bradycardia - a slow down, the most important organ in our body, the heart.It is believed that the heart is working in slow rhythm at the frequency of its cuts less than 55 beats per minute.Different sources give different figures the lower limit of normal rhythm.Basically guided by the figure of 60 beats per minute, becausea measure of the center of automaticity of the first order, sinuauricular node.Below 50 beats per minute - slowing down of the heart is already approaching a critical figure of 40 beats per minute, after which the aetiology is considered to have expressed.The most appropriate to dwell on the figure of 55 beats.min.In this line are guided not only as a figure lower frequency limit of normal rhythm, but also as the lower limit of the pulse in the selection of a dose of antiarrhythmic drugs.That is above this limit the frequency of contractions of the heart has the ability to adequately pump blood and oxygen to provide the most important organs and tissues, and th
bradycardia is very tip of the iceberg of reasons causing it.What for some people is normal, the other - deadly.So an athlete with a well-trained muscles of the heart adapted to high loads, which for him, because of their persistence, are the normal rhythm of life alone does not need a large supply of oxygen in the blood - the heart beats slowly.A newborn child is experiencing tremendous stress related to adaptation to the outside world, enhance the growth of organs and tissues, thus slowing down the rhythm of the heart causing his mother anxiety and panic.At the very least, it should cause.
Day usually all we perform a particular load, thus loading the heart of the work.Even when it seems that just sit at the table without physically moving - to keep the body in a certain position is also a job.Mental, emotional work is sometimes no less voltage than the physical.And only at night to fully relax the body, comes the "kingdom of the vagus" and heart rate slows down.It is possible that he will slow down in the range of 50-55 beats.Bradycardia is not to be a manifestation or symptom of any disease - is the norm.Therefore, bradycardia, as appropriate, may be either absolute or relative character.
Considering the essential function of the heart - the ability to fall in a given mode (automatism), and it is through her heart is working with some frequency, it is necessary to recall briefly the cardiac conduction system.Conducting system, or local power plant is able to generate pulses with a frequency that is currently required for an adequate functioning of the organism.In any serious company to be the director and his deputies.And everything here as well.The first center of automatism, the pacemaker and its overwhelming pressure of all the others - is sinoauricular node (CA- node).Hide it in the right atrium and runs his impulses on special paths.However, theories on this matter quite a lot.How many ways and they have the momentum or diffusely distributed, the answer in this case is not so important.What is important is that the pulses are so many that they suppress any activity underlying cells.Nature, modeling our heart, took care of that in case of failure of the pacemaker will work more, and can generate a pulse every muscle cell of the heart.CA- node generates pulses with a frequency of 60 per minute.With increased demand for oxygen the body gives signals and our "director" will run faster.Or vice versa - external signals provoke him to work less frequently.When the external regulation is not so perfect - CA- node is not working regularly, often, slow (arrhythmic).It is common for children and adolescents.
When CA-uzlel can no longer perform its function, its role incur AV-node and the bundle of His.Since they are not as powerful, and the pulses of these will come with a lower frequency, ie,almost always bradycardia heart.Almost always, because during exercise or exposure to drugs rhythm can participate.
consider the causes of bradycardia more detail.
Only two major causes of heart bradycardia - physiological and pathological.The first include:
- bradycardia, are registered in trained human athletes.Normal, everyday load is not for them, something transcendent, the body begins to give signals about the need for greater frequency only under extreme loads, then increased heart rate;
- here you can include sinus bradyarrhythmia children and adolescents;
- congenital complete AV-block;
- idiopathic bradycardia.
pulse bradycardia, in these cases, be sure to increase during exercise and when sinus bradyarrhythmias will thus also correct.
pathological form of bradycardia include conditions arising from the:
- CCCU (sinuauricular node weakness syndrome);
- sinuauricular blockade;
- arrest sinuauricular node;
- AV- blockade at the level of the node;
- complete transverse blockade;
- rhythm disorders by type of atrial fibrillation (bradiforma) or Frederick syndrome (a combination of atrial fibrillation and complete AV block);
- an overdose of different drugs, mainly antiarrhythmic;
- poisoning by various substances and poisons cardiotropic;
- brain damage and / or peripheral nervous system;
- disruption of the endocrine glands (eg, hypothyroidism);
- trauma (described a gunshot wound to the heart lesion bundle branch block);
- CCHD (chronic coronary heart disease);
- infarction of the heart muscle;
- terminal form of kidney, liver failure;
- electrolyte disorders (excess potassium and / or calcium in the blood).
