Author Ольга Кияница
Tachycardia is a concept that often involves a specific symptom - a rapid heartbeat. In some cases, it is associated with specific diseases in the arrhythmia group, which are characterized by a specific clinic, course, prognostic value.
The idiopathic tachycardia is most often defined as ventricular or sinus. It can occur at any age, but in most cases - in young people.
In the diagnosis of tachycardia, electrocardiography, echocardiography is used. More focused methods of investigation may be applied - transesophageal cardiomyopathy or angiography. In any case, it is often difficult to find out the cause of the pathology, therefore, what is an idiopathic tachycardia, how dangerous it is to know this disease for all people in the risk group for cardiovascular diseases.
Description of idiopathic tachycardia
The most important difference between idiopathic tachycardia and other forms of arrhythmia is the appearance of the disease against the background of complete clinical health of a person. During the research, no changes in the myocardium, metabolic or electrolyte disturbances are detected, therefore it is rather difficult to prescribe treatment with an unspecified etiology of the pathological process.
In normal condition, the heart rate is 60-90 beats. In some studies, the association between arrhythmia and the following factors was found:
- in women with heart rate is higher than in men;
- heartbeat was directly proportional to growth, consumption of coffee, the presence of bad habits (smoking);
- The heart rate reversed on age, increased blood pressure, and physical activity.
The lack of clear mechanisms for the development of the disease often does not enable the correct diagnosis to be established accurately and quickly. Nevertheless, with the help of modern diagnostic methods it is possible to appoint an effective treatment for patients with idiopathic tachycardia.
Symptoms of idiopathic tachycardia
A large group of idiopathic tachycardia patients consists of young people and women. At the same time, not everyone can recall the first attack of the heartbeat, whereas manifestations of the disease are often delayed for months and even years.
Sensation of a heartbeat, when the heart rate rises from 100 beats per minute, is often difficult to carry. Patients may feel a lack of air, "the heart seems to jump out of the chest", the difficulty of breathing. Not every patient during an attack can relax, take a little distract from a painful condition, whereas in other pathologies this distraction effect reduces the severity of symptoms.
Clinical manifestation of idiopathic tachycardia mainly complicates the presence of autonomic disorders:
- increased sweating;
- pre-anxiety states.
All these symptoms are often encountered in orthostatic tachycardia and somatoform dysfunction of the autonomic nervous system, so in the case of idiopathic tachycardia, it is extremely difficult to correctly determine the disease.Therefore, idiopathic tachycardia is considered to be the diagnosis of an exception.
Causes of idiopathic tachycardia
Based on clinical studies, it has been suggested that idiopathic tachycardia is a consequence of various mental pathologies. Also, the development of the disease may involve certain substances consumed by humans, and the consequences associated with disturbance of the normal activity of the sinus node or ventricles.
Explicit causes, cardiac or extracardiac, can not be identified in idiopathic tachycardia.
In some cases, the violation of the rhythm is associated with heredity. If the pathology occurred in relatives, then the risk of developing the disease in their children is much higher. In particular, in some patients with idiopathic tachycardia of the ventricles, there is a mutation of the SCN5A gene that participates in coding the α-subunit of the sodium channel.The mutation in this gene is also determined in other cardiac diseases: cardiomyopathies, atrial fibrillation and ventricles, syndrome of weakness of the sinus node.
Types / photos of idiopathic tachycardia
The pathology can be expressed in various forms of arrhythmias, accompanied by a rapid heartbeat, but most often, idiopathic tachycardia is associated with a disruption of the sinus node and ventricles.
Idiopathic ventricular tachycardia
In this pathology, structural, metabolic or electrolytic disorders are not determined, and QT prolonged interval syndrome is not detected. Despite the complexity of diagnosing the disease, there are three types of idiopathic ventricular tachycardia:
- fascicular tachycardias of the left ventricle, also called verapamil-sensitive;
- tachycardia developing against the background of Brugada syndrome;
- tachycardia, originating from the ventricular ventricles.
Factsicular tachycardia of the left ventricle is still known under the terms septal ventricular tachycardia, intrafacial tachycardia, ventricular tachycardia with narrow complexes. Among all forms of idiopathic tachycardia, originating from the left ventricle, it occurs most often. It develops according to the type of reentry, is often determined at a young age when no structural changes in the myocardium are yet available. Sensitive to verapamil, so this drug is prescribed in the first place. There are various types of fascillary tachycardia. In 90% of cases, there is a posterior fascicular tachycardia, much less commonly the anterior fascicular, upper septal, and interphyscicular tachycardia.
Brugada syndrome is a hereditary illness, the symptom complex of which includes paroxysmal polymorphic ventricular tachycardia, which gives frequent relapses. In addition, syncope is observed, and in the background of the course of pathology in patients, suddenly there are sudden stops of the heart.
Idiopathic sinus tachycardia
The occurrence of a pathological condition is associated with a violation of the functioning of the sinus node, in addition, failures in the functioning of the autonomic nervous system may be noted, when the activity of the sympathetic system increases or falls, a parasympathetic system. In this case, accompanying neurohormonal disorders may occur.
It manifests itself as a typical sinus tachycardia, which occurs without any apparent cause. The following evaluation criteria are taken into account:
- heart rhythm is similar to abnormal;
- The heart rate is accelerated in a calm condition or with insignificant physical activity;
- The heart rate can be 100 strokes per minute or more.
Such a diagnosis is only made when all others are analyzed and excluded.
Diagnosis of idiopathic tachycardia
Before the diagnosis should be excluded the following pathological conditions:
- hyperthyroidism, thyrotoxicosis;
- pain syndrome (acute and chronic);
- anxiety and panic attacks;
- pericarditis, myocarditis, aortic or mitral regurgitation;
- myocardial infarction;
Additionally, the patient should not drink alcohol, caffeine, anticholinergics, catecholamines. The appearance of tachycardia can not precede the abolition of b-blockers, the implementation of radiofrequency ablation in connection with the treatment of supraventricular tachycardia.
Diagnosis of idiopathic tachycardia is possible with constant tachycardia and increased heart rate without definite causes.
To clarify the diagnosis, standard electrocardiography, Holter monitoring, and in rare cases - electrophysiological examination, ultrasound examination of the heart, coronary angiography are used.
Treatment and prevention of idiopathic tachycardia
With idiopathic sinus tachycardia patients are informed about the benign course of the disease. If clinical manifestations are not strongly expressed, then treatment is limited to dietary nutrition and therapeutic physical education.
Identification of significant clinical symptoms and impaired quality of life of the patient is an indication for the appointment of pulsating therapy. It can consist of small doses of beta-blockers that do not have internal sympathomimetic activity. Also used are sinus node (jawabradine) if-channel inhibitors, which are shown to patients without beta-blockers.
Extremes are the method of treatment of idiopathic tachycardia and is radiofrequency ablation. This method has not been fully studied in the direction of complete elimination of the presented pathology, therefore it is used in the case of a constant tachycardia, which is not eliminated by medical treatment.
No specific prevention of idiopathic tachycardia exists. Only general recommendations that can be used to prevent cardiovascular disease can be used. Also a positive result of the dates is a properly selected physical activity, with the mandatory exclusion of provocative factors (smoking, alcohol intake, caffeine-containing beverages).
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