Clinically, tachycardia can be divided into three types: (1) sinus tachycardia; (2) Paroxysmal supraventricular tachycardia; ⑶ Paroxysmal ventricular tachycardia. All impulses from the sinus node pass through 100 times per minute, which is lower than 140 times, and some of them reach 180 times, but those with regular rhythm are called sinus tachycardia. After physical activity, or emotional, or excessive smoking, drinking, drinking tea, coffee, etc. It may happen to normal people. It often occurs in chronic infectious diseases, tuberculosis, acute rheumatic fever, acute pericarditis, acute myocardial infarction, heart failure, various fevers, hyperthyroidism, anemia, massive blood loss, etc.
Paroxysmal supraventricular tachycardia refers to the early excitement that originates from the upper part of the ventricle (that is, atrium or atrioventricular node) and produces more than three consecutive times. Heart rate per minute 150-220, fast and regular, with the characteristics of sudden attack and sudden stop. In this case, normal people can suddenly attack after overwork, emotional excitement, alcoholism, heavy smoking and full meal, and then suddenly disappear. Pathology is common in coronary heart disease, rheumatic heart disease, hyperthyroidism, myocarditis and other diseases. In this case, the patient will feel flustered, chest tightness, shortness of breath, dizziness and restlessness. The attack time is about a few minutes and hours. If it lasts too long, it will lead to heart failure and shock. If the original coronary heart disease, it may induce angina pectoris or acute myocardial infarction.
For paroxysmal ventricular tachycardia, the heart rate is about 65438 060-250 beats per minute, in which any part of the ventricle has more than three consecutive early excitations. This kind of tachycardia mostly occurs in serious organic heart diseases, such as acute myocardial infarction, acute myocarditis, cardiomyopathy, rheumatic heart disease and so on. Chest pain, shortness of breath, hypotension, pallor, cold sweat, syncope and other phenomena may occur during the attack, and sometimes even cardiac arrest leads to death.
The treatment of these three kinds of tachycardia should also be treated separately. To find the cause of sinus tachycardia and treat it according to the cause.
In view of the occurrence of supraventricular tachycardia, we can prevent it by increasing the ability of vagus nerve. For example: ① ask patients to hold their breath after taking a deep breath, and then exhale forcibly; ② Stimulate the throat with your fingers, causing nausea or vomiting; ③ The patient lies flat and compresses the strongest part of carotid artery with middle finger and forefinger for about 15 seconds. When you relax, you can press the right side first, and then press the left side if you fail. Never press both sides at the same time; ④ Ask the patient to close his eyes, look down, press his thumb on the upper part of the eyeball, and relax for about 15 seconds. Select one of the above methods. If you can't control it, please ask the doctor for medication.
Ventricular tachycardia should be handled actively and cautiously. First of all, we must remove the inducing factors; Lidocaine and procainamide can be used for drug therapy.
Self-test cardiac function
The heart is the core power organ of human blood circulation, and its function plays a vital role in human health, work and life. So, how do you know your heart function? The simplest method is subjective estimation. At present, the four-level grading method of cardiac function is widely used in the world. You can "sit in the right place" according to your own situation and see which level you belong to.
Cardiac function 1 means that cardiac function has complete compensatory ability. There are no symptoms such as shortness of breath, edema and angina pectoris in light activities, which is almost the same as that of normal people. They can work, study and live normally, and even be competent for heavy labor or sports activities.
At this stage, the compensatory ability of the heart has begun to lose. Therefore, during strenuous activities (such as walking fast, going upstairs or lifting heavy objects), shortness of breath, edema or angina pectoris will occur, but it can be relieved after rest. This stage already belongs to mild heart failure.
Level 3 of cardiac function refers to mild activities, such as going to the toilet, cleaning indoor hygiene, bathing, etc. It can also cause symptoms such as shortness of breath. This stage belongs to moderate heart failure and generally requires hospitalization.
Level 4 of cardiac function means that there are still symptoms such as shortness of breath at rest. Can not lie flat on the bed, life can not take care of themselves, often accompanied by edema, malnutrition and other symptoms. This stage is already a serious heart failure, which not only completely loses the labor force, but also is life-threatening. Should be admitted to hospital for emergency treatment.
