Sinus tachycardia - description, causes, symptoms (signs), diagnosis, treatment. Tachycardia Paroxysmal supraventricular tachycardia ICD code 10

Heart rhythm is associated with the work of the whole body; if the function of any internal organs is disrupted, this can cause failure of myocardial contractions.

Most often, the electrical conductivity and contractile function of the heart suffer due to disruption of the autonomic nervous system, the thyroid gland and adrenal glands, which are responsible for the production of hormones, and damage to the tissue of the heart muscle itself.

Heart rhythm can change during a temporary painful condition, with any chronic pathology.

• All information on the site is for informational purposes only and is NOT a guide to action!
• Can give you an ACCURATE DIAGNOSIS only DOCTOR!
• We kindly ask you NOT to self-medicate, but make an appointment with a specialist!
• Health to you and your loved ones!

In a healthy heart, an electrical impulse is generated in the sinus region, then sent to the atria and ventricles. Tachycardia, which is a type of arrhythmic condition, is characterized by rapid contraction of the heart muscle, and impulses may be incorrectly formed and propagated.

In some cases, tachycardia is the body’s reaction to an external stimulus or internal changes, which is not a pathology, but sometimes it poses a threat to health.

Paroxysms are heart attacks that can last several seconds, minutes, hours, and very rarely days. With paroxysmal tachycardia, the heart rate can reach 140–200 or more beats per minute, while the sinus rhythm is regular.

Paroxysms develop due to the fact that the electrical signal encounters an obstacle in its path, then the areas located above the obstacle begin to contract. They become ectopic foci, places where additional stimulation occurs.

In another case, the electrical signal has additional paths for the impulse to pass through. As a result, the ventricles and atria contract more often than necessary, while they do not have time to relax, fully take in blood and push it out. Therefore, an attack of paroxysmal tachycardia causes disruption of blood flow, oxygen starvation of the brain and other organs.

Kinds

Clinical signs of pathology and the location of formation of ectopic foci influence the course of the disease, so it can be characterized by three main stages:

According to the mechanism of development of foci of electrical impulse excitation, paroxysmal tachycardia can be:

The ectopic focus can be various parts of the heart muscle, depending on this, the pathology can be:

According to the International Classification, paroxysmal tachycardia has an ICD 10 code - I47.

Causes

Provoking factors can be of organic and inorganic origin:

Symptoms

A characteristic sign of the pathology is sudden paroxysms that begin with a shock to the heart. An attack of arrhythmia can last several seconds or days, and the contraction frequency reaches 140–250 per minute.

During an attack you may experience:

• dizziness;
• noise in the head;
• cardiopalmus;
• angina pain;
• pale skin;
• cold sweat;
• low pressure;
• polyuria.

Very often, arrhythmia is confused with an anxious psycho-emotional state. The difference between a panic attack and paroxysmal tachycardia is that during an attack there appears a “lump in the throat” and fear of an uncertain nature, which can be described as an obsessive state. This is not the case with paroxysms.

Diagnostics

It is not difficult to make a diagnosis of paroxysmal tachycardia using an ECG. It must be carried out during an attack.

The doctor may prescribe additional diagnostics using cardiac ultrasound, 24-hour ECG monitoring, bicycle ergometry, cardiac MRI, and coronary angiography.

Treatment of paroxysmal tachycardia

In most cases, patients are hospitalized in a hospital, especially if there is heart failure. In the idiopathic form, attacks are controlled with antiarrhythmic drugs. Patients with a frequency of attacks of more than 2 per month are subject to planned hospitalization and in-depth examination.

Before arriving at the hospital, the ambulance team is obliged to provide the patient with first aid and administer one of the antiarrhythmic drugs that are effective for any form of paroxysmal tachycardia:

• procainamide;
• propranolol;
• ajmaline;
• quinidine;
• rhythmodan;
• etmozin;
• cordarone.

If the attack lasts a long time and is not controlled by drugs, electropulse therapy is performed.

After the attack has stopped, patients should undergo outpatient treatment under the supervision of a cardiologist who provides antiarrhythmic therapy according to an individual regimen.

Anti-relapse therapy is used for patients with frequent attacks. Beta blockers are prescribed along with antiarrhythmic drugs to reduce the risk of developing atrial fibrillation. Cardiac glycosides are prescribed to patients for continuous use.

In severe cases, patients are prescribed surgical treatment:

• destruction (destruction) of additional pathways or ectopic foci;
• radiofrequency ablation;
• installation of a pacemaker.

First aid

First you need to establish the cause of the attack. The patient is examined, anamnesis is taken, an ECG is examined, and only after that antiarrhythmic therapy is prescribed; it can be repeated only after half an hour.

If the administration of drugs 3 times does not produce results, proceed to electrodefibrillation to prevent the development of heart or coronary failure due to a sharp drop in pressure.

First aid for supraventricular tachycardia includes “vagal” methods, when, by acting on the vagus nerve, the heart muscle is given an “order” to reduce contractions.

The patient must:

• strain;
• take a deep breath, holding the air;
• massage the eyeballs for several minutes;
• try to induce vomiting.

You can also press on the carotid artery. But all these methods cannot be applied to older people. It is best if the first aid technique is carried out under the supervision of specialists. Next, the patient is given Verapamil; if it is ineffective, Obzidan is given after 2 hours.

Lifestyle

A healthy lifestyle helps prevent the development of pathology, when alcohol and nicotine addiction are excluded, coffee and strong tea are consumed in moderation. It is also necessary to monitor your psycho-emotional state and not allow the body to be subjected to prolonged physical and mental stress, which leads to fatigue and stress.

It is better to exclude animal fats and junk foods (fried, salty, smoked, sweet) from the diet; eat more vegetables and fruits, fermented milk products, and cereals. It is necessary to reduce weight to normal, which helps reduce the load on the heart and blood vessels.

Complications

Supraventricular paroxysmal tachycardia rarely leads to complications. Serious relapses and even death can cause ventricular paroxysms.

Ventricular tachycardia can result in pulmonary edema, acute heart failure, heart attack, ventricular fibrillation, pulmonary embolism, ischemic stroke, thrombosis of the renal arteries and lower extremities.

Forecast

In the future, the health of a patient with paroxysmal tachycardia depends on the form of the pathology, the duration of the attacks, the location of the ectopic foci, the factors that caused the development of paroxysms, and the condition of the myocardial tissue.

With supraventricular supraventricular tachycardia, patients do not lose their ability to work, although the pathology rarely goes away over the years. In this case, tachycardia usually develops against the background of various organic myocardial diseases, therefore, in the first case, the treatment method is directed to the underlying pathology.

The worst prognosis is ventricular tachycardia, the cause of which is myocardial pathology, because damage to the heart muscle over time leads to the development of ventricular fibrillation.

If the patient has no complications, he can live for years with a diagnosis of paroxysmal tachycardia, being on constant antiarrhythmic therapy.

Patients with various and those who have experienced clinical death are susceptible to a lethal outcome in the ventricular form.

Prevention

Timely diagnosis and treatment of the underlying disease, elimination of provoking factors, and taking sedative and antiarrhythmic drugs are used as preventive measures for the development of paroxysms.

In some cases, surgical treatment and implantation of a pacemaker are necessary.

Patients with a high risk of death are prescribed beta blockers, antiplatelet agents, and antiarrhythmics for life.

The correct heart rhythm depends on the uniform occurrence of impulses in the sinus node and their conduction through the conduction system of fibers. The sinus node is a collection of nerve cells located in the atrium. It receives “commands” via a special nerve from the brain.

Next, the “instructions” are distributed along the nerve bundles. Thanks to the precise work, the contractions of the atria and ventricles, the filling (diastole) and contraction (systole) phases are coordinated. The endocrine system is involved in rhythm regulation through the hormone adrenaline and its derivatives.

The norm for sinus rhythm is the number of contractions ranging from 60 to 90 beats per minute. Sinus tachycardia is an increase in frequency over 90.

Sinus tachycardia is also called “normotopic” because it always depends on the main sinus, in contrast to “heterotopic”, which occurs due to increased activity of other nodes. This is how paroxysmal tachycardia is formed. In this case, the heart rate (HR) will also be above 90, but the heart rhythm goes the wrong way, the work of different departments becomes uncoordinated and incomplete. This form is dangerous for the development of complications. The terms “sinus tachycardia” and “sinusoidal”, used by inexperienced patients, are incorrect from a medical point of view.

Types of sinus tachycardia

The causes of sinus tachycardia have been studied quite well. They are not always associated with cardiac pathology. Moderate sinus tachycardia serves as a normal physiological mechanism for overcoming physical exertion and emotional stress. Depending on the predominance of causes, several varieties are distinguished.

Constitutional

It is relatively rare. Associated with a congenital disorder of excitation formation in the sinus node. A person suffers from tachycardia throughout his life. Heart rate in children is 120 per minute, in adolescents and adults it is 100 and higher.

Neurogenic

Endocrine

Increased thyroid function during thyrotoxicosis leads to the production of excess thyroxine hormone. It speeds up the basal metabolism, heart rate and blood circulation speed.

Toxic

Sinus tachycardia is caused by substances such as atropine, adrenaline, caffeine, nicotine, alcohol, and digitalis.

This type of arrhythmia is characteristic of infectious diseases. Here, in addition to the toxic effect on the node, the following play a role:

• temperature increase;
• drop in blood pressure;
• anemia (decreased hemoglobin level).

It is believed that an increase in temperature by one degree causes an increase in heart rate by 8–10 beats per minute. Hypertension is accompanied by a decrease in heart rate; with low blood pressure, tachycardia is observed. Sinus tachycardia is especially pronounced in severe infections and septic conditions, in which all types of effects are combined.

Cardiogenic

This type of tachycardia is characteristic of the initial symptoms of heart failure. It occurs as a result of a compensatory mechanism that improves the supply of oxygen to tissues. Observed when

• myocardial infarction,
• heart aneurysm,
• endocarditis,
• heart defects,
• hypertensive crises,
• atherosclerosis of the coronary arteries.

Orthostatic

When moving from a lying position to an upright position, the heart rate increases. In people with a certain type of nervous system, this acceleration is very strong. Such manifestations are especially often observed during the period of recovery from various diseases, if a person has been forced to remain in bed for a long time.

Diagnostics

According to ICD-10 (International Classification of Diseases, Tenth Revision), sinus tachycardia is classified as class I 47.1, “supraventricular tachycardia.” The terminology adopted in Russia in this case does not contradict the ICD, but clarifies it.

Clinical manifestations of tachycardia from the sinus node in the form of palpitations, pulsating tinnitus, dizziness, shortness of breath are often symptoms of other diseases and are associated with neuroses.

The diagnosis can be made by a doctor after an electrocardiographic examination (ECG). Regular listening to the heart and counting the pulse can indicate an increase in heart rate, but does not say anything about the correct rhythm. So the symptoms of sinus tachycardia can only be seen with a special study. The ECG is taken in the supine position. The pulses are recorded by electrodes and converted into a graphic image. By the nature of the teeth, the length and position of the intervals, a doctor in a functional diagnostics office can judge many diseases, including the correctness of the rhythm.

Holter observation is carried out during the day in a cardiology hospital. This is important for diagnosis if no acceleration of the rhythm is recorded on the ECG.

Sometimes, to resolve the issue of a person’s suitability for work in difficult conditions (service in the army, in units of the Ministry of Internal Affairs, admission to a military school, contact with occupational hazards), a medical commission prescribes stress tests. The most popular is to take an ECG before the test, then the patient is asked to do 20 squats at a moderate pace and an ECG is taken after the exercise. The increase in heart rate is used to judge the adaptive capabilities of the cardiovascular system.

A more thorough examination is carried out on specially equipped simulators. At the same time, not only the rhythm is monitored, but also other indicators of the functioning of different parts of the heart.

