Author Ольга Кияница
- 1 Description of ischemic arrhythmia
- 2 Symptoms of ischemic arrhythmia
- 3 Causes of ischemic arrhythmia
- 4 Arrhythmias that occur with ischemia
- 5 Diagnosis of ischemic arrhythmia
- 6 Treatment and prognosis for ischemic arrhythmia
- 7 Prevention of ischemic arrhythmia
The heart constantly pumps blood so that oxygen and nutrients are continuously fed to all tissues and organs. But the heart muscle also requires nutritional components. For this purpose, the coronary system, consisting of the arteries and venules, through which the blood flow and goes away, is forewarned. This supply allows the heart to work smoothly.
With ischemic disease, a decrease in the lumen of the coronary vessels is observed, as a result of which the heart does not absorb oxygen and the necessary nutrients. The development of IHD is most often associated with atherosclerosis of the arteries. Atherosclerotic plaques formed on the walls of the vessels make the lumen of the arteries narrow. The more an atherosclerosis defeat is, the more the clinic of ischemia manifests itself.
Description of ischemic arrhythmia
Ischemic arrhythmia is a form of disturbance of the heart rhythm appearing against the background of ischemic heart disease. In the pathogenesis of the disease there are several dysfunctions: a violation of excitability and contractility of cardiomyocytes, as well as the transmission of electrical impulses. This is due to the fact that during the coronary circulatory dysfunction, areas of ischemia are first created, and in the further development of the pathological process, they are converted into necrotized areas. As a result, some parts of the heart, most often the left ventricle, cease to function properly.
Ischemia is enough to last for 30 minutes, so that part of the heart muscle, to which oxygen is not supplied, is lost. This process is referred to as myocardial infarction.
If the focal point of necrosis is small, inflammation processes begin to occur around it, and afterwards a granulation tissue is formed. Such areas are not capable of conducting an electrical pulse, shrinking or excite, as cardiomyocytes do. If an exciting wave approaches them, they do not transmit it further, so the signal returns back, which causes the closed cycle of the impulse transmission. This causes arrhythmia, in this case ischemic origin.
Symptoms of ischemic arrhythmia
It manifests itself as other types of disturbance of the heart rhythm. First of all, patients feel:
- heart rhythm abnormalities, usually in the type of tachycardia, when more than 100 beats per minute;
- there is a feeling of "jumping out of the heart from the chest", "lack of air";
- may feel a sense of fear of death, reaching to a panic state.
Similar signs may temporarily replace or complement the clinic of the underlying disease, in this case, the CHD.
With angina there are pains behind the sternum, which have one characteristic property - to emerge after emotional experiences or physical stresses. In some cases, an attack on the stenocardia is caused by a sudden cold or other sudden stimulus. Pain lasts no more than 5 minutes. They can go on their own or after taking nitroglycerin.
Ischemic arrhythmia often occurs at peak loads and instead of cardiac pain, which happens when angina pectoris manifests itself in interruptions in the work of the heart.
In cardiosclerosis, there are no signs characteristic of the disease. The process of replacing cardiomyocytes with connective tissue is in some cases asymptomatic, therefore, such a symptom as arrhythmia causes attention to the state of the heart. Along with interruptions in the rhythm of the heart, a heartbeat appears.
In severe cases, an ischemic arrhythmic clinic is supplemented with symptoms of heart failure. Shortness of breath, swelling, heart pain become more pronounced and constant, tolerance to physical activity decreases.
Causes of ischemic arrhythmia
In the arrhythmic variant of the ischemic disease, the same factors that stimulate the formation of the pathological process lie, as in the case of IHD. Three of them:
- atherosclerosis of the coronary arteries;
- formation of blood clots in the coronary arteries due to increased blood viscosity;
- arterial spasm, which develops as a result of the action of biologically active substances.
Contraction of the coronary plaque on the ultrasound. The green is marked by an atherosclerotic plaque
Any physical activity, emotional stress makes the heart work more actively. For this, he needs more oxygen and nutrients. With their shortage due to the overlapping of the coronary arteries, a thrombus or an atherosclerotic plaque appears oxygen starvation of the organ. Also, some biologically active substances provoke arteries, including coronary, to spasm. It also provokes an inadequate supply of oxygen to the heart.
There are risk factors that contribute to the development of the coronary heart disease, and with it - ischemic arrhythmia:
- Biological - age over 55, male sex.
- Propensity for dyslipidaemia, diabetes mellitus, arterial hypertension, overweight.
- Behavioral - hypodynamia, alcohol consumption, smoking, irrational nutrition.