bradycardia may be a reflex, or under the influence of stimulation, such as carotid sinus (with cupping tachycardia or when inadvertently tighten the tie around his neck, and will put a tight collar, etc.), with pressure on the eyeballs (also usedcupping tachycardia).
bradycardia can be one of the side effects of treatment, such as the appointment of beta-blockers to patients with a variety of CCHD or rhythm disorders, heart rate may drop to 55 beats per minute.In terms of heart rate pick up the dose, avoiding lowering heart rate below 55 beats.per minute.
Analyzing the causes can be identified them in three groups:
- momentum can not be produced with the desired frequency and excite the cells to a reduction;
- pulse itself is produced with a good rate, but in carrying it to the cells there are obstacles;
- external influences on the heart do not give a full and often generate a pulse.
What does the heart to contract at a certain frequency?One goal - to deliver the bodies of nutrients and oxygen.This is only possible with blood that the heart pumps.If the power supplied is insufficient, authorities fail to fulfill their tasks or transform into conservative, economical operation.Primarily lack of nutrition affects brain cells.
man, not knowing of the existence of a problem with rhythm, will feel fatigue, weakness, drowsiness.There may be episodes of loss of consciousness, fleeting, to severe in duration.Such a long episode of loss of consciousness can be fatal.And can only disturb dizzy from expression to negligible.Such episodes of dizziness or loss of consciousness are part of the syndrome of Morgagni-Adams-Stokes equations (Adams can be read and Adams).
sudden loss of consciousness may be the only and the last in the life of human clinical manifestation of severe bradycardia.
bradycardia may be of transitory nature - a single episode, and it can cause death.
loss of consciousness most often nothing precedes unlike epileptic seizure, for example.Although, on the other arrangements and convulsions.After a period of recovery of consciousness is not stunning, again, unlike epileptiform seizure.A man may be red or pale before the attack bradycardia, sweating, etc.And such attacks may be several per day, and may be one of the year, but it must take into account.The number of attacks MEA does not indicate the severity of bradycardia.The presence of the syndrome MES necessarily indicative of the diagnosis of the patient.
People, by nature, are designed so that if the problem is disturbing them quite long and are not pronounced, they are beginning to adapt to this situation.Sleepiness and fatigue are charged to do more work, episodic vertigo - age and lack of sleep, and so on.This can lead to serious, irreparable consequences.The inability of the heart at the right time to accelerate to the desired frequency often leads to death.
Inadequate regulation of the peripheral nervous system, its sympathetic and parasympathetic divisions (the fetus is dominated by the influence of the sympathetic), intensive growth of tissues and organs that requires huge amounts of energy forces the heart to work at an accelerated rate.What will be considered an adult heart palpitations (tachycardia), the fetus will be the norm.
Norma heart rate at the growing body of 110-160 per minute.Anything less frequency of 110 per minute - is considered bradycardia.
This is a very dangerous condition, because, as stated above, is an active growth and maturation.The slightest braking in the process can lead to serious problems in the formation of organs and tissues, especially the brain.
The causes fetal bradycardia may be:
- Failure mom future baby simple rules - do not smoke, drink alcohol, walk more, do not eat foods rich in chemical additives and dyes.In short, the expectant mother had forgotten what a healthy lifestyle;
- Acceptance of a pregnant woman drugs toxic to the fetus (required carefully read the instructions);
- women having chronic lung disease, heart anemia.Occurrence of anemia during pregnancy.Exacerbation of chronic diseases, especially infectious diseases, during pregnancy the expectant mother;
- The presence of stress or great stress in pregnant women can lead to great suffering of the fetus;
- Congenital malformations of the fetus.It can be formed malformations of the heart, brain and other internal organs, Rhesus conflict;
- Multiple pregnancy, multi- or oligohydramnios;
- Heavy, prolonged morning sickness;
- Such complications as premature detachment of the placenta;
- urgent situations of suffering of the fetus, such as umbilical cord entanglement.
reasons may be different, but the outcome of one - the emergence of bradycardia entails suffering fetal hypoxia.As chronic hypoxia current and acute arose directly threatens the life of the unborn man.If time does not carry out therapeutic measures, the consequences may be irreversible - malformations, as organs and systems and / or fetal death.