Treatment

To eliminate sinus arrhythmia, it is often enough to carry out good treatment of the diseases that caused it (thyrotoxicosis, infectious diseases, hypertension, heart disease). When prescribing therapy, the doctor always takes into account the heart rate. Usually they warn about the need to control the pulse when treating with certain medications.

General procedures that strengthen the nervous system (massage, baths, showers), physiotherapeutic treatment simultaneously calm the patient and normalize arrhythmia. In complex neurogenic cases, consultations with a psychologist, treatment with hypnosis, and auto-training are recommended.

If palpitations occur, there is a well-known method of self-help: try to breathe deeply, after several breathing movements, hold your breath at the height of inspiration, tighten your abdominal muscles. This simple method helps to cope with tachycardia.

• lemon balm herb,
• hawthorn flowers and fruits,
• viburnum berries,
• valerian root.

Useful video:

You can prepare them without a steam bath, pour a tablespoon of crushed raw materials into a half-liter thermos and pour boiling water. Leave it overnight or for 5 – 6 hours. After straining, drink before meals throughout the day, combine with honey. Hawthorn can be purchased at the pharmacy in the form of an alcohol tincture. It can be added to tea 10 - 15 drops.

We should not forget that prolonged tachycardia is dangerous due to its consequences. Incomplete and incorrect contraction of the heart muscle causes it to overstrain, requires more oxygen, and disrupts the delivery of blood to the brain. An examination by a specialist doctor should be carried out as early as possible. Timely initiation of treatment will prevent the development of serious diseases.

Drugs for the treatment of sinus tachycardia

Normal heart rate in children and adults

• Treatment of joints
• Weight loss
• Varicose veins
• Nail fungus
• Fighting wrinkles
• High blood pressure (hypertension)

Causes and symptoms of pulmonary edema during myocardial infarction

Pulmonary edema during myocardial infarction is a pathological process that accompanies heart failure. In this case, the cells of the affected area of ​​the myocardium (heart muscle) die, since due to a failure of the blood flow of the coronary arteries, the supply of oxygen and nutrients to the heart is stopped. This may be accompanied by the development of edema in the lungs, which is caused by the accumulation of blood plasma released from the vessels in the lung tissues and alveoli. Thus, a heart attack is complicated by problems with the patient’s breathing; this is an extremely dangerous condition that can lead to the death of the patient and requires an immediate response.

According to ICD-10, the disease is assigned a code of 121, and its complication in the form of pulmonary edema is assigned a code of 150.1.

Why does the disease develop?

Cardiologists associate the development of this complex of pathologies with two factors:

1. Blockage of the coronary artery as a result of atherosclerosis, or significant narrowing of the lumen.
2. Too high pressure in the ventricle due to certain heart pathologies.

As you know, the job of the heart is to pump blood. The heart contracts in cycles, while the myocardium either relaxes or contracts again. When the heart relaxes (the so-called diastole), the ventricle is filled with blood, and during systole (contraction), it is pumped by the heart into the vessels.

When a patient develops a heart attack, the ventricles lose the ability to completely relax. This occurs due to the death of some muscle cells - necrosis.

Similar problems with the ventricles are observed in other pathologies:

• ischemic disease;
• aortic stenosis;
• high pressure;
• hypertrophic cardiomyopathy.

But if during a heart attack the cause of ventricular dysfunction is necrosis, in the listed cases other pathological changes act as such.

It lies in the fact that during a heart attack, blood stagnates in the capillaries of the lungs and the pulmonary circulation. Hydrostatic pressure gradually increases in them, and plasma penetrates into the lung tissue and interstitial volume, which is “squeezed out” from the blood vessels. This process causes acute respiratory dysfunction and can be fatal to the patient.

Symptoms

In medicine, it is customary to consider the following symptoms as indicators of a heart attack with edema:

• significant pain in the pit of the stomach, behind the sternum or in the area of ​​the heart;
• progressive weakness;
• increased heart rate up to 200 beats per minute, and even more (severe tachycardia);
• increase in blood pressure;
• shortness of breath, lack of air;
• presence of wheezing in the lungs. They are at first dry, gradually turning into wet;
• shortness of breath on inspiration;
• wet cough;
• cyanosis (blue discoloration of the skin and mucous membranes);
• The patient breaks out in a cold sweat.

As the pathological condition develops, the temperature rises, but does not exceed 38 degrees. The symptom can develop either five to six hours after a heart attack or a day later.

When the edema completely spreads to the lungs (this is especially typical for heart failure with damage to the left ventricle and the heart attack itself), shortness of breath intensifies. Gas exchange in the lungs continues to deteriorate, and the patient experiences attacks of suffocation. The fluid gradually enters the bronchi and alveoli, the latter stick together, and wet wheezing is heard in the lungs of patients.

Consequences of a heart attack with edema

The death of a patient can be prevented if assistance is provided promptly and correctly. If first aid was not provided, then there is a high probability of death due to asphyxia or ventricular atrial fibrillation.

This type of myocardial infarction can cause the following consequences:

• cardiogenic shock. The patient's blood pressure drops, the pulse becomes thready, and the heart muscle eventually stops;
• cardiosclerosis: after a heart attack, the heart tissue that has died as a result of the attack becomes scarred;
• atrioventricular block: disruption of the conduction of electrical impulses inside the heart, up to complete cessation of their passage;
• fibrinous periocarditis. This pathology is characterized by an inflammatory process that affects the fibroserous membrane of the heart;
• post-infarction aneurysm, in which the part of the wall of the cardiac ventricle that was affected begins to bulge. This pathology can occur several months after a heart attack, and is recorded in approximately 15 cases out of 100;
• there is a risk of developing a pulmonary infarction. Some lung tissue may also die and be replaced by scar tissue;
• cerebral infarction.

Diagnosis and assistance to the patient

The initial diagnosis is usually carried out by ambulance doctors called to the scene. It is quite simple for a trained specialist to determine the cause of a patient’s illness, since the clinical picture of the manifestations of a heart attack and pulmonary edema is visible very clearly and allows a fairly accurate conclusion to be drawn based on an initial examination.

The diagnosis is clarified using an ECG, as well as listening to the heart rhythm. When a patient is admitted to a hospital for treatment, he also undergoes ultrasound diagnostics of the lungs and heart (or X-ray examination of them). Additionally, tests are taken: the blood is examined for specific proteins and enzymes, as well as for the content of various blood cells.

In diagnosis, it is important to remember that a number of symptoms of a heart attack are similar to those of internal hemorrhage, pneumothorax, perforation of a gastric ulcer, pancreatitis and some other diseases.

Before the ambulance arrives, the patient should be placed in a semi-sitting position. To dilate the arteries of the heart, nitroglycerin is placed under the person’s tongue, one or two tablets, at intervals of 15 minutes. It is also advisable to let the patient chew and swallow 150 milligrams of aspirin. Then you should wait for the doctors to begin professional treatment.

Ways to prevent heart attacks include:

1. Physical exercise.
2. Bringing body mass index to normal.
3. Rejection of bad habits.

Regular medical examinations and timely treatment of identified diseases are of great importance.

Symptoms and treatment of hypoplastic anemia

A pathological condition characterized by a reduced content of blood cells and hemoglobin is called anemia (popular version - anemia). A reduced hemoglobin level is the main necessary sign for diagnosis. A decrease in red blood cells during anemia may not be observed and may not be considered a defining criterion. It is important to know that anemia is not an independent disease, but only a manifestation (symptom) of the underlying pathology. When the level of hemoglobin in the blood decreases, a thorough diagnosis must be carried out to discover the cause of the symptom. Anemia develops against the background of increased blood loss, decreased hemoglobin formation, and increased destruction of blood cells. According to these criteria, it is divided into the following types:

1. Posthemorrhagic develops as a result of acute or chronic blood loss (wounds, trauma).
2. Hemolytic is formed against the background of increased intra- and extravascular destruction of red blood cells. The predominant symptom is jaundice.
3. Iron deficiency occurs when the concentration of iron in the blood is reduced.
4. B12-, folate deficiency occurs when the content of these microelements is low. Vitamin B12 deficiency is characterized by anemia and neurological symptoms.
5. Hypoplastic is the most severe type of pathology, developing as a result of impaired hematopoiesis in the bone marrow.

General concepts about hypoplastic anemia

Hypoplastic anemia is a pathological change in the blood picture due to suppression of the red bone marrow. This is manifested by a decrease in the production of all blood germs (erythrocyte, leukocyte, platelet) or only red (decreased red blood cells). The history of the first description and appearance of this disease begins in 1888. At this time, P. Ehrlich identified a disease in the girl, manifested by the acute development of bleeding, fever, deep anemia and leukopenia. According to the results of the autopsy and bone marrow examination, no signs of hematopoietic disorders were identified. Anaplastic anemia as an independent disease was identified by Shoffar in 1904. Later, aplastic anemia of the Ehrlich type appeared with symptoms of sepsis, necrosis, hemorrhage and aplasia (the absence of all hematopoietic germs in the bone marrow), which manifests itself in young people (18–20 years old). The main population suffering from this disease are young girls and children. There are several stages in the pathogenesis of development. First, tissues, due to lack of oxygen and nutrients, atrophy and lose their functions. Next, adipose and connective tissue replace the dead cells, which leads to the spread of the pathological process. The progression of the disease occurs very quickly and, if left untreated, can lead to death.

Classification

Depending on the origin, hypoplastic anemia is:

• congenital. Symptoms of the disease appear in early childhood and progress rapidly. The causes of development may be genetic mutations of DNA in the fetus; hereditary predisposition (there is evidence of a similar anomaly in one of the relatives); impaired intrauterine development (pathological changes in the fetal hematopoietic system under the influence of an unfavorable factor). Studies have shown that boys suffer from congenital aplastic syndrome twice as often as girls;
• acquired. This type of hypoplastic anemia is typical for any age group.

There are idiopathic (the cause of the disease is unknown) and myelotoxic (the prerequisite is the toxic effect of an external factor) forms. The reasons that determine the development of myelotoxic form of anemia include:

• chronic intoxication with chemicals;
• medications with side effects on hematopoiesis (hormonal, tranquilizers, cytostatics);
• exposure of the body to high doses of radiation (radiologists are susceptible);
• diseases of the endocrine system (may be complicated by hypoplastic anemia);
• effects of viruses on blood cells;
• against the background of tuberculosis and pregnancy, hypoplastic anemia can also develop, but such cases are rare in medical practice.

Depending on the duration of the disease, there are:

1. Acute anemia (lasts up to 4 weeks).
2. Subacute (lasts 1–6 months).
3. Chronic (present for more than six months).

Depending on the severity of damage to bone marrow functions, there are pathologies:

1. Moderate severity. The disruption of hematopoietic elements occurs selectively, while maintaining minimal formation of full-fledged blood cells.
2. Severe severity. The bulk of the bone marrow atrophies and is replaced by adipose tissue. 30 percent of the bone marrow is functionally active.
3. Extremely severe. There is an almost complete loss of function by the bone marrow and its replacement with adipose tissue.

Depending on the affected blood sprouts, the following are distinguished:

1. Erythrocytopenia, or partial hypoplastic anemia (suppression of erythrocyte hematopoiesis).
2. Erythrocyte-, thrombocytopenia (decreased production of red blood cells and platelets).
3. Pancytopenia, or true hypoplastic anemia, (reduced production of all blood cells).

According to the International Classification of Diseases (ICD-10), anaplastic anemia has code D60 (erythroblastopenia - acquired red cell aplasia), D61 (other aplastic anemia).

