Author Ольга Кияница
Pathological bradycardia is a disease in the arrhythmia group, which is characterized by a rare heartbeat and causes obvious discomfort to the patient. In some cases, it can provoke a development of a critical condition, for example, an asystole, so it is important not to ignore the signs of the disease.
Today, physiological and pathological bradycardia are distinguished. In the first form, despite the decrease in heart rate, a person feels normal. When pathological bradycardia develops a clinical clinic, more or less pronounced.
Violation of the rhythm is diagnosed with the help of instrumental research methods, if necessary supplemented by laboratory tests. If the fact of the development of pathological bradycardia is established, then necessarily the treatment is being performed, because the slowed rhythm badly affects the work of the brain, as well as on the heart itself.
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Description of pathological bradycardia
The mechanism of the development of pathological bradycardia may be associated with a disturbance of the functioning of the conducting system in the form of blockages, the formation of other sources of rhythm, as well as the decrease in the activity of the sinus node. In the latter case, most often talk about sinus bradycardia, which may be part of the syndrome of weakness of the sinus node.
In some cases substitute rhythms arise - atrioventricular and idiometric. In case of violation for some reason of the function of the main rhythm driver (sinus node), activation of the atrioventricular node or pathological foci in the ventricles itself occurs. This often occurs on the background of organic heart disease.
Pathological bradycardia is divided into several forms, which differ from each other by changing the frequency of heart contractions:
- The easy type - the decrease in heart rate is observed in the range of 15% and in an adult may be 50 bp / min.
- Moderate type - heart rate is reduced to 35% and in people over the age of 18 can be about 40 beats / min. With such a bradycardia, the first signs of brain hypoxia begin to be noticeable.
- The expressed type - the heart rate falls below 40 beats / min, which equates to a decrease of the norm by 35% or more. Defining a similar rhythm often requires resuscitation.
What is the pathological bradycardia dangerous? First and foremost, there is insufficient blood supply to the brain and internal organs. On the background of the slowed-down rhythm, other pathological conditions may appear, which will further complicate the course of the illness.
Symptoms of pathological bradycardia
In rare cases, rhythm disturbances are asymptomatic, often the same is observed with a slight change in heart rate.Often, patients begin to complain about a lack of blood supply to the brain:
- increased sweating;
- nervous arousal;
If the pathology lasts for a long time in childhood, the risk of malformation of organs and tissues, the occurrence of a number of concomitant diseases that can have a significant effect on general well-being is increased.
Causes of the appearance of pathological bradycardia
Etiological factors lie at the basis of the classification of the disease. With the help of this separation, a more systematic pathology is organized, resulting in effective treatment. Therefore, children and adults have the following types of pathological bradycardia:
- congenital bradycardia, often associated with constitutional-familial peculiarities and activation of the parasympathetic nervous system;
- organic bradycardia - is mainly a consequence of the previously formed cardiovascular disease;
- neurogenic bradycardia - still known as vagal or extracardial, in its development there is a violation of the activity of the nervous system due to the development of somatic diseases of noncardial origin;
- endocrine bradycardia - appears due to the violation of the activity of internal secretion glands, most often thyroid and adrenal glands;
- drug bradycardia - is the result of misuse of medicines that slow down the heart (cardiac glycosides, antiarrhythmic drugs);
- toxic bradycardia - is a consequence of improper functioning of the liver or kidneys, can develop on the background of excessive in the body of potassium.
Sometimes there is a relative bradycardia, which is associated with an increase in body temperature. Such a slowing down of the rhythm can be considered not very dangerous if measures are taken on time to treat the main disease causing hyperthermia.
Diagnosis of pathological bradycardia
The first diagnostic signs of the disease are obtained during the examination and examination of the patient.Subsequently, lab tests are being carried out to help identify important clinical parameters in the form of cholesterol, lipoproteins, and the like.
The risk of pathological bradycardia is assessed using an electrocardiography available for any medical institution.Depending on the type of disorder on the ECG, signs of dysfunction of the conducting system of the heart, blockade of different localization, heart failure and non-rhythmicity may be observed.
The methods of choice are ultrasound of the heart. The study is especially useful for organic heart lesions, when the focal points of the change in the structure of the organ can be recorded on the monitor. This is especially the case with various cardiomyopathies, heart disease.
Treatment and prevention of pathological bradycardia
There are several tactics for the treatment of pathological bradycardia, the choice of which depends mainly on the severity of the clinical picture.
- With mild manifestations, you can restrict yourself to using strong coffee or tea, which can increase the tone of the vessels and the frequency of heart contractions. Also, bradycardia helps with hot tub and moderate physical activity.
- At moderately expressed symptoms, the doctor is called at home and after a survey-examination, as a rule, a specialist is prescribed those drugs that can help to eliminate unpleasant symptoms.
- Extremely pronounced bradycardia should be treated only in the hospital, as the patient may be at risk of heart failure.
If after the medication treatment no improvement in the patient's condition is observed, then a pacemaker is implanted.