Attacks of palpitations and other symptoms: shortness of breath, fear, pain, weakness

The state of tachycardia, or a strong heartbeat, is not yet a disease, but already one of the signs of a possible dysfunction of the cardiovascular apparatus, or other systems of the body. Is the danger a given condition?

The rate of heartbeats per minute for an adult varies between 60-80 times. A strong heartbeat can be said if this number exceeds 90-100 beats. Intense cardiac activity for a long time accelerates muscle wear, provokes hypoxia: because of this, for example, with tachycardia of more than 150 beats per minute, a person may experience dizziness and even fainting.

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Causes of the heart palpitations

The myocardium has a so-called sinus node that controls the contractile rhythm. A node always “responds” to all irritating factors, external or internal. It is thanks to him that the heart begins to work more actively against the background of heightened anxiety, stress, with fever or hypertension, with physical overload, shock, etc.

With certain violations, the node can “make mistakes”, causing tachycardia, seemingly “out of the blue”. However, not everything is so simple, and the causes of tachycardia are always there: the main thing is to find and fix them in a timely manner.

For example, a strong heartbeat under load, when walking for an untrained person - this is the norm, and for an athlete - an occasion to think about their health. Perhaps the body just needs a break from frequent and exhausting workouts.

Other possible causes of sinus palpitations are:

• magnesium or potassium deficiency;
• chronic sleep deprivation, prolonged lack of rest, body overload;
• prolonged stress, deep depression;
• acute intoxication, infections, injuries.

With paroxysmal heart palpitations, malfunction occurs in the atrium or ventricles: the causes of this condition often lie directly in heart pathologies. Many patients end up with sclerosis, atrophic changes in the myocardium, myocarditis, ischemic disease, malformations, heart attack, etc.

Supraventricular type of tachycardia indicates that the cause should be sought in the sympathetic division of the National Assembly.

A strong heartbeat after alcohol, with a hangover may be disturbed for a number of reasons:

• severe intoxication;
• dehydration;
• increased load on the cardiovascular apparatus;
• oxygen starvation.

You can imagine how much resources the body spends, trying to recover from the "tumultuous feast." Of course, the myocardium is overloaded, and to facilitate its work, it is urgently necessary to conduct detoxification therapy and rehydration.

Dehydration can also be associated with a strong heartbeat in the heat: this is why experts strongly advise to drink more pure water in the hot season (coffee and tea are not suitable because they have diuretic properties). Water must be taken with you for a walk, even if you are going for a short walk and not far.

But with excitement, a strong heartbeat is justified, because any degree of stress is an irritant to the sinus node. But here, too, caution must be exercised: a long period of anxiety, or excessively deep experiences, can significantly impair heart function and provoke the development of pathologies.

A strong heartbeat in a calm state is an unfavorable symptom that may indicate such problems:

• vegetative-vascular disorders;
• myocardial ischemia;
• endocrine disorders;
• problems in sympathetic departments NA.

A strong heartbeat after eating is a sign of overeating, overloading the digestive tract, endocrine diseases, and pancreatic pathologies. It happens like this with diabetes, increased blood sugar levels. The exact reason should be voiced by the doctor after performing the necessary diagnostic procedures.

In recent years, the diagnosis of vegetative-vascular dystonia is especially common among young people. This is a symptom complex, which is formed against the background of the impaired function of the autonomic NS. A strong heartbeat in the IRR is only one of the symptoms of the symptom complex. Other signs may be:

• panic states;
• dyspnea;
• meteorological sensitivity;
• frequent pain in the head;
• mood swings;
• cold extremities.

The work of the autonomic nervous system is closely related to the state of the hormonal balance in the body. Therefore, functional failures often occur in women on certain days of the menstrual cycle, during pregnancy or menopause. A strong heartbeat during menstruation is not considered a pathology, however, it will not be superfluous to make additional diagnostics and check the state of the hormonal background.

A strong heartbeat in menopause is even considered one of the main signs of hormonal adjustment, along with "tides", bouts of dizziness and other characteristic symptoms. This picture indicates a decrease in estrogenic activity.

And another possible cause of discomfort in the heart area is the use of certain medications:

• β-adrenoblocator;
• Reserpine or clonidine;
• cardiac glycosides;
• adrenomimetics, psychostimulators.

