Bradycardia in an early pregnant woman. Fetal bradycardia: causes, symptoms and treatment. What is bradycardia and what are its types?

Bradycardia is one of the types of arrhythmia, which is characterized by a decrease in heart rate. Normally, heart rate varies from 60-80 beats per minute at rest to 120-140 with significant physical activity. Conditions in which the heart rate is below 60 beats per minute are classified as different degrees of bradycardia.

During sleep or when the ambient temperature drops, the heart works in an economical mode, and physiological bradycardia is observed. A reduced heart rate, which is recorded in athletes and people with heavy physical labor, is also physiologically determined and does not pose a health hazard. Pathological bradycardia is said to occur if changes in heart rate are caused by other diseases, perhaps not accompanied by direct damage to the cardiovascular system. In such cases, abnormal heart rhythm is one of the nonspecific symptoms of the pathological condition. Bradycardia in pregnant women is relatively rare.

In cardiological practice, there are three degrees of heart rate slowing. At a heart rate of 50-60 beats per minute, a mild degree of bradycardia is stated, 40-50 beats per minute are classified as moderate bradycardia. A decrease in heart rate to less than 40 beats per minute is called severe bradycardia, which is potentially dangerous.

Bradycardia of any degree in a single case can be considered as a variant of the individual norm, if the abnormal heart rhythm is not accompanied by hemodynamic disturbances and does not affect the patient’s well-being.

Bradycardia during pregnancy

During pregnancy, the load on the cardiovascular system of the expectant mother increases greatly and differs from usual. Blood flow is hampered due to the occurrence of a fetoplacental circulation, an increase in blood volume and due to mechanical compression of some vessels. As a rule, the heart rate during pregnancy accelerates somewhat, and compensatory tachycardia develops. A slowdown in heart rate during pregnancy indirectly indicates possible disturbances in the functioning of the body.

Based on the location of disturbances in the conduction system of the heart, sinus bradycardia and bradycardia due to sinoatrial or atrioventricular heart block are distinguished.

Pathological bradycardia often accompanies various diseases. Depending on the characteristics of the underlying disease, cardiac and non-cardiac causes of heart rhythm disturbances are distinguished. The group of cardiac causes includes:

Coronary heart disease;
Cardiosclerosis;
Unstable blood pressure;
Atherosclerosis:
Myocarditis and other inflammatory heart diseases;
Myocardial dystrophy.

Among the non-cardiac causes of bradycardia during pregnancy, the following should be noted:

Some types of injuries;
Hypothyroidism;
Infectious diseases of various etiologies;
Disturbances in the electrolyte composition of the blood;
Diseases of the digestive system, in particular peptic ulcers and tumor processes;
Severe poisoning;
Some kidney pathologies.

Mild and moderate bradycardia in pregnant women is often asymptomatic. Since bradycardia, like tachycardia, in most cases is part of symptom complexes characteristic of the course of diseases of other organs and systems, its manifestations depend on the specifics of the underlying pathology. An abnormally low heart rate may be indicated by:

Increased fatigue and chronic fatigue;
Difficulty breathing;
Increased sweating;
Disorders of memory and attention processes;
Short-term visual impairment;
Feeling of vague discomfort or pressure in the chest;
Dizziness, fainting, loss of consciousness.
"Floaters" before the eyes.

Being a nonspecific symptom of a number of diseases, bradycardia provokes the same nonspecific changes in condition, some of which can be taken as a consequence of hormonal changes in the body.

The danger is posed by cases of severe bradycardia, when the heart rate is less than 40 beats per minute. A sudden decrease in heart rate can be accompanied by the development of a potentially fatal condition known as Morgagni-Adams-Stokes syndrome. It is characterized by the following symptoms:

Severe anxiety, panic attack;
Hyperemia of the facial skin;
Breathing disorders;
Dizziness, deep fainting;
Swelling of the neck veins;
Cyanosis of lips;
Pupil dilation;
Involuntary muscle contractions, severe cramps;
Urinary incontinence.

The heart rate may recover after a few seconds; when the woman comes to, she does not remember what happened. However, an attack of bradycardia, accompanied by convulsions and prolonged (more than a minute) fainting, is potentially life-threatening for the mother. In such cases, you must immediately call an ambulance. Morgagni-Adams-Stokes syndrome is an emergency condition, the patient must be immediately hospitalized in the intensive care unit.

Sinus forms of bradycardia

In cases of congenital reduced automatism of the sinus node, bradycardia is a common condition for women and does not in any way affect the course of pregnancy. As a variant of the norm, cases of bradycardia are considered in women who, before pregnancy, were actively involved in sports or heavy physical labor.

If bradycardia is a symptom of concomitant pathologies, the pregnant woman should be under the supervision of a cardiologist. Sometimes a specific type of bradycardia occurs, provoked by fetal growth. A slow heart rate can be caused by constant irritation or compression of the branches of the vagus nerve by the enlarging uterus. Sinus forms of bradycardia, as a rule, are not dangerous for either the mother or the fetus, and are not grounds for termination of pregnancy.

Heart block as a cause of bradycardia

In some cases, bradycardia during pregnancy is a consequence of dysfunction of the cardiac conduction system. In case of conduction disturbances between the sinus node and the atrium, sinoauricular block is detected. Sinoauricular block occurs against the background of cardiac pathologies of various origins. The easiest way to relieve an attack of weakness or dizziness caused by a decrease in heart rate is by drinking a cup of fresh leaf tea, preferably with a small piece of dark chocolate.

Another type of heart block is atrioventricular, when the transmission of impulses between the atrium and ventricles is disrupted. With bradycardia of atrioventricular origin, the pulse is rare, the rhythm of contractions of the atria and ventricles is uncoordinated. The attacks are accompanied by general weakness, dizziness, and fainting. Oxygen starvation of the brain can provoke a Morgagni-Adams-Stokes attack.

Diagnosis and treatment

Persistent bradycardia, accompanied by attacks of weakness or other clinical manifestations, is a reason for a more thorough examination of the pregnant woman’s health. As a rule, heart rhythm disturbances resulting from diseases of the cardiovascular system are potentially dangerous. In such cases, a plan for managing pregnancy and childbirth is developed individually; the expectant mother will visit the doctor more often for a routine examination. Monitoring by a cardiologist is required, and, if necessary, additional hardware and laboratory tests to make a diagnosis.

The fetal heartbeat is monitored at every visit to the antenatal clinic. If a pregnant woman shows signs of arrhythmia of any type, monitoring is carried out more carefully. If signs of bradycardia are detected on fetal CTG, the doctor refers the pregnant woman to a Doppler study. After the examination, treatment is prescribed to correct the identified problems.

In most cases, bradycardia during pregnancy does not require treatment.

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Sinus bradycardia in adults

Adults usually do not experience any sensations with pathology; it does not cause discomfort. Bradycardia is determined only by instrumental studies. With mechanical irritation of the carotid sinus in healthy people, the pause between contractions is about 3 seconds, while in patients this time period increases to 5 seconds.

Normally, sinus bradycardia occurs in professional athletes. Due to high physical activity, the vagus nerve in such people has increased tone. Under its influence, the sinus node reduces heart rate. This condition does not affect the health of the body in any way.

Sinus bradycardia in children

In the normal state of the body in newborns, the number of heart muscle contractions per minute reaches 140 beats. By the first year of life, this figure drops to 100 beats per minute. If at this age the above indicators are reduced, then the child is likely to develop sinus bradycardia. In this case, an examination by a specialist is required.

In children, there are two variants of the course of sinus bradycardia:

absolute – independent of external factors;
relative – depending on certain environmental factors.

The main cause of sinus bradycardia in children is heredity. In addition, additional provoking factors for the development of sinus bradycardia may be a lack of oxygen during intrauterine development or an increase in bilirubin in the blood. In the latter case, an increased concentration of this substance in the blood leads to the impregnation of brain tissue with bilirubin, which then negatively affects cardiac activity. This condition can occur with jaundice in newborns.

