According to medical statistics, pathologies of the heart and vascular system are in the first place among all diseases. What caused it? Many negative factors affect the state of the cardiovascular system. One of them is constant stress and lack of time for proper rest. Air pollution also plays a negative role in the growth of such pathologies. But man suffers not only from worsening environmental conditions. Magnetic storms have a negative impact on the he alth of the inhabitants of our planet. From these bursts on the Sun, it is the cores that feel especially bad. The initial stage of more serious pathologies, often fatal, is arrhythmia.
The essence of the disease
Often the term "arrhythmia" is not perceived by us as a diagnosis. But do not treat this violation of he alth so irresponsibly. Normally, the number of heart beats should be no more than 90 per minute. Moreover, this value should not be less than 70. But many people do not know such information. And, as a rule, we do not control our pulse, do not attendcardiologist and do not pass on our own initiative ECG. However, such actions are the most minimal measure that contributes to the preservation of one's own he alth.
Many failures in the work of such an important organ as the heart can not only be prevented, but also stopped. And the first call for taking the most urgent measures is the slightest deviation from those rhythm indicators that are considered normal.
Some of the reasons why there is a change in heart rate is:
- fatigue;
- severe stress;
- alcohol overdose;- congenital heart disease.
The essence of arrhythmia is that it is a disturbance in the functioning of the cardiac system.
Cardiologists distinguish different degrees of severity of such a deviation. For example, more simple treatment is given to such conditions in which only a few strokes are not enough to the required frequency. However, quite often, patients suffer from a significant increase in myocardial contractions. This is very dangerous for humans and can be fatal.
Types of diseases
There is currently no unified classification of arrhythmias. This is due to the ongoing discussions about the foundations that should be taken as its basis. After all, despite centuries of scientific study of this pathology, specialists have not received the desired result in its treatment.
For example, in 2014 it was suggested that the classificationarrhythmias included three basic types of pathologies. Among them:
1. Arrhythmias, which are a normal reaction of the body, manifested in conditions of adaptation, but at the same time leading to certain disorders that are dangerous for the body.
2. Arrhythmias that occur to regulate cardiac activity.3. Arrhythmias caused by disorganization of the anti-wave functioning of the heart muscle.
Classification of cardiac arrhythmias (WHO) distinguishes three large groups of these pathologies. They include the following diseases:
- caused by a violation of the formation of an electrical impulse in the cardiovascular system;
- associated with conduction disorders; - combined type, due to both the first and second causes.
Arrhythmia is also classified by reason of its origin. So, they distinguish congenital, acquired and idiopathic pathology. The first of these three types is found already from the moment a person is born. Idiopathic arrhythmia has an unclear origin. As for the acquired disease, it occurs throughout the life of the patient and becomes the result of some dangerous diseases, including coronary heart disease, diabetes mellitus and hypertension.
When an arrhythmia occurs, the heart muscle, as before, continues to pump blood. However, this pathology can cause the development of pathologies such as thromboembolism and heart failure. And this speaks of the danger of arrhythmia.
Irregular heart rate
This is one of the reasons for the development of pathology. In connection withthis is the classification of arrhythmias according to the magnitude of the heart rate. It includes:
1. sinus tachycardia. This pathology is associated with a malfunction of the sinus node, which is the main mechanism for the formation of electrical impulses of the heart.
With this type of tachycardia, the heart rate exceeds the upper threshold of ninety beats per minute. This condition is felt by the patient as a heartbeat.
2. sinus arrhythmia. This pathology is an incorrect alternation of heart contractions. Most often, sinus arrhythmia is observed in children, as well as in adolescents. Often it is functional and has a direct connection with breathing. During inhalation, heart contractions become more frequent, and during exhalation, on the contrary, they become more rare.
3. sinus bradycardia. Its main symptom is a reduction in heart rate to 55 beats per minute. This phenomenon can be observed even in he althy and physically strong people during sleep or at rest.
4. Paroxysmal atrial fibrillation. In this case, there is a very rapid heartbeat that has the correct rhythm. A person's heart rate sometimes reaches 240 beats per minute. At the same time, it causes weakness and pallor, increased sweating and fainting. The reason for this phenomenon is the additional impulses that occur in the atria. As a result of their occurrence, there is a very strong reduction in the rest periods of the myocardial muscle.
5. paroxysmal tachycardia. This pathology is correct, but at the same timevery frequent rhythm of the heart muscle. The heart rate in this case is in the range from 140 to 240 beats per minute. Paroxysmal therapy tends to come and go suddenly.6. Extrasystole. This type of arrhythmia is an extraordinary (premature) contraction of the myocardial muscle. At the same time, a person can feel both increased tremors in the region of the heart, and its fading.
To help the cardiologist
The most convenient from a practical point of view is the classification of arrhythmias according to Kushakovsky. It includes three groups of pathology. At the same time, they have a detailed description of all the pathologies included in them. Let us consider in more detail the typology that this classification of arrhythmias includes.
Irregularities in rhythm formations
This group consists of three subsections. The first of them, which this classification of arrhythmias identifies under the letter "A", includes nomotopic pathologies. They represent violations in the work of the sinus node. At the same time, they allocate:
1. Sinus tachycardia.
2. Sinus barycardia.
3. Sinus arrhythmia.4. SSS, or sick sinus syndrome.
The next subsection includes ectopic causes of cardiac arrhythmias.
