What is Heart Arrhythmia, Symptoms, Causes And Therapy

What is a heart arrhythmia?

Heart arrhythmia is a disorder characterized by an accelerated or severely slowed heartbeat. The change in heart rate is due to an increase or decrease in electrical activity in the heart muscle.

Expansion of the heart is controlled by electrical signals or impulses from the brain. An interruption in the transmission of these electrical pulses may result in the suspension of a heartbeat. The values ​​of a normal adult heartbeat are 60 to 100 beats per minute. If you have a heartbeat outside this area, talk to your doctor about it.

Arrhythmia is often a contraindication to sports.

heart-arrhythmia

When do you have to worry?

Benign arrhythmias manifest at the level of the atria (for example, atrial fibrillation) or the atrioventricular sinus. They do not lead to the death of the person. Malignant arrhythmias that can lead to death include tachycardia and ventricular fibrillation.

Causes of heart arrhythmia

Here are the main causes of irregular heartbeat and arrhythmias:

    • Coronary heart disease is a common cause of arrhythmia. It is a disorder in which the blood circulation in the coronary vessels is obstructed.
    • Stimulants such as smoking, alcohol abuse, drugs and caffeine.
    • Abnormal sodium or potassium levels in the blood.
    • Some stomach disorders, such as hiatus hernia or gastroesophageal reflux.
    • Stimulants in medicines for cough and cold.
    • They can occur during convalescence after heart surgery.
    • Hypertension or high blood pressure.
    • Thyroid dysfunction or hyperthyroidism are less common causes of arrhythmias.
    • Myocardial damage or fibrosis of the heart due to myocardial infarction.
    • Diabetes and insulin.

Symptoms of heart arrhythmia

The symptoms of an irregular heartbeat are very vague. Sometimes the patient does not feel it at all. Patients with serious arrhythmias may have few symptoms, while others with significant symptoms may present a less severe condition.

Symptoms include:

    1. Intermittent chest pain or angina, the most common symptom of an irregular heartbeat
    2. Fast and irregular frequency, strong tapping of the heart
    3. Fainting or syncope
    4. Difficult breathing, especially under stress
    5. Excessive sweating
    6. Fear and restlessness
    7. General malaise
    8. Dizziness or dizziness
    9. Fatigue

Asymptomatic arrhythmia

The asymptomatic arrhythmia is not always harmless and may cause blood clotting in the heart and / or a reduction in the amount of blood being pumped.

Heart Arrhythmia At Night

Nocturnal irregular heartbeat can have various causes. The most common are :

    • Diabetes
    • Hyperthyroidism (hyperthyroidism)
    • high blood pressure or hypertension
    • Other heart diseases
    • Some medicines
    • Smoke
    • Stressful situations
    • Some natural remedies

Arrhythmia after eating

When we eat, a large amount of blood is diverted to the digestive tract. The body immediately responds to this situation and tries to maintain normal blood pressure by increasing the heart rate and narrowing certain arteries. If this mechanism does not work, postprandial hypotension may occur (drop in blood pressure after eating). Older people may have arrhythmias after eating. People who may experience cardiac arrhythmias after meals include those with high arterial blood pressure or Parkinson’s disease.

Causes and symptoms of the disorder can vary from person to person, possibilities are:

    1. Some people suffer from tachycardia only in certain situations, for example, at night in bed, after eating sweet foods or foods with a high sodium content, etc.
    2. Inadequate water intake, which thickens the blood and thus forces the heart to work to pump the blood.
    3. Dysfunction of an endocrine gland.
    4. Problems of the digestive system.
    5. Excessive enjoyment of coffee and other stimulants.
    6. Disorders of the vagus nerve.
    7. Hiatus hernia (diaphragmatic hernia).
    8. Gastroesophageal reflux.
    9. Liver or kidney disease.
    10. People with a rapid resting heartbeat may have arrhythmias after eating.

symptoms-of-heart-arrhythmia

Atrial fibrillation (AF)

Atrial fibrillation is the most common type of arrhythmia. In this disease, the heart beats irregularly and too fast. AF can be chronic, persistent or paroxysmal. Paroxysmal atrial fibrillation occurs occasionally and temporarily, and is short-lived, from a few seconds to a few days.

