Paroxysmal Tachycardia - What To Do? First Symptoms, Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Paroxysmal tachycardia

Paroxysmal tachycardia is a disorder that is accompanied by an increase in heart rate from 140 to 250 beats per minute. The patient develops three consecutive narrow QRS complexes (less than 100 msec) from the upper sections of the myocardial conduction system. Paroxysmal tachycardia develops due to the fact that the automatism of the cells of the cardiac conduction system increases. The ectopic centers of the II and III order are referred to the conducting systems of the heart. The wave of excitation makes a repeated circle and entry, that is, arrhythmia develops according to the re-entry mechanism, in which there is no diastolic interval between repeated multiple excitation of tissues.

Paroxysmal tachycardia requires emergency medical attention. It is important to focus efforts on stopping the attack of inflammation. After that, the patient will have to receive treatment throughout his life. If the patient is not provided with medical assistance on time, he will die, or become disabled with severe injuries. Therefore, everyone should know the main symptoms of paroxysmal tachycardia and seek medical help in time.

Content:

• Causes of paroxysmal tachycardia
• Symptoms of paroxysmal tachycardia
• First aid for an attack of paroxysmal tachycardia
• Treatment of paroxysmal tachycardia
• General recommendations

Causes of paroxysmal tachycardia

Paroxysmal tachycardia can develop in both young people and elderly patients. In old age, the disorder is diagnosed more often. The main reason for the development of pathology is organic changes in the heart muscle, while in young people the disease is functional in nature.

Supraventricular paroxysmal tachycardia is most often caused by an increase in the activity of the sympathetic nervous system, and structural changes are not found in the heart itself.

Paroxysmal ventricular tachycardia is a consequence of organic lesions of the heart.

The following factors can provoke the disease:

• Postponed emotional shock. With excitement, a significant amount of adrenaline and norepinephrine is released into the blood. These hormones contribute to the fact that the heart begins to contract more strongly, the sensitivity of its conduction system increases. This is a prerequisite for the development of an attack.
• Hypothermia of the body.
• Binge eating.
• Excessive physical activity.
• Walking briskly.

Often, stress becomes the main cause of the development of paroxysmal tachycardia in shell-shocked or wounded people suffering from vegetative-vascular dystonia. It was found that 30% of patients with VSD have paroxysmal seizures. Moreover, they are functional in nature.

If the heart does not have any damage that could cause paroxysmal tachycardia, but an attack still happens, then its causes are reduced to damage to other organs: the stomach, intestines, biliary tract, kidneys, diaphragm. In this case, the tachycardia will be of a reflex nature.

More often than other patients, paroxysmal tachycardia is diagnosed in men with inflammation of the heart muscle, or with a previous myocardial infarction.

Diseases that increase the likelihood of developing an attack:

• Coronary heart disease.
• Myocardial infarction. Paroxysmal tachycardia develops in every 5 patients.
• Inflammation of the heart.
• Heart disease.
• Myocardial dystrophy.

Less commonly, pathologies that can cause tachycardia include: thyrotoxicosis, allergies, heart surgery, cardiac catheter placement.

It is important to take into account that some drugs can cause paroxysmal tachycardia. In this regard, it is dangerous to take cardiac glycosides, antiarrhythmic drugs (Novocainamide). These drugs are often prescribed for patients with heart disease. Therefore, the dose should be calculated by the doctor on an individual basis.

In children and adolescents, idiopathic paroxysmal tachycardia is sometimes diagnosed. It is not possible to establish its cause. Experts associate such attacks with the influence of the emotional component and increased sympathoadrenal activity in these age periods.

Symptoms of paroxysmal tachycardia

Paroxysmal tachycardia is manifested by symptoms such as:

• A sharp increase in heartbeat. Its pace builds up very quickly, reaches 140 beats per minute, and then suddenly ends.
• Dyspnea.
• Pain in the region of the heart.
• Dizziness.
• Increased weakness. Sometimes the patient may faint.
• A person's speech may deteriorate; on one side of the body, the muscles cease to function normally (hemiparesis). These neurological disorders occur infrequently in paroxysmal tachycardia.
• After stopping an attack of tachycardia, the patient excretes a large amount of clear urine.

An attack of paroxysmal tachycardia develops suddenly and also ends unexpectedly for a person. Its duration varies widely, ranging from a few seconds to a few days.

Symptoms of a complication of the disease

If the attack is delayed, then patients often lose consciousness, their blood pressure is greatly reduced. It is very dangerous if the heart rate exceeds 180 beats per minute. Such an attack is associated with the risk of developing atrial fibrillation.

A person may experience pulmonary edema, cardiogenic shock, angina pectoris, and even myocardial infarction.

People with paroxysmal tachycardia who have other heart conditions require immediate medical attention. In this case, a heart attack always has a complicated course, therefore it can lead to an instant death.

First aid for an attack of paroxysmal tachycardia

There are vagal techniques, which consist of certain manipulations to help cope with an attack of tachycardia.