In children over 1 year of age, symptoms are similar to those in adults:

general deterioration of health;
malaise, drowsiness and lethargy;
dyspnea;
chest pain;
increased fatigue incommensurate with the level of physical or emotional stress.

Due to the fact that young children cannot independently complain about their poor health, it is necessary to pay attention to a decrease in appetite, memory, attention and coordination of movements. If sinus bradycardia is suspected, it is imperative to undergo an examination for timely detection of pathology. Lack of treatment can lead to depletion of the heart wall. In severe cases, it can rupture and be fatal.

Sinus bradycardia during pregnancy

The reasons for the development of sinus bradycardia during pregnancy can be both the general condition of the woman and the influence of the constantly increasing size of the uterus. In the second option, the vagus nerve is compressed and its tone is increased. This, in turn, causes a decrease in heart rate. However, most often, pregnant women, on the contrary, feel an increase in heart rate.

In most cases, sinus bradycardia during pregnancy does not adversely affect the health of either the expectant mother or the fetus. Therefore, artificial termination of pregnancy or special treatment in this situation is not indicated. The exception is those cases in which hemodynamics in the female body are disrupted, manifested by dizziness with loss of consciousness.

To maintain the body of a pregnant woman, it is recommended to use general tonics and stimulants. These include green tea or a small amount of dark chocolate. In case of prolonged bradycardia, additional examination of the fetus is still recommended to exclude a dangerous pathology. A Doppler examination is usually prescribed.

Due to the fact that the fetus cannot experience sinus bradycardia, a decrease in heart rate is associated only with its hypoxia (lack of oxygen). In the early stages of pregnancy, a woman is recommended to take special medications that correct the delivery of oxygen to the unborn child. If hypoxia is detected in the later stages, a cesarean section is indicated.

Classification of the disease

Sinus bradycardia can be classified in different ways, however, it is advisable to divide it depending on the reasons that caused the decrease in heart rate and manifestations:

sinus bradycardia of athletes;
moderate sinus bradycardia in childhood accompanied by respiratory arrhythmia;
toxic form - develops when the body is poisoned;
medicinal – in case of overdose of certain medications;
physiological - occurs when the body is overcooled or during sleep.

Causes

The main causes of sinus bradycardia include:

hypothermia of the body;
burdened heredity;
increased tone of the vagus nerve;
infectious diseases;
age-related changes and vascular changes;
traumatic brain injuries;
disruption of the body's hormonal levels and diseases of the endocrine system;
cardiac pathology (coronary heart disease, atrial fibrillation...).

When several causes are combined, the course of sinus bradycardia and its manifestations will be more severe and dangerous for the body.

Symptoms

The symptoms of sinus bradycardia are no different from the manifestations of any form of bradycardia. Main complaints made by patients:

general loss of strength;
attacks of dizziness;
darkening of the eyes;
pain in the heart area;
shortness of breath with little physical exertion.

Physiological bradycardia has no symptoms or manifestations. This form does not negatively affect the functioning of the body and is detected only during medical examinations.

You can suspect sinus bradycardia on your own without the help of medical specialists. It is enough to feel your pulse and count the number of heartbeats in 1 minute. If the number of pulse beats is constantly reduced (less than 60 per minute), you should consult a cardiologist.

Instrumental diagnostic methods for determining sinus bradycardia:

recording and studying an electrocardiogram;
24-hour Holter monitoring of cardiac activity.

In some cases, an ultrasound of the heart, a biochemical blood test and determination of thyroid hormone levels may be needed.

Treatment of sinus bradycardia

Treatment is indicated only if the reduced heart rate causes significant harm to the body or can be complicated by dangerous pathological conditions for humans.

Non-drug treatment of mild forms of sinus bradycardia, in which its symptoms occasionally appear, is to maintain the general tone of the body. This includes normalizing sleep and rest time. When you lose energy, you can eat a piece of chocolate, drink green tea, or coffee.

Symptomatic drug treatment for bradycardia is prescribed to increase the heart rate. For this use:

sympathomimetics (Ephedrine, Norepinephrine...);
anticholinergics (Atropine, Platiphylline...).

In the case of the dosage form of bradycardia, the dosage of the drugs that caused the decrease in heart rate is reduced.

In severe forms of the disease with attacks of loss of consciousness or heart failure, implantation of a pacemaker is indicated. Such an artificial pacemaker supports the work of the heart, generating more than 60 pulses per minute and “forces” the heart to contract at the desired frequency.

Methods for preventing bradycardia

To prevent the occurrence of sinus bradycardia, it is recommended to follow five basic recommendations. Among them:

complete cessation of nicotine use;
maintaining an active lifestyle;
avoiding excessive consumption of alcoholic beverages;
eliminating drug abuse;
periodic medical examinations.

Possible complications of bradycardia

Lack of timely diagnosis of sinus bradycardia or its prolonged course can lead to the following complications and pathological conditions:

impaired cardiac circulation with subsequent development of myocardial infarction;
exhaustion of the heart wall and its rupture, leading to death;
development of coronary heart disease;
the occurrence of heart defects;
sudden cardiac arrest.

Disease prognosis

An unfavorable prognosis for sinus bradycardia is possible only in the case of a significant decrease in heart rate (less than 40 beats per minute). In this embodiment, the pathology sometimes leads to disability of the patient, and the risk of sudden death from cardiac arrest increases. With timely detection and treatment of bradycardia, the prognosis is favorable.

Based on the above, sinus bradycardia is a decrease in heart rate caused by a decrease in impulse generation in the sinus node. In most cases, no treatment is required. Normally found in athletes and pregnant women. Severe forms are dangerous due to the development of complications including cardiac arrest. Treatment levels for sinus bradycardia range from lifestyle changes to implantation of a pacemaker to maintain cardiac activity.

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Types of bradycardia and causes of its occurrence

Physiological bradycardia

A decrease in heart rate is often observed in completely healthy people, for example, athletes or those involved in physical labor. The number of myocardial contractions in them can decrease to 40-50 per minute in the complete absence of symptoms such as difficulty breathing, discomfort in the chest, fainting, dizziness and weakness, indicating pathology of cardiac activity. This type of bradycardia is called physiological. In some people, it occurs at night while at rest, but does not lead to negative consequences, since during night sleep the need for oxygen decreases.

One of the most significant cases of physiological bradycardia was observed in cyclist Miguel Indurain at the peak of his career. Due to the overdevelopment of the cardiovascular system, the athlete’s resting pulse was 28 beats per minute. At the same time, the volume of his lungs reached 8 liters (for an average person - 3.5 - 4.5 liters), and his blood circulation made it possible to pump up to 7 liters of blood per minute throughout the body (for ordinary people on average 3-4 liters, for his colleagues -cyclists 5-6 liters).

The main causes of physiological bradycardia in people involved in sports and leading an active lifestyle are associated with the increased functionality of their respiratory and cardiovascular systems, which provide the brain with a sufficient amount of oxygen even at a low heart rate. Often, physiological bradycardia occurs when a person is very tired, finds himself in a stressful situation, or is in the cold for a long time or in conditions of high humidity and temperature, for example, in a sauna or steam bath. It can be caused by the pressure of a tightly tied tie on the throat (carotid sinus), or a collar that is too tight to the neck. Physiological bradycardia does not pose a threat to human health, since it does not lead to a decrease in blood supply to the brain and other organs. No treatment is required for this type of bradycardia.

Pathological bradycardia

With various changes in the conductivity of the heart muscle, a pathological type of bradycardia occurs, which is conventionally divided into two types.

