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Tachycardia – the type of arrhythmia which is characterized with a heart rate more than 90 beats per minute. Tachycardia is considered norm option at increase in physical or emotional activity. Pathological tachycardia – a consequence of diseases cardiovascular or other systems. It is shown by feeling of heartbeat, a pulsation of vessels of a neck, concern, dizziness, faints. Can lead to development of an acute heart failure, myocardial infarction, IBS, cardiac arrest.

Tachycardia

Tachycardia – the type of arrhythmia which is characterized with a heart rate more than 90 beats per minute. Tachycardia is considered norm option at increase in physical or emotional activity. Pathological tachycardia – a consequence of diseases cardiovascular or other systems. It is shown by feeling of heartbeat, a pulsation of vessels of a neck, concern, dizziness, faints. Can lead to development of an acute heart failure, myocardial infarction, IBS, cardiac arrest.

The increased automatism of the sinusovy knot normal setting speed and rhythm of warm reductions, or the ektopichesky centers of automatism is the cornerstone of development of tachycardia.

The feeling the person of the heartbeat (increase and strengthening of warm reductions) not always testifies to a disease. Tachycardia develops at healthy people at physical activity, stressful situations and nervous excitability, at a lack of oxygen and the increased air temperature, under the influence of some drugs, alcohol, coffee, at sharp change of position of a body from horizontal in vertical etc. Tachycardia at children is younger than 7 years it is considered physiological norm.

Emergence of tachycardia in almost healthy people is connected with physiological compensatory mechanisms: the activation of sympathetic nervous system, emission in adrenaline blood leading to increase in warm reductions in response to influence of an external factor. As soon as the external factor is terminated, ChSS gradually comes back to norm. However quite often tachycardia accompanies a current of a number of pathological states.

Classification of tachycardia

Taking into account the reasons which caused increase of warm reductions allocate tachycardia physiological, arising during the normal work of heart as proper response of an organism to the certain factors, and pathological developing at rest owing to the congenital or acquired cardiac or other pathology.

Pathological tachycardia is a dangerous symptom since leads to decrease in volume of emission of blood and others to disorders of intracardial haemo dynamics. At too frequent heartbeat ventricles do not manage to be filled with blood, warm emission decreases, arterial pressure goes down, inflow of blood and oxygen to bodies including to the heart weakens. Long decrease in overall performance of heart leads to emergence of an aritmogenny kardiopatiya, violation of a sokratimost of heart and increase in its volume. Bad blood supply of heart increases risk of development of an ischemic disease and myocardial infarction.

On the source generating electric impulses in heart allocate tachycardia:

  • sinusovy - develops at increase in activity of the sinusovy (sinoatrialny) knot which is the main source of electric impulses setting normal a warm rhythm;
  • ektopichesky (paroksizmalny) tachycardia at which the generator of a rhythm is out of sinusovy knot - in auricles (supraventricular) or ventricles (ventricular). Usually proceeds in the form of attacks (paroxysms) which begin and stop suddenly, proceed from several minutes to several days, at the same time the frequency of serdtsebiyeniye remains constantly high.

Increase in ChSS up to 120–220 beats per minute, the gradual beginning and the correct sinusovy warm rhythm is characteristic of sinusovy tachycardia.

Reasons of sinusovy tachycardia

Sinusovy tachycardia occurs in different age groups, a thicket at healthy people, and also among patients, heart and other diseases. Developing of sinusovy tachycardia is promoted by intrakardialny (warm), or ekstrakardialny (extra warm) etiologichesky factors.

Sinusovy tachycardia at patients with cardiovascular diseases most often is an early symptom of heart failure or dysfunction of the left ventricle. Treat the intrakardialny reasons of sinusovy tachycardia: sharp and stagnant chronic heart failure, a myocardial infarction, heavy stenocardia, myocardites of rheumatic, toksiko-infectious and other genesis, a cardiomyopathy, a cardiosclerosis, heart diseases, a bacterial endocarditis, ekssudativny and adhesive perikardit.

Among the physiological ekstrakardialny reasons of sinusovy tachycardia there can be physical activities, an emotional stress, congenital features. Nevrogenny tachycardias make the majority of ekstrakardialny arrhythmias and are connected with primary dysfunction of a cerebral cortex and subcrustal knots, and also violations of the autonomic nervous system: neurosises, affective psychoses (emotional tachycardia), neurocirculator dystonia. People of young age with labile nervous system are subject to neurogenetic tachycardias most often.

Endocrine violations (a thyrotoxicosis, increase in production of adrenaline occur among other factors of ekstrakardialny tachycardia at a feokhromotsitoma), anemias, sharp vascular insufficiency (shock, a collapse, sharp blood loss, a faint), a gipoksemiya, bad painful attacks (for example, at renal colic).

The fever developing at various infectious and inflammatory diseases (pneumonia, quinsy, tuberculosis, sepsis, a focal infection) can cause emergence of tachycardia. Temperature increase of a body on 1 °C leads to increase in ChSS, in comparison with usual, at the child on 10-15 beats per minute, and the adult – on 8-9 beats per minute.

Pharmacological (medicamentous) and toxic sinusovy tachycardia arise at influence on function of sinusovy knot medicinal and chemicals: simpatomimetik (adrenaline and noradrenaline), vagolitik (atropine), eufillin, corticosteroids, tireotropny hormones, diuretics, gipotenzivy medicines, caffeine (coffee, tea), alcohol, nicotine, poisons (nitrates), etc. Some substances have no direct effect on function of sinusovy knot and cause, so-called, reflex tachycardia by means of increase in a tone of sympathetic nervous system.