Causes

There are three main groups of causes for the development of hypoplastic anemia:

1. Genetic. The hereditary factor ensures the transmission of parental genes that cause the formation of anemia, or the destructuring of chromosomes, when, under the influence of various reasons, chromosomal aberrations occur, manifested by doubling, rupture, loss, or rearrangement of their chains. A person normally has 46 chromosomes; with the described disorders, their number can change (45, 47), which is manifested by various chromosomal diseases and syndromes.
2. Main. This group includes exposure to radiation, chemotherapeutic agents, chemical compounds based on benzene and arsenic, and autoimmune diseases.
3. Rare. This category includes drugs whose side effects may include the development of hypoplastic anemia. These are drugs such as anticonvulsants, sulfa drugs, NSAIDs (nonsteroidal anti-inflammatory drugs), antibiotics, antitoxic drugs (for inflammatory processes in the thyroid gland), tranquilizers. Fungal diseases, tuberculosis, viral infections, pregnancy can also cause the disease.

The mechanism of bone marrow damage is that, under the influence of the above reasons, a change in the chromosome set occurs, causing impaired DNA synthesis. The formation of blood cells is inhibited and red bone marrow tissue is replaced by fatty tissue, which is not capable of performing a producing function. The patient's general condition worsens, and the blood picture appears to be pancytopenia.

Main symptoms of pathology

The pathogenesis of the manifestations of this disease is explained by the inability of blood cells (due to their low content) to perform their functions. Thus, the appearance of hemorrhagic syndrome is caused by thrombocytopenia and damage to the vascular wall (lack of serotonin and hypoxia lead to increased permeability).

The main manifestations of hemorrhagic syndrome include:

• frequent causeless nosebleeds;
• the appearance of bruises and bruises on the skin when pressed (finger and cuff tests);
• bleeding from the gums;
• women often complain about heavy and prolonged menstruation.

In the case of a prolonged pathological process or with massive damage to platelets, complications such as profuse internal bleeding or cerebral infarction with hemorrhage may develop. Ultimately, this can lead to the death of the patient.

A decrease in immunity and resistance to infectious agents is associated with inhibition of the leukocyte lineage. Hypoplastic anemia with immunodeficiency is represented by the following symptoms:

1. Bone marrow aplasia.
2. Renal hypoplasia.
3. Microcephaly.
4. Skeletal deformities.

A child is more susceptible to such changes, since his body is at the stage of active growth and development of all systems. The disease tends to become chronic with periodic exacerbations.

Reduced formation of red blood cells leads to the development of an anemic symptom complex:

1. Fatigue, decreased performance.
2. Syncope (manifested by fainting), flickering of spots before the eyes, dizziness.
3. Complaints of shortness of breath at rest and with low physical activity.
4. Headache.
5. Disturbed sleep.
6. Discomfort behind the sternum (pain, feeling of pressure, tingling).
7. Rapid heartbeat (over 90 beats per minute).
8. Decreased appetite.
9. Weight loss.
10. Dry, pale, marbling skin.

If an acute, severe form of the disease is detected, the prognosis for such a patient is unfavorable: death occurs within 3 months. A common cause of mortality is internal bleeding or persistent infections leading to sepsis.

Blood tests and their interpretation

To correctly make a clinical diagnosis, it is necessary to collect anamnesis, examine the patient, perform a bone marrow puncture, and examine the blood for signs of hypoplasia. If the spleen, lymph nodes and liver are not enlarged, then hypoplastic anemia can be diagnosed.

If this is an acquired form of the disease, then a blood test is presented:

• normochromic (no changes in color index), normocytic (red blood cell size is normal) anemia;
• the content of reticulocytes may be reduced or normal;
• lymphocytopenia (reduced concentration of lymphocytes), the decrease occurs to a greater extent due to neutrophils;
• platelet concentration is reduced, which is manifested by delayed thrombus formation and prolonged bleeding time. At the same time, coagulation factors are normal;
• There is an increase in total iron-binding capacity and serum iron.

If the etiology of the disease is congenital, then the following changes are detected in the blood:

• macrocytosis (increased diameter) of red blood cells;
• reticulocytopenia (low reticulocyte cell count);
• platelet and leukocyte counts are normal.

Aplastic anemia cannot be completely cured. If detected at the initial stages of development, correct differential diagnosis and timely treatment, it is possible to stop the progression of the pathology.

Treatment of hypoplastic anemia

Treatment of the disease is carried out depending on the severity, severity of manifestations and form of pathology. The following methods are distinguished:

Conservative

1. Glucocorticosteroids are used (course of treatment for 3–6 months) to stimulate the production of blood cells and in autoimmune processes. The drug of choice is Prednisolone.
2. Drugs from the group of anabolic steroids (Nerobol, Oxymetholone) promote enhanced hematopoiesis after splenectomy.
3. Androgens (“Testosterone”) are hormonal drugs prescribed to males for a long course of treatment to increase the effect. The pharmaceutical effect is to stimulate erythropoiesis.
4. Immunosuppressants (cytostatics, antilymphocyte globulin, Cyclosporine). If a hypoplastic symptom develops against the background of autoimmune processes, then cytostatic drugs are prescribed for a course of up to 3–6 months with a gradual reduction in dose.
5. Colony-stimulating factor eliminates hypoplasia of the leukocyte lineage, increases the content of neutrophilic leukocytes to prevent the development of the infectious process.
6. Immunoglobulin can stimulate thrombocyto- and erythropoiesis (course of treatment - 5 days). Transfusion therapy with washed erythrocytes and platelets.

Operational

• in case of congenital or autoimmune form of aplastic syndrome, splenectomy is performed, which gives a good result;
• in young people and in the case of anaplastic syndrome for less than 3 months, a bone marrow transplant is performed. A preliminary diagnosis of donor material for HLA compatibility is required. Before surgery, radiation and immunosuppressive therapy is performed.

Hypoplastic anemia is an incurable pathology, but with proper treatment and following the doctor’s recommendations, you can stop the progression of the disease and prevent the development of complications. By identifying impaired hematopoiesis in the initial stages and treating it correctly, it is possible to improve the prognosis of the outcome of events.

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Sinus tachycardia

An increase in heart rate can be either a physiological reaction of the body or a sign of serious pathology.

Coding of sinus tachycardia according to ICD-10

Sinus tachycardia (heart rate more than 100 per minute) is one of the most common forms of paroxysmal tachycardia, sinus tachycardia code according to ICD 10 I47.1. Cardiologists and general practitioners use the code of this disease according to the International Classification of Diseases, Tenth Revision, to record morbidity and correctly complete medical documentation.

Causes

The occurrence of tachycardia should not always be regarded as a manifestation of the disease. An increase in heart rate is a normal reaction to strong emotions (both positive and negative), physical activity, and lack of oxygen. Sinus tachycardia is also a consequence of the following pathological processes:

• external or internal bleeding;
• anemia of any etiology;
• hypotension;
• high fever;
• hyperfunction of the thyroid gland;
• dysfunction of the left ventricle of the heart;
• cardiopsychoneurosis.

An increase in heart rate in the presence of the above diseases occurs at rest and is often accompanied by other unpleasant symptoms. Sometimes an increase in heart rate can be accompanied by arrhythmia (disturbance in the correct rhythm of heart contractions). An increase in heart rate can occur with atrial and ventricular blockade, Wolff-Parkinson-White syndrome.

Diagnosis and treatment

Paroxysmal tachycardia in ICD 10 has code I47 and belongs to the section of heart diseases. If there is an increase in heart rate at rest, you should consult a physician or cardiologist. A mandatory instrumental research method for patients with an increase in heart rate or rhythm disturbances is an ECG; echocardiography and a number of other studies are also additionally performed to determine the cause of the disease. Tachycardia and bradycardia (heart rate less than 60 per minute) are serious symptoms, so you should consult a doctor promptly.

Treatment depends on the cause that caused the increase in heart rate, the presence of rhythm disturbances, and concomitant diseases. You also need to limit the consumption of caffeine, alcoholic beverages, and quit smoking. Lifestyle modification gives good results for all patients, regardless of the stage and severity of the underlying disease.

Add a comment Cancel reply

• Scottped on Acute gastroenteritis

Self-medication can be dangerous to your health. At the first sign of disease, consult a doctor.

Ventricular tachycardia according to ICD 10

Sinus tachycardia ICD 10

Upon diagnosis

Level of consciousness, respiratory rate and efficiency, heart rate, pulse, blood pressure, ECG, medical history if possible

Additional (according to indications)

Laboratory tests: hemoglobin, blood gases, CBS indicators,

electrolytes (K, Na, Mg, Ca, Cl), blood glucose, leukocytes, blood count, CPK enzymes, ALT, AST

R-graphy of the chest organs

During treatment

Monitoring in accordance with clause 1.5. Repeatedly according to indications #8212; ECG, laboratory parameters, depending on the clinical situation

Discontinuation of drugs that prolong the PQ interval on the ECG. Ensuring adequate ventilation, oxygen inhalation, intravenous access

Atropine 0.5-1 mg IV, up to a total dose of 0.04 mg/kg

Percutaneous external pacing, if not possible or as a temporary alternative until transvenous pacing can be achieved #8212; dopamine 5-20 mcg/kg/min. adrenaline 2-10 mcg/min. as a continuous dosed infusion

Correction of water and electrolyte balance

Extracardial pathological sinus tachycardia occurs with increased body temperature, acidosis, hypoglycemia, hypoxemia associated with anemia or lung damage, with pheochromocytoma and thyrotoxicosis, infectious toxicosis (neurotoxicosis when taking or overdose of drugs: adrenaline, isadrine, aminophylline, atropine, inhalation of large doses 2-adrenergic receptor agonists (terbutaline, salbutamol, etc.).

Lymphostasis, chronic fatigue syndrome. Osteopathy helps at any age. Treatment by an osteopath will be beneficial even for babies #8212; two or three treatment sessions can help restore normal sleep and relieve causeless whims and anxiety. A course of pediatric osteopathy helps improve the child’s appetite, helps normalize reflexes and muscle tone.

Hypercatecholaminemia, hypersensitivity of the sinus node to catecholamines, as well as hypovagotonia determine the pathogenesis, clinical picture and treatment tactics of this type of tachycardia 35. According to O.N. Voronina 9, in children with chronic sinus tachycardia, the leading one is pronounced autonomic dysfunction with high tone of the parasympathetic division of the autonomic nervous system.

Any symptoms of cardiac dysfunction or adolescent complaints of poor health should alert parents and be a reason to consult a doctor. Also pay attention to the active games of younger children. If a child’s behavior changes during play: Rapid fatigue, shortness of breath, pale skin, he should be examined by a cardiologist.

In this case, it is necessary to take an electrocardiogram for the child. Heart murmurs are not always audible. With obvious tachycardia and extrasystole, we can talk about a late manifestation of cardiopathy in children. Therefore, it is important to identify this pathology in a timely manner. To do this, you should constantly maintain the child’s health, follow preventive measures, and also attend an appointment with a cardiologist at least once a year, with a mandatory examination.

In children, heart rate depends on age (Table 1). Sinus tachycardia is distinguished: 1) moderate (grade I) increase in heart rate 1020 above the age norm; 2) average (II degree) by 2040; 3) pronounced (III degree) on. Sinus tachycardia can be physiological and pathological, and pathological is divided into extracardiac and cardiac 2, 21.

V.I. Starodubov dated March 6, 2008 N 1619-all organization of selection of patients for high-tech treatment methods in the profile #171; cardiovascular surgery #187; guidelines

Heart rhythm disorder, unspecified

To select for high-tech treatment methods, it is rational to classify arrhythmias based on their clinical significance.

When examining young people, it is advisable to distinguish two types of arrhythmias: Type I #8212; unstable, not significantly affecting well-being and prognosis; II type #8212; persistent arrhythmias that affect the patient’s condition and have prognostic significance.

Type I (unstable arrhythmias): supraventricular extrasystoles, rare ventricular extrasystoles (up to 10 per hour), migration of the cardiac pacemaker, sinus bradycardia and sinus tachycardia, if they do not manifest themselves clinically. When such arrhythmias are identified, these individuals usually do not need additional research; in most cases, these arrhythmias are a finding when examining young people.

