Home Gums Bradycardia disease. Why is cardiac bradycardia dangerous? Symptoms, diagnosis and treatment of the disease

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Bradycardia disease. Why is cardiac bradycardia dangerous? Symptoms, diagnosis and treatment of the disease

Most deaths in our lives occur due to heart disease. For some, these pathologies may be congenital, for others acquired, but regardless of this, the problems cannot be ignored.

If you notice a slow heartbeat, you should not put off visiting a doctor, because you may have cardiac bradycardia. Specialists will prescribe the necessary examination, conduct a survey and, based on all the data received, make a diagnosis.

Every day the number of cases is growing and even modern medicine is not yet able to cope with it. Bradycardia of the heart - what is it, what are the main symptoms and causes, how to protect yourself: you can read all this in our article below.

Bradycardia of the heart - what is it?

Bradycardia of the heart

Bradycardia is a disease accompanied by a slowdown in the activity of the heart - it begins to beat at a speed of less than 60 beats per minute.

This disease is a consequence of problems in the sinus node, which creates electrical impulses to contract the heart. It leads to a state of general weakness in a person, decreased physical activity and fainting.

A decrease in heart rate accordingly leads to disruption of blood supply and functioning of internal organs and the brain, because they do not receive enough nutrients and oxygen.

Bradycardia often occurs in athletes, and in this case it is considered normal occurrence, but most often this is a disease concomitant with other pathologies of the cardiovascular system.

The disease is not considered fatal until the heart rate drops below 40 beats per minute. In such a situation, the patient faces possible cardiac arrest. Insufficient treatment of the anomaly leads to a slowdown in the movement of blood through the vessels, which can lead to irreversible consequences.

A fifth of the entire world population is diagnosed with bradycardia. It can develop in adults and children at different ages; Moreover, in pregnant women due to various reasons Fetal bradycardia may develop. To prescribe the most effective type of treatment, the doctor must collect and analyze all medical history data during the examination.

Depending on the mechanism of development, there are two main types of disease:

Sinus bradycardia. Characterized by decreased activity of the sinus node.
Non-sinus bradycardia. It is associated with a blockade of electrical impulses between the nodes of the heart.

Bradycardia is divided into several groups depending on the cause of its development:

Physical. It is typical for people who play sports, as well as those who constantly experience intense physical activity. When the heart is under constant stress, it contracts rarely and this is enough for normal blood supply. Physical bradycardia also occurs under the influence of cold, massage chest, nicotine.
Medication. Formed against the background of taking certain medications, as a rule, is considered a temporary phenomenon and does not pose a threat to health. Drug-induced bradycardia occurs due to the use of certain medicines:

calcium channel blockers;
antiarrhythmic drugs;
adrenergic blockers;
sympatholytics;
quinidine;
cardiac glycosides.

Pathological. It is a consequence of cardiac pathologies, it develops very quickly and requires urgent treatment.

Physiological bradycardia. A decrease in heart rate is often observed in completely healthy people, for example, athletes or those involved in physical labor. The number of myocardial contractions in them can decrease to 40-50 per minute in the complete absence of symptoms such as difficulty breathing, discomfort in the chest, fainting, dizziness and weakness, indicating pathology of cardiac activity.

This type of bradycardia is called physiological. In some people, it occurs at night while at rest, but does not lead to negative consequences, since during night sleep the need for oxygen decreases.

The main causes of physiological bradycardia in people involved in sports and leading an active lifestyle are associated with the increased functionality of their respiratory and cardiovascular systems, which provide the brain with a sufficient amount of oxygen even at a low heart rate.

Often, physiological bradycardia occurs when a person is very tired, finds himself in a stressful situation, or is in the cold for a long time or in conditions of high humidity and temperature, for example, in a sauna or steam bath.

It can be caused by the pressure of a tightly tied tie on the throat (carotid sinus), or a collar that fits too tightly to the neck. Physiological bradycardia does not pose a threat to human health, since it does not lead to a decrease in blood supply to the brain and other organs. No treatment is required for this type of bradycardia.

Pathological bradycardia. With various changes in the conductivity of the heart muscle, a pathological type of bradycardia occurs, which is conventionally divided into two types.

Bradycardia due to inhibition of pacemaker activity

The occurrence of the first type of sinus bradycardia is facilitated by inhibition of pacemaker activity.

It is caused by a decrease in the tone of the sympathetic department or an increase in the excitation of the vagus nerve under the influence of humoral factors, which include an excess of acids with a high bile content in the blood, and an insufficient amount of hormones produced by the thyroid gland (hypothyroidism).

A prerequisite for the occurrence of this type of bradycardia is often vagal (neurogenic) factors, which include:

Natural aging of the body;
Disturbances in the functioning of the vegetative-vascular system;
Various kinds neuroses;
Increased intracranial pressure leading to stroke (bleeding in the brain);
Brain tumors;
Exposure to medications used to relieve symptoms of hypertension and heart disease (pilocarpine, beta-blockers, cardiac glycosides, etc.);
Myxedema;
Electrolyte imbalance (excess potassium in the blood);
Some infectious diseases.

Bradycardia caused by heart blocks

This type of sinus bradycardia can be caused by different types of heart block:

Sinoauricular block - a violation of the conduction of impulses through the atria. It is characterized by their conduction from the sinus node to the myocardium every other time.
Atrioventricular block (impaired transmission of impulses through the ventricles), during which some of the ventricular contractions are lost (their number can be reduced to 40 per minute).

There are three degrees of severity. The first (mildest) degree is characterized by slow conduction of impulses from the atria to the ventricles. With the second (moderate) severity, some impulses stop reaching the ventricles.

The third degree is characterized by a decrease in the number of contractions of the ventricles due to the fact that not all impulses reach them.

Sinus bradycardia most often occurs in a chronic (extracardiac) form. But it can also have an acute (intracardial) course, which is caused by myocarditis, post-infarction cardiosclerosis, acute heart attack myocardium.

Bradycardia in children is a decrease in the number of heartbeats below the lower limit of normal for a given age group. So, in a newborn, bradycardia will be considered a decrease in heart rate to 120 beats or less, for preschool children - less than 70 beats, in adolescents - less than 62 beats per minute.

Bradycardia is most often a sign of a pathological process occurring in the body, but sometimes it can be observed normally. Pathological bradycardia is dangerous and requires treatment, which can only be prescribed by a cardiologist.

Children's bradycardia can be triggered by various circumstances in the child's life and the state of his own body. Doctors the most common reasons of this disease are called:

disturbances in the functioning of the nervous (neuroses) and endocrine (metabolic failures) systems - especially in adolescence;
increased intracranial pressure;
a tendency to bradycardia is observed in those children who were diagnosed with hypoxia at birth;
infectious diseases suffered by the child;
general, enough severe hypothermia body;
a large dose of potent medications or their long-term use;
often after an ultrasound, even during pregnancy, a diagnosis of “tendency to bradycardia” is made when the fetal heart rate is too low - this is possible if there is an unborn baby organic disease hearts;
lead poisoning, nicotine;
rapid growth of internal organs, heart;
problems with cerebral circulation;
hypothyroidism

Sometimes a child may develop bradycardia if he is very frightened of something or, for some reason, holds his breath for too long. Even just before bed, some children may experience a decrease in heart rate under the influence of events and emotions experienced during the day.

This is a temporary phenomenon, and not a disease; in such cases, doctors are not consulted. Depending on the causes of bradycardia and the general condition of the small organism, several forms of the disease are distinguished.

If parents have doubts about whether the child has bradycardia or not, they should monitor his condition more closely. This disease most often manifests itself quite clearly. Symptoms of bradycardia include:

weakness, lethargy;
dizziness;
poor appetite;
shortness of breath, difficulty breathing;
cold, very profuse sweat;
loss of consciousness;
blood pressure surges;
absent-mindedness;
decreased concentration;
fatigue;
chest pain;
slow pulsation.

