suddenly beginning and suddenly ending the attack, the characteristic of which is the increased heart rate. This preserves the correctness of the rhythm of the heart, provided the pathological circulation of the impulse on the myocardium. Depending on where the source of pathological rhythm and how it is spread excitation, the heart rate at the time of the attack in adults is in the range of 160240 beats per minute, and in children this figure can reach up to 300 beats per minute. Attack of paroxysmal tachycardia lasting from several minutes to several hours, rarely it takes longer.
When the diagnosis is shared by two main clinical forms paroxysmal tachycardia
- ventricular (ventricular)
- supraventricular (supraventricular).
Paroxysmal supraventricular tachycardia the most common form of the disease, which is easy to diagnosis in cases when the rhythm of the heart is frequent, but correct, no changes and the form of the ventricular complexes. Prong R is imposed on the elements of the ventricular complex and is difficult.
Paroxysmal ventricular tachycardia, this form of tachycardia in 90 % associated with various diseases of the heart and is considered a more serious complication. Considered the most dangerous form, as it has the ability to turn into ventricular fibrillation. In such cases, is reduced not the whole muscle of the ventricles, but only some part of the heart is not doing its job and there is poor circulation, shock, and possible pulmonary edema.
Paroxysmal nodal tachycardia benign form of tachycardia, which is characterized by heart palpitations, but can cause psychological discomfort. When such an arrhythmia, the pulse goes in a circle inside of atrio-ventricular connection. Some patients can stop slight attacks of tachycardia by delaying respiration and natureline.
Paroxysmal tachycardia has the following causes of coronary atherosclerosis, coronary artery disease, myocardiosclerosis, as a result of chronic and acute myocarditis. Also, the reason illness is a congenital anomaly, the presence of additional nerve bundle directly in the myocardium bundle of Kent, which passes from the sinus node to the ventricles of the heart that causes rapid contraction of the ventricles of the heart. Provoke the development of the disease is very frequent nervous stress, hypertension, thyrotoxicosis, alcohol consumption and Smoking.
Paroxysmal supraventricular tachycardia has the following symptoms rapid heart rate, increased body temperature, profuse urination after attack, increased intestinal peristalsis, sweating. If the attack is long, possible fainting, weakness and unpleasant pressing sensation in region of heart muscle.
Paroxysmal tachycardia in children is rare and can be caused by heart disease or increased excitability, which almost always has a nervous origin. Symptoms of paroxysmal tachycardia in children are similar to symptoms in adults. During the attack the child feels pain in the region of the heart, anxiety, stomach cramps, complaining of nausea and fatigue. Consciousness when the attack is clear.
Supraventricular paroxysmal tachycardia is manifested by a sudden dizziness, frequent palpitation, distension of neck veins, pallor of the skin, with blood pressure normal or increased within acceptable limits, then tends to decrease.
To diagnose the diseases by using an EKG, a special performance has Holter method in which heart rate can be monitored at rest and during exercise during the day. Additionally, conduct a scan, radionuclide study, and computed tomography.
When the disease paroxysmal tachycardia, treatment requires the use of sedative substances, complete limitation of physical activity, creating a rest for the patient. When supraventricular tachycardia from the first minute it is necessary to vagus nerve stimulation, induction of vomiting spasms, pressure on eyeballs and abdominal muscles. Receiving 40 mg of propranolol, to be taken at the beginning of the attack, stop it through the introduction of 1020 min BB isoptin (24 ml of a 0,25 solution), procainamide (5 ml of a 10 solution) more efficiently. When pronounced hypotension previously administered intramuscularly mezaton. If there is heart disease, the stabilizing effect may have a strophanthin (if not overdose glycosides). If treatment with drugs is ineffective and has increased cardiovascular failure, requires the use of electric pulse treatment in stationary conditions. If the attacks are frequent, prophylaxis taking propranolol with delagil, digoxin, procainamide, diphenylhydantoin.
When the diagnosis of the disease paroxysmal tachycardia, treatment is necessary stationary. In cases where tachycardia is associated with glycoside intoxication, it is necessary to introduce intravenous preparations of potassium (Panangin 1080 ml), also use phenytoin (0.1 g 3 rd). Especially effective VV the introduction of lidocaine, procainamide. In some cases, effective quinidine ( 0.2 g through 212 h to 1.4 g per day). If the patient’s condition is severe, you need immediate behavior of the EIT (not applicable in case of overdose of cardiac glycosides!) Prevention of attacks is the use of procainamide, propranolol, potassium supplements (can be combined medicines), diphenylhydantoin. If the seizures are rare (12 times per month) treatment is usually prescribed for one month. If the seizures are frequent, the treatment will be lengthy.