Because heart function can be improved after drug treatment and rest, but it can deteriorate after fatigue and cold, it is said that heart function is not static. Moreover, some patients have no obvious symptoms in the case of cardiac insufficiency, and subjective estimation is not enough. Therefore, we should go to the hospital to objectively measure the cardiac function through various instruments, make a correct diagnosis and take effective measures. People with heart function 1 can live and work normally like healthy people without taking medicine, and usually pay attention to avoiding colds and overwork. Patients with grade 2 cardiac function should take a certain amount of cardiotonic drugs and have regular outpatient review. Patients with grade 3 or 4 cardiac function should be hospitalized and their activities should be strictly restricted under the guidance of doctors to gradually restore their cardiac function.
Self-help with accelerated heartbeat
Under normal circumstances, the beating of the heart is initiated by the sinoatrial node, the highest "headquarters" of the pacing and conduction system, so it is called sinus rhythm. The heartbeat of a normal adult is 60- 100 beats per minute. If it exceeds 100 times, it is too fast, which is medically called tachycardia.
Sinus tachycardia is very common. As the name implies, this tachycardia is caused by sinus node. At the time of attack, the heart rate of adults is between 100 ~ 150 beats per minute, and that of children can reach 200 beats per minute. It is characterized by gradual occurrence and gradual disappearance. Sinus tachycardia can be seen in normal people, and the common inducing factors are emotional excitement, fatigue, nightmares, drinking, drinking strong tea, drinking coffee and smoking heavily. Generally, no special treatment is needed, as long as the inducing factors are eliminated, they will recover on their own. Sinus tachycardia can also be caused by some diseases, such as fever, anemia, pregnancy, hyperthyroidism, heart failure, shock and autonomic nervous dysfunction. At this time, the treatment should be based on the etiology, and the following drugs can be taken under the guidance of a doctor, such as propranolol, each time 10 mg, three times a day, but asthma, heart failure, hypotension and pregnant women are prohibited; Diazepam, 2.5-5 mg each time, 3 times a day; Acupuncture at Neiguan, Hegu and Shenmen has certain curative effect.
Paroxysmal tachycardia is not caused by sinoatrial node, but by ectopic pacing point (referring to atrium, ventricle and some tissues at the junction of atrium and ventricle). According to the position of ectopic pacing point, paroxysmal tachycardia can be divided into three types: tachycardia caused by atrial ectopic pacing point is called atrial tachycardia; The tachycardia caused by ectopic pacing point in atrioventricular junction is called atrioventricular junction tachycardia; Tachycardia caused by ventricular ectopic pacing point is called ventricular tachycardia. Because atrial tachycardia and atrioventricular junctional tachycardia are often difficult to distinguish clearly on ECG, they are collectively called supraventricular tachycardia.
Paroxysmal supraventricular tachycardia can be seen in normal people, but also in patients with various heart diseases, hyperthyroidism, digitalis poisoning and so on. It is characterized by sudden attack and sudden termination, lasting for several minutes or even hours, accompanied by palpitation, shortness of breath, dizziness, fear, fatigue, precordial compression or suffocation, and even heart failure and syncope. Heart rate 160-250 beats per minute, with regular rhythm. When you have an attack, you should rest immediately to eliminate the patient's worries. The following methods of stimulating vagus nerve can often stop the attack quickly: ① Sudden cough. 2 stuttering or drinking. ③ Try to lean your head back or lean forward. (4) Hold your breath after inhaling deeply, and then exhale forcefully. ⑤ Stimulate the pharynx with tongue depressor or chopsticks, causing nausea and vomiting. In addition, acupuncture at Neiguan, Tongli and Shenmen is also effective. If the above treatment fails, you should seek medical treatment.
Paroxysmal ventricular tachycardia is more common in severe heart disease and drug poisoning. At the time of attack, the heart rate was 150-200 beats/min, and symptoms such as palpitation, shortness of breath, precordial pain, dizziness, pallor and hyperhidrosis often appeared. Most blood pressure drops, and even heart failure, shock or syncope occur. Once it develops into a fatal arrhythmia-ventricular fibrillation, sudden death may occur. Therefore, the patient should rest immediately, take oxygen, take 5 mg diazepam orally, and send it to hospital as soon as possible.
