Paroxysmal tachycardia - a sharp attack of palpitations with a heart rate of 130 to 200 and more per minute. Usually the attack begins suddenly and as suddenly ends. Duration of attack from several seconds to several hours or days.
In paroxysmal tachycardia in which either of the departments of cardiac conduction system arises center of excitation, which generates electrical impulses great frequency. Such a center may be the cells of the conduction system or ventricular fibrillation.
Accordingly, paroxysmal tachycardia is:
Atrial paroxysmal tachycardia is usually characterized by regular heart rhythm. The cause of transient oxygen starvation of the heart muscle, endocrine disorders, disorders of electrolytes (calcium, chlorine, potassium) in the blood. Most often the source of the increased production of electrical impulses - atrioventricular node. The patient complains of frequent palpitations, discomfort in the chest. Sometimes there are pains in the heart, shortness of breath.
Often accompanied by an attack of tachycardia, dizziness, weakness. If an attack of paroxysmal tachycardia is caused by disorders of the autonomic nervous system, a patient may receive increased blood pressure, fever, feeling short of breath, feeling a lump in my throat, excessive and frequent urination after the attack. Diagnosis is based on listening to the patient of frequent palpitations. Type of paroxysmal tachycardia is specified in the analysis of electrocardiograms. Sometimes these seizures are brief and can not see them on a normal electrocardiogram. Then carry out daily monitoring - continuous recording of electrocardiogram during the day. Patients with atrial form of paroxysmal tachycardia should be well examined, since treatment depends largely on the paroxysm caused the disease.
Ventricular form of paroxysmal tachycardia occurs when the center of stimulation generates electrical impulses are frequent in the ventricles and interventricular septum. Ventricular paroxysmal tachycardia can be dangerous, because it has a tendency to turn into ventricular fibrillation. This reduces not all the muscle of the ventricles, and some of its fibers in a chaotic rhythm. Then the heart is unable to perform his work as the actual phase of the systole and diastole are missing. There are severe circulatory disorders, shock, edema legkih.Prichinami ventricular paroxysmal tachycardia are generally acute and chronic forms of ischemic heart disease (CHD) is less cardiomyopathy, inflammatory diseases of the heart muscle, heart defects. In 2% of patients with ventricular tachycardia, paroxysmal forms occur in patients receiving cardiac glycosides. This is one of the signs of an overdose of cardiac glycosides. And a small number of patients the cause is unknown. Determined on the electrocardiogram characteristic of ventricular paroxysmal tachycardia complexes.
Treatment of paroxysmal tachycardia.
To combat the first attack of paroxysmal tachycardia using simple methods:
Valsalva maneuver. The patient is tense (strained abdominal muscles, legs) for 15 seconds at intervals of 1-2 minutes. Sample Chermika-Hering - massage of the common carotid artery bifurcation in the neck for 15 seconds. First left, then right, at intervals of 1-2 minutes.
This method is dangerous in elderly patients and in patients with severe atherosclerosis.
The implementation of these techniques is desirable permanent record of the electrocardiogram. Sometimes the attack comes to an end after taking korvalola, valokordin or one tablet Relanium.
If all that fails, appointed by the reception of one tablet Ethacyzin, etmozin, anaprilina, finoptin, or novokainamida sotaleksa.
If after this paroxysm persists, one of the injected anti-arrhythmic drugs (novokainamid, finoptin, ritmilen, or kordaron ritmonorm). If no effect is carried out electro-therapy.
In the treatment of ventricular form of paroxysmal tachycardia is most often used drug lidocaine. It is most effective. Lidocaine is administered intramuscularly and intravenously. In case of failure is assigned novokainamid, ritmilen, kordaron.
If you can not restore the rhythm, used cardioversion.
If an attack of paroxysmal tachycardia in a patient came first, the patient must be examined. Under the supervision of the patient pick up Holter monitoring antiarrhythmic drug. In rare paroxysms (1-2 times a month), antiarrhythmic therapy is prescribed for 3-4 weeks. Treatment with frequent attacks long - months and years.