Ventricular arrhythmia

This is a heart disorder in which the irregular rhythm of the heart and heart beats come from the heart chambers. It can be divided into: ventricular tachycardia, ventricular bradycardia and ventricular fibrillation. Tachycardia means that the heart rate exceeds 100 beats per minute, while bradycardia is characterized by beats below 60 beats per minute. Ventricular fibrillation is a disease in which the heart beats quickly and irregularly. The result is a reduction of the pumped blood.

causes

    1. Drug side effects
    2. caffeine
    3. nicotine
    4. High sodium and potassium levels in the blood
    5. Necroses and fibroses of the heart muscle
    6. cardiomyopathy
    7. myocarditis
    8. Valvular heart disease
    9. Congenital heart disease

Respiratory Sinus Arrhythmia (RSA)

Respiratory sinus arrhythmia refers to a change in heart rate that occurs during a natural breathing cycle. The vagus nerve is a cranial nerve that runs from the brain stem to the abdomen and plays an important role in the regulation of the heartbeat. It reduces the contraction force and the frequency of  the heart. During inhalation and exhalation, cells of the medulla oblongata send a signal from the parasympathetic nervous system via this cranial nerve to the heart. This causes a cyclic variation of the heart rate. Respiratory sinus arrhythmia is a physiological variant and is not considered abnormal. In fact, it is the loss of this normal reflex that signals a heart problem.

RSA is common in children and adolescents and usually goes away with self-growth. However, a doctor should be consulted on:

    1. Very fast and irregular heartbeat,
    2. Very slow heartbeat,

Heart Arrhythmia in Children

What are the specific causes of heart arrhythmia in children?

    1. Congenital heart defect
    2. Side effect on medicines

Cardiac palpitations during pregnancy

What are the causes?

    1. Mental stress
    2. body changes
    3. Excessive caffeine consumption
    4. Physical stress
    5. anemia
    6. Lack of magnesium
    7. Side effects of drugs

Diagnostics and examination

Heart arrhythmia are diagnosed by listening to the stethoscope or by an electrocardiogram (ECG). For fetal arrhythmias, echocardiography is usually performed; in the 20th week of pregnancy usually a morphological ultrasound. If the gynecologist sees a congenital anomaly, he may request  chocardiography, as this examination is much more thorough.

Therapy of heart arrhythmia

In some arrhythmias, it does not require treatment, in other cases, rapid treatment must be used to prevent heart failure.

Possible treatments are:

Physical exercises

There are several physical exercises (physiokinesis therapy) that stimulate the stimulation of the parasympathetic nervous system (the part of the nervous system that affects rest, digestion, energy recovery and recovery).

The techniques that affect the vagus nerve (vagal maneuvers) affect the parasympathetic nervous system and promote the health of the heart.

With regard to nutrition, stimulating foods, such as coffee and chocolate, are not recommended as they can affect the heart rate.

Treatment of the accelerated heartbeat

Cardioversion. If the tachycardia comes from the atria (for example, atrial fibrillation), the doctor can perform a cardioversion. It is an electrical shock that serves to restore the heart to its normal rhythm.

This procedure is usually performed in a supervised environment and does not cause pain. Emergency cardioversion (defibrillation) is also used in ventricular fibrillation and ventricular tachycardia.

Ablation therapy. In this procedure, a catheter is inserted through the blood vessels to the heart. It is placed over the place where the arrhythmias arise. The electrodes on the catheter tip are heated by radiofrequency energy.

Another method involves cooling over the catheter to freeze the tissue that is not functioning properly. Both methods destroy (ablate) a small portion of the heart tissue and create an electrical block along the pathway that causes the arrhythmia.

Implantable devices

Pacemaker. A pacemaker or pacemaker is an implantable device that helps regulate a slow heartbeat (bradycardia). A small device is placed under the skin near the collarbone. An insulated wire leads from the device to the heart where it is anchored. If the pacemaker is recording too low a heart rate or heartbeat, electrical impulses are sent to stimulate the heart to a faster heartbeat or to continue the heartbeat. Most pacemakers have a detection device that turns off when the heart rate is above a certain threshold when the frequency becomes too slow again.

Implantable Cardioverter Defibrillator (ICD).

The doctor may prescribe this device to a patient at high risk for malignant and potentially fatal arrhythmias: ventricular tachycardia or ventricular fibrillation. An ICD is a system with a battery implanted near the left clavicle. One or two electrodes go from the ICD via veins to the heart.The ICD continuously controls the heart rhythm. If too slow a rhythm, it stimulates the rhythm like a pacemaker. In fibrillation or ventricular tachycardia, it sends low-energy pulses to restore normal heart rhythm.

Surgical treatment

In some cases, surgical intervention may be recommended for the treatment of cardiac arrhythmias:

Maze procedure. The surgeon puts a series of incisions in the atria. These lesions heal in the form of fibrous scar tissue, which has an insulating effect. In this way, the electrical impulses are steered into correct paths, thereby enabling an efficient heartbeat. The surgeon can use an instrument that ices the tissue, a high-frequency probe, or a scalpel to create scars.

Coronary bypass surgery. In severe coronary artery disease and frequent ventricular tachycardia, the physician may recommend coronary artery bypass graft surgery. This can improve the perfusion of the heart and reduce the frequency of ventricular tachycardias. 