Type II (persistent, significant arrhythmias): frequent (more than 10 per 1 minute or 100 per 1 hour) and polytopic ventricular extrasystoles, paroxysmal heart rhythm disturbances (supraventricular and ventricular tachycardia, atrial fibrillation and flutter), sick sinus syndrome. This group also includes WPW syndrome and CLC syndrome, since it can be combined with latent WPW syndrome. If group II arrhythmias are detected, these individuals require additional examination in order to clarify the nature and severity of the arrhythmia, identify the mechanisms of arrhythmia development and decide on the need for their correction. The main instrumental methods for diagnosing cardiac arrhythmias are presented in Table 6.

Basic instrumental diagnostic methods

High-tech assistance for compulsory medical insurance. Morning with Gubernia. GuberniaTV

The main types of ventricular arrhythmias include ventricular tachycardia and ventricular extrasystole

1. Protocol name: Premature ventricular depolarization (ventricular extrasystole). Ventricular tachycardia (VT).

3. Duration (days)days.

4. Profile: cardiological

5 Indications for hospitalization: ventricular extrasystole of varying severity (11-5 gradation according to Lown), new or recurrent episodes of ventricular tachycardia.

Admission: planned or emergency (protracted attack of tachycardia)

6. Definition: Ventricular arrhythmias are arrhythmias in which the source of ectopic impulses is located below the His bundle, that is, in the branches of the His bundle. in Purkinje fibers or in the ventricular myocardium.

Ventricular extrasystole (VC) is a premature (extraordinary) contraction of the heart (from the above sections), directly related to the previous contraction of the main rhythm. Ventricular tachycardia is considered to be three or more ventricular complexes with a frequency of 100 to 240 beats per minute.

7. Classification of ventricular arrhythmias B. Lown and M. Wolf (1971,1983)

1. Rare single monomorphic extrasystoles - less than 30 per hour (1A - less than 1 per minute and 1B - more than 1 per minute).

2. Frequent single monomorphic extrasystoles - more than 30 per hour.

3. Polymorphic (multimorphic) ventricular extrasystoles.

4. Repeated forms of ventricular arrhythmias:

4A - paired couplets.

4B-group (volleys), including short episodes of ventricular tachycardia.

5. Early ventricular extrasystoles - type R on T.

VT and PVCs can be monomorphic or polymorphic. Polymorphic VT can be bidirectional (usually with glycoside intoxication), as well as bidirectional spindle-shaped, such as “pirouette” (with prolonged VT syndrome). Ventricular tachycardia can be paroxysmal or chronic. If the VT continues for more than 30 seconds, it is called stable.

Main diagnostic criteria (clinical and instrumental): interruptions in the functioning of the heart, episodes of palpitations accompanied by shortness of breath, pain in the heart, dizziness, and rarely episodes of loss of consciousness.

On the ECG with PVCs and VT: wide QRS complexes (more than 0.12 sec) of various configurations depending on the location of the arrhythmogenic focus (discordant changes in the final part of the ventricular complex - the ST segment, T wave - can often be observed). With PVCs, a complete compensatory pause is usually recorded. In VT, artioventricular (a-c) dissociation and the presence of conducted and/or drained QRS complexes are often observed.

The main differential diagnostic ECG signs of tachyarrhythmias (with widened QRS complexes).

Supraventricular tachycardia with functional intravenous blockade (occurring at the moment of paroxysm)

Supraventricular tachycardia (in patients with a previous violation of intravenous conduction, i.e. in sinus rhythm.

Supraventricular tachyarrhythmias (patients with ventricular preexcitation syndrome - WPW syndrome)

1. QRS complexes are often more than 0.14 seconds. 2. Mono or biphasic QRS complexes in V1 V6 are characteristic. 3. The presence of RSR in hole V1 R|S -1.0 in hole V6 in combination with a deviation of the EOS to the left. 4. There may be a-c dissociation with ventricular capture by sinus impulses (confluent complexes).

1. QRS complexes are no more than 0.14 seconds, more often up to 0.12 seconds. 2. Often QRS complexes have the form of right bundle branch block with triphasic complexes in V1 V6. (rSR type in V1 and qRS type in V6.

QRS complexes during tachycardia are the same as during sinus rhythm.

1.QRS complexes during supraventricular tachycardia are the same as during sinus rhythm (the rhythm during tachycardia is regular). There may be an increase in the degree of preexcitation at the time of tachycardia—an increase in the delta wave. 2. In patients with atrial fibrillation or flutter, the QRS complexes during tachyarrhythmia are the same as during sinus rhythm (the rhythm at the time of tachycardia is often irregular; during flutter it can be regular). I may notice an increase in the degree of pre-excitation at the time of tachyarrhythmia - an increase in the delta wave.

Mandatory minimum examinations before hospitalization:

2. general blood test.

3. General urine test.

4. Examination of feces for helminths.

Tachycardia

Tachycardia is a condition in which the heart rate exceeds 90 beats per minute. Tachycardia can occur either as a result of an increase in heart rate due to physical activity, stressful situations or anxiety, or as a consequence of an increase in heart rate at rest.

In some cases, tachycardia may occur without complications; however, it can seriously interfere with the normal functioning of the heart, increases the risk of stroke, or can lead to sudden cardiac arrest and death. Risk factors for the development of tachycardia are obesity and type 2 diabetes. There are sinus tachycardia, paroxysmal tachycardia and ventricular fibrillation.

Sinus tachycardia

Sinus tachycardia is a condition when the conduction of impulses from the sinus node to the ventricles is disrupted or the generation of impulses by the sinus nodes that control the heart rhythm is disrupted. It is detected using an electrocardiogram, and its causes can be both external factors and improper functioning of the sinus node.

Paroxysmal tachycardia

Paroxysmal tachycardia is a condition in which an attack of rapid heartbeat, with a frequency of beats per minute, suddenly appears and stops. There are three forms of paroxysmal tachycardia:

The immediate causes of this type of tachycardia are increased activity of the nervous system and dystrophic changes in the myocardium.

Ventricular fibrillation

Ventricular fibrillation is a condition in which a chaotic contraction of myocardial fibers occurs at a frequency of beats per minute, which leads to the absence of ventricular contractions and cardiac arrest. Often, ventricular fibrillation is a consequence of complications caused by extensive myocardial infarction.

Causes of tachycardia

The most common causes of tachycardia are disorders of the autonomic nervous system and hemodynamics, various forms of arrhythmia and disorders of the endocrine system.

Often, tachycardia is a consequence of hypertension. coronary heart disease, myocardial infarction and heart defects. Also, one of the causes of tachycardia is excessive consumption of caffeine, alcoholic beverages and smoking. The development of tachycardia is promoted by diseases of the thyroid gland and various infectious diseases.

Symptoms of tachycardia

Symptoms of tachycardia are:

In some cases, tachycardia may occur without the manifestation of the above symptoms. In such cases, the condition is usually discovered through a physical examination or cardiac monitoring.

Diagnosis of tachycardia

Diagnosis of tachycardia occurs through a medical examination, a series of examinations, analyzes and tests. Common tests for diagnosis are:

• Electrophysiological study, with the help of which it becomes possible to determine the source of problems in the cardiac system;
• Electrocardiography, which is used to determine the type of tachycardia and its effect on the heart rhythm;
• Holter monitoring, based on the data of which it becomes possible to obtain a complete symptomatic picture of the disease.

Treatment of tachycardia

The main directions of treatment for tachycardia are to prevent its attacks in the future, minimize the complications caused and bring the heart rate to normal. Treatment of tachycardia can be medicinal, with the prescription of special medications, or it can consist of changing the patient’s lifestyle, avoiding stressful situations and getting proper rest.

The International Statistical Classification of Diseases and Related Health Problems is a document used as a leading framework in health care. The ICD is a normative document that ensures the unity of methodological approaches and the international comparability of materials.

Currently, the International Classification of Diseases, Tenth Revision (ICD-10, ICD-10) is in force.

In Russia, health authorities and institutions transitioned statistical accounting to ICD-10 in 1999.

ICD 10 - International Classification of Diseases, 10th Revision

Tachycardia code according to ICD 10

IMPLANTS

The information posted on the site is for informational purposes only and is not official.

Sinus tachycardia

Sinus tachycardia: Brief description

Sinus tachycardia (ST) is an increase in heart rate at rest of more than 90 per minute. During heavy physical activity, the regular sinus rhythm normally increases to 150–160 per minute (in athletes - up to 200–220).

Etiology

Sinus tachycardia: Signs, Symptoms

Clinical manifestations

Sinus tachycardia: Diagnosis

Primary Menu

Purpose of this stage: arrhythmias preceding circulatory arrest require the necessary treatment to prevent cardiac arrest and stabilize hemodynamics after successful resuscitation.

The choice of treatment is determined by the nature of the arrhythmia and the patient’s condition.

It is necessary to call an experienced specialist for help as soon as possible.

I47 Paroxysmal tachycardia

I 47.0 Recurrent ventricular arrhythmia

I47.1 Supraventricular tachycardia

I47.2 Ventricular tachycardia

I47.9 Paroxysmal tachycardia, unspecified

I48 Atrial fibrillation and flutter

I49 Other heart rhythm disorders

I49.8 Other specified cardiac arrhythmias

I49.9 Heart rhythm disorder, unspecified

physiological sequence of heart contractions as a result of dysfunction of automaticity, excitability, conductivity and contractility. These disorders are a symptom of pathological conditions and diseases of the heart and related systems, and have an independent, often urgent clinical significance.

In terms of the response of ambulance specialists, cardiac arrhythmias are clinically significant, since they represent the greatest degree of danger and must be corrected from the moment they are recognized and, if possible, before transporting the patient to the hospital.

There are three types of periarest tachycardia: tachycardia with wide QRS complexes, tachycardia with narrow QRS complexes and atrial fibrillation. However, the basic principles for treating these arrhythmias are common. For these reasons, they are all combined into one algorithm - the algorithm for the treatment of tachycardias.

UK, 2000. (Or arrhythmias with sharply reduced blood flow)

Sick sinus syndrome,

(Atrioventricular block II degree, especially atrioventricular block II

degree type Mobitz II,

Third degree atrioventricular block with wide QRS complex)

Paroxysmal ventricular tachycardia,

Torsade de Pointes,

Tachycardia with a wide QRS complex,

Tachycardia with a narrow QRS complex,

PZhK - extrasystoles of high danger according to Lawn (Lawm)

during diastole. When the heart rate is excessively high, the duration of diastole is critically reduced, which leads to a decrease in coronary blood flow and myocardial ischemia. The rhythm frequency at which such disturbances are possible is more than 200 per minute for narrow-complex tachycardia and more than 200 per minute for wide-complex tachycardia.

tachycardia more than 150 per minute. This is explained by the fact that wide-complex tachycardia is less tolerated by the heart.

Rhythm disturbances are not a nosological form. They are a symptom of pathological conditions.

Rhythm disturbances act as the most significant marker of damage to the heart itself:

a) changes in the heart muscle as a result of atherosclerosis (HIHD, myocardial infarction),

d) myocardial dystrophies (alcoholic, diabetic, thyrotoxic),

d) heart defects,

Causes of arrhythmias not associated with heart damage:

a) pathological changes in the gastrointestinal tract (cholecystitis, peptic ulcer of the stomach and duodenum, diaphragmatic hernia),

b) chronic diseases of the bronchopulmonary apparatus.

c) central nervous system disorders

d) various forms of intoxication (alcohol, caffeine, medications, including antiarrhythmic drugs),

e) electrolyte imbalance.

The fact of the occurrence of arrhythmia, both paroxysmal and constant, is taken into account in

syndromic diagnosis of diseases underlying cardiac arrhythmia and conduction disorders.

