What causes heart bradycardia and how to deal with it

Cardiac bradycardia, what it is, is useful for all citizens to know, especially expectant mothers and carers for the elderly (social workers). No one is immune from such a cardiac pathology. Bradycardia has no age restrictions. It is useful for all people to know the basics of medicine, but for those who are faced with the problem of bradycardia (low pulse), it is imperative to study this issue.

Description and causes of pathology

Bradycardia is called a decrease in heart rate relative to the generally accepted norm. For adults - less than 60 beats per minute, for babies and infants - less than 100 beats, for children aged one to six years - less than 70 beats. Thus, it is a variant of arrhythmia (abnormal heartbeat). The reasons for the decrease in contractions of the heart muscle include several anomalies in the work of the heart.

1. Sinus node dysfunction (the first element in the cycle of myocardial contraction): weakening of the cells' efficiency or their complete atrophy. The pathology of this etiology is called sinus bradycardia.
2. Violation of the functionality of the atrioventricular node (the second component of the system that conducts an impulse from the atrium to the ventricle) due to atrophy of its cells.
3. Conduction disturbance caused by blockades in the conducting channels of the myocardium. The impulse sent by the sinus node does not properly propagate through the heart muscle.
4. Pathologies of the cardiovascular system (myocardial infarction, cardiosclerosis, angina pectoris, hypertension).

Bradycardia can also have a secondary nature of occurrence, that is, be of unknown etiology (develop against the background of other diseases and disorders). Additional factors provoking a pathological change in the pulse include aging (age), hormonal disorders, medication (glycosides, quinidine, adrenaline and calcium blockers, morphine), poisoning of any genesis (sepsis, hepatitis, chemicals, excess calcium or potassium, alcoholism) , infections and inflammations, diets and malnutrition.

• neuroses;
• external pressure (collar, tight clothing);
• excessive intracranial pressure;
• pressure on the eyeball (other injuries);
• swelling and swelling of the brain;
• concussions and hemorrhages;
• diseases of the gastrointestinal tract (stomach or intestinal ulcer, gastritis, colitis).

The causes of childhood bradycardia are more often congenital heart pathologies, intrauterine infections and diseases at an early age, excessive growth (the myocardium does not keep up with rapidly growing organs). Thus, all causes of bradycardia come down to one thing - dysfunction of the myocardial conduction system.

In professional sports, bradycardia is sometimes considered normal. In men, contractions can reach 50 beats per minute, and decrease by another 30% during sleep. However, it is still impossible to ignore the signs characteristic of arrhythmia. First of all, athletes are shown regular examinations by all specialists, including a cardiologist.

Classification of the disease and signs of pathology

There are four types of decrease in heart rate (heart rate): absolute, relative, moderate, extracardiac.

1. The absolute type of the disease does not depend on the state of the person, external conditions or related diseases.
2. Relative bradycardia is detected against the background of physical activity, weakening of the body (infections caused by bacteria and viruses, injuries, disorders of the thyroid gland,).
3. With a moderate type, a decrease in the pulse is noted on exhalation, and on inspiration, on the contrary, an increase. It is more common in children and adolescents, people with vegetovascular dystonia.
4. Extracardiac bradycardia is noted due to mucosal edema in violation of the thyroid gland, internal pathologies and neurology (neurosis).

In addition, the pathology is acute and chronic course. The first occurs against the background of poisoning, heart attack and disappears immediately after the treatment of the primary pathology. The second type occurs according to age-related changes, for example, atherosclerosis.

By origin, experts identified neurogenic, drug, organic, toxic and sports bradycardia. Along with this, the central, degenerative and idiopathic type of the disease is noted.

The worse the blood circulation due to bradycardia, the more pronounced the symptoms. With a moderate type of pathology, they are not observed at all, since this type does not lead to circulatory disorders.

• severe general weakness;
• fast fatiguability;
• darkening and ripples in the eyes;
• cephalgia and dizziness;
• fainting;
• hypertension and hypotension;
• breathing problems;
• decrease in the properties of the nervous system (deterioration of concentration, vision, memory, confusion);
• low performance;
• cold sweat;
• chest pain.

In some cases, not only a moderate-type disease can be asymptomatic for a long time. And it is often found by chance during a routine examination by a doctor. The first clinical symptoms are noted only when the pulse drops to 40 beats per minute. Against its background, oxygen starvation occurs, which provokes the symptoms described above.

Identification of the disease

If you suspect bradycardia or any abnormal reactions in the work of the heart, you need to contact a cardiologist for a full examination.

• conversation with the doctor (collection of an anamnesis, life history and family of the patient);
• single electrocardiography (ECG) to assess the conduction of the heart muscle;
• 24-hour conductivity monitoring;
• biochemical and general blood test;
• analysis for thyroid hormones;
• monitoring the electrical activity of the heart at home (conducting a study under the telephone control of a cardiologist);
• ultrasound examination of the heart, echocardiogram (allows you to identify noises, defects, assess the overall functionality and appearance of the organ);
• electrophysiological study of the heart (detection of muscle potential);
• contrast x-ray (allows you to evaluate the coronary arteries, their gaps).

It is possible to suspect bradycardia after the initial examination by a doctor. A rare pulse of the correct rhythm is heard, the tones are normal, breathing is uneven. Based on this, the therapist appoints a consultation with a cardiologist, who, in turn, a list of diagnostic procedures.

Electrocardiography is the main method. It shows a rare heart rate, blockade of conduction (sinus artery or atrioventricular valve). If a single study does not reveal bradycardia, but the diagnosis is still in question, then 24-hour monitoring using electrocardiography is prescribed.