Medical therapy

Many medications are available to treat cardiac arrhythmias. Some of the prescribed medications are listed here.

antiarrhythmics

These medications are used to reduce the symptoms of tachycardia.

Medicines prescribed for this purpose are:

    1. Amiodarone (Cordarex)
    2. Dronedarone (Multaq)
    3. Flecainid (Tambocor)

calcium channel blockers

These medications prevent calcium from entering the heart cells and blood vessels. The result is that the blood vessels relax and the arterial blood pressure drops.

Calcium antagonists prescribed for cardiac arrhythmia include:

    1. Amlodipine (Norvasc)
    2. Diltiazem (dilemma)
    3. Nifedipine (Adalat)

Beta Blocker

These drugs block the effects of adrenaline, lowering blood pressure and cardiac output. The most commonly prescribed beta-blockers are:

  1. Metoprolol (Beloc)
  2. Nebivolol (Nebivolol Heumann)

Anticoagulants They are known as blood thinners and prevent the formation of blood clots. The use of these medications is important in preventing complications and risks of heart arrhythmia.

    1. warfarin
    2. aspirin

Natural Remedy For Arrhythmia

Herbal remedies for heart arrhythmia include hawthorn and linden, which reduce tachycardia and cardiac palsies.

What Is The Coronary Heart Disease And How Does It Arise

Definition: What is a coronary heart disease (CHD) and how does it arise? CHD is the most common heart disease of the entire world population. It is also referred to as ischemic heart disease. In Germany, approximately 6 million patients are affected. Scientists believe that the incidence of coronary heart disease will increase with increasing life expectancy.

CHD primarily affects people over the age of 50 and is one of the most frequently reported causes of death in all industrialized countries. It is a disease of the heart caused by occlusions and constrictions in the coronary arteries.

These arteries are among the blood vessels that supply the heart with energy-giving nutrients and oxygen-rich blood. Especially with physical stress, the blood transport through the body is reduced and there are typical symptoms of CHD.

How is the calcification of coronary arteries formed?

Calcification of coronary arteries is caused by deposition of arteriosclerotic plaques by :

    • cholesterol
    • saturated fatty acids
    • lime-like particles

In some cases, initial nutritional damage already exists due to :

    • high blood pressure
    • Diabetes mellitus

The human immune system does not recognize the plaques as endogenous. This is followed by inflammatory reactions and the plaques become increasingly unstable, since activated immune cells no longer fulfill their task and die in the same. Deposits begin to open by progressive increase. The contents enter the bloodstream and finally the coronary vessels, where it settles again.

Typical symptoms of CHD

Depending on the stage of development of CHD different symptoms occur. It is distinguished into three different forms of stages of coronary heart disease.

latent CHD

A latent coronary heart disease is characterized by mild to moderate constrictions of the coronary arteries. There is a coronary sclerosis.

Although this phase is asymptomatic, there is already a significant mismatch between oxygen supply and demand. Despite the absence of symptoms, it is possible to detect a reduced perfusion of the heart muscle. In diabetics often no typical symptoms are noticeable.

Stable CHD

At this stage, sufferers notice typical CHD symptoms that occur under certain conditions. In most cases, they return alone or can be treated with medication (stable angina pectoris).

Angina Pectoris is the leading symptom of coronary heart disease. Affected notice a feeling of tightness as well as pain directly behind the breastbone. Primarily, the symptoms occur in cold, but also exercise. Other factors, such as mental stress or high-fat meals, can trigger these symptoms as well.

The resulting pain often spreads to the left arm or to other body regions such as upper abdomen, jaw or neck.

Other typical symptoms of CHD are:

    • Shortness of breath (shortness of breath)
    • sweats
    • Arrhythmia

Occasionally affected people feel dread. As soon as the affected person comes to rest or stays warm again, these symptoms of angina pectoris return.

Typical symptoms of angina pectoris vary in their frequency, intensity and duration. They are closely related to the current progression of the CHD. In patients with renal insufficiency or diabetes mellitus, chest pain persists. This also applies to persons over 75 years and operated on. Here are breathlessness, dizziness, nausea and radiation of pain in the abdominal area as warning signs.

Unstable CHD and acute coronary syndrome

Similar symptoms of angina pectoris also occur here. However, they are significantly stronger and unpredictable (unstable angina pectoris). This expression can not always be adjusted to medication.

As a result, coronary heart disease leads to a reduced resilience of sufferers and causes a reduction in performance. Depending on the severity, this affects the quality of life. In individual cases, patients can no longer sufficiently fulfill everyday tasks.

