Bradycardia: symptoms, degrees, effects

The lower limit of the normal heart rate varies within fairly wide limits for different age groups of patients. For adults of working age, this is considered to be 60 beats per minute. However, if it is found that a person's heart beats less often (bradycardia), then this does not necessarily mean pathology. Slightly slowed down frequency with which the heart muscle is reduced can be a normal variant in adolescents or in people who are constantly and seriously involved in sports. For example, in people who have stepped over half a century, the heart beats at a speed of 65 beats per minute and faster, therefore the slowed heartbeat in the elderly is recorded with a more frequent pulse. The heart muscle is reduced even faster in children, especially small ones.[1]

In this article, we will look at the symptoms and types of bradycardia and try to figure out in which cases and why the slow work of the heart can be dangerous. Nevertheless, in most patients the reduction in the frequency of cardiac emissions occurs for pathological reasons causing a violation of cardiac conduction or an automatism of the sinus node, its weakness.

Patients rarely pay attention to the first signs of bradycardia. In the initial stages, it is almost not clinically manifested. Rare vertigo and slightly increased fatigue are attributed to fatigue, changing weather, pressure fluctuations. A slight slowdown in heart rate is usually an accidental finding when undergoing electrocardiography for a completely different reason.

Severe symptoms - weakness, frequent dizziness, constant fatigue, shortness of breath, fainting, episodes of confused consciousness, speech and visual disturbances, fainting correspond to a significant decrease in cardiac emissions (less than forty per minute). They appear due to the oxygen starvation of cerebral structures, and this condition requires treatment.

Psihosomatika

Researchers of the mental causes of the emergence of various diseases rather amicably note: heart problems occur in people who forget about themselves, not enough of themselves who love and give all their strength to serve other people, help them and solve other people's problems. This position in life leads to the development of arrhythmia. A man, forgetting about himself, begins to live in an alien rhythm, adjusting to the needs of others. Tachycardia or bradycardia speaks about the urgent need to change the attitude towards oneself - to restore contact with one's heart, the need to learn to love and respect yourself.[2]

OG Torsunov explains the decrease in contractile activity of the myocardium, the occurrence of cardiac conduction disturbances by passivity and pessimistic moods. Mistrustfulness, mental stress associated with it leads to weakness of the sinus node. At the same time, sentimental, unreasonable gullibility also leads to abnormal cardiac conduction due to the increased vulnerability of the nervous tissue of the cardiac muscle.

The blockade of the bundle of the His branch, which leads to a heart rhythm disturbance, often occurs in people who are constantly working in a hard rhythm - managers, businessmen.

In a slow rhythm of heartbeats, unwillingness to grow up, grow old, grow up, try to slow down time to delay the maturing of children, the death of a close seriously ill person.

Symptoms

The appearance of negative symptoms with a reduced pulse rate suggests that it is caused by pathological causes. These can be heart diseases - inflammation or dystrophic changes in the myocardium, atherosclerosis of the coronary arteries, hypertrophic cardiomyopathy, myocardial infarction and its consequences in the form of cicatricial changes. Anyone will think about the presence of cardiac pathologies in the first place, feeling the pain in the heart in bradycardia. However, discomfort in the chest, taken for heart disease, may have a completely different origin. Hormone disorders associated with thyroid dysfunction, adrenal dysfunction, can cause endocrine bradycardia and cardiac discomfort. Neurotic origin have pains in the heart in vegetative-vascular dystonia, neuroses with impaired vegetative functions. Epigastric pain may radiate to the sternum due to spasmodic contractions of the stomach walls. They can occur with peptic ulcer disease, which also leads to a slower heart rhythm. About the gastric origin of such pain can suggest the presence of nausea, heartburn, belching. Thus, renal, hepatic, intestinal colic, esophageal-diaphragmatic hernia can occur.

Weakness in bradycardia is a completely natural symptom. With a decrease in the number of heartbeats, the “main motor” of our body does not pull. A weakness appears, the severity of which corresponds to the degree of slowness of the pulse. Severe weakness requires taking emergency measures and may indicate a pre-invasive or pre-stroke condition.

Dizziness in bradycardia may be a symptom of instability in blood pressure, oxygen starvation of brain tissue. As a result of a prolonged decrease in the volume of blood pumped per minute, all organs and tissues suffer from hypoxia, but first of all it affects the work of the brain.