Ultrasound examination is justified in the organic type of pathology. The heart size, ejection volume, sclerotic and degenerative changes in the heart muscle are assessed.

Often additional load tests are used. The most popular bike test. The patient is put on a special simulator, sensors are connected that monitor life indicators, primarily the pulse. This method evaluates the increase in heart rate depending on physical activity.

X-ray with contrast is used as an alternative to electrocardiography (single and daily) if the latter is ineffective (bradycardia is still not confirmed). Contrast X-ray reveals both organic and functional bradycardia.

Thus, the examination is carried out on an increasing basis (from minimal diagnostics to a complete examination, until bradycardia is confirmed or completely refuted). Diagnostic methods are the same for adults and children. It is worth noting that often for a long time the only symptom of bradycardia is chronic fatigue. In this connection, it is recommended to visit a cardiologist's consultation already in the presence of this sign.

Treatment and possible complications

Bradycardia can be cured. The course of therapy depends on the specifics of the case.

1. With a decrease in heart rate, but good examination results (pathologies of the cardiovascular system or other diseases that can cause bradycardia have not been identified), preventive measures will be sufficient. That is, a change in lifestyle and regular monitoring of the situation.
2. Treatment of the underlying cause of the disease.
3. The selection of a treatment plan is based on the characteristics of the course of the disease and the general condition of the patient.
4. Perhaps conservative treatment with medications or the introduction of a pacemaker that artificially dictates the rhythm of heart contractions.

Installing a pacemaker is a radical method of treatment, but the most effective. It is used in severe cases of the disease (less than 40 contractions in 60 seconds and heartbeat stops lasting from two seconds).

Prevention will be sufficient for functional (change in pulse under the influence of external conditions) and moderate bradycardia, that is, with forms of the disease that are not accompanied by clinical symptoms and organic (structural) changes in organs. The dosage form of the disease is eliminated by adjusting the dosages and the regimen for taking those drugs that caused the slowing of the heart. Other forms of the disease require treatment of the root cause of its development.

With severe depression of consciousness (pre-syncope and fainting, headache, weakness), natural and pharmaceutical energy drinks are prescribed: belladonna, ginseng, eleutherococcus, ephedrine, caffeine, isoprenaline. The dose and duration of administration are selected strictly individually, taking into account the complete history of the disease and the patient's condition. For example, during pregnancy and mental disorders, belladonna is prohibited, as it excites the nervous system (bad for the second case) and relaxes the muscles (dangerous miscarriage during pregnancy).

Without treatment, bradycardia can develop into complications. The most common is the Morgagni-Adams-Stokes syndrome (short-term frequent loss of consciousness for 15-20 minutes, involuntary muscle contractions, spasms, pale skin and blue lips, almost complete disappearance of the pulse, deep breathing). Which is potentially fatal.

In Morgagni-Adams-Stokes syndrome, surgical insertion of a pacemaker is indicated. After a successful operation, after a while, under the influence of the well-functioning work of the pacemaker, the symptoms disappear, the patient's general well-being stabilizes. Other possible consequences include sudden cardiac arrest; interruptions in blood pressure; ischemia and angina pectoris; chronic heart failure.

Prevention and prognosis

There are no specific preventive measures.

• consult a specialist in a timely manner (once a year);
• be treated correctly (follow the doctor's recommendations, dosages and courses of taking medications);
• control pressure and pulse (regularly measure yourself, write in a diary);
• follow a balanced diet (minimize the intake of salt, cholesterol, sugar, fats);
• control internal balances (mineral, water-salt, hormonal);
• give up alcohol, cigarettes, other psychoactive substances;
• normalize the mode of work and rest (get enough sleep, do not overwork);
• pick up a systematic feasible set of physical exercises, walk.

The course of the disease aggravates and negatively affects the prognosis of organic heart disease, congenital anomalies, and abnormal anatomy. Ignoring the need to implant a stimulator when the Morgagni-Adams-Stokes syndrome appears also negatively affects life prospects. The addition of ectopic arrhythmias to bradycardia is dangerous for the development of thrombosis.

A satisfactory prognosis is appropriate only for a moderate course of the disease or its physiological (functional) form. Otherwise (with a complicated and prolonged decrease in myocardial activity), a person may become disabled.

Reviews

Bradycardia is a common occurrence.

1. Anastasia: “I underwent an ECG as part of a routine medical examination for work. She was eventually diagnosed with sinus bradycardia. What is most interesting, I did not feel any symptoms either before, or after, or now. Addressed with this question to the doctor. He replied that if there are no characteristic symptoms (fainting, dizziness, hypotension), then there is no need to worry and be treated. That is, the diagnosis, although received, is not a pathology. I really hope so. I will be watching."
2. Eugene: “I want to share my opinion about the insidiousness of the disease. The only symptom I had was numbness and icing of the extremities. As a result, accidentally on examination, he received a diagnosis of bradycardia. The doctor said that in my case it’s enough to leave the sport (I did a lot) and follow my lifestyle (make it calmer).”
3. Lyudmila: “I recently visited a cardiologist. They brought me pains of a “dagger” character in the chest and holding my breath for a whole minute. The doctor ordered an electrocardiogram, the result was a slight bradycardia. The cardiologist prescribed Biovital (vitamins) and gave a referral to a neurologist (he suspects intercostal neuralgia).”

Bradycardia occurs even in newborns, which speaks of the "worn" human bodies of parents, mired in the relentless pace of life. However, this condition rarely requires drastic measures (mainly with heart defects).