At the same time, the clinical picture may continue to deteriorate and become a life-threatening stage of CHD. The so-called acute coronary syndrome is characterized by three manifestations :

    1. Unstable angina pectoris
    2. is characterized by a lack of elevations of the heart enzymes (creatine kinase MB, troponin) in the blood. ECG results show no changes that indicate a heart attack.
    3. Non-ST-elevation myocardial infarction (NSTEMI, acute myocardial infarction)
    4. shows no changes in the ECG, however, heart enzymes that point to possible heart disease and an infarction, detectable in the blood.
    5. ST segment elevation myocardial infarction (STEMI, acute myocardial infarction)
    6. manifests itself by typical changes in the ECG and detectable cardiac enzyme levels in the blood

As a consequence of these features occur :

    • Heart failure due to a heart attack
    • Heart arrhythmia due to a myocardial scar or coronary circulatory disorders
    • Sudden cardiac death
Risk factors for the development of CHD

The training of CHD is favored by numerous risk factors. Women over the age of 55 and men over the age of 45 are at particular risk. The previous lifestyle plays a particularly important role here. Unhealthy, high-fat diet, lack of exercise and smoking increase the risk of diseases such as high blood pressure, high cholesterol, lipid metabolism and glucose tolerance disorders. As a consequence of this, in turn, a CHD can arise.

Not to be ignored is the family disposition. Special caution is advised when cases of CHD to heart attack have already occurred in the family environment, if possible risk factors should be largely avoided and a special focus on a healthy, balanced lifestyle should be laid. 

what-is-coronary-heart-disease

The diagnosis of CHD

Due to the risk factors for coronary heart disease described above, the diagnosis begins with an intensive discussion. Besides the risks, complaints are also documented. In addition, an assessment of the physical capacity of the patient.

This is followed by a physical check focusing on the legs, lungs and heart. Possible signs of CHD include :

    • Cardiac malformations such as aortic valve stenosis
    • rattling breathing due to pulmonary congestion
    • heart failure

Weight, heart rate, blood pressure and vascular status are also determined in order to make a correct diagnosis. If the patient reports symptoms suggestive of possible angina pectoris, the physician also measures the heart rate.

Which laboratory values ​​are suitable for the diagnosis of CHD?

The following values ​​are recorded in case of suspected coronary heart disease during the initial examination :

    • blood count
    • Cholesterol levels (HDL, LDL)
    • electrolysis
    • total cholesterol
    • Urinary findings (because of possible albuminuria)
    • creatinine
    • Fasting blood sugar
    • triglycerides

What exactly does a further diagnosis of CHC include?

In individual cases further investigations follow, for example :

    • Stress echocardiogram
    • Computed tomography (CT)
    • Echocardiogram (ultrasound of the heart)
    • Ergometry (ECG during exercise and rest)
    • coronary angiography
    • scintigraphy

Basically, the choice of possible advanced diagnostic methods depends on the likelihood of coronary heart disease. This results from various factors such as gender, age, risks as well as symptoms.

The treatment of CHD

Therapeutic measures in diagnosed CHD are based primarily on two basic elements. On the one hand, medications can support the treatment. On the other hand, specific non-pharmacological measures, especially on the part of the patient, are necessary.

Drug treatment of CHD

The primary goals of a drug therapy of CHD are the alleviation of the symptoms and the positive influence on the further course of the disease. For this purpose different groups of active ingredients are available :

    • ACE inhibitors
    • Beta-blocker (beta-receptor blocker)
    • Cholesterol-lowering drugs (e.g., statins)
    • Platelet aggregation inhibitor (clopidogrel, acetylsalicylic acid)

Typical symptoms of angina pectoris can be alleviated with nitrates or calcium channel blockers (calcium antagonists). In addition, the flu vaccine is recommended for affected patients. In acute cases, bypass surgery may improve the CHD. Sometimes a percutaneous coronary intervention (PCI) is necessary.

Treat CHD without medication

Secondary preventive measures aim to prevent further complications as well as alleviate the current symptoms of CHD. The focus is on a healthy lifestyle. The individual components are similar to the primary preventive approach, which prevents the development of coronary heart disease.

Can a CHD be prevented?

In order to prevent a possible development of CHD, primary preventive measures can be taken to improve general heart health. A healthy lifestyle, sufficient exercise and a balanced diet are the basic requirements for this.

Sports that have a positive effect on heart health include swimming, running or cycling. Ideally, stress should be avoided, which is not completely possible for most people, so stress should be adequately processed or broken down through yoga, relaxation exercises or autogenic training.

In case of overweight, a weight reduction should be targeted. In addition, smoking cessation is recommended, which can minimize or even prevent numerous health problems. In addition, persons over the age of 35 should take the health check at the family doctor every two years. Here, typical risks, such as Diabetes mellitus, high blood pressure or elevated cholesterol, to be diagnosed for CHD.