These symptoms can be explained simply: the functioning of the heart is impaired - this organ cannot supply the body with blood in the same volume. Due to impaired blood circulation, cells die.

This can lead not only to constant loss of consciousness and exhaustion of the heart muscle: over time it ruptures, which invariably leads to death. To prevent this, you need to consult a doctor in a timely manner and start necessary treatment as soon as possible.

If the form of the disease is moderate or severe and interferes with the child’s life, treatment comes down to medication course antiarrhythmic drugs. These include:

ginseng root;
belladonna;
caffeine;
Eleutherococcus extract;
isadrin;
belladonna;
atropine;
ephedrine.

All of the listed drugs are selected individually for each small patient. The basis of therapy is the elimination in a short time of the main disease that caused bradycardia.

For mild forms, it is possible to use folk remedies, but again only with the permission of the doctor and only if the parents are absolutely sure that their child suffers from just such a disease.

Traditional medicine advises giving to children in the following cases:

a mixture of chopped walnuts, sesame oil, sugar, which is poured with boiling lemon solution;
strong tea;
seaweed and other seafood;
infusion of pine branches.

At the same time, one must not forget that small organism may react to many natural traditional medicines with allergies or individual intolerances, so parents should in this case you need to be extremely careful.

Here is the treatment of mild forms of the disease with sports - a more rational and sometimes successful option for independent treatment of bradycardia. You can help a child suffering from bradycardia by teaching him some calm sport from childhood. There is no need to send him to grueling training sessions that will require heavy physical exertion.

A well-chosen set of exercises, rational loads, and encouragement of positive results - all this will help improve the physical condition of the little athlete. Regular, fairly long (up to 3-4 hours a day) walks in clean, clean areas are recommended. fresh air. The following may also be useful:

sunbathing;
gentle dousing (read more about methods of hardening children);
morning exercises, which excludes a number of exercises associated with turning the body over;
pool.

Pronounced sinus bradycardia in children can be a reason for urgent and mandatory hospitalization of the child. Sometimes the disease becomes chronic, in which a pacemaker is implanted.

Today's modern medical technology(in particular, in cardiology) can work real miracles and treat even childhood bradycardia.

Bradycardia in the fetus

State of the art modern medicine allows you to examine the health of the child when he is still in the womb. How the baby feels is determined by its heart rate. Normally it ranges from 120 to 160 beats per minute.

This fetal vital sign is checked at every routine visit by the woman. gynecological consultation starting from eight weeks of pregnancy. At normal development Listening to heart sounds with a regular stethoscope may be sufficient.

But if the doctor reveals a decrease in heart rate, then the expectant mother is sent to additional examination: they do a CTG (fetal cardiotocogram), through which the conductivity of the heart muscle of the embryo, its excitability and contractility is checked, or a Doppler examination.

A decrease in fetal heart rate to 110 beats per minute is called basal bradycardia. It can be caused by compression of the fetal head, maternal hypotension and a number of other reasons. This type of bradycardia is not dangerous to the baby's health. But the expectant mother needs to take care of eliminating the causes that cause it so that the baby’s heartbeat returns to normal.

Decelerant bradycardia in the fetus is much more dangerous when the heart rate is less than 90 beats per minute. This indicates the child’s suffering, which is caused by oxygen starvation (fetal hypoxia). It develops when a pregnant woman takes certain types of medications, when she develops gestosis (late toxicosis) or anemia (iron deficiency), premature placental abruption, etc.

Fetal bradycardia can occur at any stage of pregnancy. In the first half of pregnancy, a lack of oxygen can affect the formation of the baby's organs, causing them to underdevelop. In the second half oxygen starvation leads to disturbances in the development of the central nervous system and problems during childbirth.

Bradycardia is dangerous because it can cause the death of a child not only during intrauterine development, but also during childbirth (fetal asphyxia), and even in the first hours after birth. During pregnancy, the fetal heartbeat is checked using a conventional obstetric stethoscope and using Doppler ultrasound, which is prescribed not only to expectant mothers who have chronic diseases of the upper respiratory tract(bronchitis, etc.), diabetes mellitus, cardiac disorders, but also for healthy women in accordance with the pregnancy management protocol.

Starting from the second half of pregnancy, future mom She herself can determine whether there are deviations in the baby’s pulse by counting his movements. If the baby turns (moves) in the mother's belly for 10 or more two-minute series, then everything is fine. If the number of episodes is less, there is a reason to undergo additional examination.

To treat bradycardia in the fetus, medications are administered to the mother. Through the general bloodstream they enter the child’s circulatory system. At the same time, there is an improvement in the woman’s uteroplacental blood flow

Drug therapy is carried out based on the type of bradycardia and its severity, the health status of the expectant mother, taking into account the duration of pregnancy. Most often, droppers with calcium gluconate, sodium bicarbonate, cocarboxylase, ascorbic acid and glucose, and oxygen masks are prescribed. The drugs are administered in the following order:

First, solutions of cocarboxylase and sodium bicarbonate;
Then, a solution of ascorbic acid with glucose;
Finally, calcium gluconate is administered.

If the devices detect the occurrence of acute bradycardia during childbirth, then the woman in labor and the newborn baby are injected subcutaneously (if possible) with atropine.

The most common reason bradycardia in old and senile age - degenerative-dystrophic changes in the tissue of the conduction system of the heart. In some cases, this is sinus node syndrome (tachybrady), sometimes it is complete atrioventricular block.

The detection of such bradycardia is a direct indication for invasive intervention - installation of a pacemaker. If, in addition to recorded bradycardia, the patient experiences fainting, then the installation of a pacemaker should be considered an emergency procedure.

We cannot agree with the practice of long-term “keeping” a patient with such bradycardia on drug therapy (except in cases where bradycardia is a consequence of inflammatory edema, for example, during myocardial infarction or myocarditis).

A patient with bradycardia due to sclerotic lesions is always a potential candidate for sudden death, since no one is studying the status of his possible lower order pacemakers. What may lead to a Morgagni-Adams-Stokes attack in one person may result in sudden death in another.

We cannot ignore such a phenomenon as arterial hypertension during bradycardia. In some cases, especially with pathological bradycardia, in order to maintain adequate perfusion of vital organs, the body seems to “try to compensate” for the missing frequency by spasm of peripheral vessels.

Often, doctors begin to reduce this pressure without eliminating the hemodynamically significant bradycardia. This leads to catastrophic consequences. The next reason that can lead to bradycardia in an elderly person is drug exposure.

Most often we encounter bradycardia during digitalis intoxication, although we note that digitalization is now prescribed much less frequently. Twenty years ago, the second drug after digitalis that caused bradycardia in older people was clonidine, which was abundantly absorbed by them. Nowadays, β-blockers, calcium antagonists and their combinations have come forward.

The simultaneous administration of diltiazem and atenolol or long-acting drugs (betaxolol!) after a certain time is guaranteed to lead the patient to uncontrollable hypotension and bradycardia.

The most difficult thing in diagnosing the causes of such bradycardia is taking an anamnesis. Even old man and remembers what he is taking, he does not always remember whether he took the medicine. Quite often we have to deal with overdoses of antihypertensive drugs, digitalis (especially when they forget to switch from the saturation mode to the maintenance dose mode), and cordarone.

In a number of cases, we encountered violations of the standardization of medicines. The patient took generic atenolol at a dose of 150 mg/day for a long time, then his son brought him several packages of atenolol from another manufacturer.

