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Everyone is familiar with the expressions “heart skipped a beat” and “heart pounding in the chest.” Maybe that’s why many people think that irregular heart rhythms are random episodes that are caused by happiness, fear or excitement. It is true that sometimes arrhythmias can occur in these conditions. But often arrhythmia is a sign of a disease.
What is cardiac arrhythmia
An arrhythmia is an abnormal heartbeat that prevents the heart from pumping blood efficiently and continuously. With an arrhythmia, the heart can beat much faster or slower than it should, and sometimes it beats out of sync.
Most arrhythmias do not cause harm to a person, but some varieties can prevent the brain, heart, and other organs from getting the oxygen they need to survive.
Some arrhythmias can be fatal, causing blood clots that can travel to the brain and cause a stroke or, less commonly, a pulmonary embolism (blockage in one of the arteries in the lungs).
Causes of cardiac arrhythmias in adults
Most arrhythmias occur in people who already have heart disease. For example, having a heart attack can increase the chances of an arrhythmia because scarring can form along the path that electrical signals travel through the heart.
Causes of arrhythmias associated with heart disease include:
Ischemic heart disease (CHD). The accumulation of atherosclerotic plaques narrows the heart arteries. As the flow of blood and oxygen to the heart decreases, the heart’s response to impulses is disrupted, which can cause atrial fibrillation. IHD often leads to a heart attack, and scarring after it can increase the risk of ventricular tachycardia and ventricular fibrillation. Both types can occur during a heart attack due to a sudden loss of blood flow to the heart.
Heart failure. This disease weakens the heart and changes the way electrical signals travel, which can lead to a variety of arrhythmias, including atrial fibrillation, atrial flutter, sick sinus syndrome, and ventricular tachycardia.
Valve damage. When the heart’s valvular system is not working properly, it can put extra stress on the heart, causing it to increase in size and become stiff. Valvular disorders are one of the most common causes of atrial fibrillation. They can also cause ventricular tachycardia.
Autoimmune diseases. Rheumatoid arthritis, lupus, and other autoimmune diseases often affect the heart and can cause arrhythmias, likely due to the chronic inflammation that occurs with such diseases. For example, lupus increases the risk of tachycardia (greater than 100 beats per minute) as well as atrial fibrillation.
In addition to these causes, there are many risk factors, some of which can be controlled and others not. All of them also increase the chances of developing an arrhythmia.
Increased blood pressure. Hypertension makes the heart work harder. As a result, the left ventricle becomes thick and stiff. Electrical signals can no longer move as easily, increasing the risk of atrial fibrillation.
Diabetes. This disease significantly increases the chances of developing heart problems – people with diabetes have a 40% higher risk of atrial fibrillation.
Obesity. Excess weight makes the heart work harder – it needs to supply a very large mass of tissues with blood, and additional stress can cause the heart to enlarge, making it susceptible to atrial fibrillation.
Apnea. When breathing is constantly interrupted during sleep, the heart receives less oxygen. Without treatment, sleep apnea can lead to atrial fibrillation and other arrhythmias.
Diseases of the thyroid gland. If the body produces too much thyroid hormone, the heart can beat harder and faster.
Age. As we age, the heart’s internal pacemaker loses cells, causing it to slow down. Arrhythmias in the elderly include atrial fibrillation, bradycardia (slow heartbeat), sick sinus syndrome, and other atrial and ventricular arrhythmias.
Birth defects. Structural anomalies of the heart can be from birth. They interfere with the conduction of electrical impulses, leading to atrial tachycardia as well as life-threatening ventricular arrhythmias.
Genetics. The most common hereditary arrhythmia is long QT syndrome, in which a rapid and irregular rhythm develops in the lower chambers of the heart, which can lead to ventricular fibrillation, a life-threatening arrhythmia. Other examples of arrhythmias that are inherited include:
- Brugada syndrome – a rare hereditary arrhythmia that causes an irregular heartbeat;
- catecholaminergic polymorphic ventricular tachycardia (CPVT) is a fatal form of arrhythmia that affects young people primarily during exercise.
Symptoms of cardiac arrhythmias in adults
Can you feel your heart speed up or slow down? Not always. The arrhythmia causes many symptoms, but the person may not have any complaints. Often people accidentally find out that they have an arrhythmia, such as atrial fibrillation. For some people, a fast or erratic heartbeat is both a noticeable and unpleasant condition.
Meanwhile, there are common symptoms that may indicate an arrhythmia:
Cardiopalmus. It can be felt in different ways: a pounding in the chest or a feeling that the heart is beating at a breakneck pace. With some arrhythmias, the pulse can be 100 beats per minute, and sometimes much higher. Sometimes there is a feeling that the heart missed a beat or the contraction occurred earlier than usual.
Shortness of breath, fatigue, dizziness and chest pain. They can appear when there is a failure in the pulse and the heart cannot pump blood efficiently. As a result, less oxygen enters the organs and tissues.
Fainting. Fainting due to an arrhythmia occurs when blood pressure drops, sometimes to dangerously low levels. These drops in blood pressure are a medical emergency, so if you have an arrhythmia, be sure to wear your medical ID and wristband so people around you know to call XNUMX.
Important! Mild symptoms or their absence does not mean at all that a person has a mild form of arrhythmia. Conversely, a patient may have severe symptoms with a relatively innocuous arrhythmia.
