Valvular arrhythmias

Author Ольга Кияница

2017-11-10

Valvular heart disease can be complicated by various pathological conditions. Valvular arrhythmias - one of them and in some cases capable to represent a threat to a patient's life. Existing diagnostic and therapeutic measures should be known to prevent adverse effects.

The heart of a person is arranged in such a way that arterial blood, which is oxygenated and directed to organs and tissues, does not mix with venous. The latter is directed from cells and tissues to the alveoli in the lungs, where oxygen is saturated with blood. For this, the heart is divided into four chambers, between which there are partitions and special input and output holes, called valves. All four of them - tricuspid, mitral, aortic, pulmonary valve.

The main purpose of the valves is to cover the venous and arterial passages, allowing the blood to go out or come back without returning.

When the valves are ill, they speak about their malformations. There are congenital and acquired malformations of valves, simple and combined, the clinic of which depends on the severity of the pathological process. Congenital malformations are treated, as a rule, surgically, whereas acquired in the initial stages do not require specific treatment.At the stage of decompensation, complications may occur, in the form of the same violations of the rhythm. What do valve arrhythmias present and is this a disease dangerous if it is diagnosed in an adult or child?

Video How the human heart works

Description of valve arrhythmias

Under arrhythmias is understood such a cardiac violation, in which there is inconsistency, irregularity of its activity. Also, the frequency of heart rate changes, which in normals in adults is 60-90 beats per minute. The newborns have heart rate of 120 beats / min. and before adolescence it decreases almost to the adult norm.

Various factors play a role in the development of arrhythmia. One of them is a violation of the normal functioning of the valves. Because of the damage to the valves, they stop functioning normally, leading to hemodynamic changes. With prolonged disease, blood stasis develops in the circulatory system. Also, in the chronic form of the pathology, it is possible to stretch the parts of the heart (atrium and ventricles), which leads to the development of severe forms of arrhythmia.

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In pathological cases, valve malformations are manifested in two forms:

  • insufficiency - valve flaps do not close tightly, resulting in regurgitation, that is, retrograde flow of blood.
  • Stenosis is a narrowing of the valve opening, resulting in the blood not being able to flow normally from one area to another.

Violation of heart rhythm often develops against mitral stenosis. Also, the primary mitral valve prolapse may be complicated by life-threatening arrhythmias. In particular, there is an increased risk of atrial fibrillation, which can lead to cardiac arrest.

Symptoms of valve arrhythmias

All forms of heart rhythm disturbances are accompanied by heart failure. The patient feels like a heartbeat, unpleasant shocks in the region of the heart, compression or "jerking heart from the chest". Also, vegetative disorders can be added in the form of weakness, dizziness, increased anxiety, sweating, and the appearance of fear of death.

The defect of the valve apparatus is manifested as follows:

  • Shortness of breath, the severity of which depends on the stage of the pathological process;
  • pain rebound, in the region of the heart compressive nature;
  • swelling, feeling of gravity and pain in the right hypochondrium.

Patients with heart defects are difficult to exercise. At first, the pathology can hardly be felt, but with the development of possible occurrence of dizziness up to the loss of consciousness.

What are the risks of valve arrhythmias? First and foremost, there is an increased risk of heart failure. Especially often this happens at the stage of decompensation of the disease, when the cardiac muscle no longer cope with its functions and there is a crippling arrhythmia.

Causes of valve arrhythmias

Developed due to the occurrence of malformations of the heart valves, most often combined. The appearance of the underlying disease, stenosis, or valve insufficiency is facilitated by the following factors:

  • rheumatism - leads to valve dysfunction in 30-50% of cases, most often forming mitral stenosis;
  • Atherosclerosis - deposition on the valves of the cholesterol component facilitates the development of stenosis, and in the future - arrhythmias;
  • infectious processes (syphilis, bacterial endocarditis, etc.) promote inflammation of the valves with further deformation and narrowing of the lumen.

Any degenerative-dystrophic processes occurring in the body, under adverse conditions, can be complicated by heart defects. This pathology, in turn, can lead to the appearance of valve arrhythmias, which under adverse conditions represent a life-threatening complication.

Predisposing factors in the development of valve arrhythmias may be:

  • dysfunction of the vegetative-vascular system;
  • increased activity of cardiomyocytes (cardiac cells that form the basis of the myocardium);
  • overstrain of the papillary muscles located near the heart valves;
  • violation of the conductivity of the pulse in the atrioventricular node.

Types of valve arrhythmias

In case of valve defects, compensatory arrhythmias may develop as sinus tachycardia. If subcompensation or decompensation of defects is observed, the probability of occurrence of atrial fibrillation increases.

