Premature ventricular contraction
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Description:
Premature ventricular contraction — untimely depolarization and reduction of heart or its separate cameras, the most often registered type of arrhythmias. Extrasystoles can be found in 60 — 70% of people.
Premature ventricular contraction symptoms:
Manifestations usually are absent, especially at an organic origin of extrasystoles. Complaints to the pushes and strong blows of heart caused by a vigorous ventricular systole after a compensatory pause, feeling of dying down in breasts, feeling of the stopped heart. Symptoms of neurosis and dysfunction of the autonomic nervous system (are more characteristic of extrasystoles of a functional origin): alarm, pallor, perspiration, fear, feeling of shortage of air. Frequent (especially early and group) extrasystoles lead to decrease in cordial emission, reduction of a brain, coronary and renal blood-groove by 8 — 25%. At the stenosing atherosclerosis of cerebral and coronary vessels there can be passing disturbances of cerebral circulation (paresis, aphasia, faints), stenocardia attacks.
Premature ventricular contraction reasons:
Generally they have functional (neurogenic) character, their emergence is provoked by a stress, smoking, alcohol, strong tea and especially coffee. Extrasystoles of an organic origin arise at injury of a myocardium (coronary heart disease, a cardiosclerosis, dystrophy, an inflammation). The extraordinary impulse can proceed from auricles, atrioventricular connection and ventricles. Emergence of extrasystoles is explained with emergence of the ectopic center of trigger activity, and also existence of the reentry mechanism. Temporary relationship of extraordinary and normal complexes is characterized by a coupling interval.
Functional character: various vegetative reactions, emotional pressure, smoking, abuse of strong tea, coffee, alcohol.
Organic origin: their emergence demonstrates rather profound changes in a cardiac muscle in the form of the centers of ischemia, dystrophy, a necrosis or cardiosclerosis, promoting formation of electric inhomogeneity of a cardiac muscle. Most often premature ventricular contraction is observed at an acute myocardial infarction, coronary heart disease, arterial hypertension, rheumatic heart diseases, myocardites, chronic heart failure. Various options of a resistant ventricular allorhythmia — a bigeminal pulse, a trigeminy — are characteristic of overdose by cardiac glycosides.
Treatment of Premature ventricular contraction:
Elimination of provocative factors, treatment of a basic disease. Single extrasystoles without clinical manifestations do not korrigirut. Treatment of neurogenic extrasystoles, observance of a work-rest schedule, dietary recommendations, regular trainings by sport, psychotherapy, tranquilizers or sedatives (for example, diazepam, Tinctura Valerianae).
Indications to treatment by specific antiarrhythmic drugs: the expressed subjective feelings (interruptions, feeling of sinking heart, etc.), sleep disorders, an extrasystolic allorhythmia, early ventricular extrasystoles accumulating on a tooth of T of the previous cardial cycle, frequent single extrasystoles (more than 5 in min.), group and polytopic extrasystoles, extrasystoles in the acute period to THEM, and also at patients with a postinfarction cardiosclerosis. Ventricular premature ventricular contraction of 1 — 2 gradation on Launa usually does not demand treatment. The 3rd gradation can be also left without purpose of special antiaritmik in the absence of organic lesion of a myocardium. The 4th gradation demands purpose of antiarrhytmic prepatar 3 groups (Amiodaronum, соталол), 4 and 5 gradation as a rule demand installation of a defibrillator cardioverter because of high risk of development of ventricular tachycardia or fibrillation of ventricles.