Of course, whether treatment is needed depends on the severity of conscious symptoms. Some people feel uncomfortable every time they have premature beats. They feel like they are rushing, sinking and twisting. Some people get dizzy when their heart rate is a little slower. Some people get flustered when their heart rate is a little faster. For these people, it is certainly good to relieve symptoms with a little medicine. However, many antiarrhythmic drugs have some side effects. Therefore, when deciding whether to take medicine, what medicine to use and how much dose to use, we should comprehensively weigh the interests and consider the gains and losses. First of all, we should consider finding ways to adjust outside the drug. For example, try to keep a regular life, avoid fatigue and emotional excitement, and quit smoking and drinking. To maintain electrolyte balance in vivo and improve myocardial ischemia. Only when the average premature beats are more than 5 times per minute, and the symptoms of consciousness are serious, and there is still no improvement after the above adjustment, it is worth taking medicine. In the treatment, we should also pay attention to the use of small doses of drugs as far as possible, so that premature beats are significantly reduced, and it is not appropriate to use large doses, so that premature beats must disappear completely. Because the risk of toxic and side effects when used in large doses is much greater than premature beats.
For bradyarrhythmia (that is, the heart rate is lower than 40 beats per minute), such as sinus node lesions or various conduction blocks, if it is new or intermittent, it means that it is possible to improve, and you should seek medical treatment as soon as possible. If it is a foregone conclusion that the heart rate is particularly slow and the interval is long, causing obvious symptoms such as dizziness or fainting, a pacemaker should be installed to ensure safety. If the heart rate is above 50 beats per minute and there are no obvious symptoms, you can observe it for a period of time without treatment for the time being.
It can be seen that whether patients with arrhythmia need treatment should be comprehensively analyzed and treated differently by doctors. Patients should not make their own decisions and buy medicines at will.
So how can we enhance heart function? The expert's advice is:
First, take part in physical exercise as much as you can. The survey shows that people who don't like sports at ordinary times will have early heart failure 10- 15 years, and the incidence of coronary heart disease is high 1-3.5 times. A well-trained athlete's heart beats slowly and forcefully. However, the amount of exercise should not be too large, and it is generally appropriate to be 50% faster than usual.
Second, avoid getting emotional. Excessive emotions, such as rage, joy, sadness, etc. , it will cause vasoconstriction, high blood pressure and rapid heartbeat, thus increasing the burden on the heart. Therefore, we should be calm, learn to be tolerant and treat everything calmly.
Third, control diet. Obesity can lead to hypertension and arteriosclerosis, overeating can induce angina pectoris and myocardial infarction, and some patients with sudden death often have a full dinner. Therefore, we should pay attention to a moderate diet, advocate eating seven or eight points full, and at the same time eat less animal fat and eat more fresh fruits and vegetables.
Fourth, the diet should be light. Too much salt will raise blood pressure, increase blood viscosity and increase the burden on the heart. Therefore, the daily salt intake of normal adults should be 6-8 grams, while that of people with cardiac insufficiency should not exceed 3-5 grams.
Fifth, increase the intake of magnesium. Magnesium can prevent the synthesis of cholesterol, inhibit the excitability of nerves, maintain the normal contraction and relaxation function of myocardial fibers and the elasticity of coronary arteries. Magnesium deficiency in human body will lead to tachycardia, arrhythmia and obvious myocardial necrosis and calcification, so magnesium has the reputation of "heart protector"
Sixth, eat meat properly. Eat red meat (such as pork, beef, mutton, etc. ) no more than 2 to 3 times a week, and eat animal internal organs (liver, heart, etc.). ) Not more than once. In addition, it is best to eat seafood twice a week, because seafood is not only rich in calcium and potassium, which can lower blood pressure, but also contains substances that greatly reduce the risk of thrombosis.
Seven, the law of life, avoid fatigue. Overworked human body is not only harmful to health, but also increases the burden on the heart.