If a person has chest pain, the first thing he fears for his heart. There is nothing strange in this, because the instinct of self-preservation works, and the heart is a vital organ. But in reality, anything can hurt in the chest: blood vessels, lungs, pleura, spine, muscles, numerous organs of the mediastinum or abdominal cavity. In a clinical setting, a doctor can conduct instrumental tests that will help you understand what is hurting you. But even at the prehospital stage, it is possible to guess where the source of pain is and for what reason it arose.
How does your heart work?
The heart is a unique muscular organ located in the middle of the chest. The heart pumps blood throughout the body, saturating cells with oxygen and nutrients. The muscular septum divides the heart longitudinally into left and right halves. The valves divide each half into two chambers: the upper (atrium) and the lower (ventricle).
As the heart muscle contracts, it pushes blood first through the atria and then through the ventricles. In the lungs, the blood is saturated with oxygen and through the pulmonary veins enters the left atrium, then into the left ventricle and from it, through the aorta and arterial vessels branching from it, it is distributed throughout the body.
Having given up oxygen, the blood collects in the vena cava, and through them into the right atrium and right ventricle. From there, through the pulmonary artery, the blood enters the lungs, where it is again enriched with oxygen. The main indicator of the heart's performance is the amount of blood it must pump in 1 minute. Usually for an adult this is at least 5.0 liters (300 liters per hour, 7200 liters per day).
The heart beats more than 100,000 times a day, pumping blood through the 20,000 km of veins and arteries that make up the human circulatory system.
When an adult is at rest, the heart beats 60 to 80 times per minute. During physical activity, at a time of stress or excitement, the heart rate can increase to 200 beats per minute.
Other causes of chest pain
Pain in the heart area at rest is possible, which is of extracardiac origin, but simulates cardiac pathology. These may be problems with the lungs (thromboembolism of the branches of the pulmonary artery, pneumonia, cancer) or damage to the intercostal muscles, costal cartilages (costochondritis), osteochondrosis. Then there will be pain in the ribs, especially when breathing deeply, aching or stabbing pain, malaise or weakness. With thromboembolism, breathing problems, severe shortness of breath, increasing dizziness, and a feeling of lack of air occur.
It is not easy to recognize these pathologies, therefore, if any pain appears in the chest area, especially in the left shoulder blade, in the chest area, above the heart area, you should immediately call an ambulance or consult a doctor.
Heart rhythm and conduction disorders
The normal heart rhythm is called sinus rhythm.
The heart has its own electrical (conducting) system, consisting of an electrical impulse generator - the main pacemaker - and conductive pathways connecting the entire electrical circuit. The main pacemaker, located in the right atrium, generates regular electrical impulses at a certain frequency, like a metronome. In response to each impulse, the chambers of the heart contract in strict sequence.
First, a wave of electrical excitation covers the atria, as a result of which they simultaneously contract, throwing blood into the ventricles. Having passed through the atria, the wave does not immediately pass to the ventricles, since they are separated from the atria by tissue that is unable to conduct electrical impulses. In only one small area, a single “bundle of wires” passes through this tissue, through which, after a short delay, the electrical impulse can travel to the ventricles and cause the same wave-like contraction as in the atria. This bundle is called the atrioventricular junction (AV node), and the delay between the contraction of the atria and ventricles is necessary so that the atria have time to “push” blood into the ventricles before the latter begin to contract.
Normally, the atrioventricular junction is the only place in the heart where the transfer of electrical excitation to the ventricles occurs. After this, the electrical impulse spreads through both ventricles, causing them to contract. At the same time, the blood is pushed out of them into the arteries, providing blood supply to all organs of the body and the heart itself.
Thus, a normal heart rhythm differs from an abnormal one in two main features: regularity and a certain frequency. Any disturbance in heart rhythm is always a consequence of dysfunction of the conduction system.
Myths and speculation
Naturally, like everything unusual, people with “incorrectly” located organs cause a lot of speculation and gossip. For example, they are often credited with psychic abilities and the ability to read minds.