Bradycardia due to inhibition of pacemaker activity

The occurrence of the first type of sinus bradycardia is facilitated by inhibition of pacemaker activity. It is caused by a decrease in the tone of the sympathetic department or an increase in the excitation of the vagus nerve under the influence of humoral factors, which include an excess of acids with a high bile content in the blood, and an insufficient amount of hormones produced by the thyroid gland (hypothyroidism).

A prerequisite for the occurrence of this type of bradycardia is often vagal (neurogenic) factors, which include:

Natural aging of the body;
Disturbances in the functioning of the vegetative-vascular system;
Various types of neuroses;
Increased intracranial pressure leading to stroke (bleeding in the brain);
Brain tumors;
Exposure to medications used to relieve symptoms of hypertension and heart disease (pilocarpine, beta-blockers, cardiac glycosides, etc.);
Myxedema;
Electrolyte imbalance (excess potassium in the blood);
Some infectious diseases.

Bradycardia caused by heart blocks

This type of sinus bradycardia can be caused by different types of heart block:

Sinoauricular block - Impaired conduction of impulses through the atria. It is characterized by their conduction from the sinus node to the myocardium every other time.
Atrioventricular block ( disruption of impulse transmission through the ventricles), during which some of the ventricular contractions drop out (their number can be reduced to 40 per minute). There are three degrees of severity. The first (mildest) degree is characterized by slow conduction of impulses from the atria to the ventricles. With the second (moderate) severity, some impulses stop reaching the ventricles. The third degree is characterized by a decrease in the number of ventricular contractions due to the fact that not all impulses reach them.

Sinus bradycardia most often occurs in a chronic (extracardiac) form. But it can also have an acute (intracardial) course, which is caused by myocarditis, post-infarction cardiosclerosis, acute myocardial infarction.

Clinical manifestations of bradycardia

The physiological appearance of this disease does not have pronounced clinical manifestations. The main symptoms of bradycardia occur in chronic forms.

These are dizziness and weakness, a rare heart rate and a feeling that the heart is stopping, problems with sleep and memory.
When an acute form of severe bradycardia occurs, caused by sinoauricular blockade, heart failure is observed, accompanied by fainting and angina. In severe cases, the person may lose consciousness. At the same time, his breathing becomes impaired and convulsions occur. This condition is called an attack of MAS (after the first letters of the last names of the doctors who worked on their study of Morgagni-Adams-Stokes syndrome). It is caused by a decrease in oxygen supply to the brain (hypoxia).
With a significant slowdown in ventricular contractions (atrioventricular block), the blood supply to the brain is disrupted. This may cause general anxiety and sudden severe dizziness and slight blackout. When the pause between heartbeats increases to 15 seconds, complete loss of consciousness or an attack of MAS may occur. Sometimes this causes cardiac arrest, which can cause sudden death.

To determine whether the decrease in heart rate is caused by a functional component or heart block, an injection of atropine is given. For physiological bradycardia, this procedure returns the number of heartbeats to normal. The lack of effect means that the cause of the disease lies in pathological disturbances in impulse conduction.

Therapy for bradycardia

Treatment of bradycardia is carried out only with pronounced clinical manifestations and obvious disruption of the hemodynamic process. If a person's heart rate is reduced to 40 per minute and frequent fainting occurs, one of the following medications is used:

Atropine - every 3 hours intravenously (2 mg) or subcutaneously (0.5 to 1.0 mg);
Isadrin - in a glucose solution (5%) by intravenous drip (2 ml per 0.5 l);
Isoproterenol - infusion (drip) administration (up to 4 mg);
Alupent (10 mg of the drug per 500 ml of isotonic sodium chloride solution) - intravenously by drip or eight oral doses of 20 mg;
Belladonna preparations for the treatment of bradycardia that occurs without pronounced symptoms.
Ginseng or Eleutherococcus extract (the dosage is selected by the doctor for each individual patient);
In case of individual intolerance or existing contraindications to the use of Izadrin or Atropine, tablets of Ephedrine hydrochloride or Ipratropium bromide are prescribed.

An acute form of bradycardia caused by a violation of impulse conduction requires urgent hospitalization and inpatient treatment, aimed at eliminating the main causes that contribute to a decrease in heart rate. If bradycardia is associated with the natural aging of the patient’s body (irreversible processes begin after 55-60 years) or drug therapy is ineffective, the patient is prescribed cardiac pacing (implantation of a special device under the patient’s skin that normalizes the number of heartbeats). Consultation with a cardiac surgeon is mandatory for patients in whom bradycardia is accompanied by attacks of MAS (fainting). Their main danger is that during fainting, the risk of cardiac arrest increases.

Traditional medicine in the treatment of bradycardia

good addition The main drug therapy for bradycardia is treatment with folk remedies. It includes the following recipes:

Radish and honey

Radish juice with honey helps speed up your heart rate. To prepare this remedy, you need to cut off the top of the radish. Make a well inside by scooping out some of the pulp with a spoon. Fill it with honey and leave overnight. The next day, consume the resulting syrup throughout the day, dividing it into three doses.

Walnuts

Walnuts are a proven remedy in the treatment of many heart diseases, including bradycardia. Take half a kilogram of peeled kernels, mix them with a glass of sugar and the same amount of sesame oil. Pour a liter of boiling water over 4 lemons cut into 4 pieces. Mix all the resulting components. Take the mixture 30 minutes before meals 3 times a day, a tablespoon.

Lemon and garlic

Lemon and garlic are the most effective methods in the treatment of bradycardia. Squeeze the juice out of 10 lemons. Chop and add 10 heads of garlic to it. Pour all ingredients with a liter of fresh honey. Leave for 10 days, shaking daily. Take 4 teaspoons on an empty stomach, dissolving each portion for at least a minute.

Pine shoots

Alcohol tincture of young apical shoots of pine. To prepare it, take 70 branches and infuse it in the sun in 300 ml of vodka for 10 days. Dosage per dose - 20 drops.

Rosehip decoction

Take 10 large berries and boil in 400 ml of water (about 15 minutes). Strain the cooled broth, rub the berries through a sieve, mix with three teaspoons of honey. Take half a glass daily before each meal until all signs of bradycardia completely disappear.

Diagnosis of sinus bradycardia

Typically, bradycardia is diagnosed at a doctor's appointment during listening.

When listening to the atria, dull tones are clearly felt during the distolic pause. They are called "echo systole".
Every 5-10 beats, the first tone of high volume is heard at the top. It is called the “Strazhesko gun tone”. It is caused by the sound of a sudden tension in the leaflets of the atrioventricular valves during the contraction of the ventricles, which were in a relaxed state before the contraction of the atria. This is the main evidence of the presence of complete atrioventricular block.

ECG

To confirm the diagnosis, an ECG is prescribed. It shows the following:

With sinoauricular block, sinus bradycardia is characterized by inconstancy of the rhythm, but the ECG reveals only a slowdown in the rhythm, the waves remain in a normal, undeformed state.
Sinus bradycardia caused by atrioventricular block on the ECG looks like this:
1. excitation of the ventricles and atria occurs independently of each other.
2. the frequency of atrial contractions is increased, but occurs in the correct rhythm, this is indicated by the amplitude of the extrasystole P wave, it is reduced;
3. the number of ventricular contractions is reduced, this is indicated by the formation of a pointed T wave of greater height, in some cases with a negative value;
4. QRS amplitude of the extrasysto- logical ventricular complex is increased;
5. part of the ventricular complexes falls out.

This means a decrease in the number of ventricular contractions. With a sharp decrease in heart rate (up to 40 beats/min), every second ventricular complex may fall out. In this case, “Strazhesko’s cannon tone” is not heard. In milder forms, every fifth ventricular contraction is lost. Bradycardia is a transient type of disease. This means that it can only be detected if the patient’s heart rate is clearly reduced at the time the ECG is taken. Therefore, doctors, before treating bradycardia, carry out Holter monitoring (control) of the functional activity of the heart. To carry it out, the patient is equipped with a portable electrocardiograph, which monitors the work of the patient’s heart muscle in everyday conditions. Monitoring is usually carried out over a day or several days.