Treatment of cardiac arrhythmias in adults
If you suspect an arrhythmia, you should contact a cardiologist as soon as possible. The sooner treatment begins, the better the prognosis. This is especially important for atrial fibrillation, which can cause a stroke if left untreated.
Diagnostics
The standard diagnosis of an arrhythmia includes asking the patient about symptoms, examining him, discussing the medical history of family members and ECG.
However, arrhythmias often come and go and may not show up on an ECG. Therefore, additional methods are often used to make a diagnosis:
Holter monitor. It is attached to the patient’s body, usually for a day, but it happens that up to several weeks – all this time he will monitor the activity of the heart during daily activities.
stress test. If the arrhythmia most often occurs during physical exertion, the doctor may prescribe a stress test, during which they will measure the pulse on a treadmill or exercise bike.
Electrophysiological test. During this surgical procedure, a catheter or thin wire is inserted through a vein, often in the groin, and brought to the heart. Electrodes at the tip of the catheter stimulate the heart so the doctor can evaluate its electrical function. This test helps to find the cause of the arrhythmia, as well as to decide on the treatment.
Table tilt test. In this case, the patient is fixed to the table in a horizontal position, then slowly raised to a vertical position. The test makes it clear how blood and heart rate react to gravity and changes in position.
Modern treatments
There are many treatments available to help manage an arrhythmia. Which one to choose – the doctor decides, taking into account specific symptoms.
Medicines. For some arrhythmias, medications can be used to restore a normal heartbeat. These include beta blockers, calcium channel blockers, and digitalis. These drugs slow down the heart and may be prescribed if the arrhythmia is causing the heart to palpitate.
Also, with arrhythmias, anticoagulants and antiplatelet agents (warfarin, aspirin) are prescribed – they prevent the formation of blood clots and reduce the risk of stroke.
In addition, antiarrhythmic drugs may be prescribed to help correct the heartbeat and keep the heartbeat normal.
operations and procedures. If medications are not working, your doctor may recommend surgical treatments:
- catheter ablation – damage to the heart with a laser or cold, as a result of which micro scars form in the right places, which block the passage of an electrical signal that causes arrhythmia;
- cardioversion – exposure of the heart to a short-term electrical discharge in order to correct the rhythm of the heart;
- implants – pacemaker or cardioverter-defibrillator.
Prevention of cardiac arrhythmia in adults at home
All prevention of arrhythmias comes down to a healthy lifestyle, which includes:
Proper nutrition. Eat more heart-healthy foods (fruits and vegetables, whole grains, legumes, lean meats and fish), avoid foods high in saturated and trans fats, limit red meat, and choose whole foods over highly processed foods that often contain sodium and sugar.
Physical activity. Exercise for 30 minutes a day, 5 days a week, or at least walk outside daily.
Normal weight. Lose weight if you are obese – this will help reduce blood pressure, stress on the heart and the risk of stroke.
Rejection of bad habits. Limit alcohol consumption – it overloads the heart and makes it beat faster, which can cause an arrhythmia. Quit smoking.
A good night’s sleep. It will help normalize the pressure.
Calm Manage stress, as excessive worry and anxiety can increase blood pressure, cortisol levels, and increase the risk of arrhythmias. Psychotherapy, walking with a loved one or friend on the street, doing what you love will help reduce stress.
Popular questions and answers
Answered questions about arrhythmia general practitioner, endocrinologist, cardiologist Alexey Zhito.
Are all arrhythmias dangerous?
But, it should be noted that some arrhythmias are pathological in nature and can lead to severe consequences and complications. Such forms of arrhythmia include atrial fibrillation, atrial fibrillation, ventricular tachycardia, frequent ventricular extrasystole, and others.
The type of arrhythmia and the degree of its danger to life and health can only be determined by a doctor. If you suspect a heart problem, you should immediately consult a doctor.
What are the complications of arrhythmias?
Acute disorders of cerebral circulation (cerebral strokes). As a result of arrhythmia, a clot can form in the cavity of the heart – a blood clot, which is able to get into the bloodstream and “clog” the lumen of the artery that feeds the brain. In this case, an ischemic stroke occurs, part of the brain dies. A more rare variant is also possible – global cerebral ischemia. If arrhythmia has led to a prolonged and pronounced decrease in blood pressure, then total oxygen starvation of the brain may occur.
Thrombotic complications from other organs. Thrombi, which can form in the cavities of the heart with some arrhythmias, are able to get into other organs with the bloodstream, for example, into the kidneys, intestines, and spleen.
Arterial hypotension. That is, a decrease in blood pressure during arrhythmia.
Pain syndrome. With some arrhythmias, myocardial nutrition may decrease, which can lead to pain in the heart area.
Heart failure. It occurs when the heart cannot adequately pump as a result of an arrhythmia.
depressive syndrome. Various kinds of arrhythmias (including physiological ones) can lead to a state of depression, which in turn can provoke the development of already more formidable changes in the heart.
When to call a doctor at home for arrhythmia?
● pain in the region of the heart – possible development of a heart attack;
● severe general weakness and pressure drop;
● loss of movement in the limbs, vomiting, drooping corners of the mouth, inability to bare teeth, show tongue – these may be signs of a stroke;
● increased heart rate – above 130 beats per minute;
● shortness of breath and feeling of lack of oxygen.