Sinus arrhythmia - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Diseases Of The Heart And Blood Vessels

frequent question: "What is sinus arrhythmia?".Indeed, this conclusion can be found quite often.Consider whether this conclusion is diagnosed and when to take action?

Sinus arrhythmia - a violation of the rhythm of the generation of electrical impulses in the sinoatrial node, the main pacemaker, located in the right atrium.

on ECG sinus arrhythmia manifested as unequal intervals between heartbeats.

Sinus arrhythmia - the norm or pathology?

In conjunction with the breathing process distinguish respiratory sinus arrhythmia and fibrillation not associated with breathing.Increased (no more than twice the original level) or slowing of the heart, related to the functioning of the respiratory system or physical activity, food intake and sleep - this is a normal process that observed in healthy people, frequently young.Admission Valsalva eliminates arrhythmia episode.

Reception Valsalva - a patient's actions, which are aimed at creating a high pressure in the middle ear cavity, the chest and abdominal ca

vities.It produced a deep breath, followed by a deep breath, and straining to breath-hold for 15 - 20 seconds.

However pronounced pathological uneven heart rate may indicate a variety of diseases of the cardiovascular system.

Causes of sinus arrhythmia

1) Cardiac (linked to heart):

- ischemic heart disease (poor blood supply and oxygen starvation of the heart muscle, causing heart pain),
- hypertension,
- rheumatic diseaseheart,
- cardio (replacement portions of muscle tissue in the heart to the scar),
- heart failure (the heart can not cope with a full-fledged pumping of blood through the body),
- endocarditis and myocarditis (inflammation of the heart for various reasons),
- cardiomyopathy (heterogeneous group of diseases characterized by structural changes in the heart muscle),
- in children it can be congenital and acquired defects, as well as space-occupying lesions affecting the conducting system of the heart.

2) noncardia:

- neurogenic (various disorders of the nervous system, including vascular dystonia and neurosis),
- hypoxic (oxygen starvation as a result of exacerbation of asthma and other diseases of respiratory system, chronic anemia),
- endocrine (disorders of the thyroid and adrenal glands, diabetes, obesity, menopausal syndrome),
- diseases of the digestive system (gastritis, liver disease, etc.),
- drugs (uncontrolled intake of diuretics, cardiac glycosides, antiarrhythmics).Because uncontrolled receiving diuretics may develop electrolyte imbalance (potassium, sodium, magnesium and calcium).
- toxic (smoking, alcohol, narcotic drugs),
- infections (brucellosis, typhoid) very rarely,
- mechanical (chest trauma, damage of electric shock),
- diseases of the spine.

3) Idiopathic arrhythmias I occurs without objective reasons, often traceable heredity.

sinus arrhythmia is also divided into tachyarrhythmias (rapid heart rate of 100 beats per minute or more), and bradyarrhythmia (slowing of heart rate less than 55).

Symptoms of sinus arrhythmia

- episodes of weakness, dizziness, blackout,
- fainting,
- the feeling of lack of air,
- headaches,
- feeling palpitations (especially should pay attention to this complaint in children, as innormally children palpitations do not feel) and a sense of pulsation in the temples,
- a sense of disruption in heart operation (when expressed sinus arrhythmia), described as "a sinking of the heart", "feeling that the heart is beating, beating, then stopped and ran faster," "failures in a heartbeat »,
- discomfort in the heart at the time of interruption or palpitations.

In infants may experience the following symptoms of sinus arrhythmia:

- irritability, or, conversely, sluggishness,
- shortness of breath at rest,
- the appearance of cyanosis (mainly in the nasolabial triangle),
- pale skin,
- loss of appetite,
- frequent regurgitation,
- insufficient weight gain,
- excessive sweating.

diagnosis of sinus arrhythmia:

- examination of a specialist (internist or cardiologist) with the collection of complaints and anamnesis, general inspection (body type, body weight, pale skin), probing pulse (counts not only the pulse of the radial artery,but the pulsation of the cervical arteries and veins, and the presence of pulsations in the cardiac apex and epigastric), heart percussion (tapping with a view to determining the boundaries of the heart), auscultation of heart sounds and noises.
- Complete blood count (especially we are interested in the level of hemoglobin) and urine.
- Biochemical analysis of blood (total protein, total bilirubin and direct, ALT, AST, glucose, creatinine, urea, cholesterol and fractions).
- thyroid hormones and the adrenal glands.
- Electrocardiography (ECG) from the stress test (exercise stress, after which repeat ECG).
- ECG monitoring (device worn on the day, and you kept a diary of their load during the day and perform a given load: climbing stairs, etc.).
- echocardiography (ultrasound of the heart) to detect possible arrhythmias organic nature (lots Cardiosclerosis, heart diseases and others.).