The treatment for most arrhythmias is determined by whether the patient has adverse signs and symptoms. About the instability of the patient's condition

In connection with the presence of arrhythmia, the following indicates:

Signs of activation of the sympathetic-adrenal system: pallor of the skin,

increased sweating, cold and wet extremities; increasing signs

disturbances of consciousness due to decreased cerebral blood flow, Morgagni syndrome

Adams-Stokes; arterial hypotension (systolic pressure less than 90 mmHg)

Excessively fast heart rate (more than 150 per minute) reduces coronary

blood flow and can cause myocardial ischemia.

Left ventricular failure is indicated by pulmonary edema, and increased pressure in the jugular veins (swelling of the jugular veins), and liver enlargement is

indicator of right ventricular failure.

The presence of chest pain means that the arrhythmia, especially tachyarrhythmia, is caused by myocardial ischemia. The patient may or may not complain about

increased rhythm. May be noted during examination “carotid dancing”

The diagnostic algorithm is based on the most obvious characteristics of the ECG

(width and regularity of QRS complexes). This allows you to do without indicators,

reflecting the contractile function of the myocardium.

Treatment of all tachycardias is combined into one algorithm.

In patients with tachycardia and unstable condition (presence of threatening signs, systolic blood pressure less than 90 mm Hg, ventricular contraction rate more than

150 per minute, heart failure or other signs of shock) recommended

immediate cardioversion.

If the patient’s condition is stable, then according to the 12-lead ECG data (or

one) tachycardia can be quickly divided into 2 options: with wide QRS complexes and with narrow QRS complexes. In the future, each of these two variants of tachycardia is divided into tachycardia with a regular rhythm and tachycardia with an irregular rhythm.

In hemodynamically unstable patients, ECG monitoring is given priority during rhythm assessment and subsequent transportation.

Assessment and treatment of arrhythmias is carried out in two directions: the general condition of the patient (stable and unstable) and the nature of the arrhythmia. There are three options

Antiarrhythmic (or other) drugs

Pacemaker (pacing)

Compared to electrical cardioversion, antiarrhythmic drugs act more slowly and convert tachycardia to sinus rhythm when used. Therefore, drug therapy is used in stable patients without adverse symptoms, and electrical cardioversion is usually preferred in unstable patients with adverse symptoms.

ICD 10 tachycardia

Symptoms and methods of treatment of vegetative-vascular dystonia in children and adolescents

Vegetative vascular dystonia in children is a disruption of the functioning of body systems due to failures in the mechanism of regulation of their work by the autonomic nervous system. Most often this is manifested by a violation of vascular tone.

According to ICD 10 of the International Classification of Diseases, this pathology is classified as a disease of the nervous system and in a certain way affects the functioning of all internal organs and systems of the body. It can be observed in infants, but most often manifestations of VSD affect children of primary school age and adolescents. After reaching puberty, in most cases, the negative manifestations of the disease go away.

Today, vegetative-vascular dystonia is not considered a specific disease, but rather a condition that signals failures that have occurred in the body. Therefore, narrow specialists study the manifestations of pathology and treat them: a pediatric neurologist, a cardiologist, an endocrinologist, a gastroenterologist and others.

Who is at risk for VSD?

According to statistics, signs of autonomic disorders are observed in more than half of all children aged from five years to the end of puberty.

However, there are risk groups that include children most susceptible to the influence of this pathology:

1. Girls are more prone to the appearance of vegetative-vascular disorders. This is due to fluctuations in their hormonal levels during changes in the body and a lag in the development of the nervous system compared to physical growth. The female nervous system is more susceptible to stress, psychological and emotional stress.
2. Teenagers. VSD during puberty is associated with a discrepancy between the development of the nervous system and physical characteristics, as well as changes in hormonal levels in a teenager. In addition, it is during this period that workloads at school increase, bad habits appear, relationships in the team are perceived most acutely, competition between teenagers intensifies, and an increased interest in the opposite sex is manifested.
3. Dystonia very often occurs in preschool children and newborns who have suffered birth trauma, who suffer from congenital pathologies of the cardiovascular and nervous systems, who suffered cerebral circulatory disorders in infancy, whose mothers suffered from gestosis and other disorders during pregnancy.
4. Heredity, especially on the maternal side, increases the risk of developing vegetative-vascular disorders in a child.

In addition, there are a number of reasons and external conditions due to which any child may experience disturbances in the functioning of the autonomic nervous system. Parents should promptly pay attention to deviations in the child’s behavior and well-being. Seeking help from specialists is mandatory, since manifestations of pathology can affect the functioning of vital systems of the body and cause dangerous complications and disorders.

Causes of vegetative-vascular disorders

VSD in children and adolescents is most often observed during the period of active growth and restructuring of the body.

“Trigger mechanisms” can be very diverse:

1. Circumstances that traumatize the child’s psyche - conflicts in the family and among peers, psychological and mental overload associated with mastering the school curriculum.
2. Diseases are acute and chronic – neurological, infectious, endocrine, allergic.
3. Poor nutrition and irrational daily routine (staying at night at the computer), lack of physical activity or excessive overload of the body.
4. Climatic conditions, weather dependence, unfavorable environmental conditions.

What symptoms should parents be wary of?

Children, as a rule, are not always able to objectively assess their condition and clearly formulate a health problem. They are mobile and impulsive, subject to frequent mood swings, but there are a number of signs that cannot be ignored. Symptoms of vegetative-vascular dystonia in children are determined by the nature of the disorders.

Parents should be alert to changes in the child’s behavior and should also pay close attention to his complaints, including:

• headaches and dizziness;
• constant fatigue;
• poor memory;
• absent-mindedness, forgetfulness;
• insomnia or drowsiness.

Alarming signs include tearfulness and fearfulness, anxiety and apathy, unreasonable fears, hysteria, and depression.

Cardiac symptoms of VSD are characterized by the following features:

• tachycardia, bradycadia;
• fluctuations in blood pressure – hypertension or hypotension;
• ringing in the ears, darkening of the eyes;
• pain in the heart, very rapid pulse.

These symptoms cannot be ignored, as they may indicate the presence of serious disorders in the body.

Sometimes parents may hear complaints from their child about respiratory manifestations during VSD:

• shortness of breath both when moving and at rest;
• feeling of lack of air;
• "bloating" of the chest, cough;
• low-grade fever.

The child may complain of chills or a feeling of heat, intolerance to cold or heat.

Manifestations of VSD due to disruption of the gastrointestinal tract.

Vegetative vascular dystonia in adolescents and children can also manifest itself in disorders of the gastrointestinal tract, which is often expressed as:

• abdominal pain;
• diarrhea, flatulence, constipation;
• nausea and vomiting;
• loss of appetite.

Parents should pay attention if their child is losing weight or rapidly gaining weight.

Vegetative-vascular dystonia in children also manifests itself in disorders of the urinary system, the symptoms of which are as follows:

• very frequent urination or retention;
• swelling of the face and limbs;
• pain in the lumbar region or lower abdomen.

Disturbances of the endocrine system during VSD in adolescents can manifest themselves in the form of:

• rashes on the skin of the face;
• increased activity of sebaceous and sweat glands;
• sudden changes in weight.

Treatment methods for vegetative-vascular disorders

Treatment of VSD is complex and takes into account the nature of autonomic disorders. If no serious concomitant pathologies are detected during the diagnostic process, preference is given to non-drug methods. Treatment of VSD in children also requires lifestyle changes and consultation with a psychologist.

What parents can do to help their child:

1. Review your diet. Provide the body with vitamins and microelements by including more vegetables, fruits, grains, and nuts in the menu. Eliminate foods containing “empty” calories, preservatives, and trans fats. Minimize the consumption of salt and sugar, animal fats, carbonated drinks, fast food.
2. Normalize your daily routine, sleep and rest. Try to minimize your child’s interaction with the computer, smartphone and TV, especially at night.
3. Get interested in sports, outdoor activities, communication with peers and pets.
4. Provide the child with positive communication in the family, support and understanding of loved ones, protect him from stress, balance the load with rest and help him find an interesting activity.

It is very important to provide the child with emotional balance and more positive emotions. If necessary, it would not be a bad idea to contact a psychologist.

In addition, the following will have a positive impact on the state of the child’s or adolescent’s body and his psycho-emotional mood:

• physiotherapeutic measures - electrophoresis, acupuncture, magnetic laser therapy and others;
• massage - it can be done even by the smallest;
• water procedures - contrast showers and baths;
• physical therapy and swimming.

Children and adolescents suffering from vegetative-vascular disorders are monitored by a pediatrician, who monitors their condition every few months.

Rapid heartbeat of the atrial type: features and treatment

What is atrial tachycardia, and what factors influence the development of pathology? This is a condition in which accelerated atrial automatism is observed as a result of damage to certain areas of myocardial tissue. In the supraventricular zone, the conduction of electrical impulses generated by the sinus node is disrupted. This provokes the appearance of an abnormal focus of circulation, which causes excessive stimulation of cardiac activity and an acceleration in the frequency of contractions, fluctuating in the range of beats per minute.

The disease is most often detected in the elderly and children; according to statistics, it accounts for about 20% of all arrhythmic disorders; according to ICD 10, the code is assigned to 147.2 (paroxysmal ventricular tachycardia).

Classification

Atrial tachycardia can be chronic or paroxysmal. In the first case, a prolonged chaotic contraction of cardiomyocytes is observed over the course of 24 hours, days or even months; in the second, the attack lasts from several minutes to two to three hours. Depending on the nature of origin, pathology is classified into the following subtypes:

1. Trigger. This form of the disease is extremely rare and is detected, as a rule, in elderly people taking cardiac drugs of the glycoside group, which over time lead to intoxication of the body. One of the reasons may also be excessive physical activity and increased sympathetic tone.
2. Reciprocal. A distinctive feature of the pathology is that the paroxysm is not controlled by antiarrhythmic drugs. Flutter occurs when an electrical impulse re-enters the atrium. One of the methods for relieving a pathological condition is extrastimulation of the affected area. The etiology of this form of the disease is not fully understood, but a certain relationship can be traced between atrial tachycardia and other types of arrhythmias, for example, atrial fibrillation.
3. Polytopic. This form is detected in both elderly and young people. Often accompanied by pathologies of the respiratory system and heart failure. Not much different from supraventricular arrhythmia. Treatment is usually aimed at eliminating the underlying cause of the tachycardia, but antiarrhythmic drugs may be prescribed if necessary.
4. Automatic. This type of arrhythmia often occurs against the background of heavy physical activity. Young people are most susceptible to this form of pathology. If left untreated for a long time, the clinical picture may worsen with the appearance of acute pain and, as a result, a state of shock.

Causes of the disease

Sometimes it is impossible to determine the exact origin of the pathology, especially if the patient has not sought medical help for a long time.

In rare cases, in the absence of organic heart damage and other destructive processes, unexpressed atrial tachycardia can be taken as a normal variant.

Negative factors that provoke the development of the disease include:

• cardiovascular diseases of an infectious nature;
• arterial hypertension;
• endocrine disorders;
• respiratory diseases, especially pneumonia;
• obesity;
• poisoning of toxic origin.

Tachycardia is most often a consequence of chronic diseases. In a child, pathology can develop in the presence of congenital heart defects, in adults with an atrial septal defect, blockades, and also after surgical procedures.

Atrial tachycardia can only be diagnosed at the moment of paroxysm, which makes it difficult to identify the disease itself and determine further treatment tactics.

Because of this, the doctor may ask the patient to undergo several types of tests at different times.

Symptoms of the disease

In young and elderly people, the clinical picture can be very different. For example, people suffering from severe diseases of the cardiovascular system sometimes do not even notice an acceleration in heart rate and other minor signs of progression of the pathology, which usually happens in old age. In relatively healthy patients, a change in condition for the worse rarely goes unnoticed. But in most cases, patients are bothered by the same symptoms, such as:

• chest pain;
• dyspnea;
• dizziness;
• pre-fainting states;
• feeling of heartbeat.