A few days later, the patient ended up in the cardiac intensive care unit with severe hypotension and bradycardia. As it turned out, when using a standardized drug, 100 mg/day is sufficient.

The cause of bradycardia, hypothyroidism, occurs in older people, much more often than one might think. The inattention of the attending physician sometimes leads to tragic consequences in an absolutely curable situation.

Imagine an elderly person, for example, who also suffered a myocardial infarction. He has swelling, shortness of breath, and weakness. The fact that in addition to this there is also drowsiness, constipation, dry skin (he takes diuretics!) most likely will not be noticed at all.

Nobody will measure body temperature at all, and the absence of its increase with, say, colds, will be attributed to the general unresponsiveness of the patient with chronic heart failure. After some time, such a patient will die, and his death will be attributed to the same chronic heart failure, without trying to find out, if not during life, then at least after death, how the thyroid gland behaved there.

The tragedy of this situation lies in the simplicity of correcting this condition with L-thyroxine. The possibilities of hormone research are completely clear thyroid gland in district hospitals, but why does everyone forget about the possibility of prescribing trial therapy

Yes, indeed, we started with very small doses, increasing them step by step by 12.5 mg of thyroxine, but in a number of cases such titration was rewarded with an absolutely fantastic treatment effect.

Sinus bricardia

In some cases, not only hypothyroidism, but also thyrotoxicosis (in especially severe forms with necrotization of sinus node tissue) can be the cause of bradycardia. Cases of bradycardia have been described in almost all systemic diseases connective tissue, at diabetes mellitus, with Friedreich's muscular dystrophy.

We observed a patient with a huge floating thrombus in the inferior vena cava, which reached with its free end to the right atrium appendage. CNS effects (sometimes related to our medical manipulations) can quite often cause bradycardia.

Let us also recall bradycardia as a component of the hypertension-cerebrospinal fluid syndrome. Excessive vagal effects can even cause reflex cardiac arrest. The last section of our review is devoted to bradycardia, which, in both the elderly and the young, is, unfortunately, a harbinger of death.

This bradycardia occurs when compensation is completely exhausted and is accompanied by severe hypotension, hypothermia and impaired consciousness. Electrocardiographically, significantly widened ventricular complexes with a significantly prolonged QT interval are recorded.

As the condition progresses, there is a migration of the pacemaker from the sinus node to lower-order pacemakers with the final outcome in small-wave ventricular fibrillation, and more often, immediately in asystole. This scenario is realized in almost all causes of terminal conditions and is the final manifestation of multiple organ failure. In this case, we cannot help such a patient.

Moderate bradycardia does not lead to disturbances in the body's blood supply and the appearance of serious signs of illness. Clinical picture clearly visible if the heart muscle contraction frequency drops to 40 beats per minute or below.

If the anomaly is mild or moderate in severity, it is manifested by the following symptoms:

Chronic fatigue.
Brokenness.
Excessive sweating.
Chest pain.
Absent-mindedness.
Difficulty concentrating even on a short time.
Changes in blood pressure.

It should be emphasized that there may be no apparent symptoms of the disorder. Signs of severe bradycardia are more severe and obvious. The disease manifests itself:

fainting and semi-fainting;
frequent dizziness;
"floaters" before the eyes;
difficulty breathing;
rarely – periods of confused thinking.

Bradycardia of the heart in children in many cases occurs without clear signs, but the main symptom when a child complains of chest pain or fatigue is a slow pulse.

Diagnostic methods

If you experience noticeable symptoms, you should immediately make an appointment with a cardiologist. He will examine you, write down all your symptoms and ask you to do an ECG (electrocardiogram). You will receive a graph that will show changes in the rhythm of the heart, carried out to the surface of the human body.

Today there is ECG monitoring according to the Holter principle. This modern method allows you to monitor changes in heart function all day long and at the same time make a continuous electrocardiogram. This efficient apparatus allows automatic continuous measurement of blood pressure.

You will definitely need to take general and other (at the doctor’s discretion) blood tests, as well as check your thyroid hormones. There is such an innovation as an ECG over the phone. The patient can call the clinic at any time and their heart rhythm will be determined.

At the same time, he must wear two special bracelets and place one electrode under the belt. The doctor shows him the positions in which he should lie for correct diagnosis.

This method eliminates the need to leave the house and saves a lot of time. The doctor may also prescribe additional diagnostics to fully and accurately determine the diagnosis or stage of the disease:

ECHO – known as cardiac ultrasound;
electrophysiological examinations;
coronary angiography ( exact method for the diagnosis of coronary heart disease).

Very often, bradycardia can develop without any symptoms at all. Therefore, even if you feel constant fatigue or fatigue for several weeks, this is a reason to consult a specialist.

In case of a sudden attack of bradycardia, the patient must be given assistance. To do this you should:

Place the person on their back so that their legs are slightly higher than their body. Then call ambulance.
It is necessary to free your breath by unfastening the buttons.
If the patient has lost consciousness, it is necessary to try to bring him to his senses.
A person can be brought out of deep fainting using ammonia.
When the patient does not regain consciousness, those around him need to monitor his body temperature. To prevent hypothermia, it is covered with heating pads.
If a person wakes up, the first thing you should do is measure his pulse.
You can give him the medications he takes in such cases. But you can’t self-medicate.

Helping a person with bradycardia often saves his life, especially if he faints during an attack. After all, this can happen anywhere, for example, on the street or in transport.

If bradycardia is associated with the natural aging of the patient’s body (irreversible processes begin after 55-60 years) or drug therapy is ineffective, the patient is prescribed cardiac pacing (implantation of a special device under the patient’s skin that normalizes the number of heartbeats).

Consultation with a cardiac surgeon is mandatory for patients in whom bradycardia is accompanied by attacks of MAS (fainting). Their main danger is that during fainting, the risk of cardiac arrest increases. The main methods of treating cardiac bradycardia:

If it is found that the heart rate does not exceed 60 beats per minute, but no heart disease or pathology has been identified, then the main method of treatment is the use of regular preventive techniques.
If bradycardia is caused by another disease, then you first need to cure yourself of the underlying disease.
Most best method treatment – pacemaker implant. This is a special operation that is performed when the rhythm is slow - less than 40 beats per minute, as well as cardiac arrest for 2-2.5 seconds. The device, which is implanted into the heart muscle, sends electrical impulses and independently stimulates the functioning of this organ, accelerating blood circulation.
Drug therapy is prescribed only by a doctor.
Complications and dangerous species bradycardia requires urgent hospitalization and medical intervention.

With bradycardia, as with other diseases, it is strictly not recommended to self-medicate. This can lead to further damage to the body, as well as to the main organ – the heart.

People can live perfectly well their entire lives with bradycardia. The most important thing is to notice the symptoms in time and regularly implement preventive treatments. If as a result of prevention there is a noticeable deterioration in the condition, do not hesitate - contact a specialist.

When bradycardia is a secondary symptom of some other disease, the main thing in this case is to eliminate the underlying disease or at least control its course. For example, if the cause that caused the symptoms of bradycardia is hypothyroidism, then the existing disease should be dealt with.

These disorders are usually corrected with medication and hormone replacement therapy. If bradycardia is caused by medications, then most often it goes away immediately after stopping them or in the near future. You should only take sorbents such as enterosgel, liferan, white coal for a week or two.

If heart rhythm disturbances are caused by vegetative causes, then medications are prescribed that increase vascular tone, such as toginal. When bradycardia is caused by some kind of intoxication, they also fight the source of infection with the help of antiviral or antibacterial drugs.

If hemodynamic disturbances are observed, such as fainting conditions accompanied by profuse sweating, weakness, dizziness, Eleutherococcus preparations, ginseng root, belladonna, ephedrine, isadrine, caffeine and other drugs are prescribed, which are selected individually after the diagnosis.