Treatment of fetal bradycardia is in the following events:
- First of all treatment must wear a preventive character and be aimed at the mother's condition.The organization of its daily routine, avoiding harmful habits, normalization of food and frequent walks in the fresh air will help not only my mother to regain strength, but also the fetus to avoid worsening hypoxia.Expectant mother is necessary to explain the benefits of iron supplementation, if she has anemia, it is also necessary to compensate for its other chronic diseases, especially infectious, if any;
- Dynamic monitoring of the fetus.The easiest way to spend it, believing heart rate of the fetus during the CTG (cardiotocography), statoscope doctor spends listening heartbeat of the fetus through the abdominal wall of women, since the second half of pregnancy or ultrasound (performed, starting at 12 weeks of pregnancy, the possibility of intrauterineultrasound).These methods of investigation carried out a certain number of times during pregnancy to assess fetal development at different stages of pregnancy and timely detect bradycardia, if any.
- If the fetus is viable, and the gestational age is large and significant fetal suffering, perhaps deciding on the termination of pregnancy by cesarean section.Such decisions are often in a hospital, collectively.
fetal hypoxia may occur during childbirth and manifest themselves slowing heart rate.Therefore, for this indicator, be sure to follow midwives during the birth process.The suffering of the fetus in this difficult period for him may be due to compression of both his pelvis and possible ingestion of amniotic fluid and hit them in the respiratory tract.
In any case, the presence of hypoxia, bradycardia in the fetus during pregnancy and childbirth spoke about the need to oversee him neonatologists and pediatricians.
Bradycardia in children
Children, unlike adults, are not yet fully formed body.Rather the body they are in the stage of formation.So what it is the pathology of the adult, child - age norm.This concerns parameters heart rate and a graphic image of the heart (ECG).The older the child becomes, the closer its performance to that of an adult.
It is believed that the aetiology of children will take place if:
- for the newborn - a decrease in the number of heartbeats per minute less than 100;
- after a year and about six years this figure - less than 70 beats.per minute;
- a teenager - is less than 60 bpm.per minute.
Because even imperfect conduction system of the heart, not fully formed sinuauricular node, the child can be seen on an electrocardiogram expressed respiratory arrhythmia, pacemaker migration, etc.Simple exercises - squat or deep breathing, walking can "lead" ECG to normal.It speaks to the great influence of the autonomic nervous system.When the baby is asleep or very frightened he can fix bradycardia - this is not a pathology, and functional changes, and they will be growing up with a baby.
We should not forget that the child actively involved in sports, as well as an adult will take place bradycardia athlete.
Unfortunately, not all heart rhythm deceleration can be attributed to a functional state.Causes of pathological bradycardia children are approximately the same as that of adults.It was the first time in childhood are diagnosed:
- congenital disorders of rhythm and conduction;
- the effects of hypoxia during pregnancy and / or during labor can be seen in young children, especially if the brain suffered;
- congenital heart disease.
If the immune system is weakened, frequent colds, meningitis, pneumonia, myocarditis and endocarditis can lead to disruption of the function of internal organs, endocrine glands, brain, heart, including the formation of acquired heart disease.In this case, bradycardia will carry a secondary character.
Clinic bradycardia in children may not be as pronounced as in adults.Mom kid or teenager should be especially careful to follow the suddenly changed the general well-being of the child.The emergence of unmotivated weakness, fatigue, drowsiness, dizziness, and the appearance of unexplained syncope - are all reasons to see a doctor and get tested.
treatment of bradycardia in children is based, primarily, on preventive measures.This includes the prevention of fetal hypoxia, prevention of fetal distress in labor, prevention of colds.This can be achieved only when the dispensary first regular monitoring of the pregnant woman, and then the baby.