These include:

• Valsalva test. In this case, a person needs to close his mouth and nose with his palms, limiting the access of air. In parallel, you need to try to make a sharp exhalation. Straining with a breath holding should last about half a minute. Sometimes deep breathing helps to cope with the problem.
• Ashner test. The person will need to press on the eyes with their fingertips. This pressure is performed for 5 seconds.
• You can narrow blood vessels and reduce your heart rate by immersing your face in cold water.
• You can try to induce vomiting. For this, pressure is exerted on the root of the tongue.
• You can squat down.
• Goering-Chermak test. It involves putting pressure on the carotid artery.

All of these methods can alleviate a person's condition, but they cannot replace qualified medical care. Even if the attack was stopped, a medical team call is required, since paroxysmal tachycardia may recur after a few hours.

Treatment of paroxysmal tachycardia

Therapy for paroxysmal tachycardia involves taking medications from different groups.

Antiarrhythmic drugs

• ATP (Sodium Adenosine Triphosphate). ATP allows you to relieve tension from smooth muscles, stabilize the conduction of nerve impulses in vegetative nodes, and normalize signal transmission from the vagus nerve to the myocardium. In parallel, suppression of the Purkinje fibers and the sinus atrial node occurs. It is forbidden to use this drug for people with acute myocardial infarction.
• Novocainamide (150 rubles). Novocainamide is in the form of a solution, it is used for intramuscular injections, or infused intravenously. The method of using the drug is determined by the doctor, which depends on the severity of the course of the attack. The dose for intramuscular administration is calculated based on the patient's body weight. For each kilogram of weight, take 50 mg of solution. For intravenous administration, the drug is used in a dosage of 100 mg. If a decision is made to put a dropper, then the patient should receive 500 mg of the drug. The doctor calculates the daily dose for each patient individually.
• Isoptin (500 rubles). To cope with acute paroxysmal tachycardia, the patient is prescribed 240-360 mg of the drug. When the attack can be stopped, the patient is transferred to oral administration of the drug. It must be taken in the morning and the dose is 240 mg. Sometimes it is doubled. Such an adjustment is required in severe disease. In this case, the patient should receive 240 mg of the drug in the morning and 240 mg of the drug in the evening. The duration of the course is determined by the doctor.

Antiarrhythmic drugs are most often prescribed in order to quickly eliminate an attack of paroxysmal tachycardia and prevent the development of such dangerous conditions as myocardial infarction and angina pectoris.

Cardiac glycosides

• Strofantin (500 rubles). It is a potent drug that is administered intravenously. It is used for treatment only in a hospital setting, since it requires constant monitoring of the patient's condition. The dose and frequency of administration of the drug is determined by the doctor, based on the specific features of the course of the disease. The solution is injected over 7 minutes. If you do this faster, the patient may develop shock. When it is not possible to immediately deliver an intravenous injection, first the patient is injected with Novocaine in a dose of 5 ml, and then they switch to the introduction of Strofantin, which is previously diluted with an anesthetic drug.
• Korglikon (200 rubles). Korglikon is an intravenous drug. Most often it is prescribed at 10-20 ml per day (solution 20-40%). If the solution has a higher concentration, then a single administration of the drug is limited. The duration of the therapeutic course should be determined by the doctor. The drug is administered only in a hospital setting.
• Digoxin (50 rubles). At the initial stage of therapy, the patient is prescribed 2-4 tablets of the drug. Then the patient is given 1 tablet of the drug every 6 hours. Treatment continues until Digoxin has the desired therapeutic effect. After this, the patient is transferred to maintenance doses.

Glycosides are prescribed to reduce the likelihood of recurrent paroxysmal tachycardia. The doctor determines the dose on an individual basis. The drugs are administered under ECG control.

Beta-blockers

• Metoprolol (20-100 rubles). This drug helps to stabilize the heart rate and normalizes blood pressure readings. The patient is prescribed 100 mg of Metoprolol. You need to take the drug in the morning. If necessary, the dose is divided into 2 doses. Provided that the therapeutic effect does not develop, the dose is doubled. Metoprolol can be administered intravenously (5 mg of the drug). The attending physician gives precise instructions for the treatment.
• Anaprilin (20-100 rubles). The starting dose of the drug is 0.02 g three times a day. If the patient responds normally to therapy, then the dose is increased and brought to 120 mg (maximum 240 mg), which is taken 2-3 times a day. Further increase in dosage is impractical, since the patient may develop bradycardia and other pathological symptoms.
• Betalok (500 rubles). This drug allows you to normalize blood pressure and heart rate. The average dose is 0.1-0.2 g, which is taken 1-2 times a day. This drug can be prescribed as part of complex therapy, since it is well tolerated by patients. It is recommended to take the drug in the morning, before meals.

Beta-blockers can be used for outpatient management of patients, but in this case, it is recommended to take drugs in tablet form.

General recommendations

When the acute stage of paroxysmal tachycardia passes, it will be necessary to maintain the state of your body. It is important to follow all medical recommendations, adhere to a dietary diet.

If a person suffers from obesity, you need to deal with excess body weight. The menu should include protein foods and foods that are sources of complex carbohydrates. Diet and medication can help avoid recurrent attacks.

The author of the article: Molchanov Sergey Nikolaevich | Cardiologist

Education: Diploma in "Cardiology" received at the PMGMU. I. M. Sechenov (2015). Here I completed my postgraduate studies and received a diploma "Cardiologist".