How to increase heart rate with bradycardia?

If a person suddenly feels dizzy or has another ailment indicating bradycardia, it is necessary to measure the pulse. This function is available in all modern tonometers. If your heart rate drops sharply (less than 40 per minute), you should drink a cup of coffee or hot tea. The caffeine they contain will begin to work after the first sips. You can enhance the effects of these drinks adding a few drops (from 10 to 15) of pharmaceutical tinctures of eleutherococcus, belladonna or ginseng. Taking a hot bath, a short jog or exercise, or massage will help increase your heart rate during bradycardia. But these techniques can be used to increase heart rate only with physiological bradycardia, when there are no medical contraindications. It is recommended to use medications as prescribed by the attending physician, observing the prescribed dosage, since exceeding it can cause a sharp increase in blood pressure. Some believe that One of the effective fast-acting drugs is Zelenin drops. However, this drug has coronary dilation properties, which leads to a slowdown in rhythm, so Zelenin drops are more suitable for rhythm disturbances such as tachycardia. This is a drug based on plant extracts of belladonna, valerian, lily of the valley and menthol. But they are the ones that can cause unwanted side effects in the form of apathy and lethargy. For bradycardia with a decrease in heart rate to 35 beats per minute, treatment at home is not recommended, as this can be life-threatening. A person with an abnormal heartbeat should be given the necessary assistance and immediately call an ambulance.

Video: a doctor’s opinion about a pulse that is dangerous to health

How to provide first aid?

If there is a sharp decrease in heart rate due to bradycardia, when a person is close to fainting or has lost consciousness, he should be given first aid, which consists of the following:

If the patient falls on the floor, then he must be turned over on his back, raise his legs, placing a cushion or pillow under them. It is advisable to maintain this situation until the arrival of doctors, whose call cannot be postponed. A conscious person must also be laid on a flat surface and his legs raised.
Free your breath by unbuttoning the top button of your shirt and loosening your belt.
If you lose consciousness, try to revive the person by patting him on the cheeks. If this doesn't help, spray your face with water.
In case of deep fainting, inhaling products with a pungent odor (vinegar, ammonia) can bring a person to his senses. However, it should be remembered that ammonia (and vinegar too) must be handled very carefully, since if brought close to the nasal passages, it can cause a sharp bronchospasm up to respiratory arrest.
If fainting persists and none of the above remedies help, care should be taken to ensure that the patient does not become hypothermic. To do this, his body is covered with heating pads with warm water.

After the patient returns to consciousness, you need to measure his pulse.
If you know what medicine he takes, then you need to give it to him to drink.
The arriving ambulance team must be told in detail about all the actions performed.
Even if you have the skills to administer injections, it is better not to do the treatment yourself. Drugs such as mezatone and atropine, which cause an increase in heart rate, are unlikely to be present in every person’s home medicine cabinet; they are only available with a prescription. However, in the case of a long-term course of the disease, they are still sometimes prescribed to the patient, after informing relatives about the precautions.

Bradycardia in childhood

Sinus bradycardia is often observed in childhood. Its etiology, clinical manifestations and course are similar to the course and symptoms of the disease in adults. The difference is that the diagnosis of bradycardia in a child over 6 years of age is made when the heart rate drops to 70-80 beats per minute. Bradycardia in children is caused mainly by the same reasons as in adults: increased excitability of the vagus nerve, exposure to hypoxemia, various infections and intoxication of the body. In adolescents, the cause of bradycardia may be a lag in the development of the cardiovascular system from the rapid growth of other organs and metabolic disorders. It should be noted that bradycardia in childhood is very often the body’s reaction to cold or heat, fear or fatigue. Sometimes it happens that a child faints at the first school assembly in his life. Most children experience mild sinus bradycardia during night sleep or deep inspiration. In many families, bradycardia is a hereditary disease that accompanies congenital heart disease. Children in most cases do not notice bradycardia, especially if it does not have a significant effect on the volume of blood moved. The first symptoms appear when there are disturbances in blood flow and associated oxygen starvation of the brain. These include:

Shortness of breath while walking and when doing exercises in physical education lessons;
Dizziness;
Headache and pain in the heart area;
Increased sweating;
General weakness;
Decreased appetite.

If these symptoms appear in a child, it is necessary to do an ECG. With sinus bradycardia, the cardiogram clearly shows that the sinus rhythm is slow. This is indicated by the reduced height of the P waves, while their amplitude is slightly expanded. T waves, on the contrary, are higher, with a wide amplitude. The QRS interval of the ventricular complex is also widened. The P-Q interval, indicating the duration of the impulse, is also increased.

To treat bradycardia in children, medications are prescribed to help correct carbohydrate metabolism, maintain normal electrolyte balance, and improve oxygen supply to the brain. In addition, the underlying disease causing the slow heart rate is treated. It is recommended to take special vitamin complexes and introduce olive or sesame oil and seaweed into the diet. In some cases, bradycardia in children goes away with age.

Bradycardia in the fetus

The level of development of modern medicine makes it possible to examine the health of a child when he is still in the womb. How the baby feels is determined by its heart rate. Normally it ranges from 120 to 160 beats per minute. This fetal vital sign is checked at every woman's routine gynecological appointment, starting at eight weeks of pregnancy. With normal development, listening to heart sounds with a regular stethoscope is sufficient. But if the doctor detects a decrease in heart rate, then the expectant mother is sent for an additional examination: a CTG (fetal cardiotocogram) is performed, through which the conductivity of the heart muscle of the embryo, its excitability and contractility is checked, or a Doppler examination. A decrease in fetal heart rate to 110 beats per minute is called basal bradycardia. It can be caused by compression of the fetal head, maternal hypotension and a number of other reasons. This type of bradycardia is not dangerous to the baby's health. But the expectant mother needs to take care of eliminating the causes that cause it so that the baby’s heartbeat returns to normal. Decelerant bradycardia in the fetus is much more dangerous when the heart rate is less than 90 beats per minute. This indicates the child’s suffering, which is caused by oxygen starvation (fetal hypoxia). It develops when a pregnant woman takes certain types of medications, when she develops gestosis (late toxicosis) or anemia (iron deficiency), premature placental abruption, etc.

Fetal bradycardia can occur at any stage of pregnancy. In the first half of pregnancy, a lack of oxygen can affect the formation of the baby's organs, causing them to underdevelop. In the second half, oxygen starvation leads to disturbances in the development of the central nervous system and problems during childbirth. Bradycardia is dangerous because it can cause the death of a child not only during intrauterine development, but also during childbirth (fetal asphyxia), and even in the first hours after birth.

During pregnancy, the fetal heartbeat is checked using a conventional obstetric stethoscope and using Doppler ultrasound, which is prescribed not only to expectant mothers with chronic diseases of the upper respiratory tract (bronchitis, etc.), diabetes mellitus, cardiac disorders, but also to healthy women in accordance with pregnancy management protocol. Starting from the second half of pregnancy, the expectant mother herself can determine whether there are deviations in the baby’s pulse by counting his movements. If the baby turns (moves) in the mother's belly for 10 or more two-minute series, then everything is fine. If the number of episodes is less, there is a reason to undergo additional examination.
To treat bradycardia in the fetus, medications are administered to the mother. Through the general bloodstream they enter the child’s circulatory system. At the same time, the woman’s uteroplacental blood flow also improves. Drug therapy is carried out based on the type of bradycardia and its severity, the health status of the expectant mother, taking into account the duration of pregnancy. Most often, droppers with calcium gluconate, sodium bicarbonate, cocarboxylase, ascorbic acid and glucose, and oxygen masks are prescribed. The drugs are administered in the following order:

First, solutions of cocarboxylase and sodium bicarbonate;
Then, a solution of ascorbic acid with glucose;
Finally, calcium gluconate is administered.

