Author Ольга Кияница
Ischemic bradycardia is a clinical definition that is not included in the International Classification of Diseases. Often this term describes a violation of the rhythm that arose against a background of ischemic heart disease, the so-called IHD.
Today, the ischemic heart disease is one of the most common cardiac diseases that occurs after age 55. At the same time, men are more affected than women, perhaps because of the prevalence among the strongest of such harmful habits as smoking and drinking.
The disease is rather bright, therefore, often one symptom is diagnosed with the primary. Instrumental research methods and laboratory tests are indispensable, which makes it possible to create an objective picture of the patient's health.Before treatment, all aspects of the onset of ischemic heart disease are established, as this allows the appointment of necessary medications.
Video Facts about the heart. Ischemic heart disease
Description of ischemic bradycardia
The conductive heart system is closely linked to such structural elements of the myocardium as cardiomyocytes. With their help, a wave of excitation is transmitted across all parts of the heart, therefore, with the slightest organic disturbances, various forms of rhythm disturbance, including ischemic bradycardia, arise.
The heart tissue affected by ischemia is not able to spontaneously carry out the pulse, so the heart rate is slowed down.The more extensive pathological focus, the more violated contractility of the myocardium.
During the coronary artery disease, sinus bradycardia, as well as conduction blockades, can be observed if pulsed transfer nodes are involved in the pathological process. The second type of arrhythmia can not be considered a complete bradycardia due to another mechanism of development of the slowed heartbeat, than with sinus bradycardia.But in both cases there is a decrease in pulse, which is expressed in the corresponding clinic.
Symptoms of ischemic bradycardia
The clinical course of ischemic bradycardia largely depends on the localization of the pathological focus and degree of myocardial damage. Often, the slow heartbeat is not observed continuously; there can also be a combination of two different pathologies in the clinic - bradycardia, which is replaced by tachycardia. Therefore, in order to assess the general condition of the patient, only the manifestations of bradycardia are not used.
Clinic of ischemic bradycardia combines manifestations of IHD and slowed heartbeat:
- pain in the region of the heart;
- shortness of breath
- pronounced weakness;
- pulse reduction
- pale face;
- half-bad or faint state;
The severity of the clinic depends on the severity of the blood supply to the heart. The more ischemia, the worse the patient feels. At extensive pathological foci, a myocardial infarction and death can immediately occur.
Causes of ischemic bradycardia
The main factor of the development of ischemic bradycardia - IBS. This disease can be manifested as angina pectoris, myocardial infarction, and each of these pathologies represents an obvious threat to health, and sometimes to life, to a person. In addition to this disease, there are other pathologies that cause organic damage to the heart, and along with it - ischemic bradycardia.
- Diffuse and focal cardiosclerosis - with this pathology, cardiomyocytes necessary for contraction are replaced by connective tissue, resulting in disturbed functioning of the conducting system of the heart.
- Myocarditis - is characterized by inflammation of the myocardium, as a result of which infusion areas are formed that are incapable of conducting an electrical impulse and causing a slowing of the heart rate.
- Endocarditis - inflammation of the inner lining of the heart - endocardium. With this pathology, adhesions can be formed in the heart chambers, which do not allow the body to function normally.
There are risk factors that are more relevant to the coronary heart disease, but they also contribute to the development of bradycardia:
- Biological indicators - male sex, elderly age, genetic heredity.
- Anatomical, metabolic and physiological parameters are a disorder of carbohydrate metabolism, elevated blood pressure, diabetes mellitus, excess body weight.
- Behavioral features - malnutrition, the presence of bad habits, hypodynamia, frequent stressful situations.
The stronger the impact of the risk factors on the human body, the more likely the development of coronary heart disease, and with it - bradycardia.
Diagnosis of ischemic bradycardia
It is possible to independently measure the pulse on the radius (in the area of the wrist) and the sleepy (neck) arteries. If heart rate is lower than 50 bpm, you should contact the doctor for a more detailed examination.
Basic methods of examining patients with ischemic bradycardia:
- Auscultation - conducted by a physician during the examination of the patient, for use of the phonendoscope. While listening, you can hear the sound of tones, determine the presence of noise, but precisely to establish a diagnosis this method does not allow.
- Electrocardiography is an effective method of research that is widely used in medical practice. With the aid of ECG, any form of arrhythmias, including sinus bradycardia, is defined. This disturbance of rhythm in the case of IHD and other pathologies appears on the ECG only with a decrease in heart rate, while the rhythm remains the correct sinusoidal. With blockages, you can see more changes, for example, an increase in the interval PQ, change and loss of the ventricular complexes, a more frequent reduction of atrium compared with the ventricles.
- Phonocardiography is a widely used method that can more accurately determine the activity of the heart with the subsequent fixation of data on a special tape.
To clarify the diagnosis and establish the exact cause of the disease, biochemical blood and urine tests, as well as blood tests for hormones, toxic substances, echocardiography and bacteriological examination may be performed.
Treatment and prevention of ischemic bradycardia
Not all cases require an immediate medical treatment of ischemic bradycardia. The main indications for therapy are the following symptoms:
- fainting and frequent dizziness;
- reduction of blood pressure;
- long-not-passing and frequent attacks of bradycardia;
- the presence of a patient's subjective intolerance to ischemic bradycardia;
- abrupt decline in performance.
Hospitalization of patients with ischemic bradycardia is carried out in cases where hemodynamic disorders are present.In other cases, medicines are taken at home, if necessary, the doses of drugs are adjusted after consultation with the cardiologist.
Preventive measures are to maintain a lifestyle at a prerequisite level, for which it is necessary to abandon bad habits, to perform physical exercises, to eat properly. If necessary, general-fixing physiotherapy procedures are carried out.