent - used as a solution with sodium chloride and in tablets.
- Isoproterenol is used by the intravenous route of administration.
Some patients do not tolerate atropine and isadrine or have contraindications to these drugs. In such cases, ephedrine is prescribed.
Herbal preparations can also help cope with bradycardia, but their treatment should be agreed with the treating doctor.For example, for the treatment of extracardiac bradycardia, preparations of beauty, eleutherococcus extract and ginseng are often used.
In accordance with the main disease for treating arrhythmias, various national methods of therapy are used. Pretty effective are recipes based on radish and honey, walnuts, lemon with garlic, pine shoots and hips.
The prevention of extracardiac tachycardia consists in the treatment of the underlying disease, as well as the implementation of the recommendations of the doctor on dietary nutrition, physical activity, regulation of the mode of rest and work.