If the devices detect the occurrence of acute bradycardia during childbirth, then the woman in labor and the newborn baby are injected subcutaneously (if possible) with atropine.

Bradycardia in infants

Bradycardia in newborns occurs not only with organic diseases of the cardiovascular system. It can develop as a consequence of birth trauma, perinatal encephalopathy, pneumonia, toxic-allergic manifestations, metabolic disorders, etc. Sometimes the baby's heart rate slows down as he exhales during long walks on frosty days. This is a kind of reaction to the cold. This type of disease is characterized by a decrease in heart rate to 100 beats per minute. Often, bradycardia in newborns precedes or during an attack of apnea (stopping breathing). Of particular concern is severe sinus bradycardia in an infant with a heart rate less than 70 beats per minute, which indicates congenital heart block. The following signs appear:

The baby suddenly turns pale, his skin acquires a bluish tint.

He stops moving, as if he freezes. This condition may be accompanied by seizures.
Apnea attacks occur and the newborn's heart may stop.

When these signs appear, a screening examination of the baby is carried out, his cardiovascular system is checked in order to exclude congenital heart disease. Subsequently, the newborn is under constant supervision of a pediatrician, continuous monitoring of the work of his heart is carried out, and, if necessary, drugs are administered to stop bradycardia, which has hemodynamic significance. Treatment is carried out aimed at eliminating the diseases that cause bradycardia. Many people do not always pay due attention to their health. They do not pay attention to the signals that the body gives. After all, even seemingly harmless nocturnal bradycardia can eventually develop into more serious heart rhythm disturbances. Therefore, if you notice that your heart rate is increasingly slowing down, try to take a different look at your lifestyle. Perhaps something needs to be changed about it. And then your heart will always work like a clock, supplying blood to the brain and other organs on time.

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Bradycardia is the mechanism of formation

Bradycardia refers to a class of heart rhythm disorders because the heart rate is lower than normal. And a correct, normal and healthy heart rhythm should be sinus, uniform and have a certain number of contractions per minute. If the rhythm becomes uneven, that is, the same amount of time passes between two heartbeats, then this is an arrhythmia. Arrhythmia also refers to a condition in which the heart beats evenly, but the number of its contractions per minute is less than normal. Thus, when talking about bradycardia, doctors mean one of the variants of arrhythmia. And since the correct heart rhythm is the key to the normal functioning of all organs and tissues, any variant of arrhythmia is very carefully analyzed and, if possible, corrected. Bradycardia reflects a violation of such a property of the cardiac conduction system as automaticity.

To understand the classification of arrhythmias, including bradycardia, it is necessary to understand how an electrical impulse is formed that causes the heart to contract regularly and evenly.

Deep in the muscular wall of the heart is the so-called sinus node, or pacemaker, as it is called in the medical literature. It is in this sinus node that excitation regularly develops, which is transmitted along nerve fibers to the muscles of various parts of the heart, causing them to contract. The sinus node provides regularity, sufficient strength, automaticity and constancy of electrical impulses that cause the heart to contract. The sinus node operates completely autonomously, independent of signals from the brain. It constantly, with a clearly defined and measured frequency, generates electrical impulses, transmits them through the conduction system of the heart, causing it to beat. If heart contractions are provoked by the sinus node, then the rhythm is called sinus, or correct.

However, one sinus pacemaker cannot transmit an electrical impulse to all the muscles of the heart, causing them to contract evenly and harmoniously. To do this, there are several more nodes in the heart that conduct the signal from the sinus pacemaker to the heart muscles. From the sinus node the impulse is transmitted to the sinoatrial node. Further from the sinoatrial to the atioventricular node, from which, in turn, the electrical impulse is transmitted through structures called the Hiss bundle to all parts of the heart muscle, causing the heart to contract. If a disturbance occurs in the process of transmitting an electrical impulse from one node to another, then the heart begins to contract incorrectly, first of all, slowly - that is, bradycardia develops. In such a situation, the rhythm is still correct, but the impulse is transmitted weakly, as a result of which the heart contracts more slowly than it should.

However, if for some reason the sinus node becomes suppressed (for example, due to aging changes in the tissues of the heart, the appearance of scar tissue after a heart attack, taking certain medications, etc.), then it will begin to generate impulses slowly, due to This is why bradycardia occurs. Such bradycardia, combined with the correct rhythm, is called sinus. If the sinus node generates electrical impulses with normal frequency and strength, but their conduction in the sinoatrial or atrioventricular nodes is impaired, then the bradycardia is not sinus, but is associated with a blockade of excitation conduction.

Bradycardia - symptoms, signs

Bradycardia is manifested by clinical symptoms and objective signs. Clinical symptoms include various complaints of health disorders. Objective signs of bradycardia include pulse rate and changes in the ECG.

Pulse with bradycardia is calculated in exactly the same way as normal and is less than 60 beats per minute.

ECG signs of bradycardia characterized by prolongation of the P–Q(R) interval by more than 0.12 s (from 0.15 to 0.20 s), while the P wave remains unchanged. With non-sinus bradycardia, the ECG shows prolonged Q-T intervals, widened QRS waves and a negative T wave.

Clinical symptoms of bradycardia the following:

Vague sensations of discomfort in the heart area;
Heartbeat;
Feeling short of air;
Reduced blood pressure;
Fainting;
Paleness of the skin and mucous membranes;
General weakness;
Fast fatiguability;
Dizziness;
Brief episodes of visual impairment;
Dyspnea;
Absent-mindedness, low concentration;
Edema;
Convulsions;
Arrhythmias.

The listed symptoms of bradycardia may have varying degrees of severity. Moreover, with bradycardia, it is possible to develop all of the listed clinical symptoms, or only some. The symptoms are not specific, and therefore are often perceived by people as signs of aging, fatigue, etc.

Typically, with bradycardia 40–59 beats per minute, a person does not have any clinical symptoms. With bradycardia of 30–40 beats per minute, weakness, fatigue, memory and attention disorders, shortness of breath, dizziness, swelling, blurred vision, pale skin and palpitations appear. If the pulse becomes less than 30 beats per minute, then the person may develop convulsions or fainting. Loss of consciousness due to severe bradycardia is called a Margagny-Adams-Stokes attack. If this condition develops, a person must receive immediate medical care to prevent respiratory arrest and subsequent death.

Classification, types of bradycardia and their general characteristics

Depending on the mechanism of development, bradycardia is divided into the following types:
1. caused by a decrease in the activity of the sinus node of the heart;
2. Non-sinus bradycardia associated with blockade of electrical impulses between the nodes of the heart:

Impaired impulse conduction between the sinus and sinoatrial nodes;
Impaired impulse conduction between the sinoatrial and atrioventricular nodes.

For a person suffering from bradycardia, there is absolutely no difference whether it is sinus or non-sinus, since their manifestations are the same. This classification is important for doctors because it allows them to choose the optimal treatment. Otherwise, sinus bradycardia is no different from non-sinus bradycardia, so in the following text we will describe both types of heart rate decrease, without specifying their type depending on the mechanism of development.

Depending on the reason that provoked the decrease in heart rate, bradycardia is divided into three large groups:

Physiological bradycardia, which is often observed in healthy people. Physiological bradycardia is especially common in athletes or simply in people who are physically well developed and trained. Approximately 25% of healthy young men have physiological bradycardia.
Pharmacological or drug-induced bradycardia, which develops against the background of the use of certain medications.
Pathological bradycardia, which develops against the background of pathology and is a symptom of various diseases of the heart and other organs and systems.