If a person develops serious health problems associated with a slow heart rate: fainting, ventricular arrhythmia, arterial hypotension, angina attacks, serious treatment of bradycardia should be started.

If the cause of the disease is electrical disturbances of the heart, then only a pacemaker can help. This implant is surgically inserted. It is a kind of rhythm regulator, constantly producing frequency electrical impulses that are equal to physiological ones.

After implantation in this way, the given rhythm gradually restores hemodynamics. If bradycardia is combined with organic lesions of the heart, this aggravates its course, the patient should be hospitalized several times a year, even if attacks and deterioration of the condition are not observed.

Such combined pathologies can lead to blood clots and can cause other serious complications in the course of these diseases. These pathologies, if not seriously treated, can lead to disability.
Important! Any drug treatment is prescribed only by a doctor and taking folk remedies should not be started without consulting him.

Each medicine has not only therapeutic effect for this or that pathology, it also has a lot of contraindications, side effects and various negative effects on the body, which can be even more dangerous than the disease itself.

Treatment of bradycardia is carried out only with pronounced clinical manifestations and obvious disruption of the hemodynamic process. If a person's heart rate is reduced to 40 per minute and frequent fainting occurs, one of the following medications is used:

Atropine - every 3 hours intravenously (2 mg) or subcutaneously (0.5 to 1.0 mg);
Isadrin - in a glucose solution (5%) by intravenous drip (2 ml per 0.5 l);
Isoproterenol - infusion (drip) administration (up to 4 mg);
Alupent (10 mg of the drug per 500 ml of isotonic sodium chloride solution) - intravenously by drip or eight oral doses of 20 mg;
Belladonna preparations for the treatment of bradycardia occurring without severe symptoms;
Ginseng or Eleutherococcus extract (the dosage is selected by the doctor for each individual patient);
In case of individual intolerance or existing contraindications to the use of Izadrin or Atropine, tablets of Ephedrine hydrochloride or Ipratropium bromide are prescribed.

An acute form of bradycardia caused by a violation of impulse conduction requires urgent hospitalization and inpatient treatment aimed at eliminating the main causes that contribute to a decrease in heart rate.

Heart rate stimulator

Electrical stimulation of the heart involves initiating its contractions using external electronic devices. The stimulator contains an electrical pulse generator, electrodes that transmit pulses and a microcomputer, which can be freely programmed, selecting individual settings for each specific patient.

You can choose the heart rate, the strength and duration of the impulse, sensitivity and other parameters of its operation. The procedure for implanting a pacemaker is carried out under local anesthesia. The electrode is inserted through a vein under the control of an X-ray machine, into the right ventricle, and sometimes into the right atrium.

During the implantation operation, measurements of heart parameters are taken to allow the device to be programmed correctly. The stimulator itself is implanted subcutaneously under the collarbone.

A patient with an implanted pacemaker should undergo routine annual examinations. Unfortunately, having an implanted system carries a certain risk of complications. The most common are:

movement of the electrode into the heart, causing disruption of pacing (in such a situation, another procedure is necessary);
increasing the stimulation threshold (reprogramming the pacemaker is required);
tachycardia (results from improper programming of the pacemaker);
local infections: with weakened immunity, it can even lead to sepsis.

How to increase your heart rate during bradycardia yourself? If the diagnosis has already been made, a person can detect an attack of bradycardia by the first symptoms. But in any case, you need to check your pulse. When your heart rate per minute is much lower than normal, you should increase your number.

Naturally, these methods “work” only when light forms diseases when the patient does not lose consciousness, etc. After measuring the pulse, the pressure should be checked. Bradycardia is characterized by its decrease, but sometimes the levels may be higher than normal.

And, for example, caffeine, which increases blood pressure, can only do harm, not help. High pressure is not always associated with this disease, but affects the ways in which the heart rate increases. In this case, doctors prescribe diuretics and inhibitors.
But hypotensive people often use energy drinks, which allows them to quickly raise their heart rate.

But it is not recommended to use this method constantly, since caffeine is not very beneficial for the body. A patient who wants to get rid of bradycardia must first avoid stressful situations. At increased anxiety you should take a course calming tablets, having previously discussed this with your doctor.

If there are no contraindications, then you can use the most accessible way to raise your heart rate - physical exercise. You don't have to run a marathon or exercise for hours. It is enough to do regular exercise to increase your heart rate. Running short distances for a long time helps to increase your heart rate.

The presence of bradycardia does not mean that the patient will soon face a heart attack and other serious diseases. This disease is not dangerous, but if not treated sufficiently, it can still quickly become chronic and cause complications.

Therefore, you cannot do without consulting a cardiologist. The doctor will help cure the disease by prescribing appropriate medications.

Traditional medicine recipes can be used only in the presence of bradycardia of the first and second degrees, in which heartbeat does not fall below 40 beats/min. Tinctures based on herbs such as immortelle, lemongrass, tartar and yarrow are used. Recipes for preparing decoctions:

Immortelle - 1 tsp. dried immortelle inflorescences are poured into 500 ml of boiled water. Leave for 2-3 hours. Take 1 tsp. infusion three times a day. It is not recommended to consume after 7 pm.
Tatarnik - baskets of grass are used to prepare the decoction. 100 g of ingredient pour 1 l hot water, bring to a boil, simmer over low heat for 10 minutes. Cool and strain before use. Every time before meals, take 1 tbsp. l.
To prepare lemongrass tincture, fresh fruits are used, which must be filled with medical alcohol in a ratio of 1 to 10. Take as an additive for tea (no more than 1 teaspoon of tincture per cup) in the morning and evening.
Pour dry crushed yarrow into a glass of hot water, boil for 10 minutes, let cool. Use 3 tsp. twice a day.

Why is pathology dangerous?

It is necessary to understand what health risks this disease poses and what complications it can cause. This disorder can greatly impair the patient's quality of life and performance. The disease does not make it possible to live a full life: constant weakness and the risk of loss of consciousness impose serious restrictions not only on work, but even on many usual activities: carrying heavy objects, driving a car, concentration and Attentive attitude to getting things done.

Any fainting poses a threat of deterioration in a person’s health and the development of complications, because oxygen starvation and lack of nutrients can cause serious and even irreversible disturbances in the functioning of the heart, circulatory system or brain.

Fainting can last 15-20 minutes and occur up to several times a day. It is very difficult to feel the pulse at this time; the condition may be accompanied by cramps of the limbs. Complications that can occur with bradycardia can lead to severe and fatal consequences:

angina pectoris;
cardiac ischemia;
sudden changes in pressure;
stopping the work of the heart muscle;
clinical death.

Of particular danger to the patient is acute attack bradycardia, which is characterized by redness of the patient’s face, dizziness, loss of consciousness, rapid breathing and general cramps. In this state, the pulse is almost impossible to feel.

To avoid severe consequences An attack of bradycardia can only be treated by immediate hospitalization, medical intervention and electrical stimulation of the heart.

Prevention of bradycardia is aimed at eliminating symptoms and the occurrence of further attacks. After all, treatment alone is never enough. If bradycardia appears, it means there is a malfunction in the body. And close attention should be paid to lifestyle.

From bad habits, especially smoking and alcohol, you will have to give up, as these are the first enemies of the cardiovascular system. As for physical activity, it is limited only in case of pathological bradycardia and in individual cases. In other cases, the load must be present.

Diet also affects the heart, so as a preventative measure you need to review your diet. The ideal solution would be to follow a light diet. To do this you need:

limit the consumption of animal fats and salt;
reducing the calorie content of food;
eating foods rich in fatty acids (for example, nuts).