It is also known which drug greatly reduces heartbeat. We are talking about opiates - drugs that have a sedative, "inhibitory" effect. This category includes natural and synthetic morphine-like substances: heroin, opium (acetylated, raw), methadone. Other drugs - for example, amphetamines, cocaine, hallucinogens, ecstasy - usually cause an increase in cardiac activity.

Risk factors

Heart palpitations can be triggered by many causes. To prevent the development of pathologies, experts identified a number of factors that each of us should be aware of:

• Eating disorders.

It is necessary to pay attention not only to how much food is absorbed, but also to the quality of the food.

• Elevated cholesterol, hyperlipidemia.

Blood tests should be taken regularly to assess cholesterol levels.

• Overweight, obesity.

Control of body weight is necessary: excess weight is an additional load on the cardiovascular apparatus.

• Hypodynamia.

Low physical activity - a very negative factor for the heart and blood vessels, so you need to regularly do exercises, make walking.

• Bad habits.

It is no secret that smoking and drinking alcohol negatively affect the quality of the circulatory system, increase the risk of thrombosis and angina pectoris, inhibit platelet activity, and cause heart muscle dystrophy.

• Frequent stress, depression.

Prolonged or permanent mental stress leads to early wear of blood vessels and heart overload.

In addition, women may be at risk during pregnancy and during menopause, as well as all elderly people.

Pathogenesis

A strong heartbeat can have several pathogenetic variants. So, pathogenesis may be related:

• with organic disorders of the cardiovascular apparatus (myocardial pathologies, vascular pathologies);
• with a direct effect on the cellular structures of the sinus node on the background of oxygen starvation, toxic effects, infectious diseases, fever (it is believed that an increase in temperature by one degree causes an increase in heart rate of 10 beats per minute);
• neurogenic factor and the state of the central nervous system and autonomic NA;
• with drug exposure (tachycardia can be triggered by taking sympathomimetics, thyroidin, caffeine-containing drugs, corticosteroid hormones, etc.).

Most often, a strong heartbeat becomes one of the signs of cardiac neurosis, hyperthyroidism, angina, rheumatic heart disease, myocarditis, anemia, pulmonary heart, etc.

Often, this condition is found in healthy people - mainly against the background of physical and mental overload.

Long-lasting tachycardia worsens central and coronary hemodynamic parameters: the heart begins to consume more oxygen, energy consumption increases, and capillary coronary circulation suffers. If there are problems in the myocardium, frequent and strong heartbeat can lead to the development of heart failure, or aggravate its course.

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Symptoms

The patient usually characterizes a strong heartbeat as follows: the heart begins to beat hard, every contraction of the myocardium is felt. Sometimes a darkening in the eyes, a feeling of panic fear, dizziness or an attack of headache joins these signs.

Failure of the rhythm may be accompanied by chest pains, severe severe weakness, difficult breathing, increased blood pressure, a feeling of heat or, conversely, cooling, as well as the appearance of a "coma" in the throat.

The first signs may be more vague: the patient notes loss of appetite, insomnia, hand tremor, pallor of the skin. Such a nonspecific picture arises as a result of overload on all systems of the human body.

Reddening of the skin on the face and in the upper part of the body, heart palpitations and sweating, chills or fever are somewhat less common: the patient starts to panic, his head starts to ache sharply. Typically, a problem can arise both in a calm state and after a certain kind of load: sports, a stressful situation, after taking medicine, fright, etc. Sudden heart palpitations can make themselves felt even during sleep — that is, without communication with any annoying factor. In such a situation, without complete diagnostics is indispensable.

Not a rarity and such a symptomatic combination as a strong heartbeat and high pressure: with an increase in heart rate, blood pressure rises in the arterial vessels, and this is one of the variants of the pathological mechanism. Sometimes it happens the other way around: the heart begins to work harder against the background of a jump in blood pressure. And in fact, and in another case, you need to look for the root cause of the violation. However, the stabilization of pressure in any of these mechanisms of development will allow "to calm" the heart activity.

It is possible and a strong heartbeat for hypotension. For example, a rapid drop in pressure occurs during the development of a shock state - in case of anaphylaxis, trauma, in the background of an infectious toxic or psychogenic shock, etc. The cardiovascular apparatus “responds” to such processes by accelerating myocardial contractions: it is necessary, first of all, for keeping adequate blood pressure - that is, it is a peculiar compensation mechanism.