Pathological bradycardia can be acute or chronic, depending on the specific causative factor. Acute bradycardia develops sharply, simultaneously, under various conditions that directly or indirectly injure the heart, for example, poisoning, myocarditis or heart attack. Chronic bradycardia has existed for many years and is associated with severe, long-term diseases of the heart or other organs and systems.

In addition, pathological bradycardia is traditionally divided into intracardial and extracardial. Intracardial bradycardia occurs in various heart pathologies. Extracardiac bradycardia is provoked by diseases and dysfunctions of other organs that can indirectly affect the functioning of the heart.

Depending on the severity of the decrease in heart rate, bradycardia is divided into the following types:

Severe bradycardia, at which the heart rate is less than 40 beats per minute;
Moderate bradycardia, at which the heart rate is from 40 to 50 beats per minute;
Mild bradycardia, at which the heart rate is from 50 to 60 beats per minute.

With moderate and mild bradycardia, circulatory disorders do not develop, since the heart contracts and pushes out blood with sufficient force. But with severe bradycardia, numerous circulatory disorders develop, especially in the system of intracranial arteries. Due to poor circulation, a person’s skin and mucous membranes turn pale, loss of consciousness and convulsions develop.

General characteristics of physiological bradycardia

Physiological bradycardia occurs in physically strong or well-trained people, since their heart works at maximum load, and in order to ensure blood supply to all organs and tissues, it only needs to contract rarely. Therefore, bradycardia is always observed in athletes and people engaged in heavy physical labor. In addition, a physiological decrease in heart rate can be observed in the following situations:

Massage of the chest in the area of the heart;
Pressure on the eyeballs (Danyini-Aschner reflex);
Pressure on the carotid artery (for example, with a tightly tied tie, neckerchief, scarf, etc.);
Cold;
Chronic nicotine poisoning (smoking).

Strictly speaking, bradycardia is a decrease in heart rate of less than 60 beats per minute. But for many people, the normal heart rate is less than 60 per minute, which is their physiological feature. Therefore, in principle, any bradycardia is physiological, against the background of which a person feels normal, he is not bothered by fatigue, weakness, dizziness, fainting, difficulty breathing, rapid heartbeat and incomprehensible discomfort in the chest area.

Bradycardia in athletes

Bradycardia in athletes is physiological, that is, it reflects the norm. The fact is that during constant training, the heart gets used to working at maximum power in order to meet the body's increased needs for oxygen and nutrients, for which it has to pump a large volume of blood over a limited period of time. That is, the heart contracts powerfully and strongly, pushing out a large volume of blood in one beat, which is necessary for the organs and tissues of an exercising person. When an athlete does not train, his heart, accustomed to contracting strongly, still pumps blood through the vessels with powerful impulses. Due to good contraction force, the heart may beat less often. After all, one powerful contraction is enough to give the blood a strong impulse, and it will flow through the vessels for a relatively long time. Therefore, due to the strength and power of contractions, it is enough for the heart to beat less often to pump blood.

Bradycardia in children - age norms and possible causes

Children's heart rates are normally higher than those of adults. Moreover, different age categories have their own standards. So, for children from birth to one year, a pulse of 100 or more beats per minute is considered normal. Therefore, for an infant under one year old, a pulse of less than 100 beats per minute will be considered bradycardia. In a child from one to six years old, a pulse of 70 to 80 beats per minute is considered normal. This means that in a child aged 1–6 years, bradycardia is a heart rate of less than 70 beats per minute. In children over 6 years of age, the pulse rate becomes the same as in adults, that is, from 60 to 70 beats per minute, so bradycardia for this age category is a pulse of less than 60 beats per minute.

The classification and types of bradycardia in children are exactly the same as in adults. Causal factors for bradycardia are also associated with various diseases of the heart or other organs, active training, heavy physical work, taking medications, or simply physiological characteristics. If the child feels well and does not complain of increased fatigue, shortness of breath, profuse cold sweats, weakness, fainting or chest pain, then bradycardia is a physiological variant of the norm, that is, an individual feature of a growing organism. If a child complains of any of the listed symptoms, then this indicates pathological bradycardia, which is a sign of another serious disease.

Bradycardia in a child can develop against the background of the following diseases and conditions:

Neuroses;
Metabolic disease;
Infectious diseases;
Hypothermia;
Increased body temperature;
Overdose of drugs;
Smoking;
Lead poisoning;
Heart diseases, including congenital;
Rapid growth of the child;
Insufficient functioning of the thyroid gland (hypothyroidism);
Cerebral circulation disorders.

Bradycardia is much more dangerous for children than for adults, since the adaptive mechanisms of the child’s body are not yet developed, and therefore cannot ensure the redistribution of blood to fully meet the needs of all organs and tissues. This means that bradycardia can provoke sudden loss of consciousness, exhaustion of the body, and even death of the child. Because of this, bradycardia in children requires mandatory treatment by a cardiologist.

Fetal bradycardia

Currently, the CTG (cardiotocography) method allows you to record the fetal heart rate during pregnancy. The lower limit of normal fetal heart rate is 110 beats per minute. If the fetal heart rate is less than 110 beats per minute, then we are talking about bradycardia. Typically, bradycardia indicates intrauterine hypoxia, cerebrovascular accidents, or some other pathology of the fetus. It is impossible to determine from bradycardia alone what kind of developmental disorders the fetus has, since additional detailed examination is necessary using ultrasound, Doppler, possibly genetic analysis, etc. Therefore, fetal bradycardia is a signal for subsequent examination, the purpose of which is to identify any abnormalities present in the fetus.

Currently, many pregnant women are concerned about fetal bradycardia in early pregnancy and ask many questions about this. However, you should know that the information value of measuring heart rate to assess the condition of the fetus occurs no earlier than 20–22 weeks of pregnancy. It is from this time that it makes sense to do CTG and calculate the fetal heart rate. Any measurement of the fetal heart rate earlier than 20–22 weeks of pregnancy is not informative. Until the 20th week of pregnancy, the only information that can be obtained about the fetal heartbeat is whether it is present or not. That is, to record whether the child is alive or dead. If there is a heartbeat, then the child is alive; if it is not heard, it means that the fetus died in utero. Its heart rate does not provide any information about the condition of the fetus until the 20th week of pregnancy. This means that women do not have to worry about fetal bradycardia at 5, 6, 7, 8 ... 19 weeks of pregnancy, since this does not mean anything other than stating the fact that the baby is alive, growing and developing.

Bradycardia in adolescents

Bradycardia in adolescents is quite common and in most cases it is transient, that is, temporary. Bradycardia is noted due to rapid growth and hormonal changes occurring in the body, to which the heart rhythm has not yet adjusted. After some time, when a balance is achieved between active growth and regulatory mechanisms from the central nervous system, the teenager’s bradycardia will go away on its own, without creating any negative consequences.

Bradycardia during pregnancy

In women during pregnancy, bradycardia develops extremely rarely, if it did not exist before pregnancy. Bradycardia can be physiological or pathological. Physiological bradycardia is a variant of the norm and is usually noted if, before pregnancy, a woman led an active lifestyle, trained, physically worked, etc. In this case, bradycardia does not pose any danger to the fetus or to the woman herself.

Pathological bradycardia during pregnancy is usually provoked by the following pathologies:

Thyroid diseases;
Kidney and liver diseases;
Diseases of the heart and blood vessels;
Dysregulation of the central nervous system.

In the presence of pathological bradycardia, a pregnant woman should receive treatment, the purpose of which is to eliminate the diseases that caused the decrease in heartbeat. Pathological bradycardia can be dangerous for the mother and fetus.