Do not underestimate the diet for bradycardia, since improper nutrition sometimes nullifies all treatment. In addition, with the help of such restrictions, the development of blood clots and heart failure can be combated. By violating the diet, the patient worsens his health.

Bradycardia is a change in heart rate in which the pulse becomes less than 60 beats per minute. Such a rare heartbeat is normally found in athletes and well-trained people. All types of bradycardia are based on a decrease in the frequency of ventricular contractions, which can occur due to a disruption in the generation of a nerve impulse in the sinus node or a disruption in its conduction through the cardiac system.

With bradycardia, the pulse is less than 60 beats per minute. Mild and moderate degrees of bradycardia usually do not cause circulatory problems and do not cause any symptoms. With a very low heart rate, there is a lack of blood supply to organs and tissues, which leads to disruption of their normal functioning.

Approximately 25% of physically trained young men have a normal heart rate (HR) of 50-55 beats per minute. Heart rate also decreases during sleep. This occurs under the influence of the autonomic nervous system. The number of heart beats per minute in this case can be reduced by 30%. In most cases, bradycardia appears due to some disease or pathological process in the body.

Classification of bradycardia

A decrease in heart rate, depending on the cause, is divided into 2 types:

Sinus bradycardia - occurs when the automatism of the sinus node is impaired, in which the frequency with which impulses are generated in it becomes less than 60 per minute.
Sinoatrial and atrioventricular blocks are disturbances in the conduction of nerve impulses between the sinus node and the atria or between the atria and ventricles.

Bradycardia can be:

Physiological - during sleep, in athletes, sometimes in pregnant women.
Pathological – if the cause is any disease.

Pathological, in turn, can occur in two forms:

Acute - this is observed in myocarditis, myocardial infarction, and some poisonings.
Chronic – occurs mainly in chronic age-related heart diseases.

Depending on the cause of occurrence, the following types of bradycardia are distinguished:

Organic (for some heart lesions).
Extracardiac (if the cause is not cardiac pathology).
Toxic.
Medicinal.
Sinus bradycardia of athletes.

Causes of bradycardia

Extracardiac forms can develop with:

vegetative-vascular dystonia;
increased intracranial pressure – observed with subarachnoid hemorrhage, meningitis, brain tumor, intracranial hematoma;
mechanical pressure on the carotid sinus - when wearing a tight collar or tie;
pressing on the eyeballs.

Causes of bradycardia of organic origin:

myocarditis;
myocardial dystrophy;
cardiosclerosis;
myocardial infarctions.

These diseases contribute to fibrotic changes in cardiomyocytes in the sinus node or damage to the conduction system of the heart, causing blockages and arrhythmias.

Schematic representation of the heart Organic damage to the source of the heart rhythm causes a pathology called sick sinus syndrome. With this disease, the frequency of generated impulses sharply decreases, which leads to bradycardia or the alternation of other pacemakers with a change from bradycardia to tachycardia. Complete defeat sinus node is fraught with complete failure of impulse generation.

If degenerative changes affect the conduction system of the heart, then some signals from the source of the pacemaker in a certain place are blocked. This leads to the fact that the impulse does not reach the ventricles. As a result, heart contraction does not occur and blood from the heart cavity does not exit into the vascular system body. This is often another reason for the development of bradycardia.

It is not uncommon for your heart rate to decrease as a result of taking certain medications. These include:

beta-blockers (Metoprolol, Anaprilin);
cardiac glycosides (Corglicon, Digoxin);
sympatholytic agents (Reserpine);
antiarrhythmic drugs (Quinidine, Novocainamide, Amiodarone);
calcium channel blockers (Nifedipine, Verapamil);
narcotic analgesics (Morphine).

Bradycardia can also be caused by the effects of certain toxins on the myocardium. A decrease in heart rate may be observed with:

hepatitis;
sepsis;
typhoid fever;
uremia;
poisoning with FOS (organophosphorus compounds).

This group of bradycardias includes a decrease in the generation of pulse frequency with an excess of potassium (hyperkalemia) or calcium (hypercalcemia) in human blood.

The idiopathic form of bradycardia includes those cases in which it is not possible to find the cause of the decrease in heart rate. This happens during natural aging processes in the body, i.e. in old age.

Symptoms of any bradycardia

Moderate bradycardia does not affect the condition of the body in any way, because with it there is no significant circulatory disturbance. Symptoms of bradycardia occur when the frequency of contractions of the heart muscle decreases to less than 40 beats per minute. Patients are usually concerned about:

general malaise, fatigue;
attacks of dizziness;
fainting conditions;
fluctuations in blood pressure;
chest pain;
labored breathing.

As a result of insufficient blood supply to the brain during bradycardia, the following symptoms may occur:

impaired memory, attention and concentration;
attacks of visual impairment;
confused thinking.

Symptoms of bradycardia always directly depend on the severity of the circulatory disorder of a particular organ. As a result of the fact that the brain primarily reacts to this deficiency, often the only manifestations of the disease are:

loss of consciousness;
convulsions;
manifestations of Morgagni-Adams-Stokes syndrome (incoming attacks of impaired consciousness with its independent restoration).

All these symptoms are extremely dangerous for the body and therefore require urgent help. The need for emergency medical observation is due to the possible development of complications. For example, with prolonged attacks described above, respiratory arrest may occur.

Why is bradycardia dangerous?

Based on the above symptoms, it can be assumed that bradycardia is not such a harmless disorder of the heart. At its core, a decrease in heart rate has a direct connection with the development of a deficiency of blood supply to organs and tissues of the body. The danger of the pathology lies in the occurrence of complications and some consequences of this disorder. All conditions that develop against the background of bradycardia are caused by this insufficiency.

Attacks of dizziness are fraught with loss of consciousness due to a lack of oxygen delivery to the brain. In this case, seizures, strokes and, in severe cases, respiratory arrest may occur. Insufficiency of blood circulation in the brain is manifested by fainting, in which a person often gets various injuries due to falls on hard objects. Such loss of consciousness is dangerous due to the development of traumatic brain injuries.

Insufficient blood supply to the heart can lead to the development of myocardial ischemia up to complete disruption of blood circulation in the heart muscle (to a heart attack). Thus, it is fair to conclude that bradycardia is dangerous due to disruption of oxygen supply and nutrients any organ of the body. Depending on the damage to a certain structure or system of a person, complications develop up to fatal outcome.

Diagnosis of bradycardia

Bradycardia can be suspected based on the patient's complaints described above. When examining the patient, a rare regular pulse is determined. The sonority of heart sounds is not changed. Severe respiratory arrhythmia is noted. When determining bradycardia, consultation with a cardiologist is required to determine the cause of the pathology.

Instrumental studies and their interpretation:

Principles of treatment of bradycardia

Moderate degree bradycardia and functional form do not require any treatment. Therapy of the underlying disease is carried out using organic, toxic or extracardiac options. Bradycardia caused by taking medications is eliminated by adjusting the dosage or completely stopping the substance that caused the decrease in heart rate.

Active treatment of bradycardia is carried out if the patient develops angina, hypotension (low blood pressure), fainting, attacks of ventricular arrhythmia, or heart failure. If frequent attacks of Morgagni-Adams-Stokes occur, an urgent consultation with a cardiac surgeon is required to perform an operation to implant an IVR (pacemaker). Such artificial driver rhythm will generate impulses at a predetermined frequency, which will eliminate signs of hemodynamic disorders (circulatory disorders).

Disease prognosis

In general, mild bradycardia has a favorable prognosis. However, with the addition of organic changes or persistent circulatory disorders without adequate treatment, the likelihood of developing fainting with all possible complications such. A consistently reduced heart rate in combination with tachyarrhythmias of various origins significantly increases the risk of developing thrombosis and thromboembolic complications, in particular myocardial infarction and stroke.

