How to distinguish cardiac from pulmonary dyspnea

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If your heart is beating fast, it is normal to feel it. In cases where the condition is caused by physiological factors, the state of health returns to normal on its own, without visiting a doctor.

Every person has experienced heart palpitations at one time or another. This condition can be either normal or pathological. Only a doctor can determine the exact cause after an examination, but you can independently determine whether you should rush to a specialist or not to worry.

Causes of increased heart rate

When assessing a person’s condition, one must take into account the pulse: is it elevated or normal. If your heart is beating fast, it is normal to feel it. Physiological reasons for this condition:

• strong excitement;
• age up to 7 years;
• exercise stress;
• fright;
• poisoning;
• drinking coffee and other tonic drinks.

In cases where the condition is caused by physiological factors, the state of health returns to normal on its own, without visiting a doctor.

The feeling of palpitations is also characteristic of some pathologies. Most often this is associated with endocrine, vascular and neurological disorders. In this case, a comprehensive diagnosis is required to determine the cause.

If the pressure is not like that of an astronaut

— When I try to sleep on my left side, my heart starts to work like a hammer drill - at first I even thought that the neighbors below were crushing the wall. What could it be?

- The description looks like tachycardia or palpitations with an enlarged left ventricle. It is necessary to be examined to determine the exact cause and correct the functioning of the heart. This in itself is not dangerous, but can lead to heart failure and other complications. That is why, in case of hypertension, it is necessary to promptly normalize high blood pressure so that the heart does not increase in size and its functionality is not impaired.

— Please tell me how to protect yourself from heart disease? What examinations need to be completed?

— You need to start by measuring your blood pressure at home. If you feel pain behind the sternum or in the heart area, you need to consult a doctor and get an ECG. You should check a biochemical blood test - cholesterol and its fractions - to see if there is an indirect threat of coronary disease, the cause of which may be atherosclerosis. For a more detailed examination of the heart, the use of echocardiography is effective, allowing you to check the structure of the heart, valve function, contractility and other parameters. Modern methods include CT coronary angiography, which determines the degree of blood flow disturbance. There are methods of functional diagnostics that can be intermediate - the first manifestations of disorders can be checked using stress tests - for example, bicycle ergometry or treadmill, 24-hour ECG monitoring.

— When should you start monitoring your blood pressure?

- If there is evidence, then from childhood. But even if there are no problems, you should undergo an annual medical examination. As a rule, problems begin between the ages of 40 and 45 for men, and after 55 for women. At this age, you need to begin to control the situation - regularly measure your blood pressure. But this does not mean that you cannot get a myocardial infarction in your youth. For example, the risk of developing myocardial infarction in young women is high when two factors are combined - smoking and taking hormonal contraceptives. In addition, early heart attacks and strokes can be a consequence of genetic predisposition, that is, hereditary.

— Everyone knows that smoking is bad for the heart. What can you say about electronic cigarettes?

— Less information has been accumulated on electronic cigarettes, but the trend is the same - atherosclerosis and hypertension develop more often. Among smokers, the mortality rate from cardiovascular diseases is twice as high.

— I am 79 years old and have atrial fibrillation. I’ve been taking three medications for three years, but to no avail...

- You are receiving good treatment. Atrial fibrillation or atrial fibrillation leads to dangerous complications - thrombosis and strokes. The fact that these diseases did not develop is precisely a consequence of three years of use of these drugs. Since you have had atrial fibrillation for more than three years, it is permanent. In this situation, you need to achieve a normal heart rate so that the heart rate is 60 - 70 beats per minute. If, with the help of the prescribed medication, you manage to achieve these numbers, then good, the treatment is correct.

— I wore a holter* for a day, which showed 8568 ventricular extrasystoles. Please tell me what this indicator says?

- You have more extrasystoles than a healthy person should have. This may be due to emotional stress, as well as functional heart diseases. You definitely need to see a cardiologist to determine the exact cause. If the indicator persists, shortness of breath and other ailments may subsequently appear. To make an appointment with me or other doctors at the REAVIZ clinic, call (846) 321-21-21.

Pathologies in which the heart beats strongly

If there are no physiological reasons, but the heart is pounding, you need to look for pathology. Conditions in which symptoms are observed:

• pathologies of the cardiovascular system: infection, heart disease; arrhythmia, cardiosclerosis, hypertension, heart failure, pericarditis;
• endocrine diseases: diffuse toxic goiter, hyperthyroidism;
• cardiopsychoneurosis;
• anemia;
• menopausal syndrome;
• neurosis.

