definition

Under one Cardiac arrhythmia or one Arrhythmia of the heart one understands you too fast (Tachyarrhythmia) or one too slow heartbeat (Bradyarrhythmia) or that Occurrence of additional "extra" heartbeats (Extrasystoles). Extrasystoles can temporarily disrupt the heart's normal rhythm. You also will be described as palpitations and often have a frightening effect on the person concerned.

Symptoms

Symptoms can vary depending on the type of arrhythmia very different be. Extrasystoles are either described as tripping or dropping out. you are unpleasant, but disturb the heart function in most cases Not. Is it a tachycardia Arrhythmia (too fast) strong palpitations up to racing heart described. Additionally can Chest pain, dizziness and Shortness of breath occur. At a bradykarden (too slow) arrhythmia can lead to it Dizziness, headache, nausea and unconsciousness because too little oxygen arrives in the brain due to the slow heartbeat.

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causes

There are many causes of arrhythmias. They are divided according to the place of origin in the heart. Arrhythmias can be caused by the atria and sinus nodes or the ventricles.Cardiac arrhythmias that cause atria and sinus nodes are called supraventricular arrhythmias. The sinus node is the heart's clock, it ensures a regular and orderly heartbeat. If he gets out of step, the heart's action is too fast (tachycardia) or too slow (bradycardia), depending on the type of arrhythmia. The most common supraventricular arrhythmia is atrial fibrillation, the atria beating disorderly and much too quickly. This causes an absolute arrhythmia of the whole heart, the pulse is very irregular and fast. In addition, atrial fibrillation can cause thrombi, which can cause a stroke or pulmonary embolism.

Other causes can be an AV block. The transition from the atrium to the ventricle is not correct here. The symptoms of the AV block are bradycardia. In addition, there can be an additional conduction path between the atrium and ventricle that disrupts the sinus rhythm. This is referred to as Wolf-Parkinson-White syndrome.

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Arrhythmias emanating from the ventricles are life-threatening and an urgent emergency. When the heart flutters or flickers, there is no longer any decent contraction; there is functional cardiac arrest. Apart from that, extrasystoles can occasionally occur between the normal sinus rhythm, which are perceived as “stumbling” or “dropping out”. Here, too, the chamber becomes an irregular clock and disrupts the sinus rhythm. In the vast majority of cases, they are harmless, but should be clarified.

My heart stumbles while lying down - do I have to worry?

Patients often notice a rhythm disturbance with cardiac stumbling, especially when lying down, which is explained by the relief of the filling of the heart and the pumping act, which no longer have to take place against the force of gravity.

In principle, disturbances of the heart rhythm are a common phenomenon that only requires limited therapy. In particular, congenital disorders of the conduction of stimuli in the atrium or in the context of the transition from atrium and ventricle are harmless and are only treated if the patient has associated complaints.

The greater risk is when atrial fibrillation occurs, which leads to disordered excitation of the atria and inadequate atrial contractions. This results in a significantly increased risk of blood clots forming in the atrium, which can enter the circulation via the heart chamber and consequently into peripheral vessels, for example in the brain. This can close the vessel and thus cause a shortage of supply in the corresponding area, which manifests itself as a stroke in the brain, for example. As a result, possible complications of the arrhythmia usually pose a risk, and depending on the type of arrhythmia, the risk profile of the patient should be assessed and, if necessary, prophylactic therapy should be initiated.

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Palpitations while lying on the left side

Cardiac arrhythmias are often perceived at rest, even though a faster heartbeat is more likely to cause heart stumbling than a slower one. This is mainly because we have a fast heartbeat when we are moving or otherwise busy, we are distracted and do not think so much about what our heart is doing. In addition, dropouts or stumbling are more noticeable with a slow pulse, as there are fewer beats per unit of time.

However, rhythm disturbances can be very position-dependent, i.e. they only occur when lying on one side. Since the heart is more on the left side of the chest, when lying on the left side it is pressed against the wall of the chest. Because the rib cage is innervated more closely, we feel the heartbeat much more than when we stand. In this way, not only are the normal heartbeat perceived to a greater extent, but also the extrasystoles, which would not even be noticed while standing. In addition, the lying position leads to a stronger heartbeat. The blood doesn't have to be pumped back to the heart against gravity, which makes the heart easier and more blood to fill. This not only makes the heartbeat stronger and easier to feel, but also the extrasystoles.

Also read the article: Palpitations at rest.

Palpitations while lying on the right side

The rhythm disturbances become especially when lying down On the right side perceived, it has almost the same causes as lying on the left side. Here, too, it plays a role that extrasystoles are more noticeable at rest, with a slow pulse, and that we pay more attention to them than when we are distracted and busy. Laying the heart fills more with bloodsince the venous return flow to the heart more easily goes as if the blood has to be drawn against gravity. The heartbeat and thus also the extrasystoles are more powerful and thus better perceived. Since the heart is not always in the chest in the same way, it is possible that when lying on the right side, the heart is pressed more strongly against the wall of the chest than when lying on the left side. Since the Chest very well innervated is, the extrasystoles are particularly or exclusively perceived in this position and in no other.

