Sinus arrhythmia
The content of the article:
- Forms
- Causes
- Signs
- Sinus arrhythmia during pregnancy
- Sinus arrhythmia in children
- Diagnostics
- Sinus arrhythmia treatment
- Prevention
- Consequences and complications
Sinus arrhythmia is a group of cardiac arrhythmias, the development of which is caused by fluctuations in automatic activity in the sinus-atrial node or by obstacles in the conduction of an impulse to myocardial fibers.
Sinus arrhythmia is a commonly observed pathology. In some cases, its appearance is considered as a normal physiological state, and in others - as a symptom of diseases of the cardiovascular and nervous systems, intoxication, violations of water and electrolyte balance.
With sinus arrhythmia, irregular impulses are formed in the sinoatrial node
Forms
Sinus arrhythmia is often seen in young people and trained athletes. Provided that there are no causes of cardiac arrhythmias, sinus arrhythmia in this case is called physiological. Physiological sinus arrhythmia can also be observed in healthy people during sleep and after a large meal.
In childhood and adolescence, respiratory arrhythmia is often observed. With this variant of sinus arrhythmia, a child has an increase in heart rate at the moment of inhalation, and, on the other hand, at the moment of exhalation, a decrease. As they grow older, the manifestations of respiratory arrhythmias in children weaken, and then completely disappear.
In addition to physiological, sinus arrhythmia is also pathological, in this case it occurs as one of the symptoms of certain diseases.
Sinus arrhythmia is common in athletes
There are two types of sinus arrhythmias, depending on the heart rate in one minute:
- tachyarrhythmia (pulse over 80 beats per minute);
- bradyarrhythmia (pulse rate less than 60 beats per minute).
Causes
The formation of a cardiac impulse occurs in a special group of myocardial cells capable of generating an electrical impulse. These cells form a congestion called a sinus node. The resulting impulse propagates in the heart wall along the nerve fibers that form the cardiac conduction system. The fibers of the conduction system branch out and go to each fiber of the myocardium. The sinus node and the conducting system of the heart provide its harmonious and rhythmic contractile activity. The conducting system ensures the correct sequence in the contraction of the parts (atria and ventricles) of the heart. Any disturbances in the process of the formation of a nerve impulse by the cells of the sinus node or its conduction through the fibers of the pathways and leads to the development of sinus arrhythmia.
The reasons that can cause the development of sinus arrhythmia are divided into several groups:
- cardiac or cardiac - ischemic heart disease and myocardial infarction, acute and chronic heart failure, cardiomyopathies, congenital and acquired heart defects, myocarditis of various etiologies;
- non-cardiac - the largest group of causes, including vegetative-vascular dystonia, respiratory diseases (bronchial asthma, pneumonia, bronchitis), anemia, diabetes mellitus, adrenal and thyroid dysfunction, long-term use of certain medications (antiarrhythmics, cardiac glycosides, diuretics);
- water-electrolyte - violations of the concentration in the blood of the main electrolytes (magnesium, sodium and potassium), which are directly involved in the transmission of nerve impulses and contraction of myocardial fibers;
- poisonous, or toxic - including smoking and alcohol abuse.
Alcohol abuse is one of the possible causes of sinus arrhythmia
If, during the examination of the patient, it is not possible to identify the cause that led to the violation of the rhythm of the heart contractions, a diagnosis of idiopathic sinus arrhythmia is made.
Signs
Many patients do not feel the manifestations of sinus arrhythmia, heart rhythm disturbances are detected in them during a medical examination or electrocardiography. In other patients, sinus arrhythmia is accompanied by complaints of a feeling of uneven contractile activity of the heart (“the heart stops and then beats quickly and quickly,” “the heart stops and then starts to beat again”), dizziness, general weakness, feeling short of breath, shortness of breath.
Sinus arrhythmia during pregnancy
Sinus arrhythmia during pregnancy is very common. This is due to the fact that from the first days of fertilization, the body of a pregnant woman is rebuilt for bearing and giving birth to a fetus. A number of changes contribute to the occurrence of sinus arrhythmias:
- decreased resistance to stress and increased neuro-emotional lability;
- violations of water and electrolyte balance, developing against the background of toxicosis in the first half of pregnancy;
- increased activity of the sympathetic nervous system;
- an increase in the volume of circulating blood by 20%, as well as the formation of blood circulation in the uteroplacental circle, which causes an increase in the load on the heart;
- changes in hormonal balance;
- iron deficiency anemia, leading to oxygen starvation of all organs, including the heart muscle.