Untimely or incorrectly selected treatment can lead to the development of a multifocal form of atrial tachycardia, which is an advanced stage of the disease and is much more difficult to treat.

Diagnostics

The most informative way to diagnose atrial tachycardia is an ECG (electrocardiogram), which must be performed right at the time of the attack, which is usually difficult to implement in practice. In this regard, 24-hour monitoring using the Holter method is often used: the patient is at home or in a hospital setting with sensors connected to him that record any changes in heart rate.

Blood and urine samples are also collected for laboratory testing. This procedure allows you to identify the breakdown products of adrenaline and the concentration of red blood cells. This is necessary in order to exclude the possibility that the patient has leukemia and other serious diseases.

Treatment

Since atrial tachycardia is not an independent disease, treatment should be aimed at the main cause of the pathology. For example, for heart injuries, surgery is used; for infectious damage to the membranes of the organ (pericarditis), anti-inflammatory therapy is required.

In other cases, antiarrhythmic drugs are prescribed, such as Amiodarone or Propafenone. Beta blockers are used to eliminate excessive stimulation of the heart by impulses generated within the atria. Drugs in this group can lower heart rate and have a pronounced hypotensive effect, which is important if a person has arterial hypertension. If drug therapy is not enough, according to the indications of the attending physician, catheter ablation is performed to destroy the pathological tissue bundles that produce impulses.

Patients with asymptomatic and short-term attacks of atrial tachycardia are not prescribed treatment, since in this case the arrhythmia is a natural reaction to internal pathological processes. Prevention of paroxysms consists of maintaining a healthy lifestyle and treating existing diseases.

Complications and prognosis

The life prognosis for minor hemodynamic disturbances and the rare occurrence of paroxysms is favorable. This pathology, even with systematic relapses, does not lead to dysfunction of the cardiovascular system, and also tends to self-heal. A possible complication is weakening of the myocardium and, as a result, increased symptoms of tachycardia, which, as a rule, does not affect the patient’s life expectancy.

Accessory chord of the left ventricle

An additional chord in the left ventricle is a diagnosis that is established only on the basis of ultrasound; it cannot be detected either by listening or by ECG. Of course, if a young patient has a heart murmur and no serious defect is suspected, then the doctor may assume that this is either an additional chord or valve prolapse.

Very often, unscrupulous doctors, especially pediatricians, after listening to the child and looking thoughtful, say that the child has a heart murmur and this is an additional chord, and it is urgent to do an ultrasound of the heart in “such and such” place and write out a direction, on a beautiful on the form of a private clinic, putting your stamp there. At the same time, not a word about noise is written on the outpatient card, and if you go to an uninterested expert, it turns out that there is no noise at all. After all, with an additional chord, a heart murmur is an extremely rare occurrence.

The additional chord itself is a cord, which is attached on one side to the valve leaflet and on the other to the wall of the heart. Each person has several such chords, and their main function is to help the valve not sag and hold blood while the heart contracts. If one or more of these chords is thicker or denser, then it becomes visible on ultrasound. This is certainly written about in the conclusion, most often adding the word “hemodynamically insignificant” - i.e. does not affect the functioning of the heart in any way. Such a chord does not require treatment and generally you should not pay special attention to it.

If the additional chord is still hemodynamically significant, then it is necessary to consult a cardiac surgeon. But don’t worry, this doesn’t mean that it will have to be excised, you just need to understand the current situation.

Please note that all information posted on the site is for reference only and

not intended for self-diagnosis and treatment of diseases!

Copying of materials is permitted only with an active link to the source.

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Sinus tachycardia code ICD 10

Types, causes, symptoms and treatment of arrhythmia

Arrhythmia is a condition in which the frequency, strength and sequence of heart contraction changes. In the International Classification of Diseases, 10th revision (ICD-10), arrhythmia is assigned class 149 - Other cardiac arrhythmias. According to ICD-10, we can distinguish:

1. Ventricular fibrillation and flutter - 149.0 (ICD-10 code).
2. Premature atrial depolarization - 149.1.
3. Premature depolarization emanating from the atrioventricular junction - 149.2.
4. Premature ventricular depolarization - 149.3.
5. Other and unspecified premature depolarization - 149.4.
6. Sick sinus syndrome (bradycardia, tachycardia) - 149.5.
7. Other specified heart rhythm disturbances (ectopic, nodular, coronary sinus) - 149.8.
8. Unspecified rhythm disturbance - 149.9.

This ICD-10 class excludes unspecified bradycardia (code R00.1), arrhythmia in newborns (P29.1), as well as arrhythmia complicating pregnancy, abortion (O00-O07) and obstetric operations (O75.4).

In most cases, arrhythmia involves an abnormal heart rhythm even when the heart rate is normal. Bradyarrhythmia is an abnormal rhythm accompanied by a slow heart rate not exceeding 60 beats per minute. If the contraction frequency exceeds 100 beats per minute, then we are talking about tachyarrhythmia.

Types of arrhythmia and reasons for their development

To find out the causes of rhythm disturbances, it is necessary to understand the nature of the normal rhythm of the heart. The latter is provided by a conducting system consisting of a system of successive nodes formed from highly functional cells. These cells provide the ability to create electrical impulses passing along each fiber and bundle of the heart muscle. Such impulses ensure its reduction. The sinus node, located in the upper part of the right atrium, is responsible for the generation of impulses to a greater extent. Heart contraction occurs in several stages:

1. Impulses from the sinus node spread to the atria and the atrioventricular node.
2. At the atrioventricular node, the impulse slows down, allowing the atria to contract and pump blood into the ventricles.
3. Next, the impulse passes through the branches of the His bundle: the right one conducts impulses passing through the Purkinje fibers to the right ventricle, the left one - to the left ventricle. As a result, the mechanism of excitation and contraction of the ventricles is triggered.

If all structures of the heart function smoothly, the rhythm will be normal. Rhythm disturbances occur due to pathology of one of the components of the conduction system or due to problems with the conduction of impulses along the muscle fibers of the heart.

There are the following types of arrhythmia:

1. Extrasystoles are premature contractions of the heart, the impulse in which does not come from the sinus node.
2. Atrial fibrillation, or atrial fibrillation, is a heart rhythm disturbance caused by disordered excitation and contraction of atrial fibers.
3. Sinus arrhythmia is caused by an abnormal sinus rhythm, accompanied by alternating deceleration and acceleration.
4. Atrial flutter is an increase in the frequency of atrial contractions up to 400 beats per minute, combined with their regular rhythm.
5. Supraventricular tachycardia forms within a small area of ​​atrium tissue. Atrial conduction disturbance is observed.
6. Ventricular tachycardia is an acceleration of the heart rate coming from the ventricles, due to which they do not have time to fill with blood normally.
7. Ventricular fibrillation is a chaotic flutter of the ventricles, provoked by a flow of impulses from them. This condition makes it impossible for the ventricles to contract and, accordingly, further pumping blood. This is the most dangerous type of rhythm disturbance, as a person falls into a state of clinical death within a few minutes.
8. Sinus node dysfunction syndrome is a violation of the formation of an impulse in the sinus node and its transition to the atria. This type of arrhythmia can provoke cardiac arrest.
9. The blockade occurs against the background of a slowdown in the conduction of the impulse or its cessation. They can manifest themselves in both the ventricles and atria.

The causes of arrhythmia include:

1. Organic organ damage: congenital or acquired defects, myocardial infarction, etc.
2. Violation of the water-salt balance caused by intoxication or loss of potassium (magnesium, sodium) by the body.
3. Thyroid diseases: due to increased thyroid function, the synthesis of hormones increases. It increases metabolism in the body, which increases heart rate. When the thyroid gland produces insufficient hormones, the rhythm weakens.
4. Diabetes mellitus increases the risk of developing cardiac ischemia. With a sharp drop in sugar levels, the rhythm of its contractions is disrupted.
5. Hypertension provokes thickening of the wall of the left ventricle, thereby reducing its conductivity.
6. Consumption of caffeine, nicotine and narcotic substances.

Symptoms

Each type of rhythm disorder is characterized by certain symptoms. During extrasystoles, a person practically does not feel any discomfort. Sometimes a strong shock may be felt coming from the heart.

With atrial fibrillation, symptoms such as chest pain, shortness of breath, weakness, darkening of the eyes and characteristic bubbling in the heart area are observed. Atrial fibrillation can manifest itself in the form of attacks that last several minutes, hours, days, or be constant.

Symptoms of sinus arrhythmia are as follows: increased (slow) pulse, extremely rarely, pain in the left side of the chest, fainting, darkening of the eyes, shortness of breath.

With atrial flutter, blood pressure rapidly drops, the heart rate increases, and dizziness and weakness are felt. There is also an increase in pulse in the neck veins.

As for supraventricular tachycardia, some people who have a similar heart rhythm disorder do not feel any symptoms at all. However, most often such arrhythmia is manifested by increased heart rate, shallow breathing, profuse sweating, pressure in the left side of the chest, throat spasm, frequent urination and dizziness.

With unstable ventricular tachycardia, symptoms such as palpitations, dizziness, and fainting are observed. With persistent arrhythmia of this type, there is a weakening of the pulse in the neck veins, impaired consciousness, and an increase in heart rate up to 200 beats per minute.

Ventricular fibrillation is characterized by cessation of blood circulation with all the ensuing consequences. The patient immediately loses consciousness, he also experiences severe convulsions, absence of pulse in large arteries and involuntary urination (defecation). The victim's pupils do not react to light. If resuscitation measures are not implemented within 10 minutes after the onset of clinical death, death occurs.

Sinus node dysfunction syndrome is manifested by cerebral and cardiac symptoms. The first group includes:

• fatigue, emotional instability, amnesia;
• feeling of cardiac arrest;
• noise in ears;
• episodes of loss of consciousness;
• hypotension.

• slow heart rate;
• pain in the left side of the chest;
• increased heart rate.

A dysfunction of the sinus node may also be indicated by a disorder of the gastrointestinal tract, muscle weakness, or insufficient amount of urine excreted.

Symptoms of heart block include a decrease in heart rate to 40 beats per minute, fainting, and convulsions. Possible development of heart failure and angina pectoris. The blockage can also cause the death of the patient.

Signs of arrhythmia cannot be ignored. Rhythm disturbances significantly increase the risk of developing serious diseases such as thrombosis, ischemic stroke and congestive heart failure. Selection of adequate therapy is impossible without preliminary diagnosis.

Diagnostics

First of all, the cardiologist examines the complaints of a patient who suspects a heart rhythm disorder. The following diagnostic procedures are indicated for the subject:

1. Electrocardiography allows you to study the intervals and duration of the phases of heart contraction.
2. Daily monitoring of electrocardiography according to Holter: a portable heart rate recorder is installed on the patient’s chest, which records rhythm disturbances throughout the day.
3. Echocardiography allows you to study images of the chambers of the heart, as well as evaluate the movement of the walls and valves.
4. Exercise testing makes it possible to assess rhythm disturbances during physical activity. The subject is asked to exercise on an exercise bike or treadmill. At this time, the heart rhythm is monitored using an electrocardiograph. If physical activity is contraindicated for the patient, it is replaced with medications that stimulate the heart.
5. Tilt table test: performed when there are frequent episodes of loss of consciousness. The person is fixed on a table in a horizontal position, and the pulse and blood pressure of the subject are measured. The table is then moved to a vertical position, and the doctor re-measures the patient's pulse and blood pressure.
6. Electrophysiological study: electrodes are inserted into the heart cavity, thanks to which it is possible to study the conductivity of the impulse through the heart, thereby determining the arrhythmia and its nature.