Drug-induced bradycardia

Drug-induced bradycardia is also called pharmacological and develops with the use of the following medications:

Cardiac glycosides (Strophanthin, Korglykon, Digitoxin, Digoxin, etc.);
Beta-blockers (Bisoprolol, Timolol, Propranolol, Nadolol, Atenolol, Acebutolol, Betaxolol, Metoprolol, Esmolol, Pindolol, Sotalol, Esatenolol);
Verapamil;
Quinidine;
Antiarrhythmic drugs (Adenosine, Amiodarone, Dronedarone, Phenytoin, Procainamide, Propaphenone, Trimecaine, etc.);
Morphine;
Sympatholytics (Reserpine, Bretilate, Raunatin).

After discontinuation of medications, bradycardia goes away on its own and does not require special treatment.

Bradycardia - causes

The causes of pathological bradycardia can be cardiac or extracardiac. Cardiac causes include the following heart diseases:

Myocardial infarction;
Atherosclerotic or post-infarction cardiosclerosis (replacement of normal heart tissue with scar);
Age-related changes in the heart;
Endocarditis or myocarditis (inflammation of the outer or muscular layer of the heart);

Extracardiac causes of bradycardia are diseases of any other organs except the heart. Currently, extracardiac causes of bradycardia include the following:

Hypothyroidism (underfunction of the thyroid gland);
Increased intracranial pressure;
Meningitis;
Brain contusion;
Bleeding in the brain or meninges;
Brain swelling;
Infectious diseases (hepatitis, influenza, typhoid fever, sepsis);
Uremia (increased urea content in the blood);
Hypercalcemia (increased concentration of calcium in the blood);
Obstructive jaundice;
Peptic ulcer of the stomach and duodenum;
Hypothermia (low body temperature);
Tumors of the mediastinum (esophagus, diaphragm, etc.);
Starvation;
Hypertension;
Renal colic;
Intubation;
Meniere's syndrome;
Poisoning with organophosphorus compounds.

Since bradycardia is not an independent disease, it is provoked by the above pathologies, and at the same time is their symptom.

Why is bradycardia dangerous?

If a person does not have clinical symptoms of bradycardia, then it does not pose a threat to human life and health. But the presence of bradycardia indicates some pathological process occurring in the body, and therefore is a reason for examination and subsequent treatment, which can stop further progression of the disease and maintain good health.

If bradycardia is combined with clinical symptoms, then the danger is unexpected fainting, during which there is a very high risk of sudden death due to cardiac arrest. In such a situation, doctors usually recommend installing a pacemaker.

Bradycardia - treatment

If there are no clinical symptoms with bradycardia, then treatment is not necessary. Treatment for bradycardia is indicated only if it is accompanied by syncope, hypotension (low blood pressure), heart failure, or ventricular arrhythmias. In this case, treatment depends on the reasons that provoked the bradycardia.

If bradycardia is associated with intracardiac causes, then the optimal method of treatment is the installation of a pacemaker. If the decrease in heart rate is provoked by extracardiac factors, then it is necessary to treat the underlying disease, for example, adjust the level of thyroid hormones, eliminate cerebral edema, etc. In addition to treating the underlying disease that provoked bradycardia, a symptomatic increase in heart rate is carried out using the following medications:

Atropine - administered intravenously or subcutaneously at 0.6 - 2 mg 2 - 3 times a day;
Isadrin - administered intravenously at 2 - 20 mcg per minute in a 5% glucose solution until a normal heart rate is achieved;
Eufillin - administered intravenously at 240 - 480 mg or taken orally at 600 mg 1 time per day.

However, these medications only help to temporarily increase the heart rate, so they can only be used as an emergency measure. To achieve a permanent cure for bradycardia, you should begin treatment for the underlying disease that provoked the decrease in heart rate.

Zelenin drops for bradycardia can be taken 35-40 drops 3 times a day. This remedy is effective for moderate bradycardia.

Alternative treatment for bradycardia

Various traditional methods are a good help in the complex treatment of bradycardia, as they allow you to achieve a lasting effect. However, traditional methods are recommended to be used not instead of drug therapy, but in combination with the latter, and then the total therapeutic effect will be maximum.
Currently, the following traditional methods have proven effectiveness in the treatment of bradycardia:

Walnuts that you should eat every day. Nuts should be present in the human diet every day. The best time to eat nuts is for breakfast.
A mixture of honey, lemon and garlic. To prepare it, wash the lemons and scald them with boiling water, then squeeze the juice out of them. Then peel 10 medium heads of garlic and chop them to a paste. Mix the prepared garlic pulp with lemon juice until a homogeneous mass is obtained. Then add one liter of honey to the garlic-lemon mixture and mix the whole mixture well. Place the finished mixture in a sealed container in the refrigerator and leave for 10 days. Then eat 4 teaspoons every day before meals.
Yarrow decoction. To prepare it, pour 50 g of dry grass into 500 ml of warm water, then bring it to a boil. Boil for 10 minutes, then leave for an hour. Strain the finished broth and take one tablespoon three times a day.

Typically, treatment for bradycardia is long-term, and traditional methods can be used for as long as desired.

In addition, to normalize your heart rate, you must adhere to the following rules of life to strengthen your heart:

Follow a fat-restricted diet;
Consume low-calorie foods;
Engage in regular physical exercise;
Quit smoking;
Limit intake of alcoholic beverages.

Do they take into the army with bradycardia?

In the Schedule of Diseases, on the basis of which a conscript is declared unfit for military service, there is no diagnosis of “bradycardia”. This means that if bradycardia is present, the conscript undergoes an examination of the heart and vascular system, and the question of fitness or unfitness for service is decided on the basis of the identified disease of the cardiovascular system.

Sinus bradycardia is an arrhythmic pathology, which is a decrease in heart rate. Such a deviation from the norm often occurs in absolutely healthy people and is discovered only during a preventive medical examination. With this type of bradycardia, the natural pacemaker (sinus node) continues to work, however, impulses are generated in it at a lower frequency.

The heart rate (HR) reaches 35-40 beats per minute, when 60-90 contractions are considered normal. Depending on concomitant diseases, age and physiological conditions of the body, sinus bradycardia has certain characteristics.

Sinus bradycardia in adults

Sinus bradycardia Adults usually do not experience any sensations with the pathology, it does not cause discomfort. Bradycardia is determined only by instrumental studies. With mechanical irritation of the carotid sinus in healthy people, the pause between contractions is about 3 seconds, while in patients this time period increases to 5 seconds.

Sinus bradycardia in children

In children, there are two variants of the course of sinus bradycardia:

absolute – independent of external factors;
relative – depending on certain environmental factors.

In children over 1 year of age, symptoms are similar to those in adults:

general deterioration of health;
malaise, drowsiness and lethargy;
dyspnea;
chest pain;
increased fatigue incommensurate with the level of physical or emotional stress.

Sinus bradycardia during pregnancy

Classification of the disease

Sinus bradycardia can be classified in different ways, however, it is advisable to divide it depending on the reasons that caused the decrease in heart rate and manifestations:

sinus bradycardia of athletes;
moderate sinus bradycardia in childhood accompanied by respiratory arrhythmia;
toxic form - develops when the body is poisoned;
medicinal – in case of overdose of certain medications;
physiological - occurs when the body is overcooled or during sleep.

Causes

The main causes of sinus bradycardia include:

hypothermia of the body;
burdened heredity;
increased tone of the vagus nerve;
infectious diseases;
age-related changes and vascular changes;
traumatic brain injuries;
disruption of the body's hormonal levels and diseases of the endocrine system;
cardiac pathology (coronary heart disease, atrial fibrillation...).

When several causes are combined, the course of sinus bradycardia and its manifestations will be more severe and dangerous for the body.

Symptoms

The symptoms of sinus bradycardia are no different from the manifestations of any form of bradycardia. Main complaints made by patients:

general loss of strength;
attacks of dizziness;
darkening of the eyes;
pain in the heart area;
shortness of breath with little physical exertion.