Classification highlights this list of pathologies under the letter "B". This subsection includes disorders caused by heterotopic rhythms that arose due to the predominance of automatism in the work of ectopic centers. This list contains:
1. Substitute (slow)escape rhythms and complexes, including atrial and ventricular, as well as from AV connections
2. Migrations seen in a supraventricular pacemaker.3. Non-paroxysmal types of tachycardia or accelerated rhythms of the ectopic type.
The next subsection indicates arrhythmias that are not associated with a violation of automaticity of the heart. The classification highlights pathology data under the letter "B". This includes:
1. Extrasystole (ventricular, atrial and AV connections).
2. Paroxysmal tachycardia.
3. Atrial flutter.
4. Atrial fibrillation.5. Ventricular fibrillation.
Irregularities in conduction
This group includes slightly different ventricular arrhythmias.
Classification according to Kushakovsky highlights:
1. Sinoatrial block.
2. Intra-atrial block.
3. AV block.
4. Intraventricular blockade of the branches of the His bundle, including mono-, bio- and triophaoscicular pathologies affecting one, two or three branches of the atrioventricular bundle, respectively.
5. Ventricular asystole.6. Syndromes of premature excitation of the ventricles.
Combined rhythm pathologies
This group includes the following violations:
1. Paroxystopia.
2. Ectopic rhythms characterized by exit block.3. AV dissociation.
International Scheme
It is worth saying that when defining such a disease as arrhythmia, the WHO classification considers such groupsin almost the same order. In this case, the pathology is divided into ailments caused by various causes of dysfunction of the heart muscle. Thus, WHO distinguishes the following groups of arrhythmias:
1. Caused by violations of automatism, including:
a) pacemakers in the sinus node (sinus tachycardia, barycardia and arrhythmia, as well as SSS and non-respiratory sinus arrhythmia); b) pacemakers outside the sinus node (lower atrial, atrioventricular and idioventricular rhythms).
2. Caused by disturbances of excitability, including:
a) by the sources of pathology (ventricular, atrial and atrioventricular);
b) by the number of sources (mono- and polytropic);
c) by the time of occurrence: early (during atrial contractions), late (at the moment of relaxation of the heart muscle) and interpolated (with a point of localization between atrial contractions and relaxation of the heart);
d) by frequency: group (with several in a row), paired (two at the same time), single (five or less) and multiple (more than five);
e) in order (quadrigeminy, trigeminy, bigeminy);e) paroxysmal tachycardia.
3. Caused by conduction disorders, that is, its increase (WPW-syndrome) or decrease (various types of blockades).
4. Mixed (flicker/ventricular flutter/atrial flutter).
All types of diseases are accompanied not only by disturbances in the anatomical structure of the heart. They lead to an imbalance in all metabolic processes occurring in the myocardial muscle. This causes various in nature andduration types of arrhythmias. Only a cardiologist can make a true diagnosis. They will establish the cause of cardiac arrhythmia, classification, etiology, pathogenesis, clinic based on the obtained electrocardiographic data.
Ciliary type of pathology
The classification of this type of disease includes the nature of its clinical course, electrophysiological mechanisms, and etiological factors.
What is atrial fibrillation? The classification distinguishes its following types:
- chronic (permanent);
- persistent;- transient (paroxysmal), lasting from 24 hours to seven days.
At the same time, chronic and persistent forms of pathology can become recurrent.
Also, atrial fibrillation is distinguished by the type of heartbeat disturbance. At the same time, flutter and atrial fibrillation are distinguished.
According to the frequency with which the ventricles contract, atrial fibrillation is distinguished:
- tachystolic (90 or more times per minute);
- normosystolic (60-90 times per minute);- bradysystolic (less than 60 times per minute).
Extrasystole
This variant of the pathology is characterized by extraordinary contractions of the heart muscle or its individual parts (extrasystoles). At the same time, a person feels anxiety, lack of air, a strong push of the heart or its fading. This pathology sometimes leads to angina pectoris and cerebrovascular accidents.
Any extrasystole is characterized by a lot of parameters. Exactlytherefore, in its full classification, more than ten sections are distinguished. However, for practical use, only those of them are singled out that can most closely reflect the course of the disease.
Laun's classification of arrhythmias was an important step in the history of cardiology. Using the proposed grouping, the practitioner is able to adequately assess the patient's pathology and the severity of its course. The fact is that gastric extrasystole of the heart (ZHES) is very widespread. This pathology is observed in almost fifty percent of patients who seek advice from a cardiologist. In some of them, the disease is benign and does not pose any threat to life. However, there are patients who have a malignant form of PVC, which requires a certain course of therapy.
The main function performed by the Lown classification is to separate malignant from benign pathology. At the same time, five classes of the disease are distinguished:
1. Monomorphic ventricular extrasystole, the frequency of which is less than 30 per hour.
2. Monomorphic PVC with a frequency of more than 30 per hour.
3. Polytopic.
4. In the fourth grade, two subsections are distinguished (paired PVCs and ventricular tachycardia with three or more PVCs in a row).5. Extrasystole when the R wave is on the first 4/5 of the T wave.
This classification is used in cardiology and cardiac surgery. It has also been used by doctors of other speci alties for many years. Introduced in 1971year, it has become a reliable support for specialists in the installation of arrhythmia, classification and treatment of this pathology.