Blood pressure does not always affect the appearance of heart problems. Thus, a strong heartbeat under normal pressure is not excluded, if a person has vegetative-vascular dystonia, anemia, endocrine system diseases (in particular, thyroid hormones are often the cause of the problem). It is not worth finding out the cause on your own, and it is unlikely that it will be possible: it is better to visit a doctor in a timely manner.

Especially it is necessary to be wary and to think seriously about the help of the doctor in case of the following symptoms:

• prolonged bouts of chest discomfort;
• frequent painful episodes associated with even the slightest annoying factors;
• both heart palpitations and pain in the heart.

With the appearance of similar symptoms, it is possible to suspect a deficiency of calcium or iron (hemoglobin) in the blood, and endocrine or cardiac pathologies.

But, in most cases, if there really is an immediate heart disease, then several symptoms always bother you — for example, severe shortness of breath, a lack of air and a heartbeat, a feeling of constriction in the chest. But for the functional disorder of the thyroid gland, other signs are characteristic - this is a strong weakness, palpitations, anorexia and sleep disturbances.

For anemia - low hemoglobin level - characterized by a strong heartbeat and dizziness, pallor, frequent headaches.

Prompt medical care is required when the patient observes:

• protrusion of the veins of the neck;
• difficult breathing (as if something is interfering);
• chest pain;
• a sharp change in blood pressure;
• palpitations and fear, disturbance of consciousness.

It doesn’t matter whether all of these signs are present, or one of them: a visit to the doctor must necessarily follow.

Often you can hear from patients: I wake up at night from a strong heartbeat, I can not sleep, I constantly listen to my feelings. What's happening?

Such symptoms are not uncommon in people with endocrine disabilities: to solve this problem, you must go through a number of diagnostic procedures.

About the possible danger of warning such "signs":

• difficulty breathing with normal exhalation (sometimes a person breathes with a whistle, hard, hard);
• heart palpitations, dizziness, headache;
• sensation of noise in the head or ears;
• darkening of the eyes;
• disturbance of consciousness.

These signs indicate the need to urgently call the ambulance carriage.

If a person has the first signs of SARS or influenza, and a strong heartbeat and temperature, fever are detected against their background, then symptomatic treatment is necessary, affecting not the heart’s work, but the elimination of the symptoms of viral infection. When the temperature returns to normal, a strong heartbeat stabilizes by itself.

Acute poisoning is sometimes characterized by nausea and palpitations. To remedy the situation and improve well-being, it may be sufficient to simply induce vomiting, or to drink activated charcoal (depending on the severity of intoxication). The main thing is to properly understand the situation and other dangerous symptoms - abundant liquid stool with vomiting and dehydration - to seek medical help.

In people suffering from hypertension, palpitations and trembling in the hands often occur with a sharp drop in blood pressure - for example, if a person has taken an excessive dose of an antihypertensive drug, or in other circumstances. It is easy to trace such a state: you only need to measure the indicators more often with a tonometer.

But symptoms such as palpitations and a lump in the throat should alert: most likely, there are real problems with the work of the heart. Such a condition is not uncommon in post-stress situations. Additional pathological signs may be headaches, dizziness, pressure in the chest, difficulty breathing.

Heart palpitations and tinnitus may indicate an increase in pressure, or other critical conditions that require not only treatment, but also emergency medical care. There is a special cause for concern if the problem arose without any obvious reason, amid well-being, peace of mind, or even sleep.

[5]

Strong heartbeat in a child

Children are not so rarely found all sorts of functional disruptions in the cardiovascular system, and a strong heartbeat is no exception. The greatest number of such failures are diagnosed in adolescence, against the backdrop of the active growth of the child's body. In addition, some symptoms occur at the age of five or six.

Should this problem be treated in a child? It depends on the intensity of the clinical symptoms, on the general condition of the heart and the vascular network. In the absence of organic disorders of the heart and with minor bouts of heart palpitations, there is no need for treatment: only small changes in lifestyle are sufficient. Hydrotherapy, exercise therapy will help to improve the functioning of the heart and the body as a whole, and in more complicated cases it is possible to draw up a treatment regimen using bromine, valerian, atropine.

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Heart palpitations during pregnancy

During pregnancy, the occurrence of frequent and severe heartbeat is not uncommon. In this case, the attacks can suddenly appear, and also disappear abruptly on their own. And not in all such cases, a woman should be worried. Often, tachycardia is associated with an increasing load on the cardiovascular system of the expectant mother, as well as an increase in circulating blood volume. Other reasons include the following:

• intense hormonal changes;
• a sharp weight gain, which is accompanied by an increase in the load on the heart;
• pronounced toxicosis;
• drop in hemoglobin level, development of anemia;
• constant worries, fears;
• low blood pressure.