This symptom may be aggravated over time with periodic fainting and convulsive states. Cerebral hypoxia leads to the development of cerebral insufficiency, which is manifested in attention disorders, forgetfulness, episodic visual, speech and intellectual disorders.

Headache in combination with a rare pulse can be symptoms of a pre-stroke condition, subarachnoid hemorrhage, neoplasms of cerebral localization, and may be due to unstable blood pressure or neurocirculatory disorders.

In patients with bradycardia, breathing disorders are often observed: shortness of breath, a violation of the respiratory rhythm. Such symptoms may accompany any cardiac pathology, and also indicate the presence of primary pulmonary hypertension. Patients complain of coughing with bradycardia, feeling of respiratory failure. The most characteristic symptoms of pulmonary hypertension are progressive dyspnea and fatigue, in the initial stages such conditions occur under the influence of physical exertion. These disorders are associated with right ventricular heart failure and are caused by a decrease in cardiac output. The development of pathological changes is expressed in discomfort in the chest, dizziness, reaching the pre-fainting paroxysms.[3]

Features of bradycardia in different categories of the population

Slow cardiac activity is found in most cases in adult patients. This is just a symptom that may indicate a variety of diseases, both directly of the cardiovascular system and other organs.

Bradycardia in adults may be physiological and pathological. In young people who have a tendency to slow heart work, bradycardia is often associated with respiratory arrhythmias, due to physiological reasons - instability of the tone of the sympathetic part of the autonomic nervous system, its inadequate activity. With age, activity often stabilizes, and with it, heart rate. Among the risk factors for the onset of symptoms such as bradycardia, acquired causes, cardiac and extracardiac, begin to predominate, leading to abnormal sinus node automatism or conduction disturbances.

Bradycardia in women of fertile age is often associated with hypothyroidism, intoxication, vascular dystonia, and stress. Heart diseases in women generally develop later than in men. They are protected by estrogen. An increased risk of developing cardiovascular pathologies is associated with the use of hormonal contraceptives. Smoking and alcohol on the cardiovascular system of the female body also has a disastrous effect. Pathological pregnancy - late toxicosis, accompanied by hypertension can cause a heart rhythm disorder in the expectant mother, and even in a remote consequence, 10 years after birth.

Bradycardia during pregnancy is manifested by the same symptoms as outside of it. Moderate can not worry much, but if a woman constantly has tinnitus, dizziness, and lack of air, then the attention of the doctor leading the pregnancy should be brought to this attention. Fatigue and weakness should also not be ignored. Some women do not attach importance to such symptoms, considering that it is natural during pregnancy. However, if they are associated with bradycardia, insufficient cardiac emissions lead to impaired blood circulation, placental insufficiency, fetal hypoxia, and premature termination of pregnancy.[4]

Bradycardia after childbirth also requires examination. She, of course, can pass with time, since childbirth - stress for the body and light bradycardia can be physiological, especially if a woman gained excess weight during pregnancy, was not very active, chronically underfed, overworked, endured and gave birth to twins or triplets However, pregnancy complications, in particular, the already mentioned preeclampsia, unstable blood pressure, genetic predisposition to heart disease, recent cold and other causes can be activated in the postpartum period, and bradycardia after birth will be the first symptom of a developing pathology.

Pathological bradycardia in men of working age is often associated with myocardial infarction and post-infarction complications, hypertension. The likelihood of developing a heart attack in men, on average, begins to increase ten years earlier than in women. Various intoxications, endogenous and exogenous, peptic ulcer are more characteristic of men. But men are not accustomed to complaining of dizziness, tinnitus and pre-unconsciousness. Therefore, they can start the pathological process.

Physiological bradycardia in athletes and men engaged in heavy physical labor is not uncommon. Among the male population, a low pulse at rest is observed in approximately one fourth of its representatives. Sinus bradycardia at rest with good health indicates a well-trained heart. Still, pathology in this part of the population cannot be excluded without a survey.

With age, the prevalence of cardiac arrhythmias increases in proportion to the growth of cardiovascular pathologies, past diseases and intoxications, taken medications. Bradycardia in the elderly is not uncommon. Women with the onset of menopause are often forced to take estrogen-containing drugs to reduce the symptoms of menopause - hot flashes, anxiety, insomnia, the risk of osteoporosis. Hormone replacement therapy, especially long and intensive, increases the likelihood of developing heart disease and reducing heart rate. American cardiologist H. Glassberg does not advise to get involved in HRT, especially for women with a heart condition. She believes that it is better to fight age-related manifestations with diet and special exercises.