In addition, it is believed that such babies will get sick more. In fact, there is no scientific basis for this. It’s just that such people must have a note about their particularity in their medical record, and also exercise certain caution when actively engaging in physical education.
Bradycardia. Slow heart rate
Your heart rate usually beats between 60 and 80 beats per minute.
A reading below 60 beats per minute is called bradycardia. For many people in good physical shape, or if such a rhythm occurs during rest and sleep, then such a rhythm is normal. A distinctive feature of such bradycardia is that with increasing physical activity, the heart rate begins to accelerate, covering the body’s needs with its frequency.
We talk about bradycardia as a disease when the rhythm has a very low frequency, does not respond by increasing frequency to physical activity, or large pauses occur in the rhythmic contraction, which can reach or even exceed more than 2 seconds. Such disturbances lead to fatigue, dizziness and loss of consciousness.
The most common cause of a slow heart rate is:
• Sinus node dysfunction (SU).
• Impaired conduction of the electrical signal from the atria to the ventricles through the atrioventricular node (AV).
When bradycardia is confirmed diagnostically and such a rhythm is the only manifestation, then such a rhythm is effectively corrected by a pacemaker. ICDs can also be used for bradycardia, but only if there are appropriate indications for ICD implantation (life-threatening cardiac arrhythmias).
Symptoms for which you need to call an ambulance
The manifestations of different types of acute coronary syndrome are similar, and it is often impossible to distinguish between angina and heart attack based on symptoms alone.
The symptoms of angina are quite typical. People usually experience an attack of pressing, squeezing pain under the shoulder blade or behind the sternum. People often interpret this sensation as discomfort or heaviness rather than pain. Discomfort may also occur in the shoulder or on the inside of either arm, spreading through the back into the throat, jaw or teeth. However, in people with unstable angina the picture changes. Attacks of pain occur more frequently or more severely, or attacks occur at rest or after light physical activity. About two out of three people who have a heart attack experience unstable angina, shortness of breath or fatigue in the days or weeks before. This change in chest pain patterns can lead to a heart attack.
With a heart attack, the most recognizable symptom is usually pain in the middle of the chest, which may spread to the back, jaw, or left arm. Less commonly, the pain spreads to the right arm. The pain of a heart attack is similar to that of angina, but is usually more severe, lasts longer, and is not relieved by rest or nitroglycerin. Less commonly, the pain is felt in the abdomen, where it may be mistaken for indigestion, especially because burping may provide partial or temporary relief.
For unknown reasons, women often experience atypical symptoms that are less likely to be accurately diagnosed as a heart problem. About a third of people who have had a heart attack do not experience chest pain. Typically these include women, people over 75, those with heart failure or diabetes, and those who have had a stroke.
Other symptoms of an attack include feeling lightheaded or faint, sudden heavy sweating, nausea, shortness of breath, and fast heartbeat (tachycardia).
During a heart attack, a person may become restless, anxious, sweat profusely, and may experience a feeling of impending doom. Lips, hands or feet may turn slightly blue. During the first hours of a heart attack, a heart murmur and abnormal heart sounds can be heard with a stethoscope.
Tachycardia
If your heart rate exceeds 100 beats per minute, it is called tachycardia. Tachycardia can be sinus and belong to normal, physiological tachycardia. Tachycardias with a high frequency, which exceed 180 beats per minute, arising in connection with frequent, group extrasystole, additional conduction pathways are classified as a group of non-normal fast heart rhythms.
Physical activity, emotional stress, and certain diseases can cause an accelerated heart rate that exceeds 100 beats per minute.
When your heart rhythm is very fast or your heart beats for no reason at a high frequency and irregularly, it is called tachyarrhythmia.
Pathological tachycardia is harmful for several reasons. Firstly, with a rapid heartbeat, the efficiency of the heart decreases, since the ventricles do not have time to fill with blood, as a result of which blood pressure drops and blood flow to the organs decreases. Secondly, the conditions of the blood supply to the heart itself worsen, since it does more work per unit of time and requires more oxygen, and poor conditions of the blood supply to the heart increase the risk of coronary disease and subsequent heart attack.