Prevention of bradycardia

The main way to prevent the development of bradycardia is to eliminate the factors that cause it:

treatment of organic heart diseases;
adequate selection of dosages of medications;
elimination of toxic effects on the myocardium.

Thus, it is fair to conclude that bradycardia is a type of arrhythmia in which the heart rate becomes less than 60 beats per minute. For athletes, a decrease in heart rate is normal. Non-physiological bradycardia may be accompanied by low blood pressure, loss of consciousness, dizziness, and chest pain. When the heart rate decreases to 40 beats per minute, heart failure may develop, requiring implantation of a pacemaker.

The heart is the organ from uninterrupted operation on which human life and its quality depend. That is why even small deviations from the norm should attract attention and alert. What is bradycardia and why is it dangerous? We will consider below what symptoms are characteristic of this pathology.

Arrhythmias

U healthy person The parts of the heart contract and relax evenly, pumping blood. Normal heart rate (HR) ranges from 60 to 90 beats per minute. You can register this indicator by placing a watch with a second hand in front of you and simply counting the pulse on the radial artery. Normally, it should be of good filling and tension, uniform, that is, the same time should pass between two blows. If the heart rhythm is disturbed, this condition is called arrhythmia. It can be of several types.

Types of arrhythmia

tachycardia? This question arises among those happy people who have not encountered heart disease closely. These are two polar rhythm disturbances. Tachycardia is an increase in the number of heart contractions over one hundred beats per minute. There is another type of arrhythmia - extrasystole. It is characterized by premature contractions of the heart. Answering the question of what bradycardia is, we can say that it is a decrease in the number of heartbeats to 55 or lower. As a rule, such rhythm disturbances in the early stages have no clinical signs and are detected during a routine examination.

Physiological bradycardia

If you are interested in what sinus bradycardia is and have counted your pulse and found out that it is below 50, do not panic and call an ambulance. In those people who engage in sports or physical labor, bradycardia is not at all uncommon. However, they do not experience any discomfort, that is, the volume of blood flowing to the brain does not decrease. This is due to the fact that, thanks to the constant load, their respiratory and cardiovascular systems are more developed than those of the average person. Thus, the question of what bradycardia is loses relevance for them. Its occurrence in a healthy person is possible in stressful situation, with severe fatigue and after a long stay in the cold or in a hot and humid climate (or, for example, in a steam room). Moderate sinus bradycardia (we'll talk more about what it is below) can be triggered by a tight tie or collar. Such conditions do not pose a threat to human health and do not require special treatment.

Bradycardia resulting from inhibition of pacemaker activity

When analyzing what bradycardia is and why it is dangerous, it should be mentioned that a pathological decrease in heart rate can be caused by several reasons. And one of them is inhibition of the pacemaker. This occurs due to a decrease in the tone of the sympathetic nervous system or increased excitation of the vagus nerve. In turn, the cause of these phenomena may be such humoral factors as high levels of bile acids in the blood, low level thyroid hormones. The development of bradycardia in this case can be provoked by the following factors:

neuroses;
vegetative-vascular dysfunctions;
high intracranial pressure;
taking certain medications;
high levels of potassium in the blood;
myxedema;
infectious diseases.

Decreased rhythm due to blockades

Speaking about what bradycardia is, the following should be noted: it can also be caused by heart block (the transmission of impulses to various departments organ). However, it can be sinoauricular. There is a disturbance in the transmission of impulses through the atria when currents are transmitted from the sinus node to the myocardium every other time. It may also be atrioventricular. In this case, a violation of impulse transmission occurs through the ventricles? and some of their contractions simply fall out of the heart rhythm. The development of such blockades is divided into three degrees. With the first, there is a slight decrease in the speed of impulse transmission to the ventricles, with the second, not all of them reach, and with the third, there is a decrease in the number of contractions caused by blockade of the conduction system.

Symptoms of bradycardia

Well, finally we got to the most important thing. Let's answer the main questions: "Sinus bradycardia - what is it and what are its symptoms?" It should be noted that in most cases this pathology proceeds unnoticed and is discovered accidentally during preventive examinations. Only when it becomes chronic, the disease begins to actively manifest itself. This is due to the fact that as a result of a decrease in the frequency of contractions, the volume of blood decreases, as well as the amount of oxygen and glucose entering the brain. In the early stages, the disease manifests itself as weakness, dizziness, and cold sweat. Sleep and memory are disturbed. Patients complain of anxiety, heart palpitations, and shortness of breath. Despite the apparent insignificance of the symptoms, in order to understand sinus bradycardia - what it is and what real danger it poses, it is enough to consider the symptoms that appear when the process enters the acute stage. Here, the signs of brain hypoxia are of a pronounced nature of heart failure. In addition, the patient may be plagued by pain in the heart (angina), darkening of the eyes, and frequent moments of confusion (fainting). Severe bradycardia may be complicated by the Morgagni-Adams-Stokes sign. It is manifested by loss of consciousness, severe pallor of the skin, breathing problems, and convulsions. It must be remembered that if the interval between ventricular contractions exceeds 15 seconds, then cardiac arrest and clinical death are possible.

Moderate bradycardia

Moderate bradycardia is considered if the heart rate falls within the range of 55 to 45 beats per minute. As a rule, it is asymptomatic or manifests itself with minor autonomic disorders. It is most often caused by an increase in the tone of the vagus nerve, which is responsible for the contractile function of the heart. Clinically, moderate bradycardia can manifest itself as increased fatigue, dizziness, and shortness of breath.

Bradycardia in children: causes

Sadly, this disease can manifest itself at any age, and the diagnosis of “sinus bradycardia” in children is quite often noted. We have discussed what it is in adults, but in young patients the pathology will have slightly different criteria. The baby's heart beats faster, so the indicators change. A diagnosis of bradycardia in children can be made in the following cases:

if the heart rate of a newborn baby is below 100 beats per minute;
for children from one to six years old - less than 70;
for teenagers - from 60 and below.

As a rule, such deviations from normal rhythm, even if they do not have any external manifestations, do not lead to anything good and in the future can become the cause of the development of many pathological conditions. Therefore, the sooner bradycardia is identified, its cause is determined and treatment is prescribed, the greater the chance of avoiding complications that cerebral hypoxia can cause. The reasons that caused this pathology are also different. Often it can be caused by such ordinary things as holding your breath, fear, or impressions accumulated during the day (many children have an order of magnitude lower heart rate in the evening than in the morning). In addition, bradycardia can be caused by:

neuroses, endocrine disorders in teenagers;
fetal hypoxia;
increased intracranial pressure;
infectious diseases;
fast growth;
lead poisoning, nicotine;
hypothyroidism

Symptoms of bradycardia in children

During this disease, three stages of development can be distinguished. If at first bradycardia appears only as a slight deterioration in well-being and it can only be determined using laboratory diagnostics, then at the second stage its manifestations are already more pronounced. You can suspect this pathology in a child if he makes the following complaints:

lethargy, fatigue, attacks of dizziness;
decreased appetite;
difficulty breathing, shortness of breath;
cold sweat, loss of consciousness;
absent-mindedness;
chest pain, slow pulse;
pressure surges.

Despite all these symptoms, moderate bradycardia does not pose a threat to the child’s life and can be easily treated. However, the third stage of the disease can cause serious pathological changes both in the myocardium and in other organs and have very serious consequences, including death. That is why it is important to promptly identify bradycardia and begin its treatment.