When the heart is beating strongly and a person experiences chest pain and fear of death, you should immediately call an ambulance. This could be an attack of angina. It is quickly relieved with nitroglycerin, but the patient requires examination and medical supervision.

Diagnostics

If you have increased heartbeat, you should consult a therapist. He will refer you for an examination, with the results of which the patient will go to a specialist: a cardiologist, endocrinologist or neurologist. The list of diagnostic measures if the heart is beating strongly includes:

• general blood analysis;
• ECG;
• blood test for thyroid hormones;
• Ultrasound of the heart (EchoCG);
• daily monitoring of pulse and heart activity according to Holter;
• Ultrasound of the thyroid gland.

If the disease cannot be detected by laboratory and instrumental methods, a consultation with a psychiatrist may be required.

Read also: Heartache

Tachycardia when changing lying position

Tatiana

September 6, 2021

Good afternoon
On August 19, amid prolonged stress, I overexerted myself and suffered a nervous breakdown. Because the piece didn’t go down my throat and the things that made me happy stopped making me happy, so I turned to a psychotherapist. According to her prescription, I started taking escitalopram 1/4 (10 mg) and atarax 1/2 x 3 r. (25 mg). I took it for two days. While taking it, my anxiety intensified and, most importantly, severe nocturnal tachycardia began. Due to the appearance of suicidal thoughts it was cancelled. I have had tachycardia for two weeks now, the mechanics of which I don’t understand. It begins after a long stay in a lying position, in the second half of the night, closer to the morning. It is provoked by a change of position: from the side to the back, from the back to the side, raising the arms. Strong, feels like over 100. Gradually it decreases to tolerable. The psychotherapist promised that this would go away on its own, but over the past time there has been only a slight improvement: at first I could not sleep on my back or right side at all, the tachycardia flared up and lasted longer, now it may subside faster. Previously, the intestines often worked during these attacks and weakened, now less often. The therapist listened, as I understood, there were no noises, sinus rhythm, no edema, she sent me for biochemistry, told me to take 1/2 Concor (2.5 mg), but the medicine does not affect the occurrence of the described tachycardia. Please explain to me what type of tachycardia this is, why it can occur and is it possible to cure it? I am 37 years old, 55 kg, I don’t smoke, I don’t drink alcohol, tea, coffee. A couple of years ago, cholesterol was normal, sugar according to the tonometer was ok. Hemoglobin according to the general analysis is 130, biochemistry should show the depot. There is reflux, but it is always there, and this tachycardia began 2 weeks ago. According to the heart - PMK 1 tbsp. without regurgitation, sinus tachycardia, extrasystoles within normal limits (wearing a holter). Thyroid hormones were usually normal, but now they just need to be checked. Currently I take Omez (prevention of duodenal ulcer), Mebicar (2 times a day), 1/4 phenazepam at night (1 mg), if there was tachycardia - anaprilin 10 mg, now Concor. For my anxiety-depressive disorder, it is recommended to replace it with mirtazapine, but I am afraid to start taking an antidepressant until the problem with this type of tachycardia is resolved. Without it, in 2 weeks my mood improved, my strength increased, my interest in some things and my appetite returned, so it doesn’t seem to be a problem. Chronic diseases:
duodenal ulcer in remission, mitral valve prolapse stage 1. without regurgitation, osteochondrosis, scoliosis, Kimmerli anomaly

The question is closed

tachycardia

antidepressant

SSRIs

Anxiety-depressive disorder

Treatment of increased heart rate

Treatment tactics depend on the diagnosis. Treatment options:

• antiarrhythmic drugs are prescribed in the presence of cardiac arrhythmias;
• tranquilizers are required for neurosis;
• antibiotics are prescribed if there is a heart infection;
• nootropics and antispasmodics are needed for neurocirculatory dystonia;
• thyreostatics or radioactive iodine are indicated for thyrotoxicosis and hyperthyroidism;
• Hormone replacement therapy is carried out for menopausal syndrome;
• for anemia, treatment is prescribed taking into account its type: iron supplements, vitamin B12, etc.

If after 10–14 days of treatment a person does not feel better, further examination is carried out to determine the cause. Sometimes you just need to change the drug to a similar one due to the individual characteristics of the patient.

The feeling of palpitations can be considered normal in several cases. But if the condition recurs frequently and without provoking factors, you need to consult a doctor to find out the cause.