Tachycardia is not a disease, but a symptom, since it can occur as a manifestation of many different diseases. The most common causes of tachycardia are disorders of the autonomic nervous system, endocrine system disorders, hemodynamic disorders and various forms of arrhythmia.
Treatment of the disease
If the false chord is not life-threatening and does not affect health, preventive monitoring by a cardiologist is indicated. Moreover, treatment as such is usually not prescribed - the patient regularly visits a specialist every 3-6 months.
If the situation is dangerous and the chord threatens the functioning of the heart (can lead to cardiac arrest), surgical intervention is indicated to remove it. Such a decision is made if the functioning of the heart is severely impaired, causing regular disruptions in the distribution of blood flow.
It is also allowed to use folk remedies (in consultation with the doctor):
- Take a handful of raisins every day in the morning (on an empty stomach);
- take valerian decoctions;
- drink tea based on peppermint or calendula flowers.
Tachyarrhythmia
This is an abnormally fast heart rate (usually 100 to 400 beats per minute, which occurs either in the upper chambers of the heart (atrial fibrillation, supraventricular tachycardia) or in the lower chambers (ventricular fibrillation, ventricular tachycardia)).
Causes of tachyarrhythmia:
• Heart diseases such as high blood pressure, coronary artery disease (atherosclerosis), heart valve disease, heart failure, cardiomyopathy, tumors and infections.
• Other medical conditions, such as thyroid disease, some lung diseases, electrolyte imbalances, and alcohol and drug abuse.
• Caused by abnormal accessory pathways or extrasystoles.
Tachyarrhythmias occur when the impulse contracting the heart muscle arrives earlier than normal heart rhythm would suggest. Tachyarrhythmias can begin in the upper or lower chambers of the heart.
Tachyarrhythmia includes various types of cardiac arrhythmias:
• Supraventricular tachycardia.
• Ventricular tachycardia (VT).
• Ventricular fibrillation (VF).
Bad habits
35. Cardiologists consider smoking to be the most harmful habit.
36. Excessive alcohol consumption also adversely affects cardiovascular health.
37. Stress is an important factor that contributes to poor diet, smoking, excessive alcohol consumption, and lack of exercise.
38. A sedentary lifestyle contributes to weakness of the heart muscle - the vessels become fragile and therefore the risk of stroke and heart attack increases.
39. Excess weight is an important risk factor for heart disease, ventricular dysfunction, chronic heart failure, stroke and arrhythmia, as well as diabetes.
Supraventricular tachyarrhythmias
Rhythm disorders involving the atria are called supraventricular (supraventricular) arrhythmias. This group of rhythm disturbances is the most common, and it is the one that doctors and patients have to deal with most often. There are 5 main types of supraventricular arrhythmias:
• atrioventricular nodal tachycardia;
• Wolff-Parkinson-White syndrome;
• intraatrial tachycardia;
• atrial flutter;
• atrial fibrillation.
What to eat and what to avoid for heart health?
74. It is recommended to eat at least 400–500 g of vegetables and fruits per day.
75. Nuts, legumes, seeds should be eaten 3-4 times a week.
76. You should eat fish at least twice a week.
77. Cardiologists recommend using extra virgin olive oil as the main fat for cooking.
78. Eat whole grains – at least three times a week, with a preference for brown rice and whole grain pasta.
79. You should eat meat at least twice a week, choosing lean and high-quality meat (not meat products!), and choose low-fat dairy products.
80. 7 grams of dark chocolate (70% cocoa content or more) per day improves heart health.
81. It is forbidden to eat trans fats, which are contained, for example, in store-bought cookies, pies, cakes, pates!
82. Limit salt intake: Healthy adults are recommended to consume no more than 6 g of salt per day, patients with heart disease - no more than 2.3 g per day, and patients with high cholesterol - no more than 1.5 g of salt per day.
83. Alcohol: if you drink it, do it in moderation! The permissible dose for women is a glass of wine, for men – two glasses.
Atrial fibrillation (AF)
Atrial fibrillation is the most common arrhythmia, usually a manifestation of other heart diseases (coronary heart disease, valvular disease, myocarditis, etc.) or metabolic disorders (thyrotoxicosis, electrolyte imbalance, etc.). Sometimes it occurs without an obvious cause, and then it is called idiopathic.