Treatment

This type of heart rhythm disorder, such as ventricular fibrillation, can cause instant death. In this case, the patient is indicated for immediate hospitalization in the intensive care unit. A person is given an indirect cardiac massage. Connection to a ventilator is also shown. Ventricular defibrillation is performed until the rhythm disturbances are eliminated. After restoring the rhythm, symptomatic therapy is indicated, aimed at normalizing the acid-base balance and preventing a recurrent attack.

If disturbances in the rhythm of heart contractions do not threaten a person’s life, we can limit ourselves to drug therapy combined with a healthy lifestyle. Heart rhythm disturbances are corrected with antiarrhythmic drugs: Ritmonorm, Etatsizin, Quinidine, Novocainamide. For any cardiac arrhythmia, medication is indicated to prevent the formation of blood clots. These include Aspirin Cardio and Clopidogrel.

It is also worth paying attention to strengthening the heart muscle. For this purpose, the doctor prescribes Mildronate and Riboxin. The patient may be prescribed calcium channel blockers (Finoptin, Adalat, Diazem) and diuretics (Furosemide, Veroshpiron). Correctly selected drugs can stop the progression of arrhythmia and improve the patient’s well-being.

If heart rhythm disturbances provoke heart failure and threaten serious consequences for a person’s life, including death, the decision is made in favor of surgical treatment. For arrhythmia, the following types of operations are performed:

1. Implantation of a cardioverter-defibrillator: implantation of an automatic device into the heart that helps normalize the rhythm.
2. Electropulse therapy: delivering an electrical discharge to the heart to normalize the rhythm. The electrode is inserted through a vein into the heart or esophagus. External use of the electrode is also possible.
3. Catheter destruction: an operation that involves eliminating the source of arrhythmia.

Lifestyle

People who have heart rhythm disturbances must follow all recommendations of their cardiologist. Controlling body weight, limiting the consumption of salty, fatty and smoked foods, moderate physical activity and quitting smoking and alcohol will help enhance the effectiveness of treatment. It is also important to monitor your blood pressure daily. Patients with arrhythmia should be regularly examined by a cardiologist and have an electrocardiogram performed at least once a year. All medications must be taken in consultation with your doctor.

Sinus tachycardia

An increase in heart rate can be either a physiological reaction of the body or a sign of serious pathology.

Coding of sinus tachycardia according to ICD-10

Sinus tachycardia (heart rate more than 100 per minute) is one of the most common forms of paroxysmal tachycardia, sinus tachycardia code according to ICD 10 I47.1. Cardiologists and general practitioners use the code of this disease according to the International Classification of Diseases, Tenth Revision, to record morbidity and correctly complete medical documentation.

Causes

The occurrence of tachycardia should not always be regarded as a manifestation of the disease. An increase in heart rate is a normal reaction to strong emotions (both positive and negative), physical activity, and lack of oxygen. Sinus tachycardia is also a consequence of the following pathological processes:

• external or internal bleeding;
• anemia of any etiology;
• hypotension;
• high fever;
• hyperfunction of the thyroid gland;
• dysfunction of the left ventricle of the heart;
• cardiopsychoneurosis.

An increase in heart rate in the presence of the above diseases occurs at rest and is often accompanied by other unpleasant symptoms. Sometimes an increase in heart rate can be accompanied by arrhythmia (disturbance in the correct rhythm of heart contractions). An increase in heart rate can occur with atrial and ventricular blockade, Wolff-Parkinson-White syndrome.

Diagnosis and treatment

Paroxysmal tachycardia in ICD 10 has code I47 and belongs to the section of heart diseases. If there is an increase in heart rate at rest, you should consult a physician or cardiologist. A mandatory instrumental research method for patients with an increase in heart rate or rhythm disturbances is an ECG; echocardiography and a number of other studies are also additionally performed to determine the cause of the disease. Tachycardia and bradycardia (heart rate less than 60 per minute) are serious symptoms, so you should consult a doctor promptly.

Treatment depends on the cause that caused the increase in heart rate, the presence of rhythm disturbances, and concomitant diseases. You also need to limit the consumption of caffeine, alcoholic beverages, and quit smoking. Lifestyle modification gives good results for all patients, regardless of the stage and severity of the underlying disease.

Sinus tachycardia

Sinus tachycardia: Causes

Etiology

Clinical manifestations

ECG identification of heart rate at rest - 90–130 per minute Each P wave corresponds to a QRS complex, the P–P intervals are equal to each other, but when combined with sinus arrhythmia they can differ by more than 0.16 s. With severe ST, the P waves can merge with the T waves preceding them, simulating atrial or atrioventricular paroxysmal tachycardia. Differential sign - vagal reflexes (massage of the carotid sinus, Valsalva maneuver) slow down the rhythm for a short time, helping to recognize the P waves.

Differential diagnosis

Sinus tachycardia: Treatment methods

Treatment

Reduction

Did this article help you? Yes - 0 No - 2 If the article contains an error Click here 857 Rating:

Click here to add a comment to: Sinus tachycardia (Diseases, description, symptoms, folk recipes and treatment)

Diseases and treatment with folk remedies and medicines

Description of diseases, application and healing properties of herbs, plants, alternative medicine, nutrition

Tachycardia code according to ICD 10

IMPLANTS

The information posted on the site is for informational purposes only and is not official.

Sinus tachycardia

Sinus tachycardia: Brief description

Sinus tachycardia (ST) is an increase in heart rate at rest of more than 90 per minute. During heavy physical activity, the regular sinus rhythm normally increases to 150–160 per minute (in athletes - up to 200–220).

Etiology

Sinus tachycardia: Signs, Symptoms

Clinical manifestations

Sinus tachycardia: Diagnosis

Primary Menu

Purpose of this stage: arrhythmias preceding circulatory arrest require the necessary treatment to prevent cardiac arrest and stabilize hemodynamics after successful resuscitation.

The choice of treatment is determined by the nature of the arrhythmia and the patient’s condition.

It is necessary to call an experienced specialist for help as soon as possible.

I47 Paroxysmal tachycardia

I 47.0 Recurrent ventricular arrhythmia

I47.2 Ventricular tachycardia

I47.9 Paroxysmal tachycardia, unspecified

I48 Atrial fibrillation and flutter

I49 Other heart rhythm disorders

I49.8 Other specified cardiac arrhythmias

I49.9 Heart rhythm disorder, unspecified

physiological sequence of heart contractions as a result of dysfunction of automaticity, excitability, conductivity and contractility. These disorders are a symptom of pathological conditions and diseases of the heart and related systems, and have an independent, often urgent clinical significance.

In terms of the response of ambulance specialists, cardiac arrhythmias are clinically significant, since they represent the greatest degree of danger and must be corrected from the moment they are recognized and, if possible, before transporting the patient to the hospital.

There are three types of periarest tachycardia: tachycardia with wide QRS complexes, tachycardia with narrow QRS complexes and atrial fibrillation. However, the basic principles for treating these arrhythmias are common. For these reasons, they are all combined into one algorithm - the algorithm for the treatment of tachycardias.

UK, 2000. (Or arrhythmias with sharply reduced blood flow)

Sick sinus syndrome,

(Atrioventricular block II degree, especially atrioventricular block II

degree type Mobitz II,

Third degree atrioventricular block with wide QRS complex)

Paroxysmal ventricular tachycardia,

Torsade de Pointes,

Tachycardia with a wide QRS complex,

Tachycardia with a narrow QRS complex,

PZhK - extrasystoles of high danger according to Lawn (Lawm)

during diastole. When the heart rate is excessively high, the duration of diastole is critically reduced, which leads to a decrease in coronary blood flow and myocardial ischemia. The rhythm frequency at which such disturbances are possible is more than 200 per minute for narrow-complex tachycardia and more than 200 per minute for wide-complex tachycardia.

tachycardia more than 150 per minute. This is explained by the fact that wide-complex tachycardia is less tolerated by the heart.

Rhythm disturbances are not a nosological form. They are a symptom of pathological conditions.

Rhythm disturbances act as the most significant marker of damage to the heart itself:

a) changes in the heart muscle as a result of atherosclerosis (HIHD, myocardial infarction),

d) myocardial dystrophies (alcoholic, diabetic, thyrotoxic),

d) heart defects,

Causes of arrhythmias not associated with heart damage:

a) pathological changes in the gastrointestinal tract (cholecystitis, peptic ulcer of the stomach and duodenum, diaphragmatic hernia),

b) chronic diseases of the bronchopulmonary apparatus.

c) central nervous system disorders

d) various forms of intoxication (alcohol, caffeine, medications, including antiarrhythmic drugs),

e) electrolyte imbalance.

The fact of the occurrence of arrhythmia, both paroxysmal and constant, is taken into account in

syndromic diagnosis of diseases underlying cardiac arrhythmia and conduction disorders.

The treatment for most arrhythmias is determined by whether the patient has adverse signs and symptoms. About the instability of the patient's condition

In connection with the presence of arrhythmia, the following indicates:

Signs of activation of the sympathetic-adrenal system: pallor of the skin,

increased sweating, cold and wet extremities; increasing signs

disturbances of consciousness due to decreased cerebral blood flow, Morgagni syndrome

Adams-Stokes; arterial hypotension (systolic pressure less than 90 mmHg)

Excessively fast heart rate (more than 150 per minute) reduces coronary

blood flow and can cause myocardial ischemia.

Left ventricular failure is indicated by pulmonary edema, and increased pressure in the jugular veins (swelling of the jugular veins), and liver enlargement is

indicator of right ventricular failure.

The presence of chest pain means that the arrhythmia, especially tachyarrhythmia, is caused by myocardial ischemia. The patient may or may not complain about

increased rhythm. May be noted during examination “carotid dancing”

The diagnostic algorithm is based on the most obvious characteristics of the ECG

(width and regularity of QRS complexes). This allows you to do without indicators,

reflecting the contractile function of the myocardium.

Treatment of all tachycardias is combined into one algorithm.

In patients with tachycardia and unstable condition (presence of threatening signs, systolic blood pressure less than 90 mm Hg, ventricular contraction rate more than

150 per minute, heart failure or other signs of shock) recommended

immediate cardioversion.

If the patient’s condition is stable, then according to the 12-lead ECG data (or

one) tachycardia can be quickly divided into 2 options: with wide QRS complexes and with narrow QRS complexes. In the future, each of these two variants of tachycardia is divided into tachycardia with a regular rhythm and tachycardia with an irregular rhythm.

In hemodynamically unstable patients, ECG monitoring is given priority during rhythm assessment and subsequent transportation.

Assessment and treatment of arrhythmias is carried out in two directions: the general condition of the patient (stable and unstable) and the nature of the arrhythmia. There are three options

Antiarrhythmic (or other) drugs

Pacemaker (pacing)

Compared to electrical cardioversion, antiarrhythmic drugs act more slowly and convert tachycardia to sinus rhythm when used. Therefore, drug therapy is used in stable patients without adverse symptoms, and electrical cardioversion is usually preferred in unstable patients with adverse symptoms.

Sinus tachycardia - description, causes, symptoms (signs), diagnosis, treatment.

Short description

Sinus tachycardia (ST) is an increase in heart rate at rest of more than 90 per minute. During heavy physical activity, the regular sinus rhythm normally increases to 150-160 per minute (in athletes - up to 200-220).

Causes

Etiology - generation of excitation impulses by the sinoatrial node with increased frequency Physiological causes Fever (an increase in body temperature by 1 ° C causes an increase in heart rate by 10 per minute) Excitation (hypercatecholaminemia) Hypercapnia Physical exercise Diseases and pathological conditions Thyrotoxicosis MI Endocarditis Myocarditis PE Anemia Syndrome vegetative-vascular dystonia Mitral stenosis Aortic valve insufficiency Pulmonary tuberculosis Shock Left ventricular failure Cardiac tamponade Hypovolemia Drugs (epinephrine, ephedrine, atropine) Pain.