Then, if necessary, further diagnosis (search noncardia causes of arrhythmia) can be assigned

- radiography,
- X-ray of the spine,
- ultrasound of the thyroid gland and the adrenal glands,
- ultrasound of the liver, gallbladder, pancreas and kidney,
- EGD,
- MRI of the brain,
- sex hormones,
- advice endocrinologist,
- gynecologist consultation (gynecologist-endocrinologist),
- consultation of the neurologist, psychotherapist.

Treatment of sinus arrhythmia

establish that in your case, sinus arrhythmia is not dangerous and does not require treatment, can only specialist doctor after a series of diagnostic procedures.

The treatment does not require a sinus arrhythmia, which is:

- has no effect on systemic hemodynamics (expressed no blood pressure changes, fainting, children not accompanied by cyanosis or pale skin, dizziness) and only appears on auscultation and ECG;
- the ECG revealed a moderate irregular sinus arrhythmia or heart rate did not significantly deviate from the norm;
- sinus arrhythmia is caused by external factors (required to cancel the established factor).


treatment - General recommendations (respect for work and relaxation, restful sleep, reasonable exercise, the best walking, swimming).

- Rational food restriction greasy and excessively spicy food, the inclusion in the diet of seasonal fruits and vegetables, a diet rich in potassium and B vitamins (meat, nuts, herbs, dairy products, tomato paste, dried apricots, avocados, figs, potatoes, apples, mushrooms, bananas), abstinence from alcohol, smoking and substance use.Do not eat large amounts of food at night as crowded stomach increases the risk of arrhythmia.

- Treatment of the underlying cardiac disease (correction of the blood pressure numbers, treatment of coronary heart disease and heart failure, etc.).Treatment of the underlying disease with noncardiac cause.

- Breathing exercises (applies regardless of the age of the patient).

- Reflex treatment methods , aimed at slowing the rate of heart contractions.One is based on the voltage of the eyeballs: they should slightly press and hold for a few minutes.Another method is to massage the side surfaces of the neck.

- Acupuncture and physiotherapy (treatment of heat, magnetic field, are excluded types of physiotherapy with the use of electric current).

- Multivitamins .

- Sedatives (used as herbal medicines (Persia 2 tablets 2-3 times per day to 1 month, motherwort forte 1-2 pills 2 times a day to 1-2 months, novopassit 1 tablet or50 ml 3 times per day to 1 month), and tranquilizers).

- Nootropy (glycine 1 tablet 2-3 times a day for 14-30 days, Pantogamum 250 mg 1-2 tablets 3 times a day 1-3 months, sometimes the course is extended to 6 months, according cavinton1-2 tablet 3 times a day 1-3 months), to reduce the manifestations of neurosis and the improvement of blood microcirculation.

- Metabolic preparations (trimetazidine 35 mg 2 times a day, 2 months, Omacor 1000 mg 1 time per day unlimited rate) that improve metabolism in the heart muscle and thus indirectly reduce the incidence of arrhythmia.

- Complexes minerals containing potassium and magnesium (or Pananginum asparkam 1-2 tablets 3 times a day, the duration of the course is determined by a physician, regular reception is possible).

- In severe sinus arrhythmia appointed antiarrhythmics (aymalin, etmozin), calcium channel blockers (verapamil), beta blockers (metoprolol, bisoprolol, propranolol) during tachyarrhythmia, atropine and atropine drugs in bradyarrhythmias.

- When sinus bradyarrhythmias with a heart rate less than 45 per minute (professional athletes a lower limit of at least 35 gifts per minute) should consider the installation of a pacemaker.The particular model is made based on the clinical picture and the type of sinus arrhythmia.

Prevention sinus arrhythmia

- a healthy lifestyle,
- control of stress, relaxation of the possession of skills,
- normalized physical activity,
- maintaining a normal weight,
- timely diagnosis (medical examination) and the treatment of the identified disease.

Weather Forecast favorable in most cases.Sinus arrhythmia in children and adolescents are often on their own after the establishment of the hormonal system (the girls after the formation of a regular menstrual cycle).Sinus arrhythmia, causing no subjective complaints do not threaten life.In the case of pronounced sinus arrhythmia (as bradi- and tahiformy) prognosis depends on the correct prescribed treatment and patient adherence.Take

whether the army with such a diagnosis?

Sinus arrhythmia is common in young men of pre-conscription age.This raises the question of their suitability for military service.

Sinus arrhythmia without severe underlying disease does not hinder the passage of military service, admission to military schools and colleges.

on military service do not call boys if sinus arrhythmia is a manifestation of the following diseases:

- rheumatic heart disease with moderate to severe circulatory failure,
- cardio,
- heart disease,
- after surgical intervention conducted onheart,
- severe dysfunction of the left heart,
- paroxysmal rhythm disturbance (tachy-and bradycardia, prolonged failure rate),
- sinus.

However, in each case, the question is decided individually on the basis of detailed survey data of instrumental and laboratory research.It is not excluded hospitalization to monitor and follow the expert opinion of the cardiologist.

doctor therapist Petrov AV