Physiological bradycardia has no symptoms or manifestations. This form does not negatively affect the functioning of the body and is detected only during medical examinations.

Diagnosis of sinus bradycardia

Instrumental diagnostic methods for determining sinus bradycardia:

24-hour Holter monitoring of cardiac activity.

In some cases, an ultrasound of the heart, a biochemical blood test and determination of thyroid hormone levels may be needed.

Treatment of sinus bradycardia

Treatment is indicated only if the reduced heart rate causes significant harm to the body or can be complicated by dangerous pathological conditions for humans.

Symptomatic drug treatment for bradycardia is prescribed to increase the heart rate. For this use:

sympathomimetics (Ephedrine, Norepinephrine...);
anticholinergics (Atropine, Platiphylline...).

In the case of the dosage form of bradycardia, the dosage of the drugs that caused the decrease in heart rate is reduced.

Methods for preventing bradycardia

To prevent the occurrence of sinus bradycardia, it is recommended to follow five basic recommendations. Among them:

complete cessation of nicotine use;
maintaining an active lifestyle;
avoiding excessive consumption of alcoholic beverages;
eliminating drug abuse;
periodic medical examinations.

Possible complications of bradycardia

Lack of timely diagnosis of sinus bradycardia or its prolonged course can lead to the following complications and pathological conditions:

impaired cardiac circulation with subsequent development of myocardial infarction;
exhaustion of the heart wall and its rupture, leading to death;
development of coronary heart disease;
the occurrence of heart defects;
sudden cardiac arrest.

Disease prognosis

Bradycardia and pregnancy - as a rule, this combination is harmless and occurs without any additional disorders of the cardiovascular system. However, bradycardia can also be a sign of serious disorders, such as myocarditis. Therefore, a pregnant woman is examined and treated if necessary.

Bradycardia during pregnancy - types and causes

During pregnancy, a woman's cardiovascular system is under significant stress, so her heart rate (HR) usually increases. But it also happens that during pregnancy the heart rate decreases, that is, bradycardia develops. This is not always a sign of severe pathology and most often is not accompanied by unpleasant symptoms.

The heart muscle is capable of contracting automatically under the influence of impulses arising within itself. This automaticity is ensured by the conduction system of the heart - special muscles that run along the thickness of the entire heart, forming branches (bundles) and clusters of cells (nodes). The conduction system of the heart consists of nodes located in the atrium and on the border between the atria and ventricles, as well as bundles extending from them that conduct excitation to the myocardium (heart muscle).

Bradycardia is divided into sinus (it can be a variant of the norm), when the main pacemaker (the place where impulses arise) - the sinus node - works slowly and bradycardia as a result of a violation (blockade) of the conduction of heart rhythms at different levels (between the sinus node and the atrium or between atrium and ventricles).

Sinus bradycardia during pregnancy

If the sinus node has congenital reduced automaticity, then sinus bradycardia during pregnancy may be a normal variant. Such a woman from birth adapts to precisely this rhythm without any damage to her health, and her pregnancy proceeds normally.

But sometimes pathological sinus bradycardia develops during pregnancy. It is most often caused by irritation or compression of the vagus nerve (the vagus nerve is a cranial nerve that runs throughout the chest and abdominal cavity) by the growing uterus. Certain chemicals, medications, as well as inflammatory or metabolic diseases of the heart muscle (myocarditis, myocardial dystrophy, coronary heart disease) can also have a depressing effect on the sinus node.

The pulse during sinus bradycardia in pregnant women is rare (up to 60-70 beats per minute), but rhythmic. Sinus arrhythmia almost never causes significant disturbances in the functioning of the heart or discomfort in this area. Sinus bradycardia during pregnancy does not worsen the condition of patients and is not an indication for its interruption.

Bradycardia in pregnant women due to heart blockade

The conduction of impulses in the heart muscle may be disrupted when they pass to the atria or ventricles. A conduction disorder between the sinus node and the atrium is called sinoauricular block, and not all impulses reach the heart muscle of the atria and ventricles. The cause of this blockade can be any disease of the heart muscle. If a pregnant woman feels an attack of dizziness or weakness, it can be relieved by drinking a cup of freshly brewed tea.

With bradycardia in pregnant women, which develops against the background of conduction disturbances between the atrium and the ventricles (atrioventricular block), the pulse will be even rarer, and rhythm disturbances will appear (the atria and ventricles contract in different modes). A woman may experience weakness, dizziness, fainting and fainting conditions.

With significant bradycardia in pregnant women, the brain is primarily affected due to insufficient supply of oxygen and nutrients. This condition is called Morgagni-Adams-Stokes syndrome and is manifested first by dizziness (everything is spinning, the vision becomes dark), and then by loss of consciousness, temporary cardiac and respiratory arrest, convulsions and involuntary urination. After some time, the heart function is restored and the woman regains consciousness (she does not remember what happened to her).

Fedorov Leonid Grigorievich

Even in case of slight deviations from the norm, the expectant mother should be constantly under the supervision of a doctor. If the fetal heart rate is too low, it is important to follow all its instructions.

In most cases, hospitalization and treatment in a hospital are necessary.

If the problem arose at a later stage, and the intrauterine development of the embryo proceeds without deviations, then cesarean section is recommended as a method of delivery.

If an ultrasound showed a deterioration in the fetus’s heart function, slowing or stopping of movements, the presence of sudden respiratory movements and convulsions, the woman should:

Completely give up bad habits.
Normalize your lifestyle.
Use vitamin and mineral complexes selected by your doctor.
Drink teas and tinctures based on medicinal plants.
Take selected medications.

In each case, separate methods for solving the problem are prescribed.

Prevention measures

To prevent any disturbances in the development of the embryo, more attention should be paid to:

Planning pregnancy.
Treatment of chronic diseases before conception.
Healthy lifestyle.
Walking in the fresh air.
Consumption of vitamins and minerals.
Regular rest.
Eliminate stress and physical activity.
Passing preventive examinations.

It is much easier to try to avoid bradycardia than to eliminate it. By following simple recommendations, you can successfully carry and give birth to a completely healthy child.

Preventive measures help avoid the development of bradycardia and eliminate the pathological process in the initial stages of formation. This can also help reduce the likelihood of abnormalities in fetal development.

Bradycardia of any degree in a single case can be considered as a variant of the individual norm, if the abnormal heart rhythm is not accompanied by hemodynamic disturbances and does not affect the patient’s well-being.

Based on the location of disturbances in the conduction system of the heart, sinus bradycardia and bradycardia due to sinoatrial or atrioventricular heart block are distinguished.

Coronary heart disease;
Cardiosclerosis;
Unstable blood pressure;
Atherosclerosis:
Myocarditis and other inflammatory heart diseases;
Myocardial dystrophy.

Among the non-cardiac causes of bradycardia during pregnancy, the following should be noted:

Some types of injuries;
Hypothyroidism;
Infectious diseases of various etiologies;
Disturbances in the electrolyte composition of the blood;
Diseases of the digestive system, in particular peptic ulcers and tumor processes;
Severe poisoning;
Some kidney pathologies.

Clinical manifestations of bradycardia

Increased fatigue and chronic fatigue;
Difficulty breathing;
Increased sweating;
Disorders of memory and attention processes;
Short-term visual impairment;
Feeling of vague discomfort or pressure in the chest;
Dizziness, fainting, loss of consciousness.
“Floaters” before the eyes.

Being a nonspecific symptom of a number of diseases, bradycardia provokes the same nonspecific changes in condition, some of which can be taken as a consequence of hormonal changes in the body.

Severe anxiety, panic attack;
Hyperemia of the facial skin;
Breathing disorders;
Dizziness, deep fainting;
Swelling of the neck veins;
Cyanosis of lips;
Pupil dilation;
Involuntary muscle contractions, severe cramps;
Urinary incontinence.