If during attacks, the general state of health of the woman does not suffer, then, most likely, we are talking about physiological tachycardia, which does not require special treatment. All that can be advised to a future mother is rest, relaxing procedures, good nutrition and sleep, weight control.

If a strong heartbeat is accompanied by dizziness, impaired consciousness, nausea, chest pain, paresthesia, a feeling of lack of oxygen, you should immediately consult a doctor for help. Most likely, it is necessary to carry out a number of diagnostic procedures.

Stages

A heartbeat many experts are divided into several stages:

• Stage I is characterized by the appearance of tachycardia only on the background of physical exertion. Other symptoms are usually not observed.
•  Stage II _and is characterized by the appearance of palpitations during exercise (physical, stressful), as well as other adverse symptoms (difficulty breathing, increased fatigue, blanching of the skin).
• II _B  stage is characterized by the occurrence of seizures, even at rest. Frequent and strong heartbeat can be felt in a dream, during rest; there may be a feeling of fear, headache, shortness of breath, etc.
• Stage III is accompanied by marked changes in the cardiovascular system. Acrocyanosis is observed, the heart borders are widened, tones are muffled, arrhythmia is possible.

Forms

Conventionally, there are two types of heart palpitations. It is about situational tachycardia, which is a kind of heart response to certain external and internal irritants, as well as chronic tachycardia.

Situational heart palpitations disappear on their own, by themselves, as the irritating factor disappears (for example, fear, stress, physical exertion, etc.).

Chronic heart palpitations do not disappear on their own, as it is the result of certain cardiac pathologies, or functional problems in other organs or systems. To normalize chronic tachycardia, it is necessary to eliminate the original cause of the pathological condition.

In addition, intermittent or constantly disturbing palpitations are divided into the following distinctive types:

• Paroxysmal type - an attack develops abruptly, and also ends abruptly. The number of beats per minute can reach 200 and even more. For example, such a heartbeat often occurs in the morning or during the day: it may be accompanied by increased sweating, a sense of panic.
• Non-paroxysmal type - an attack develops at a gradual pace, with a subtle and short increase in heart rate. Over time, the duration of episodes increases to several hours and even days. Often, the patient appears insomnia, heart palpitations do not allow to sleep, work, etc.
• Sinus type - is less noticeable, since the frequency of contractions of the heart rarely exceeds 120 beats per minute. The clinical picture may be vague, or it may not be at all. Rarely, the patient notes a strong heartbeat at bedtime, when falling asleep the problem becomes more noticeable: in most situations, this type of tachycardia is detected during diagnostic activities.

Diagnostics of the heart palpitations

Diagnostic procedures usually begin with a preliminary survey of the patient. The doctor needs to listen to complaints, assess the general well-being of a person, clarify the severity and location of pain or discomfort, find out after taking any medications the patient feels relieved.

Examination is also necessary, but in the initial stages of the disease it may not be effective. However, the doctor is able to assess the condition of the skin, determine overweight, see signs of anemia, and suspect endocrinological disorders.

Using palpation and percussion methods, heart borders are determined; auscultatory the doctor listens to heart sounds, noise, assesses the rhythm.

Additionally, you may need to measure blood pressure.

Laboratory diagnosis most often includes:

• general blood and urine tests;
• blood biochemistry + determination of glucose level;
• determination of the level of hormones in the blood (in particular, thyroid hormones are studied).

Instrumental diagnostics consists of the following procedures:

• Radiography - is assigned to determine cardiac size, likely aneurysms and signs of insufficient cardiac activity.
• ECG - helps to determine the quality of myocardial blood supply.
• Coronary angiography - allows you to assess the status of the vascular network, to detect atherosclerosis and the narrowing of the arteries.
• Daily monitoring (Holter monitoring) is used to conduct daily continuous recording of the heart dynamics on an ECG. The study requires a special portable device that records any irregularities in the work of the heart during the day. This method is most informative in the diagnosis of heart palpitations.
• Load tests - are carried out using a bicycle ergometer or a treadmill. The patient is invited to evaluate the heart activity on the background of the dosed physical load. The purpose of this method is to determine the relationship between the appearance of a strong heartbeat and signs of impaired blood supply to the myocardium on the electrocardiogram.
• A tomographic study of the heart and blood vessels is most often used for differential diagnosis.
• Thyroid ultrasound - is prescribed for suspected disorders of the endocrine system.