Senile bradycardia in individuals of both sexes can be physiological and can be observed after sleep, stress, and physical overstrain, but more often it is a symptom of ill-being. Elderly people with arrhythmia are recommended to be regularly examined: visit a cardiologist, do a cardiogram, monitor pressure indicators. Persistent weakness, dizziness, loss of coordination, vision, paresthesia, pallor, and discomfort in the chest can be symptoms of a cardiac pathology.[5]

Bradycardia in children may be a variant of the age norm, and may be pathological. In the first case, it is usually not clinically manifested. In the second, in babies most often caused by congenital anomalies of the heart or cerebral disorders, past infectious diseases, intoxications and other causes. Prone to violations of the rhythm of the heart babies, born out of a difficult birth, undergoing hypoxia. The noticeable symptoms of bradycardia in a child (fatigue, shortness of breath, poor appetite and, especially, fainting) indicate the presence of pathology and require compulsory examination.[6]

Stages

The complex of symptoms, corresponding to slowing of the pulse and, accordingly, the minute volume of blood circulation, can be expressed in varying degrees. Easy bradycardia does not manifest itself, is detected by chance, its correction usually does not present difficulties. It is also called grade 1 bradycardia and is diagnosed with heart rate indicators that differ from the lower limit of the age norm by no more than ten beats per minute. Slightly slow pulse practically does not affect hemodynamics, however, if such work of the heart is caused by pathological reasons, then the process of slowing down can progress. Therefore, accidentally identified bradycardia, even with well-being, requires differentiation of the onset of painful changes in the body from physiological characteristics associated with a constitutional hereditary type or good physical training.

Moderate bradycardia may also not affect blood circulation, therefore, in most cases it does not have noticeable symptoms and is also an accidental find. Grade 2 bradycardia is diagnosed when the pulse rate differs from the lower limit of the age norm by no more than 20 beats per minute. People with a moderate slowdown in their heart rate may notice that they are tired of physical exertion, they have shortness of breath and dizziness, however, usually these symptoms do not cause much anxiety. Sometimes they note unclear discomfort in the retrosternal zone. However, if second-degree bradycardia is found, it is necessary to be examined and find out its cause.

Severe bradycardia is manifested by noticeable symptoms - severe weakness, dizziness, shortness of breath, pre- and fainting states. All organs and tissues suffer from insufficient blood supply, but, in the first place, brain activity is disturbed. The patient may begin problems with memory and attention, with vision, there is an episodic confusion. Grade 3 bradycardia is diagnosed in patients with a heart rate of less than 40 beats per minute. Severe bradycardia is manifested by bouts of unconsciousness with convulsions (Morgagni-Adams-Stokes syndrome). The attack lasts from a few seconds to a few minutes and often goes away on its own. When the work of the heart is restored, consciousness quickly returns to the victim and, in most cases, the seizure is amnestied. In young patients without pathologies of cerebral and coronary arteries, an attack can proceed without loss of consciousness - severe weakness and lethargy occur. In patients with atherosclerosis, it develops rapidly and lasts more than one minute, such an attack can be fatal.[7]

Depending on the provoking factor, there is an acute and chronic form of slowing of the heartbeat. Sharp bradycardia occurs in vascular accidents (heart attack, stroke), acute poisoning, inflammation and infections. Chronic develops with severe long-term diseases.

Complications and consequences

Physiological bradycardia is not dangerous. But only until the symptoms appear: weakness, shortness of breath, fainting and others. A healthy person today may get sick tomorrow, and his physiological peculiarity may turn into pathology.[8]

What is dangerous bradycardia? The long-term slow heart rhythm of pathological origin can be complicated by angina, atrial fibrillation, arterial hypertension, chronic hemodynamic disturbances. This affects the work of all body systems.

Complications of severe bradycardia include the development of such ambiguous in the prognostic sense states as acute myocardial infarction or acute cerebrovascular accident, ventricular extrasystole. [9]

An attack of bradycardia, accompanied by a significant decrease in the pulse, is fraught with the development of Morgagni-Adams-Stokes syndrome, asystole and sudden cardiac death. [10]

You should not underestimate the slow heart rate, although the prognosis in this case completely depends on the nature and severity of the underlying disease and the degree of slowing of the heart activity.