Author Ольга Кияница
Paroxysmal bradycardia is a symptomatic disease that is often diagnosed in childhood on the background of affective-respiratory attacks. It manifests itself as a slowing down of the rhythm, while the heart rate can decrease to 40 beats / min and below. Such a condition often threatens the health and even the life of the child.
The definition of paroxysmal bradycardia is not universally recognized as it is not found in the International Classification of Diseases. Therefore, they are more likely to use practitioners to refine the course of the slowed heartbeat.
In the diagnosis of pathology, the same methods are used as in other types of rhythm disturbance. First, electrocardiography is performed, then laboratory and instrumental methods of research are used, which are necessary to clarify the pathology and the causes of its occurrence. Subsequently, on the basis of the received data, the treatment of paroxysmal bradycardia, which includes one or several drugs, is prescribed.
Video Bradycardia and treatment
Description of paroxysmal bradycardia
Above, it was indicated that a separate disease, such as paroxysmal bradycardia, was not isolated in ICD-10. If, however, from doctors or in communication with patients still have to hear such a definition, it is most likely due to the need to describe a state distinct from the usual bradycardia.
The paroxysmal condition is a pathological symptom complex, in the development of which there is an attack or occurrence of cerebral genesis or a chronically leaky disease.
In the case of bradycardia, paroxysm, or adnexa, develops due to a violation of the activity of the sinus node, when its activity is sharply reduced. As a result, the heart rate decreases, and sometimes arterial hypotension arises. Other pathological mechanisms may also be involved in the development of the disease. In particular, with organic damage to the heart, the activity of its conducting system changes, as a result of which blockages of various levels can be formed, which impede the passage of impulses to different parts of the heart.
Mechanism of development of paroxysmal bradycardia against the background of respiratory attacks of the "white" type:
- Exposure to external stimulus (fear, pain, emotional overvoltage).
- Increased activity of the parasympathetic department of the nervous system.
- Decreased heart rate up to asystole.
In children, a similar process passes very fast, so literally in a few seconds from the beginning of its development, the child becomes softened and fainted. It is extremely important in such cases to timely orient and, without panicking, immediately consult a doctor.
Symptoms of paroxysmal bradycardia
Pathology is characterized by an extremely pronounced clinical picture, especially in combination with an affective-respiratory attack. The sick child first makes soft sounds. This phase of the "white" attack is also called "silent". Further, the frequency of heart contractions decreases, blood pressure decreases, the appearance of extremely pronounced pallor becomes externally. On this feature just got its name "white" ARP. With an end to cardiac activity anoxic spasms develop.
In some cases, the so-called paroxysmal tachycardia develops without pronounced symptoms. The heart rate is sharply reduced, but it is extremely difficult to determine precisely why this happened. For clarification of such questions it is necessary to address to the cardiologist.
Causes of paroxysmal bradycardia
Paroxysmal states can be associated with different organs and systems, therefore, today common causes and risk factors that contribute to the development of a clinic of a particular type of paroxysm are identified.
The causes of paroxysm may be:
- pathology of the prenatal and postnatal developmental period;
- infectious diseases;
- intoxication processes;
- somatic disorders.
The risk factors for the development of paroxysm are:
- hereditary predispositions;
- living conditions;
- emotional and psychological atmosphere in the family;
- bad habits;
- professional harm.
Among the risk factors, one should stress stress situations that often provoke the development of paroxysmal bradycardia. Therefore, in children with ARP, any excitement can cause an attack.
Diagnosis of paroxysmal bradycardia
The presence of a slowed rhythm is confirmed by electrocardiography made during paroxysm. The standard way to conduct such an investigation in the case of ARP is not suitable, therefore, children who are suspected of affective-respiratory attacks for a day or two, and sometimes for a week, are offered to wear a special device that records cardiac activity for further analysis.
In addition, ECG and Holter monitoring use ultrasounds of the heart, load tests. Also important is the observation of a sick child and his family relationships in order to identify abnormalities in the family environment and their correction.
Treatment and prevention of paroxysmal bradycardia
With weakly expressed ARP in combination with paroxysmal bradycardia, medical treatment is often not performed.Frequently occurring "pale" attacks can be corrected by such drugs as theophylline, atropine, and other holinolytics may also be prescribed.
In critical cases, electrocardiogram is shown using an implanted device. In particular, the indication is paroxysmal bradycardia, with which the heart rate falls significantly (less than 40 beats / min), or the asystole is fixed at a duration of 3 seconds or more.
Specific prophylaxis of paroxysmal bradycardia is absent. Parents who have children with ARP and paroxysmal bradycardia should pay more attention to the proper education and development of healthy relationships within the family. In particular, hyperopics should be excluded or, conversely, the frequent creation of conflict situations. For children, waking and resting is important, proper nutrition, so the regulation of these indicators also needs to be addressed.