Dear patients! Remember that only a qualified doctor can make an accurate diagnosis, determine the causes and nature of the disease, and prescribe effective treatment. You can make an appointment with our specialists or call a doctor at home by calling 8-(4822)-33-00-33

Be healthy and happy!

Examinations for arrhythmias

The human heart works throughout life. It contracts and relaxes approximately 60 to 100 times per minute at rest. During the systole phase, the heart contracts, ensuring blood flow and delivery of oxygen and nutrients throughout the body. In the diastole phase it rests. It is very important that the heart contracts at regular intervals. Any violation of the frequency, rhythm and sequence of contractions of the heart muscle leads to problems.

Contractions of the heart muscle are provided by electrical impulses that originate in the sinus node and then spread along the conduction pathways, reaching the muscle fibers. Therefore, in order for the cardiac “motor” to work properly, rhythmic regulation of electrical impulses and their clear, coordinated conduction throughout the heart is necessary.

The rhythm of heart contractions is regulated by the endocrine system (through hormones contained in the blood) and the autonomic nervous system. Therefore, the main causes of rhythm disturbances are changes in nervous and endocrine regulation. Your doctor, Lyubov Andreevna, is absolutely right in directing you to do a hormone test.

Tachycardia and bradycardia

An increase in heart rate (more than 100 per minute) is called sinus tachycardia. In this case, the contractions of the heart muscle are full and the picture of the heart on the electrocardiogram (ECG) does not change, an increased rhythm is simply recorded. Tachycardia can be a healthy person’s reaction to stress, an unusual situation or physical activity.

A decrease in heart rate (less than 60 per minute) is called sinus bradycardia. This condition often occurs in physically trained people. However, bradycardia is also accompanied by diseases of the endocrine organs, poisoning, hypothermia, etc.

In addition, among the heart rhythm disturbances there are extrasystole (extraordinary contractions), atrial fibrillation (erratic, completely disturbed rhythm), paroxysmal tachycardia (sudden increase in heart rate to 150-200 beats per minute), etc.

With tachycardia, extrasystole or atrial fibrillation, a person describes his sensations as “strong heartbeat” or “interruptions in the heart”, he feels fading, cardiac arrest. In this case, dizziness occurs, and in rare cases, loss of consciousness.

The traditional way to deal with interruptions in heart function is to take Corvalol, Valocordin, etc. However, self-medication is unacceptable, because along with relatively harmless arrhythmia, which responds well to treatment, there are life-threatening cardiac arrhythmias. Only a cardiologist or arrhythmologist can determine the degree of danger of arrhythmia and its origin. After a full examination, he prescribes treatment. If arrhythmia is not an independent disease, but a symptom of another disease, then the primary disease must be treated.

The main method for diagnosing heart rhythm disorders is an electrocardiogram. But if arrhythmia develops episodically and is difficult to “catch”, daily Holter ECG monitoring is used - recording an electrocardiogram over several hours or days. In this case, the patient leads a normal lifestyle (the sensors installed on the chest do not interfere), but notes the actions he performs by the hour (sleep, rest, physical activity). When deciphering, the doctor compares the ECG data with the patient’s records: finds out the frequency, duration, time and causes of the arrhythmia.

More modern electrophysiological research methods are also used to diagnose rhythm disturbances: intracardiac (from the internal cavity of the heart) and transesophageal.

It is in your power to make the diagnosis easier for the doctor. To do this, when preparing for the reception, think through the answers to such questions.

• How long have you been suffering from arrhythmia? Do seizures occur frequently?

• What exactly do you feel during an attack: strong heartbeat, rapid heartbeat, irregular heartbeat, heart palpitations, interruptions, “failures”?

• What triggers your attack (physical activity, certain body position, food intake)? Or does arrhythmia occur in different situations? Do you experience irregular heart rhythms while at rest, for example, while lying in bed?

• How does an arrhythmia attack begin - gradually or suddenly, how does it end? How long does it last?

• What helps relieve an attack of arrhythmia? Changes in body position, medications?

Also bring records of previous ECGs and examination results to your appointment.

When prescribing drug therapy, the doctor tries to select the minimum effective dose. If there is no effect, it is better not to increase the dose, but to choose another drug or their combination. In addition, treatment is constantly adjusted according to the ECG results.

There are several other causes of rhythm disturbances. It also goes astray in the event of the development of heart anomalies, violations of its anatomical structure (congenital and acquired defects). Sometimes arrhythmia is a reaction of the heart to the pathology of other organs and systems, to drinking alcohol, smoking, and also to medications.

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