Sinus arrhythmia during pregnancy is accompanied by dizziness and pounding in the temples
Sinus arrhythmia during pregnancy is accompanied by the following symptoms:
- dizziness;
- a feeling of strong palpitations, perceived as a blow to the left side of the chest;
- knocking at the temples;
- fast fatiguability;
- shortness of breath, developing under the influence of physical exertion.
Severe sinus arrhythmia during pregnancy can lead to a deterioration of the uteroplacental blood circulation, which, in turn, leads to hypoxia and fetal malnutrition.
Sinus arrhythmia in children
Sinus arrhythmia is also not uncommon in children and adolescents. This is largely due to the immaturity of the nervous system. The younger the child, the more often episodes of heart rhythm disturbances are observed. Factors predisposing to the occurrence of sinus arrhythmia in a child are:
- prematurity;
- intracranial hypertension syndrome;
- postnatal encephalopathy;
- rickets;
- increased body weight;
- periods of rapid growth of the child.
As the child grows, his autonomic nervous system matures and the likelihood of sinus arrhythmia decreases.
Sinus arrhythmia in a child can be caused by other reasons:
- hereditary predisposition;
- acute infectious diseases, accompanied by dehydration, fever and severe intoxication;
- violations of water and electrolyte balance;
- cardiopsychoneurosis;
- myocarditis of various etiologies (diphtheria, cytomegalovirus);
- rheumatism;
- congenital and acquired heart defects.
In children, sinus arrhythmia is associated with the immaturity of the nervous system.
In most children, manifestations of sinus arrhythmia, and especially respiratory arrhythmia, are not accompanied by the appearance of any negative signs. But sometimes the child complains of pain in the region of the heart, dizziness, weakness, shortness of breath, rapid heartbeat. In this case, it can be assumed that in addition to sinus arrhythmia, he has some other pathology of the cardiovascular system. Such complaints are a serious reason for consulting a cardiologist.
Diagnostics
Sinus arrhythmia is diagnosed based on the results of an electrocardiographic study. On the electrocardiogram, an irregular rhythm is revealed, i.e., unequal RR intervals. The fluctuation in the duration of these intervals exceeds 0.16 seconds. Another ECG sign of sinus arrhythmia is the presence of a P wave in front of each complex.
Sinus arrhythmia is diagnosed based on ECG results
When confirming sinus arrhythmia, it is necessary to conduct a medical examination of the patient in order to identify the primary disease that caused the heart rhythm disturbance.
Sinus arrhythmia treatment
With sinus tachycardia, patients are recommended to have adequate rest, limitation of physical and mental stress, adherence to a diet (restriction in the diet of sweet and fatty foods, fried foods, fast food, an increase in the content of fresh fruits, vegetables, berries and herbs).
Acupuncture, physiotherapeutic procedures (massage, hydrotherapy, magnetic therapy), psychotherapy sessions to increase stress resistance have a good therapeutic effect in sinus arrhythmia.
Acupuncture has a good therapeutic effect in sinus arrhythmia
Drug treatment of sinus arrhythmia with antiarrhythmic drugs is carried out only in the case of a severe course of the pathology, when the above non-drug methods do not lead to a positive result.
If the disease that caused the development of sinus arrhythmia is known, the main efforts are directed to its treatment.
Prevention
Prevention of the development of sinus arrhythmia includes the following measures:
- rational and balanced nutrition;
- observance of the regime of work and rest;
- refusal to drink and smoke;
- elimination of stressful situations;
- refusal from uncontrolled intake of drugs;
- timely diagnosis and therapy of diseases of the cardiovascular, respiratory and endocrine systems.
Consequences and complications
Sinus arrhythmia itself does not lead to complications. If against its background there is a deterioration in the condition and the appearance of other cardiopathologies, this is associated with the underlying disease, whose symptom is a violation of the heart rhythm by the type of sinus arrhythmia.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
