Orthostatic tachycardia

rthostatic tachycardia (OST) is one of the varieties of rhythm disturbance, in which the characteristic characteristic of tachycardia is defined - a rapid heartbeat. Orthostatic pathology is called due to the appearance of signs of the disease during the transition of a person from a lying position in the sedentary.

Orthostatic tachycardia is not universally accepted, so this term is not included in the International Classification of Diseases 10 revisions. Most often it is used in clinical practice by cardiologists.

The highest occurrence of the pathology is observed among reconvalescents, that is, patients who go to the correction.Often, OST is noted for those people who did not get out of bed for a long time. To find out how dangerous orthostatic tachycardia is, read the information provided in more detail.

Video Three tests with abnormal pulse. Live great!

Description of orthostatic tachycardia

Pathology develops as a result of a sharp transition from a horizontal position to a vertical one. Observed disturbances of the rhythm can be both clinically healthy people and patients who are chained for a long time to bed. The emergence of a characteristic characteristic of the orthostatic test of symptoms is associated with a sharp decrease in blood pressure due to the rapid change in body position, which contributes to a reflex increase in the frequency of cardiac contractions, that is, tachycardia.

When a single occurrence of an orthostatic tachycardia is not able to cause serious disturbances, but with its frequent development, changes in the circulatory system may be observed. In particular, tachycardia leads to a decrease in the diastolic phase, which in turn contributes to a smaller filling of the ventricles. This causes a decrease in the minute and systolic volume, resulting in organs receiving oxygen and nutrients in an insufficient amount.

A significant tachycardia becomes a cause of coronary artery disease, which in turn causes damage to the heart muscle.

Due to shortened diastole during a tachycardia, heart muscle disrupts biochemical processes that slow down the process of recovery of the myocardium. The heart is overexploited faster, due to which it becomes more susceptible to various destructive processes. If in addition to the myocardium there is an excess of thyroxine production in case of thyrotoxicosis or lack of oxygen in anemia, cardiac insufficiency can develop very rapidly.

Pronounced tachycardia is often a cause of:

• functional heart disease disorders;
• blood stagnation in the venous system;
• Decompensation of already existing heart failure.

Therefore, any tachycardia, including orthostatic, presents a danger to human health, especially at a very pronounced level.

Symptoms of orthostatic tachycardia

Apart from the heartbeat, the main symptom of tachycardia, patients may feel a number of other pathological changes:

• in the head is often felt "emptiness";
• dizziness of varying degrees of severity;
• sight becomes as if clouded;
• during the stay weakness is strongly expressed;
• feeling sick, headache;
• there may be fainting conditions.

During ORT, the same symptoms are often determined, as in panic attacks, anxiety and somatised disorders. Therefore, often orthostatic tachycardia is often related to neurological diseases.

A characteristic symptom of orthostatic tachycardia - after moving to the vertical position of a person swings to the sides, as a result of which he can quickly sit up, even completely not straightened up, or fall into fainting. Immediately after this patient feels a strong heartbeat, which can quickly pass or, in more difficult cases, continue for some time.

The severity of the severity of the listed symptoms depends on many factors. First of all, the presence of an organic pathology of the heart, which, on the background of a frequent emerging tachycardia, can significantly deteriorate. The condition of the patient is influenced by the presence of concomitant non-cardiac pathology, especially negatively affects the health of thyrotoxicosis, pheochromocytoma.

Video A girl with a syndrome of postural tachycardia was taken for an alcoholic

Causes of orthostatic tachycardia

The occurrence of orthostatic tachycardia has not yet been studied. Some scholars have the disease correlated with the syndrome of postural tachycardia. Together with idiopathic hypovolemia and mitral valve prolapse, it is included in orthostatic intolerance syndrome.

The main causes contributing to the development of orthostatic tachycardia:

• Violation of sympathetic innervation of the lower extremities with preserved cardiac sympathetic innervation.
• Vegetative neuropathy, which may occur after infectious diseases or immunosuppressive conditions.
• Changes in venous functions with simultaneous violation of baro-reflex activity.

Increased sympathetic activity is the main reason most scholars tend to fall. Its role in the occurrence of OST is due to the fact that in a calm state, elevated levels of arterial norepinephrine and increased heart rate are detected.

Types / photos of orthostatic tachycardia

Specific forms and types of orthostatic tachycardia do not exist. The disease often manifests itself as a typical sinus tachycardia, which develops from the horizontal position of the body to the vertical.

Due to the development of orthostatic tachycardia, they are divided into primary and secondary. The first occur without visible effects, the latter are often associated with concomitant diseases.

Diagnosis of orthostatic tachycardia

Patients with suspicion of orthostatic tachycardia are firstly referred for testing through a turntable. A standing method can also be used. A positive result is considered in the case of an increase in heart rate to 120 per minute in the first 10 minutes or a heartbeat increase of 30 beats per minute. At the same time, orthostatic hypotension should not arise.

The determination of norepinephrine in the venous plasma is another diagnostic test for orthostatic tachycardia. A positive result is considered if in a calm condition it is determined up to 600 ng / ml norepinephrine.

Additional methods for studying patients with orthostatic tachycardia:

• echocardiography;
• stress echocardiography;
• Holter monitoring;
• laboratory tests (glucose, thyroid hormones, catecholamines).

It is important that all provoking tests be performed in a calm state in different positions of the body (lying, sitting, standing).

Treatment and prevention of orthostatic tachycardia

For today there is no optimal way of treating orthostatic tachycardia. Positive influence on the dynamics of the disease is the exclusion of provocative factors:

• dehydration;
• long-term location in the immobilized state;
• unbalanced food.

Some patients on ORT help with salt infusion and the introduction of mineralocorticoids. Testing on the swing table also has a positive effect in some cases, but this method has not yet been used as a permanent therapy. In the course of studies, the success of the use of agonists of adrenergic receptors in the form of midodrine was determined.

In some studies, propranolol, a beta-blocker, was used. At first, they prescribed small doses of the drug and gradually adjusted to an optimal amount, for example with 10 mg increased to 30 mg 3-4 times a day.