Treatment of bradycardia

What is bradycardia and how to treat it? These questions become vitally important for those who have been given a similar diagnosis. It should be noted that this pathology refers to those diseases that require drug therapy only in case of severe clinical manifestations. If you have been given a similar diagnosis, but there are no special deviations in the body’s vital functions, treatment is not carried out. If the patient’s condition worsens, frequent fainting, dizziness are observed, and symptoms of heart failure increase, therapy consists of taking one of the following drugs:

“Atropine” - after three hours, 2 milligrams intravenously or 0.5-1.0 milligrams subcutaneously;
“Isoproterenol” - intravenous drip up to 4 milligrams;
"Alupent" - infusion (10 milligrams per 500 milliliters of saline solution);
extracts of eleutherococcus or ginseng;
belladonna preparations.

In severe cases, treatment is carried out in a hospital setting and is aimed at stabilizing hemodynamics and eliminating the causes of bradycardia. The dose of medications is determined by the doctor for each patient individually.

Electrocardiostimulation

In cases where bradycardia is associated with natural aging of the body or cannot be stabilized with drug therapy, cardiac pacing is prescribed. Indications for this intervention include a decrease in heart rate to 30-40 beats per minute, frequent loss of consciousness, symptoms of MAS, and signs of heart failure. The procedure is carried out using a probe, which is inserted into the heart cavity through the subclavian vein. In this case, cardiac stimulation can be either temporary (in case of acute disorders) or permanent. The procedure is permanently carried out using the implantation of a pacemaker. Modern models are a device no larger in size wristwatch and weighing less than 100 grams. Under local anesthesia, it is implanted just below the collarbone. Thanks to this, the patient is able to simulate the heart rhythm. For example, with constant bradycardia, the device also works constantly, and if it is transient, the pacemaker turns on only during the attack, and turns off after it ends. In addition, there are now rhythm-adaptive stimulators that can independently increase heart rate during increased physical activity. Thus, the patient gets the opportunity to forget about what bradycardia is.

Modern medicine can withstand many dangerous diseases. But, despite all its capabilities, heart pathologies occupy first place in terms of mortality. To avoid such a sad outcome, be more attentive to your health. Eliminate bad habits, and if you feel unwell, do not put off visiting a doctor. Then the question of how bradycardia manifests itself, what it is and how to treat this disease will lose relevance for you.

Bradycardia is a decrease in heart rate (pulse slowdown) of less than 60 beats per minute in adults at rest, below 100 beats per minute in newborns and less than 70 beats per minute in children from 1 year to 6 years.

Causes of bradycardia

disruption sinus node (sinoatrial node, sinoatrial node), from which it begins in the atria heartbeat(sick sinus syndrome or SSS - death of working cells in the sinus node to a critical level). Heart rhythm disturbances with this symptom are called sinus bradycardia;
disruption atriventricular node (AV node, atrioventricular node), through which the electrical impulse passes into the ventricles. The reason is the death of working cells in the AV node to a critical value;
disruption cardiac conduction system- all kinds of blockades occur, including sinoatrial (SA block), atrioventricular (AV block), etc. The conduction system of the heart is a kind of electrical wire through which the impulse from the sinus node passes to all myocardial cells, what makes a person's heart beat.
all these disorders are most often a consequence of coronary heart disease (angina pectoris, acute coronary syndrome, myocardial infarction, post-infarction cardiosclerosis), arterial hypertension, age-related changes, taking certain medications, kidney diseases, thyroid diseases (hypothyroidism), infectious diseases, fasting, intoxication, poisoning, etc.
disorders in the conduction system of the heart can also be idiopathic, i.e. have no apparent reason.

Cardiac bradycardia also occurs in children. The reasons may be:

Congenital heart defect;
past infectious diseases;
advanced growth schedule of the body;
and even poor nutrition.

Of course, this is not the entire list of possible reasons. That is why it is possible to determine the cause of bradycardia only with contact a specialist!

Types of bradycardia

1. Absolute bradycardia- bradycardia, which can always be determined, regardless of the conditions and condition of the person at the time of examination.

2. Relative bradycardia characteristic of fever, meningitis, hypothyroidism, infectious diseases, injuries; after physical activity. This also includes “athletes’ bradycardia.”

3. Moderate bradycardia observed in people with respiratory arrhythmia. At the same time, at the height of inspiration, the heart rate increases, and at the height of exhalation, it decreases. Most often, respiratory arrhythmia occurs in children and adolescents, in people with increased tone autonomic nervous system.

4. Extracardiac bradycardia occurs with diseases of internal organs, neurological pathology, myxedema.

Symptoms of bradycardia

general weakness;
dizziness;
darkening in the eyes, “midges” before the eyes;
loss of consciousness (fainting);
cold sweat;
increased fatigue;
and complete absence symptoms.

If a person experiences any of the above symptoms, it is necessary to immediately consult a specialist. Why is bradycardia dangerous? Its consequences can be such dangerous conditions as:

Attacks of MES (Morgagni-Adams-Stokes syndrome) - periodic sudden loss consciousness. After 15-20 seconds. fainting is accompanied by general muscle cramps. The pulse becomes rare or not detected at all, the skin becomes very pale, breathing is deep. Possible death.
Sudden cardiac arrest.
Arterial hypertension or unstable blood pressure.
Ischemic disease hearts. Angina pectoris of exertion and rest.
Development of chronic circulatory failure.

Diagnosis of bradycardia

When symptoms of bradycardia appear You must immediately consult a cardiologist or arrhythmologist to determine the main cause of tachycardia.

Examination by a medical specialist;
Analysis ECG;
Holter ECG monitoring (daily monitoring ECG);
Laboratory research(clinical and biochemical blood tests, thyroid hormone analysis)
Monitor your heart rate at home yourself (ECG by phone)

If necessary, undergo additional diagnostics:

ECHO (ultrasound of the heart);
electrophysiological study (EPS);
coronary angiography;

Bradycardia often occurs with virtually no symptoms, therefore, the appearance of such a condition as “ chronic fatigue"is a reason to contact a cardiologist. Cardiac bradycardia in children is diagnosed using the same methods.

Basic principles of treatment of bradycardia. Prevention

TO preventive measures bradycardia may include control of blood pressure and heart rate (ECG by phone), adherence to a diet (diet low in salt and fat), quitting smoking and adequate consumption of alcohol, maintaining a “work-rest” regime, walking in the fresh air, regular classes fitness with individual selection of load.

An annual examination by a cardiologist will allow you to promptly identify and quickly treat any type of bradycardia.

Principles of treatment of bradycardia.

If the heart rate is less than 60 beats per minute, but no diseases of the cardiovascular system or other organs have been identified, it is enough to apply preventive measures.
Treatment of the underlying disease that provoked bradycardia.
Drug treatment should only be carried out by a qualified cardiologist, since only he can adequately assess the pros and cons of drug therapy.
The most effective method The treatment for severe bradycardia is implantation of a pacemaker. An pacemaker is installed for bradycardia with a heart rate of less than 40 beats per minute and cardiac arrest for more than two seconds.

Dangerous types of bradycardia require emergency care and hospitalization of the patient!!!

Never self-medicate!!!

Bradycardia, what is it? Why does the heart begin to beat frighteningly slowly, and sometimes not very smoothly? Such questions are asked by those who have experienced sensations of a slowing pulse, accompanied by severe weakness and fear.

But is a slow heart rate always dangerous? When does it need urgent treatment, and when is it considered normal?

less than 60 per minute in adults;
less often 60-70 per minute in children from 1 to 6 years old;
less than 100 per minute in infants.

Rare contractions of the heart lead to blood circulation slowing down, tissues and organs receiving less oxygen and nutrients, and metabolism slowing down. Against the background of starvation of vital systems and organs, a person feels:

weakness;
cold sweat;
severe fatigue even after usual work;
dizziness;
darkening of the eyes;
blurred vision due to flashing flies;
loss of consciousness (the duration of fainting depends on the severity of the disease).

