Vagal sample - Causes, Symptoms and Treatment .MF .
ability of the heart to decline smoothly throughout a person's life is supported by subtle mechanisms of neuro-humoral regulation.The heart, like any internal organ, braided network of capillaries and nerve fibers originating from the nerves of the autonomic nervous system.It includes the sympathetic and parasympathetic nerves.Sympathetic fibers cause an increase in the frequency and strength of heart contractions, parasympathetic, on the contrary, a decrease in these indicators.Parasympathetic divisions ensured branches of the vagus nerve (nervus vagus, vagus).
Sometimes there is accelerated transfer of electrical impulses within the heart, and then develops tachycardia, palpitations manifested and sometimes blood circulation in the brain with loss of consciousness.There are several types of tachycardia, some can be dangerous and out only medicines, and some do not cause the expressed circulatory disorders and can be stopped vagal techniques.
vagal sample - this technique reflex action on the vagus n
By vagal samples include:
1. carotid sinus massage.Carotid sinus - a division of the common carotid artery to the internal and external carotid arteries.It is the site of the vessel, equipped with the most abundant receptors picks up the slightest fluctuation in the pressure and the gas composition of the blood.
2. Aschner test - pressure on the eyeballs closed
3. reflex dog "diving" (holding your breath and dive face in a basin of cold water) and encasing the face with ice cubes
4. Valsalva maneuver - straining at the height of a deep breath
5.squatting on his haunches with straining
6. induction of vomiting reflex by pressure on the root of the tongue
7. evocation of the cough reflex.
On what basis vagal sample?
These techniques are based on the mechanical stimulation of the nerve fibers of the nerve nuclei in the brain which can transmit signals to the nuclei of the vagus nerve, causing the branches that innervate the heart, they will be activated.For example, the mechanical pressurization in the carotid sinus pressoretseptorami captured signals from them on the branches of the glossopharyngeal nerve carotid enter the brain (nucleus in the medulla oblongata), switch to the nucleus of the vagus nerve.Through the influence of the vagus nerve on the heart is slowing down the heart rate and decrease blood ejection into the aorta.If work on the outside of the sine, which is what happens during a massage, carried out this reflex circuit.Admission Aschner caused eye-cardiac reflex.Mechanical irritation from the branches of the trigeminal nerve and transmitted to the brain, which are activated nucleus of the vagus nerve.Cold exposure on the skin causes bradycardia (slowing of heart rate) due to vagal reflexes with skin due to the activation of the nuclei of the vagus nerve.
Other techniques (coughing, vomiting, straining) are based not only on reflexes, but also to increase the pressure in the chest and abdominal cavities, leading to collapse of large veins, slowing blood flow in them and reduce venous flow to the heart.This reduces the force of contraction and heart rate.
Indications for vagal samples
techniques to activate the vagus nerve is mainly applied in the following situations:
1. Elimination of unpleasant symptoms of a sinus or supraventricular (atrial, atrioventricular), tachycardias independently by the patient or under a doctor's supervision, performing test.
2. Differential diagnosis of the type of tachycardia (together with the registration of the ECG)
3. carotid sinus massage can be used to diagnose carotid sinus syndrome failure occurring in persons over 60 years of age and manifests itself in the form of short-term loss of consciousness or dizziness expressed when turning heads, wearing apparelnarrow collar, tilted her head.It called atherosclerotic lesions of aorta branches, inflammatory or neoplastic processes of the neck.This fainting are not a consequence of neurological disease or organic heart disease.
Contra vagal samples
impossible to carry out tests in order to restore the normal rhythm of their own at heart palpitations, which is accompanied by the following symptoms:
- severe pain in the chest
- shortness of breath, cough with frothy sputum
- severe weakness,
pressure drop -
loss of consciousness - pale or cyanotic skin coloration
- convulsions, sensitivity and movement in the limbs.
These symptoms may be signs of life-threatening arrhythmias and develop complications (heart attack, stroke, pulmonary edema), so any effect on heart activity is dangerous.It should be as soon as possible to call the ambulance.
physician should not conduct tests for suspected following diseases:
- pulmonary embolism
- acute cerebrovascular accident
- acute coronary
syndrome - marked atherosclerosis of the aorta
Procedure vagal samples
vagal receptions are held at home alone or inhospital.Massage of the carotid sinus, especially in the elderly, it is best carried out under the supervision of a physician.The patient is laid on the couch on his back, turn left and head massage the right side of the neck at the angle of the mandible.Simultaneously performed ECG and blood pressure measurement.Pressing the sine circular movements carried out during 5 - 10 minutes, after which the doctor may begin to massage the left, if necessary.At the same time, both sinus massage is unacceptable, since this could lead to the impoverishment of the blood flow in the brain.
Other tests may be carried out at home if a doctor has a patient taught these techniques.For reflections from the skin enough to wash in cold water, wipe the skin with ice or immerse the face in a bowl of ice water for a few seconds, after holding his breath.
own vomit cause necessarily, quite a few times with breaks on a spoon to press the tongue, by analogy with a tour of the tonsils and throat doctor.You can simulate a cough or tighter, as in the act of defecation.
What best helps to cope with a bout of palpitations, each patient defines himself through their experience.The duration of each reception may be from 30 seconds to several minutes, until a subjective improvement may be repeated several times.
Interpretation of results
samples were considered positive if:
- was the elimination of subjective symptoms of tachycardia
- during the tests a doctor or ambulance to the hospital for an ECG is recorded to restore the correct rhythm
differences between different types of tachycardia, registered on the ECG during trial:
- rhythm with sinus tachycardia becomes less during the reflex action, then again accelerated
- with supraventricular tachycardia rhythm or restored, or no change ( "all or nothing»)
- in atrial fibrillation rhythm can significantly slow down
- atventricular tachycardia no effect on heart rate
of course, only the result, restored the right rhythm or not, it is impossible to judge whether a particular form of tachycardia, as a final diagnosis is made on the ECG.
Test with carotid sinus massage is considered positive if the ECG recorded during the absence of heart rate (asystole) for longer than 3 seconds, or reduced blood pressure more than 50 mm Hg.This result may indicate carotid sinus syndrome, but we need further examination (duplex neck vessels, MRI of the head and neck).
therapists Sazykina OJ