Extrasystole of the heart in adults

Extrasystole has several other names: ectopic contractions, premature contractions, premature atrial or ventricular complexes.

What is extrasystole of the heart

Extrasystoles are contractions that disrupt the normal rhythm of the heart. They occur when an excess electrical discharge is formed. Extrasystoles are common in people with perfectly normal hearts and do not cause any problems. However, they can also be a sign of certain heart conditions.

Extrasystoles are divided into 2 types depending on the place of occurrence.

• Atrial extrasystoles. Often seen in healthy people with normal hearts. They are detected by 60-hour Holter monitoring in more than XNUMX% of healthy adults. They can also occur against the background of heart failure or damage to the mitral valve, aggravated by alcohol and caffeine.
• Ventricular extrasystoles. Premature ventricular contractions occur in 1% of clinically healthy people examined using a standard ECG, as well as in 40-75% of apparently healthy people who have recorded an ECG for 24-48 hours. But they are more common in people with structural heart disease.

Ventricular extrasystoles are the most common type of arrhythmia that occurs after myocardial infarction. They can also appear in severe left ventricular hypertrophy, hypertrophic cardiomyopathy, and congestive heart failure.

Causes of extrasystole of the heart in adults

Extrasystoles can also occur in a healthy heart. But more often they are provoked by:

• hypertension;
• heart disease – acute myocardial infarction, valvular heart disease, cardiomyopathy, ventricular hypertrophy, heart failure;
• electrolyte disturbances – hypokalemia, hypomagnesemia, hypercalcemia;
• hyperthyroidism;
• stress;
• drugs – digoxin, aminophylline, tricyclic antidepressants;
• excessive alcohol consumption;
• infectious diseases;
• operation.

Perhaps central sleep apnea is also associated with ventricular ectopia.

Stimulants such as caffeine may play a role, although this has not been proven in ventricular premature beats.

If extrasystoles occur infrequently and the person does not have heart disease, then they are usually not dangerous. But if they happen more than 12 times a day, there is a risk of death. In any case, if the heartbeat is abnormal, you should consult a doctor.

Symptoms of extrasystole of the heart in adults

The main symptom is abnormal heartbeat. For example, the heart beats normally, and then stops. After that it runs normally again. Or, additional heart beats or strange sensations, similar to a somersault, may be felt.

For some people, extrasystoles can cause discomfort and severe anxiety.

Symptoms usually get worse at rest and may improve with exercise. But if the symptoms worsen with exercise, this is cause for more concern – you should definitely consult a doctor.

Other possible symptoms:

• fainting or fainting (dizziness);
• atypical chest pain;
• fatigue.

There are reports of cases where extrasystole caused a chronic cough.

Treatment of extrasystole of the heart in adults

First, the doctor will ask the patient about disturbing symptoms, check for other cardiac signs, including chest pain, shortness of breath, fainting or dizziness, and symptoms of an arrhythmia, such as a persistent heart palpitations). Family history is also important – early heart disease or sudden death among close relatives, previous heart disease or coronary heart disease (CHD).

Diagnostics

The doctor evaluates the entire cardiovascular system, including blood pressure, heart murmurs, and any signs of heart failure.

Patients with palpitations will first do an ECG, an analysis of the level of blood electrolytes – calcium and magnesium in the serum.

If symptoms are brief but frequent (more than 2 to 3 times a week), a 24-hour Holter monitor is used for examination. If symptoms are transient and infrequent (less than 1 per week), use an event monitor or transtelephone recorder.

In addition, echocardiography may be prescribed – to assess the function of the left ventricle and the structure of the heart, testing with physical activity – the connection of extrasystoles with exercises may be important for the prognosis of treatment.

Modern treatments

With a rapid heartbeat or suspected arrhythmia, a referral for treatment is required if there is:

• emergency symptoms (eg, chest pain, shortness of breath, or loss of consciousness);
• fainting or pre-fainting (especially fainting on exertion);
• symptoms suggestive of abnormal tachycardia, such as an accurate description of a very fast heartbeat with sudden onset and displacement;
• significant ECG deviations;
• serious heart disease;
• a serious underlying problem, such as an endocrine or metabolic disorder, an infection;
• family history of sudden death or heart disease at a young age.

Low-risk patients who have no other heart problems and symptoms (or only mild symptoms) can simply see a doctor. Other patients (with heart disease, heart risk, or significant symptoms) usually require additional testing, treatment, or follow-up.

Extrasystoles are usually treated with drugs – beta-blockers (atenolol, metoprolol). In some cases, radiofrequency catheter ablation may be required.

Prevention of extrasystole of the heart in adults at home

It is extremely important to find out what can cause extrasystole and act early to prevent it.

First of all, stimulants such as coffee, nicotine or alcohol should be avoided. You need to get rid of stress and be in good physical shape. And stick to a healthy diet.

Popular questions and answers

Answered popular questions about extrasystoles cardiologist, arrhythmologist Vladimir Syrovnev.