Sinus bradycardia - a violation of the contractile activity of the heart rate with the number of less than 60 times in 1 minute, and the correct timing, due to lower automatism of the main pacemaker (sinoatrial node).It is a separate disease, and one of the most frequent complications of myocardial infarction.Within one hour after the death of cardiac muscle bradycardia develops in 30-40% of patients after 4 hours - 20%.From the above it follows that her medical treatment is a topical issue in modern cardiology.
reasons for bradycardia:
- irritation of the vagus nerve receptors in the heart muscle;
- decrease in blood circulation in the area of the main pacemaker (thrombosis of the right coronary artery);
- pronounced pain in myocardial infarction;
- use of morphine analgesic purpose.
In most cases, the disease is caused by increased activity of the vagus nerve.
Most experts believe that the number of cuts bradycardia 50-60 in 1 minute is not life-threatening, especially since it helps to reduce the
cardiogram with bradycardia
Indications for treatment
- reduction in blood pressure as a result of the small number of contractions of the heart;
- progression of signs of circulatory failure;
- occurrence of ventricular fibrillation;
- myocardial infarction in the acute phase;
- frequent fainting.
Medical tactic is at a small number of heartbeats
Causes of heart attack and its consequences
- causes Remedy that caused the disease.
- Reception extract or tincture of belladonna drops Zelensky, belaspon, platifillina gidrotartrata - at a moderate bradycardia.
- reception of atropine sulfate, tartrate platifillina - in severe bradycardia.
- With the ineffectiveness of these drugs previously appointed alupent, ephedrine.Caution should use these medications to persons with underlying heart disease, since they increase the demand of the heart muscle of oxygen.
- bradycardia may occur in patients receiving metoprolol, propranolol, bisoprolol, and similar drugs.In this case, the use of these medications stops and start the treatment by intravenous administration of glucagon.
- If there is bradycardia 40 heart beats in 1 minute or less, which is accompanied by a significant decrease in blood pressure and circulatory failure, arrhythmias of ventricular pacing is the treatment method.It is especially important for patients with myocardial infarction.
Indications for treatment of myocardial infarction complicated by bradycardia
- heart rate less than 50 to 1 minute;
- decrease in blood pressure;
- circulatory failure;
- arrhythmias of ventricular origin.
Treatment of myocardial infarction Treatment
bradycardia atropine should be administered under the strict control of the number of contractions of the heart, which should be at the level of 60-65 in 1 minute.It is not allowed the emergence of tachycardia, which will strengthen the heart muscle ischemia.In some cases, the use of small doses of atropine may exacerbate the phenomenon of bradycardia.
If there are contraindications to the use of atropine (paresis of the bladder, glaucoma, prostatic hypertrophy) or absence of a positive effect from its application are used isoproterenol, alupent, izadrin.Because of its ability to increase the excitability of the ox heart muscle receiving these drugs is contraindicated in ventricular ekstrosistoly.
must be remembered that due to the presence of comorbidities, and patient non-compliance with the dosage, the drug can have quite the opposite effect therapeutic action.Therefore, medication should be carried out under the strict supervision of a specialist.
In case of failure of ongoing medical treatment, progressive heart failure, hypotension, low cardiac contractility shows the use of pacing.In
if bradycardia complicated by a decrease in blood pressure, good effect giving the patient position with raised legs at 45 degrees.This method will increase the inflow of venous blood to the heart, which may increase the frequency of contractions and blood pressure.