Treatment of pathological bradycardia
Author Ольга Кияница
Pathological bradycardia is a variety of slowed-down rhythms that are characterized by a decrease in heart rate below 50 ud / min (in children below 70-110 beats / min, depending on age). The mechanism of the formation of pathological bradycardia varies, but with the severe course of the disease there is one threat - sudden cardiac arrest.
The reduction in pulse rate can be observed in physically trained people, mainly athletes. In the absence of a clinic, such an option of the course of bradycardia is also not considered pathological.
The expressed slowing of the rhythm, which reduces the capacity of a person, seriously affects his well-being must be duplicated with appropriate medications. A patient examination is also conducted to identify the cause of pathological bradycardia. After that, the treatment of the disease is conducted with the individual selection of doses of medical preparations.
Arrhythmia or heart rhythm disturbance
Before starting treatment, the cause of pathological bradycardia should be determined. The main causative factors are divided into the following groups:
- Disruption of the nervous system. Such is noted during vegetative dysfunction, neurosis, neurocirculatory dystonia.
- Reflex impact. With strong pressure on the eyeballs or squeezing of the carotid sinus due to wearing a tightly tied tie or fastened collar, the heart rate may drop sharply.
- Increased intracranial pressure. Pathological condition is observed in brain tumors, edema of brain tissues, head trauma.
It is extremely important to carry out timely treatment of cardiosclerosis, myocardial dystrophy, myocarditis, as these diseases often lead to disturbances in the region of the main driver of the rhythm (sinus node), resulting in the development of organic bradycardia.
In some cases, bradycardia can be medically or toxic, when specific substances such as quinidine, morphine, alcohol or nicotine negatively affect cardiac activity. Then it is extremely important to stop receiving such components in time so that there is no terrible complication in the form of a heart stop.
General recommendations for patients with pathological bradycardia:
- It is important to stick to dietary foods that include useful foods (sea fish of fatty varieties, nuts, dried apricots, flaxseed oil, apples, watermelon, bananas).
- Harmful habits should be abandoned, especially the use of alcoholic beverages and smoking.
- Clinical parameters such as cholesterol, glucose, and also arterial pressure should be monitored.
- It is worth paying attention to vitamin complexes, which can be useful for the cardiovascular system.
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Medicinal treatment of pathological bradycardia
There are several tactics for the treatment of pathological bradycardia. The choice of a particular type of treatment depends on the course of the disease, the severity of the symptoms. In particular, a moderate or poorly expressed pathology, as a rule, does not present a health hazard, therefore specific treatment is not carried out. It is enough for the patient to adhere to the general recommendations in order not to stimulate the development of pathological bradycardia.
In the presence of severe symptoms, the general condition of the patient is assessed and it is determined whether there are manifestations of heart failure, low blood pressure, excessive pulse (40 beats / min). The following treatments are considered below:
- The presence of the above-mentioned complications is indicative of an intravenous administration of 0.5 mg of atropine sulfate. In the absence of the effect of using the drug, it continues to be administered up to 3 mg. If no result, then resort to adrenaline.
- In the absence of the above complications, the question of the presence of the risk of development of the asystole is studied. In particular, had there been stops of the heart for more than 3 seconds, did the atrioventricular block develop.
In the presence of a high risk of development of the asystole, a variant of implantation of the rhythm driver is considered.If there is no risk, but the patient continues to experience attacks of slowed-down rhythm, then standard monitoring is carried out.
The determination of the patient's symptoms of hemodynamic disturbances (pronounced weakness, dizziness, pre-bloating condition) is an indication of the use of drugs in the form of caffeine, ephedrine, handsome, ginseng root.
Emergency care is provided in case of bradycardia with the following pathologies:
- Angina pectoris
- Heart failure.
- Ventricular extrasystoles.
- Reduced arterial pressure.
- Wound condition.
The attack of Morgani-Adams-Stokes is a frequent complication of bradycardia. In the event of signs of such a pathology (loss of consciousness, seizures, superficial breathing, involuntary urination or bowel movement), an urgent consultation of doctors (cardiologist and therapist) should be conducted.
Correctly chosen treatment tactics help to quickly restore hemodynamic parameters to normal levels. But in case of failure of medical therapy, they resort to a more radical method - implantation of a pacemaker.
Operative treatment of pathological bradycardia
It is based on the implantation of an electrical pacemaker, which, due to specially programmed, maintains the heart rate within the established limits. As a result, patients with a high risk of development of the asystole can carry out more qualitative and long-lasting activities.
Implantation of the pacemaker refers to small operations, as it takes only 1 hour to carry it out. For anesthesia local anesthesia is used, after which a small incision is made under the left collarbone, through which electrodes are introduced into the heart cavities. After installing them in the right place, a small device is attached to them. In the future, the pacemaker is determined in a small depression made through the same incision. After checking the operating status of the device, the patient may return to normal lifestyle.
Do I need to take medications with a built-in pacemaker?
Often yes, as the device increases the heart rate, but it can not control the amount of blood pressure. Therefore, in most cases, patients need to continue to take cardiology. The only way, in some cases, is to reduce the dosage of the medicine.