Sinusovy tachycardia can be adequate and inadequate. Inadequate sinusovy tachycardia can remain at rest, not depend on loading, reception of medicines, to be followed by feelings of strong heartbeat and shortage of air. This rather rare and poorly studied disease of not clear genesis. Presumably, it is connected with primary defeat of sinusovy knot.

Symptoms of sinusovy tachycardia

Existence of clinical symptoms of sinusovy tachycardia depends on degree of its expressiveness, duration, the nature of the main disease. At sinusovy tachycardia subjective symptoms can be absent or be insignificant: heartbeat, unpleasant feelings, feeling of weight or pain in heart. Inadequate sinusovy tachycardia can be shown by permanent heartbeat, feeling of shortage of air, short wind, weakness, frequent dizzinesses. Fatigue, sleeplessness, a loss of appetite, working capacity, deterioration in mood can be observed.

Degree of subjective symptoms is dictated by the main disease and a threshold of sensitivity of nervous system. At heart diseases (for example, coronary atherosclerosis) increase in number of warm reductions can cause stenocardia attacks, aggravation of symptoms of heart failure.

At sinusovy tachycardia the gradual beginning and the end are noted. In case of the expressed tachycardia symptoms can reflect violations of blood supply of various bodies and fabrics in connection with reduction of warm emission. There are dizziness, sometimes faints; at defeat of vessels of a brain - focal neurologic violations, spasms. At long tachycardia there is a lowering of arterial pressure (arterial hypotonia), reduction of a diuresis, the cold snap of extremities is observed.

Diagnosis of sinusovy tachycardia

Diagnostic events are held for identification of the reason (damage of heart or extra warm factors) and differentiation of sinusovy and ektopichesky tachycardia. The ECG possesses the leading role in differential diagnostics of a type of tachycardia, determination of frequency and rhythm of warm reductions. Daily monitoring of the ECG on Holtera is highly informative and absolutely safe for the patient, reveals and analyzes all types a warm rhythm, change of action of the heart in the conditions of usual activity of the patient.

(echocardiography), heart MRT (a magnetic and resonant tomography) carry out for detection of the intracardial pathology causing pathological tachycardia of EFI (an electrophysiological research) of heart, studying distribution of an electric impulse on a cardiac muscle, allows to define the mechanism of tachycardia and violations of conductivity of heart. Additional methods of a research (the general blood test, determination of content of tireotropny hormones in blood, brain EEG, etc.) allow to exclude blood diseases, endocrine violations, pathological activity of TsNS, etc.

Treatment of sinusovy tachycardia

The principles of treatment of sinusovy tachycardia are defined, first of all, by the reasons of its emergence. Treatment has to is carried out by the cardiologist together with other experts. It is necessary to eliminate the factors promoting increase in heart rate: to exclude kofeinsoderzhashchy drinks (tea, coffee), nicotine, alcohol, spicy food, chocolate; to protect itself from psychoemotional and physical overworks. At physiological sinusovy tachycardia of treatment it is not required.

Treatment of pathological tachycardia has to be directed to elimination of the main disease. At ekstrakardialny sinusovy tachycardias of nevrogenny character consultation of the neurologist is necessary for the patient. In treatment use psychotherapy and sedatives (luminal, tranquilizers and neuroleptics: , diazepam). In case of reflex tachycardia (at a gipovolemiya) and compensatory tachycardia (at anemia, a gipertireoza) elimination of the reasons which caused them is necessary. Otherwise the therapy directed to decrease in ChSS can lead to sharp lowering of arterial pressure and aggravate violations of haemo dynamics.

At the sinusovy tachycardia caused by a thyrotoxicosis in addition to the tireostatichesky medicines appointed by the endocrinologist apply β-adrenoblokator. Preference is given to β-blockers of group of an oksiprenolol and a pindolol. In the presence of contraindications to β-aderonoblokator use alternative medicines - antagonists of calcium of not hydropyridinic row (verapamil, diltiazy).

At the sinusovy tachycardia caused by heart failure in combination with β-adrenoblokator warm glycosides (digoxin) are appointed. Target ChSS has to be selected individually, depending on a condition of the patient and his main disease. Target ChSS of rest at stenocardia is usually equal 55-60 beats per minute; at neurocirculator dystonia – 60 - 90 beats per minute, depending on subjective shipping.

At paraksizmalny tachycardia of increase in a tone of the wandering nerve it is possible to reach special massage - pressing on eyeballs. In the absence of effect enter intravenously antiarrhytmic means (verapamil, , etc.). Patients with ventricular tachycardia need emergency aid, the emergency hospitalization and performing antirecurrent antiarrhytmic therapy.

At inadequate sinusovy tachycardia, at inefficiency of b-adrenoblokatorov and in case of considerable deterioration in a condition of the patient, apply transvenous RChA of heart (restoration of a normal warm rhythm by cauterization of an affected area of heart). In the absence of effect or threat of life of the patient perform surgery of implantation of an electropacemaker (EX-) — the artificial driver of a rhythm.

Forecast and prevention of sinusovy tachycardia

Sinusovy tachycardia at patients with heart diseases most often is display of heart failure or dysfunction of the left ventricle. In these cases the forecast can be rather serious as sinusovy tachycardia is reflection of reaction of cardiovascular system to reduction of fraction of emission and disorder of intracardial haemo dynamics. In case of physiological sinusovy tachycardia, even at the expressed subjective manifestations, the forecast as imparted, satisfactory.

Prevention of sinusovy tachycardia consists in early diagnosis and timely therapy of cardiac pathology, elimination of the extra warm factors promoting development of violations of heart rate and function of sinusovy knot. In order to avoid serious consequences of tachycardia observance of recommendations about a healthy lifestyle is necessary.

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