Sinus tachycardia

Relates to a group of arrhythmias and is a super-ventricular form of rhythm disturbance. Characterized by accelerated sinus activity of the heart, at which the heart rate is more than 100 beats per minute (correspondingly, the adult norm). It may be physiological, which is the response of the body to external stimuli (taking coffee, alcohol, medication, physical or emotional load), and pathological, which causes a hemodynamic disorder.

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With valve dysfunction sinus tachycardia develops often at the stage of compensation, when small changes in the activity of the cardiovascular system are observed. Patients are often not perceived, therefore, in the absence of subjective inappropriation, they do not need correction by medical treatment.

Inverted arrhythmia

Pathology is also known as atrial fibrillation. Represents a non-coordinated contractile activity of the heart, expressed in tachycardia from 350 to 700 times per minute. It can be detected as a heartbeat at an irregular interval. Most often occurs when organic damage to the heart, contributing to the development of severe hemodynamic disorders.

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With heart defects occurs mainly at the stage of decompensation, when the contractile capacity of the myocardium is exhausted. Atrium are less resistant than the ventricles, so the first ones react to long-running valve valves with the development of arrhythmia. With atrial fibrillation, the risk of thromboembolism increases, which in turn leads to the death of the patient.

Diagnosis of valve arrhythmias

An important consideration in the diagnosis of the disease is the primary examination of the patient, as well as three basic medical methods: palpation, percussion and auscultation. In particular, it is possible to suspect the presence of valve dysfunction on the sinusity of the nasolabial triangle, shortness of breath, swelling of the cervical veins.

Listening to cardiac activity with the help of the phonendoscope allows you to determine the change in heart tones. For example, in the stenosis of the mitral valve, the rhythm of the quail (three-part tone) is heard.

ECH cardioscopy with doplerography is the main method of diagnosing valve dysfunctions. During its conduct, the severity of the pathology, as well as the degree of decompensation, if any, is evaluated.

Video Acquired heart malformations. Echocardiographic diagnosis

The standard electrocardiogram - is appointed for the purpose of evaluation of cardiac activity. The same method allows to reveal valve arrhythmias, even if the patient does not complain about heartbeat.

ECG signs of sinus tachycardia:

  • the heart rate, in comparison with the age norm, increases and in adults is more than 100 times per minute;
  • the rhythm remains correct, sinus, which is evident in the presence of the tart R.

ECG signs of atrial fibrillation:

  • the teeth P are not determined;
  • Fibrillation (flickering) indicates frequent and uneven waves f;
  • RR intervals of different lengths;
  • ventricular complexes have not been changed.

Treatment and prognosis of valve arrhythmias

Some types of defects, such as the mitral valve prolapse, do not require treatment because they rarely cause hemodynamic disorders. Therefore, patients with an unconventional clinic of valve arrhythmia and vice recommend restricting their lifestyle correction, getting rid of bad habits, proper nutrition and moderate physical activity. It is also important to avoid stressful situations or, in case of anxiety, to take sedative medications.

Patients with comorbid and subcompensated valvular malformations often offer medical and surgical treatment. The first is to receive anti-inflammatory drugs, which reduce the severity of the inflammatory process and, thus, the degree of damage. Operative intervention allows you to conduct plastic valve valves, eliminate stenosis, or assemble the damaged valve "on grains".

The treatment of valve arrhythmias primarily depends on the shape of the rhythm disturbance, the severity of the clinical picture. Sinus tachycardia can not be treated at all, or, at worst, antiarrhythmic drugs are used. In case of atrial fibrillation, urgent medical intervention is required. Therapy of fibrillation is carried out in two ways:

  1. Restoration of normal cardiac rhythm, for which cardioversion is used, and further prophylactic treatment of relapse of arrhythmia is carried out.
  2. Control of the frequency of cardiac activity - drugs are used for the gradual reduction of heart rate.

In any case, anticoagulant therapy is being used to prevent the development of pulmonary artery thromboembolism or brain vessels.

The prognosis for valve arrhythmias is generally favorable. The only thing that requires timely medical attention when flickering.

Prevention of valve arrhythmias

Events associated with the prevention of valve arrhythmias are associated with the treatment of heart defects. It is important for all patients, even with insignificant heart defects, to follow the recommendations of the doctor and to carry out the examinations in a cardiologist in a timely manner.

To facilitate the condition of the patient, and therefore to prevent the occurrence of complications in the form of valve arrhythmias, it is possible at the following tips:

  • Determination of vegetative-vascular disorders (fatigue, irritability, sweating, sensation of anxiety) should be stopped by the administration of magnesium-containing drugs.
  • Regularly take the course of taking vitamins with vitamin content of PP and B.
  • It is necessary to normalize the mode of work and work with giving enough sleep to sleep.

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