But why is bradycardia dangerous? And the fact that if it is not treated in a timely manner, then insufficient blood supply and the resulting symptoms can provoke the following complications:

ischemic myocardial damage, accompanied by attacks of angina of varying intensity;
the occurrence of chronic circulatory failure;
VSD, often of the hypotonic type, but the development of hypertension is also possible;
Morgagni-Adams-Stokes attacks, when sudden fainting is accompanied by convulsions caused by cerebral hypoxia (from epileptic seizure it differs in that it occurs suddenly, there are no precursors characteristic of epilepsy);

In children with bradycardia, symptoms are more severe than in adults and pose a greater health hazard. This is due to the fact that in the child’s body the processes of adaptation to unfavorable factors are not sufficiently developed and the distribution of intake for nutrition of vital organs is not always complete. Severe symptoms often provoke the development of convulsive seizures, during which cardiac arrest and death are possible.

Why does pulse pathology occur?

Bradycardia of the heart can be:

pathological;
physiological.

Pathological pulse failure

The development of pathology is possible for several reasons:

Organic. Impaired myocardial conductivity (the heart muscle ceases to fully conduct the contractile impulse to areas of the heart). It may occur due to weakness of the sinus node (the pacemaker that sets the frequency of contractions), various blockades, or myocardial necrosis that occurs during ischemia.
Toxic. Infectious diseases accompanied by severe intoxication of the body (meningitis, hepatitis, typhoid fever), provoke the appearance of organophosphorus compounds in the blood. These blood substances have a depressing effect on the contractile function of the heart. Sometimes this can occur due to excess potassium or sodium ions in the blood. This group also includes poisoning with gases and certain substances.
Hormonal. Suppression of thyroid function (hypothyroidism) and some diseases of the adrenal glands provoke changes in hormonal levels. Lack of hormones often provokes a slowdown in rhythm.
Medicinal. Taking certain medications (veropamil, nifedipine, reserpine) has a depressing effect on the functioning of the sinus node.
Household. Alcohol and smoking cause chronic intoxication, inhibiting the activity of the heart rhythm driver.
Starvation. This most often happens in women trying to lose weight quickly. Most diets exclude from the diet foods that contain substances important for metabolic processes, which leads to changes in the blood formula and general cellular starvation. After a diet, women feel severe weakness, fatigue and note that their heart has become less frequent.
Extracardiac, extracardiac. They arise due to an indirect effect on the contractile function of the myocardium. These include: irritation carotid sinus(located at the bottom of the neck on the right and left) by wearing tight collars, with peptic ulcer stomach and intestines or with increased intracranial pressure.
Ideopathic. When the causes of bradycardia cannot be identified, but there is a periodic or constant lack of pulse, a diagnosis of idiopathic bradycardia is made.
Pregnancy. Changes in the body associated with pregnancy can cause disruptions in the functioning of systems and organs. This condition is dangerous for the pregnant woman and for the child she is carrying. Bradycardic symptoms in pregnancy require immediate evaluation and treatment.

But despite the differences in causes, they all cause life-threatening organ dysfunction. The most dangerous is a decrease accompanied by arrhythmia (the pulse becomes uneven, a long pause occurs between 2 pulse waves). Bradyarrhythmia is most often observed against the background of organic disorders and severe intoxication.

Physiological reduction in heart rate

Rare heartbeats do not always indicate the development of pathology; in some cases they occur for physiological reasons. The types of physiological bradycardia include:

Sports. The pulse of an athlete or a person constantly engaged in heavy physical labor, even while awake, can be 35-40 beats per minute. This occurs because the heart muscle, trained by exercise, effortlessly disperses blood throughout the organs and tissues, providing them with adequate nutrition. During physical activity, an athlete’s pulse is 60-80 beats (an ordinary person experiences physiological tachycardia at this time), and at rest it decreases.
Respiratory. As you exhale, the heartbeat slows down, and as you inhale, it returns to normal. This change in heart rate is due to the fact that the pressure inside the chest fluctuates when breathing. It is easy to identify this reason: at the time of taking the ECG, it is enough to ask to hold your breath for a short time. Holding your breath will even out your pulse.
Peace. In children and adults under the age of 40, a temporary atrioventricular block may appear during sleep, slowing the pulse to 30-40 beats. This condition is a normal variant, and treatment for bradycardia is not required.
Senile. In old age and senility, there is a gradual decline in all body functions and a decrease in the activity of metabolic processes. If there are no serious diseases and the condition does not cause a person severe discomfort, then a decrease in heart rate in the elderly is considered normal.

With a physiological decrease in the frequency of myocardial contractions, there is no discomfort, the person’s well-being does not suffer. Therapeutic measures for physiological bradycardia are not required.

Diagnostics

Severe bradycardia, when a rare pulse persists for a long time, is easily diagnosed. An ECG is enough. But moderate bradycardia, in which a low heart rate alternates with a normal one, is more difficult to diagnose and often the reason for examination by a cardiologist will be a complaint of chronic fatigue. To identify pathology, the following is prescribed:

ECG. Even if at the time of examination there is no slowdown in rhythm, then the film will show signs of weakness of the sinus node or the presence of blockades will be detected, suggesting a tendency to bradycardia.
ECG monitoring. Taking an ECG at a certain time during the day. The examination is carried out in the following way: electrodes are attached to the patient’s body, and the person returns to his usual lifestyle. These examinations make it possible to determine the severity of bradycardic phenomena in connection with the degree of human activity.
Echocardiography. Examines the state of the myocardium and allows you to detect changes in tissue structure (necrosis, ischemia).
Biochemistry of blood. The biochemical composition of venous blood makes it possible to determine the ratio of its main components (potassium, sodium), as well as to identify pathological compounds that arise during poisoning or infectious-toxic processes.

These examinations help not only to identify the probable cause, but also to determine the severity of the process:

light (50-60 per minute, no treatment required);
moderately expressed (40-50 per minute, adjusted by diet and lifestyle changes);
severe (less than 40 per minute, requires serious treatment).

Treatment of bradycardia is carried out on the basis of data obtained during examinations.

Basics of treating the disease

How to treat bradycardia? Can it be cured at home? And is it always necessary to treat this disease?

Treatment of bradycardia almost always takes place in a hospital; this disease can be cured at home only if it is caused by fasting for the purpose of losing weight. If the diet has not been very long, and only mild or moderate bradycardia is diagnosed, then the violations can be corrected with proper nutrition.

In all other cases, examination and treatment measures are required inpatient conditions. Children, regardless of the causes of the pathology, are treated only under the supervision of a pediatric cardiologist.

Depending on what caused the decrease in heart rate, the following is carried out:

elimination of the provoking factor (giving up bad habits, treatment infectious processes), very often this is enough to eliminate the symptoms that have arisen;
establishing a proper work and rest regime;
selection of adequate physical activity appropriate to age and general health;
creating a menu for nutritious meals;
prescription of medications.

In severe cases (usually a weak sinus node or complete blockades When the conduction of the cardiac impulse is completely blocked), treatment of bradycardia is carried out by implanting a pacemaker. The indication for implantation of a rhythm stimulator is a decrease in heart rate below 40 per minute, if there is a pause between contractions and pauses of more than 2 seconds or in the presence of frequently occurring bradyarrhythmia.

If there are no dysfunctions of organs, and general state the person does not suffer, then drug treatment not required. Such people are given recommendations regarding their daily routine and proper nutrition, leaving them registered with a cardiologist in a risk group for the development of pathology.

First aid to a patient

How to help a person at home when he suddenly turns pale and his heart almost stops beating?

It is impossible to provide full assistance at home; you need to call an ambulance. Before the ambulance arrives, you can alleviate the patient’s condition using the following actions.