Since the heartbeat is not always possible for the doctor to listen to (at the time of examining the patient, the heart may turn out to be normal), it is very important to concentrate on how the patient describes his own feelings at the time of the attack. It is recommended that such patients independently measure the frequency of heartbeats and evaluate its rhythm with the onset of a strong heartbeat. First of all, differential diagnosis should be carried out with a psychogenic heartbeat, with organic lesions (for example, aortic insufficiency with an increase in stroke volume).

With a correct, but accelerated rhythm, it is possible to suspect both emotional or physical overload, and atrial or ventricular tachycardia.

Arrhythmias are even spoken when episodic extrasystoles take place: the compensatory period that follows extrasystoles is a kind of cardiac arrest, and the subsequent contraction is felt as a strong blow. However, according to the description of the patient, it is difficult to distinguish extrasystolic seizures from atrial fibrillation.

Tachycardia appears or increases with hyperthyroidism, hypoglycemia, at elevated body temperature, with pheochromocytoma, and after taking certain medications (atropine, thyroid hormones, epinephrine, ephedrine, aminophylline). Contribute to a strong heartbeat smoking, drinking alcohol, abuse of coffee, strong tea. Some factors that cause tachycardia can be identified only when conducting additional diagnostics: we are talking about thyrotoxicosis, pulmonary problems, heart defects.

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Treatment of the heart palpitations

Long-term therapy for heart palpitations is prescribed depending on the root cause of the pathological symptom. Most often it is necessary to resort to receiving antiarrhythmic drugs and cardiac glycosides.

Complications and consequences

Repeated bouts of heart palpitations can negatively affect the state of the cardiovascular system. Elderly patients and people suffering from organic cardiac pathologies are at particular risk. Against the background of increased heart rate, the myocardium requires more oxygen: if it is not enough, then ischemia can develop, or even a heart attack. That is why, due to the high probability of developing complications, frequent bouts of tachycardia are a reason to consult with a cardiologist.

Perhaps the most frequent complication of systematic paroxysmal palpitations is angina. This pathology develops as a result of myocardial nutritional deficiencies due to insufficient blood flow to the muscle. Angina pectoris is characterized by sudden pain and a feeling of squeezing in the chest: this condition can last for about 15-30 minutes, after which everything returns to normal. In some patients, after the attack, there is a feeling of weakness, nausea, increased sweating. It is characteristic that in the supine position the pathological symptoms only increase. If a person discovers similar symptoms in himself, then he should immediately contact a doctor: not only his health, but also his life is at stake.

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Prevention

To reduce the likelihood of a “meeting” with such a problem as heart palpitations, it is necessary to take several steps recommended by experts.

The first is the eradication of bad habits. It is no secret that tobacco smoke and alcohol significantly increase the load on the myocardium and the vascular network.

It is equally important to avoid stressful situations, nervous shocks, and also not to allow excessive physical overloads.

You need to selectively treat the use of various beverages and medicines, as many of them can cause heart palpitations. For example, we are talking about energy soda, coffee, strong teas, as well as caffeine-containing medicines.

Nutrition and, in particular, dietary habits are of great importance for heart health: the cardiovascular apparatus "does not like" overeating, restricting fluid intake, lack of plant foods in the diet, as well as excess animal fat. Obesity and atherosclerosis are common causes of heart problems. Therefore, it is necessary to do everything possible to prevent these pathologies.

What you need to do:

• regularly visit the doctor to monitor the work of the heart, ECG, measurement of blood pressure indicators;
• control the functionality of the hormonal system, systematically passing the appropriate tests;
• fully and qualitatively relax, adhere to the daily routine;
• avoid emotional and physical overload.

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Forecast

No medical specialist will be able to give an unambiguous prediction for a person who complains of a heartbeat. One thing can be said: this symptom cannot be left unattended. It is necessary to diagnose, find out the cause of tachycardia and be treated under the supervision of a doctor.

Situational heartbeat usually has a favorable prognosis, as it can be normalized by the use of soothing medications, relaxing procedures, good sleep and rest.

Frequently repeated or even constant heart palpitations are more than a serious reason to seek medical advice. In such a situation, the quality of the forecast depends entirely on how timely the visit to the doctor was and the subsequent treatment.

[13], [14]