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Palpitations while lying on the left side and sitting

The same applies here: In physical rest and with a slow pulse, extrasystoles are more noticeable and more attention is paid to them, especially if the arrhythmias occur more frequently and those affected are sensitized to them. If you are just waiting for your heart to stumble, every dropout or double beat will be noticed. While sitting, especially if you can bends forwardthat will Heart against the chest wall (Chest wall) pressed. Because the rib cage is well pervaded by nerves, we feel heartbeats and palpitations particularly clearly or only then perceive them.

Palpitations get better when lying down

The stumbling of the heart as a symptom of cardiac arrhythmias, can be improved or flattened while lying down and thus under physical rest, which can have various causes.

If the body is brought into a lying position, whether relaxed on the sofa during the day or to sleep in the evening or at night, the circulation comes to rest and relaxation occurs more. Not only for the body, but also for the psyche. Stress as a major risk factor for cardiac arrhythmias and cardiac stumbling is reduced (briefly), which can definitely lead to the cardiac stumbling getting better.

Another point of view is that in a lying position there is more blood available in the direct body circulation than in a sitting, standing or walking position. In a standing position, a certain percentage of blood sinks into the peripheral veins, as it is often said in the vernacular: "the blood sinks into the legs". This blood is then “missing” in the direct circulation, which the heart tries to compensate with a faster beat. This extra work of the heart can in turn provoke heart palpitations. A lying position stabilizes the circulation, more blood is available for circulation, the heart beats more slowly and the stumbling of the heart can improve.

Palpitations get worse lying down

If heart stumbling worsens while lying down, it is usually not because the arrhythmia itself is getting worse or worse, but because the body is more calm and the person concerned becomes more vigilant towards their own body.

Because the body comes to rest more when lying down, stress generally flattens a bit, blood pressure drops and the heartbeat slows down, the cardiac arrhythmias are usually better and the heart palpitations less.
Nevertheless, when lying down there is also the point that “distracting” disruptive factors in the environment often disappear and those affected automatically concentrate more on themselves. Not only ambient noises and all perceptions in everyday life distract from one's own body perception, the body's own movements also dampen the perception of the palpitations while standing and walking to a certain extent.

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If the body comes to rest while lying down, there are no movements, the visual, tactile or auditory stimuli become less and the concentration returns more to one's own body. It is often the case that the palpitations are felt to be louder or worse, although they have not changed or even improved somewhat compared to the rest of the time of the day. It is even possible that the stumbling of the heart can also worsen, as the increased perception creates a feeling of fear that puts the body in a stressful situation and makes the heart beat faster, which can increase the occurrence of heart stumbling.

Heart stumbling while lying down during pregnancy

The body is subject to many changes during pregnancy. Hormonal changes in particular can cause cardiac arrhythmias. Therefore, cardiac arrhythmias in women often only occur in life when the body is exposed to strong hormone fluctuations. This is the case on the one hand during pregnancy, but also during menopause. In addition, the heartbeat becomes physiologically faster during pregnancy, which is quite normal.

After all, not only the mother's body but also that of the fetus must be supplied with oxygen and nutrients. A faster heartbeat promotes arrhythmias. Taken together, all these factors mean that arrhythmias are not uncommon in pregnancy and are not dangerous if they do not occur too often. Because most extrasystoles have no hemodynamic (circulatory) effects. They usually only exist temporarily and calm down again as soon as the additional risk factors are gone. The dangerous tachyarrhythmias (arrhythmias with a heartbeat that is too fast) such as atrial fibrillation or reentry tachycardias are less common. In case of doubt and especially if it occurs frequently, one should look for it.

You can find further information under our topic: Palpitations during pregnancy

therapy

The most arrhythmias are harmless and do not require any treatment. However, there is one manifest heart disease behind it or have the arrhythmias Consequences for the circulatory function, action must be taken. The only Antiarrhythmic (Medicines for irregular heartbeat), which extends the lifetime of proven measurements, is that cardioselective beta blockers. As the name indicates, blocked the drug the Beta adrenergic receptors, Receptors for adrenaline and noradrenaline. The two messenger substances increase heart rate and volumethat pumps the heart. When these receptors are turned off, that becomes especially the most Heart rate throttled. In the case of a tachycardiac arrhythmia, the too high frequency reduced to a natural level - the problem is solved.

Beta blockers also help against extrasystoles, because a slower heart rate makes it difficult for them to come about. But you should cautiously if the blood pressure is already low be because beta blockers also lower blood pressure. All other antiarrhythmic drugs disrupt the natural excitation of the heart. You can do impressive EKG cosmetics with them, but they disrupt the flow of the excitation wave of the clock in the heart, the sinus node.

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Read a lot more information at: Therapy of heart stumbling

forecast

The prognosis, of course, depends on the cause. Since the most arrhythmias benign are and no serious consequencen bring with them, they have one good prognosis and no further restrictions. You are merely unpleasant.

prophylaxis

To prevention (Prevention) or for Improvement of cardiac arrhythmias can Endurance sports bring a lot and partly replace drug therapy. Through the endurance training the heart rate decreases over time from. Since a fast pulse promotes arrhythmias, this can be counteracted by a "natural" lowering of the heart rate. After all, beta blockers do nothing but reduce the heart rate.


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