The mechanisms of development of atrial fibrillation are still not fully understood. In some patients, it occurs due to the presence of many chaotic circular waves of electrical excitation in the atria.
Atrial fibrillation is usually treated with medications that maintain a normal rhythm or prevent the heart rate from getting too fast. A prerequisite for atrial fibrillation is the use of anticoagulant therapy. It is used to thin the blood to prevent the formation of blood clots.
For the surgical treatment of atrial fibrillation, the method of radiofrequency ablation (RFA) is used, which is used to slow down the heart rate (RFA of the AV junction) or RFA “isolation of the pulmonary veins” is performed to restore sinus rhythm.
What problems arise
A person whose organs are mirrored will feel the symptoms of common diseases differently, which naturally complicates the work of doctors. So, for example, when appendicitis develops, all the characteristic signs will be felt, but not on the right, but on the left, or even practically not felt at all, since the appendix is often located slightly posteriorly. If the spleen hurts, the doctor, without additional research, can attribute such manifestations to the liver or gall bladder. As a result, the wrong treatment will be prescribed.
The issues of transplantology in patients with mirror placement of organs stand apart. After all, donors, as a rule, are people with the usual variant of internal development. Replacing an organ in the presence of a reverse arrangement is a rather complex process and requires special qualifications and experience from the doctor, since it is necessary to correctly position the vessels so that they do not reject the organ and take root well.
Article on the topic
Surgery in the womb: doctors operated on the heart of an unborn child
Ventricular tachycardia (VT)
VT refers to an abnormally rapid heartbeat. The source of such a rhythm may be an ectopic focus in the myocardium of the right or left ventricle. Typically, the cause of ventricular abnormal pacemakers is diseases of the heart muscle (coronary heart disease, arrhythmogenic dysplasia of the right ventricle, etc.). In VT, the heart does not pump blood as efficiently as it does in normal sinus rhythm. The rapid rhythm of contractions prevents the ventricles from filling completely between individual heartbeats. As a result, the volume of blood circulation in the body decreases.
With VT, symptoms such as dizziness, fainting, presyncope, and loss of consciousness occur. For most patients, VT is considered a very dangerous rhythm, which can lead to the death of the patient.
woman's heart
62. Cardiovascular disease is the No. 1 cause of death among women.
63. Coronary heart disease is diagnosed in every eighth woman aged 45 to 54 years and in every third woman after the age of 65.
64. The worst risk factors for women at any age are smoking, diabetes and lack of physical activity, i.e., inactivity.
65. The study showed that women with an optimistic attitude are 14% less likely to die from cardiovascular disease than pessimists.
Ventricular fibrillation (VF)
VF is a very fast, irregular heart rhythm that occurs in the right or left ventricle of the heart. VF is a more serious pathology than VT because the electrical system of the heart and the heartbeat cycle are completely disorganized. The ventricles tremble and the body receives only a small amount of pumped blood or none at all.
When the heart does not pump blood, the body quickly begins to experience oxygen starvation and sudden cardiac arrest occurs.
Symptoms develop immediately: first the pulse disappears, then consciousness, then the ability to breathe. If sudden cardiac arrest occurs, cardiopulmonary resuscitation (CPR) is required to keep the blood circulating until an external defibrillator can be used to restore the heart rhythm. Defibrillation can be performed by a doctor or emergency medical personnel using an external defibrillator by discharging an electric current through plates located on the chest. If the patient has an ICD implanted, defibrillation will occur automatically after a few seconds of VF onset.
What is a chord
The human heart consists of 4 chambers through which blood regularly passes - 2 ventricles and 2 atria. Blood flow moves through valves, which open in chords. When tensioned, the valve opens the flaps, and when loosened, it closes. Thanks to this, the blood flows only in a given direction and does not move backward.
The valves tension special longitudinal strands - chords. But along with the main ones, additional chords are often identified. They are also attached to certain parts of the heart, but do not take any part in pumping blood. Therefore they are also called false chords.