Video of heart disease and heart attacks
Arrhythmias that occur with ischemia
Coronary heart disease leads to organic lesions of the myocardium. Established ischemia foci contribute to a violation of cardiac rhythm of varying severity: sinus tachycardia, extrasystole, blockade of different localization. In particularly complex cases, atrial fibrillation and fibrillation of the ventricles, which are provoked by long-lasting ischemia and developing on its background, have a cardiac insufficiency.
Often considered as a variant of the norm, but for this person should not be observed serious clinical signs. In addition, such a state should pass in a calm state.
With IBS in the heart muscle there are organic changes that disrupt the normal process of the rhythm of the organ.When a load on the heart increases the frequency of its contraction, but if normal recovery is rapid, then with ischemia, the restoration processes are inhibited, therefore, the person can even feel sinus tachycardia at rest. This variant of the course is clinically unfavorable and requires medical intervention.
They represent cardiac abnormalities, which often have a pronounced character in coronary heart disease. Basically, ventricular extrasystoles develop, which are prognostically unfavorable. This is due to the fact that any violation of the rhythm of the ventricles very quickly becomes such a dangerous condition as fibrillation.
Extrasystoles can occur rarely (up to 10 hours per hour), relatively often (from 10 to 30 per hour) and often (more than 30 per hour). Also distinguished extrasystoles are single and pair, polymorphic and monomorphic. Some patients can hardly feel extrasystole, others emphasize the feeling of "turning the heart inside." In any case, you should contact your doctor for more detailed examinations.
Violation of conductivity, blockade
By the nature of the occurrence, distinguish transient blockades and constants. For a coronary heart disease, a permanent form of blockade is more characteristic. This is due to serious organic changes in the myocardium arising from the background of ischemia. There is a high percentage of blockade in patients with myocardial infarction.
The blockades of the legs of the Gissa beams in a constant form arise due to ischemia in 50% of cases.
Ischemic arrhythmia in the form of blockade is not dangerous to the patient, Her appearance often indicates the progression of organic myocardial damage. Therefore, the blockade is considered a unique marker of possible complications.
It is characterized by a rapid reduction of ventricles up to 200 times per minute, which can be provoked by acute myocardial infarction. An attack of tachycardia develops suddenly, accompanied by pain in the heart, which also indicates a lesion of the myocardium.
Ventricular tachycardia is detected in 80% of patients suffering from ischemic heart disease. It is more common in men than in women.
This type of ischemic arrhythmia is dangerous to the risk of developing ventricular fibrillation. Patients who are particularly weak may have a sudden cardiac mortality. Therefore, with pronounced pain in the area of the heart, you should immediately call for medical help.
Diagnosis of ischemic arrhythmia
Conducted with the participation of a standard list of research methods that help determine the functionalities of the cardiovascular system:
- Electrocardiography - is prescribed in the first place, since it allows for only 5-10 minutes to learn the basic indicators of cardiac activity. It is conducted at various stages of the provision of medical care and practically in all age categories.
- Echocardiography (echocardiography) is performed to evaluate the status of the heart chambers, their thickness and their ability to reduce.
- Daily ECG monitoring - is intended to diagnose weakly manifested arrhythmias that could not be fixed on a standard cardiogram.
- Coronary angiography is the gold standard in the diagnosis of coronary heart disease, since it allows you to see all changes that have occurred in coronary vessels.
Since the development of ischemic arrhythmias directly depends on the degree of severity of atherosclerosis, this indicator is also important to diagnose. As indirect methods of research, various load tests are used in the form of loading scintigraphy of the myocardium, bicycle ergometry, transesophageal stimulation of the atrium, and so forth.
Treatment and prognosis for ischemic arrhythmia
The tactics of conducting a patient with ischemic arrhythmia are associated with the stopping of progression of the underlying disease - the IHD. Today, medical, interventional and surgical treatment of this disease is distinguished. Much depends on the height of the risk of possible complications.
Emergency care is required in the development of complete blockade of the legs of the Hyza beams, ventricular fibrillation and prolonged ventricular tachycardia. In some cases, extrasystole may also not be reversed in the usual way, then an ambulance is urgently called.
Prevention of ischemic arrhythmia
It enters into the maximum weakening of the influence of factors contributing to the development of coronary artery disease and ischemic arrhythmia in particular. Therefore it should be:
- Have a healthy lifestyle.
- With the permission to perform physical exercises.
- Avoid stress or take calming medications on time.
- It is right to eat, which will help keep the weight in the normal and do not contribute to the progression of atherosclerosis.
Video Prevention of Heart Disease. Risk Factors and Prevention of Ischemic Heart Disease