Symptoms (signs)

Clinical manifestations: Palpitations, a feeling of heaviness, sometimes pain in the heart area. Symptoms of the underlying disease.

Diagnostics

ECG - identification of heart rate at rest - 90–130 per minute Each P wave corresponds to a QRS complex, the P-P intervals are equal to each other, but when combined with sinus arrhythmia they can differ by more than 0.16 s. With severe ST, the P waves can merge with the T waves preceding them, simulating atrial or atrioventricular paroxysmal tachycardia. Differential sign - vagal reflexes (massage of the carotid sinus, Valsalva maneuver) slow down the rhythm for a short time, helping to recognize the P waves.

Differential diagnosis Supraventricular paroxysmal tachycardia Atrial flutter with regular conduction to the ventricles 2:1.

Treatment

Treatment Elimination of the identified risk factor: avoidance of smoking, drinking alcohol, strong tea, coffee, eating spicy foods, sympathomimetic drugs (including nasal drops) Treatment of the underlying disease b - Adrenergic blockers in small doses orally (rarely prescribed) Sedatives For concomitant heart failure - cardiac glycosides, pathogenetic therapy.

Reduction. ST - sinus tachycardia.

I47.1 Supraventricular tachycardia

Supraventricular arrhythmia is repeated episodes of rapid heartbeat that begin in the upper chambers of the heart. Mainly observed in children. Sometimes it is a family disease. Risk factors include physical activity, alcohol and caffeine abuse. Gender doesn't matter.

Supraventricular tachycardia (SVT) is a form of arrhythmia caused by disruption of electrical conduction and regulation of heart rate. During an episode of SVT, which can last several hours, the heart beats quickly but steadily. The heart rate reaches 140–180 beats per minute, and sometimes more. In a healthy heart, each contraction is initiated by an electrical impulse from the sinoatrial node (the heart's pacemaker), located in the right atrium (the upper chamber of the heart).

The impulse then passes to the second node, which sends the impulse to the ventricles. In SVT, the sinoatrial node does not control cardiac contractions, both due to the formation of pathological conduction pathways through which the electrical impulse constantly circulates between the atrioventricular node and the ventricles, and due to the formation of an additional node that sends additional impulses that disrupt cardiac output. rhythm. SVT may first appear in childhood or adolescence, although the condition can occur at any age. In some cases, the cause of SVT is a congenital disorder of the cardiac conduction system. The attacks begin for no apparent reason, but they can be triggered by physical activity, caffeine and alcohol.

Symptoms of SVT usually appear suddenly. They can last from a few seconds to hours. Among them:

Chest or neck pain.

A complication of SVT is heart failure. In some cases, a prolonged bout of SVT can lower blood pressure to alarming levels.

If the doctor suspects SVT, the patient will be referred for an ECG to record the electrical activity of the heart. These studies last 24 hours or more because SVT occurs intermittently. Additional studies are possible to identify pathology of the cardiac conduction system.

Prolonged and severe attacks of NVT require urgent hospital treatment. At the hospital, the patient will be given oxygen and given intravenous injections of antiarrhythmic drugs. In some cases, electrical impulse therapy is used to restore normal heart rhythm.

Patients with short and infrequent episodes of SVT can control their heart rate by stimulating the vagus nerve. One way of such stimulation is to rub the skin on the neck above the carotid artery, although this is not recommended for people over 50 years old - this can provoke a stroke. You can also wash your face with ice water or begin to strain, as if you are having a bowel movement. Your doctor will tell you about these stimulation methods. Severe attacks of SVT can be treated with a long course of antiarrhythmic medications. Radiofrequency ablation is also used to treat SVT, which is performed during electrophysiological studies. In this case, pathological conduction pathways are destroyed, but there is a danger of complete blockade of the conduction system of the heart. In most cases, SVT does not affect life expectancy.

to the order of the Ministry of Health and Social Development of the Russian Federation

STANDARD OF MEDICAL CARE FOR PATIENTS WITH SUPRAVENTRICULAR TACHYCARDIA

1. Patient model

Nosological form: Supraventricular tachycardia

What is sinus tachycardia of the heart, what are the symptoms in adults, children and pregnancy, treatment features?

Probably every person has experienced increased heart rate at least once in their life.

Cardiologists often have to work with such complaints and make a diagnosis of “sinus tachycardia.”

Is this really dangerous and requires immediate treatment, or is this a normal option?

What is sinus tachycardia?

An attack of the disease begins against a background of strong emotions, stressful conditions, physical work or lack of oxygen. This does not entail any negative consequences. The pulse returns to normal as soon as the stimulus disappears.

However, changes in the speed of the heart can be associated with a number of pathologies. Thyroid problems, heart disease, and blood vessel problems can all affect your heart rate, indicating the need for treatment.

General concept and code according to ICD 10

Let's consider what sinus tachycardia is from the point of view of modern cardiology. In medicine, it is characterized by a significant increase in heart rate.

According to the International Classification of Diseases (revision 10), ICD 10 code “sinus tachycardia” is 149.8.

Depending on what caused the tachycardia, it is divided into:

1. Pathological. In this case, significant changes are observed in the blood supply system, as well as in the myocardium. As the speed of the heart increases, the chambers do not have time to completely fill with blood. This causes circulatory disorders, and as a result, oxygen starvation occurs in the tissues of other organs. After some time, the heart expands and the contractility of the heart muscle decreases. Cardiomyopathy develops. This form is also accompanied by myocardial ischemia, this is due to poor blood flow in the coronary arteries. If the vessels are susceptible to atherosclerosis, then the patient is at risk of myocardial infarction.
2. Physiological. This is a type of norm. An increase in heart rate occurs due to certain external reasons: stress or physical activity. After the cessation of external influence, heart rate (heart rate) returns to its original value. In this case, no hemodynamic disorders or changes in the heart muscle occur. The only danger can be that increased heart contractions can provoke an exacerbation of some other pathology.

Moderate

To understand what moderate sinus tachycardia is, it is important to determine the permissible heart rate. The pulse in this case varies from 90 to 135. The patient does not feel any symptoms of the disease. Most often, the disease manifests itself under stress and strain.

Expressed

With it, the pulse increases significantly and ranges from 135 to 185 beats/minute. The patient may feel significant weakness. Dizziness and loss of consciousness may occur. If such symptoms occur, it is recommended to see a doctor for further examination.

Sinus tachycardia: symptoms and treatment

Sinus tachycardia - main symptoms:

• Mood swings
• Dizziness
• Sleep disturbance
• Loss of appetite
• Dyspnea
• Fainting
• Lack of air
• Fast fatiguability
• Heartache
• Insomnia
• Low blood pressure
• Feeling of heartbeat
• Decreased urine output
• Cold extremities
• Feeling disgusted by food
• Discomfort in the chest area

Sinus tachycardia is a disease in which the heart rate increases, which occurs against the background of active work of the sinus node. This condition is typical for both adults and children. A wide range of predisposing factors can cause the development of such a disorder, which are not always associated with the course of any other disease. The source can also be severe stress or excessive physical activity.

The disease has characteristic symptoms, including pain in the chest area, a person’s sense of their own heart rate, weakness and severe dizziness.

To make a correct diagnosis, a whole range of measures is required - from a physical examination performed by a cardiologist to instrumental examinations of the patient.

The disease can be cured using conservative methods, which boil down to physiotherapeutic procedures, taking medications and following a gentle diet.

The International Classification of Diseases, Tenth Revision, classifies this disorder as supraventricular tachycardia. It is worth noting that this is a clarified name for a similar pathology. Thus, sinus tachycardia code according to ICD-10 is as follows – I 47.1.

Etiology

The correct heart rhythm directly depends on how evenly impulses arise in the sinus node and are carried through the fiber system. The sinus node is a collection of nerve cells that are localized in the atrium.

Normally, the optimal values ​​for sinus rhythm are the number of contractions, which range from sixty to ninety beats per minute. It follows from this that sinus tachycardia is nothing more than an increase in heart rate over 90 times per minute. It is worth noting that in children, such a disorder is diagnosed if the heart rate increases by more than 10% of the norm characteristic of a particular age.

This pathology occurs in any age category, in the vast majority of cases in healthy people, as well as among those diagnosed with heart disease. Given that the disease develops due to a large number of factors, they are usually divided into several groups - pathological and not related to the course of a particular disease.

Physiological predisposing sources of the formation of sinus tachycardia of the heart are presented:

• excessive physical exertion - the permissible values ​​​​can be no more than 160 beats per minute, the rest, higher indicators, belong to this type of arrhythmia. It is worth noting that the only exception is professional athletes - heart rate can reach 240 beats per minute - only in such cases there is no need for emergency care;
• prolonged exposure to stressful situations or one-time severe nervous strain;
• addiction to bad habits;
• irrational use of medications, for example, glucocorticoids, antidepressants, calcium antagonists, diuretics, substances containing caffeine, as well as medications aimed at treating bronchial asthma.

In addition, it should be noted that an increase in heart rate can be affected by an increase in body temperature. Each increase in the thermometer value by one division leads to the fact that the heart rate in a child increases by about 15 beats per minute, and in an adult - by 9.

The causes of sinus tachycardia in women can be:

• the period of bearing a child - despite the fact that sinus tachycardia is a normal phenomenon in pregnant women, it can develop against the background of pathological causes, which is why the appearance of symptoms of the disease should be the impetus for seeking qualified help;
• the course of menstruation;
• hot flashes observed during menopause, as well as any other hormonal disorders.

In childhood, such a disorder may be an individual norm. It is noteworthy that it is most often observed in girls.

Classification

The main division of sinus tachycardia in a child or adult divides the disease into:

• functional - is such in cases of influence on the human body by strong emotions or physical activity, as well as an increase in temperature;
• pathological - also called prolonged sinus tachycardia.

Forms of long-term varieties of the disease depending on the etiological factor:

• neurogenic – develops due to an unstable or labile nervous system;
• toxic – caused by the negative effects of toxic substances on the body;
• medicinal;
• endocrine;
• hypoxic – represents the body’s natural response to lack of oxygen;
• myogenic – formed against the background of cardiac pathologies.

Separately, it is worth highlighting orthostatic or vertical sinus tachycardia. This means that a heart rate disturbance is observed when the body moves from a lying to a standing position.

There are also three degrees of severity of the disease:

• mild sinus tachycardia – does not require any specific therapy;
• moderate sinus tachycardia - often occurs in children under six years of age, as well as in adolescents during puberty. This variety should not cause concern, since its symptoms are completely absent or mild;
• severe sinus tachycardia - most often appears in older people, but can also occur in a child. In such cases, the alternation of a rapid pulse with a condition such as bradycardia, in which the heart rate is reduced, is considered dangerous. This combination requires urgent emergency care.

Symptoms

The presence and severity of symptoms of this pathology depends on several factors:

• severity of sinus tachycardia;
• duration;
• predisposing factor.

With a mild course of the disease, symptoms are completely absent, which is why a person may not even suspect that he has such a disorder.

Moderate sinus tachycardia can also be completely asymptomatic, but sometimes the signs may be minor. These include:

• feeling your own heartbeat;
• discomfort and stiffness in the chest area;
• shortness of breath;
• sleep disturbance;
• fatigue;
• frequent mood swings.

Symptoms of severe sinus tachycardia, in addition to increasing the severity of the above clinical manifestations, have the following signs:

• frequent and severe dizziness;
• intense pain in the heart area;
• lack of air;
• the appearance of shortness of breath at rest;
• complete lack of sleep;
• loss of appetite or complete aversion to food;
• fainting;
• decreased blood pressure;
• cold extremities;
• reduction in the daily volume of urine excreted.

It is worth noting that this is only the main symptomatology of sinus tachycardia, which will be supplemented by the clinical manifestations of the disease against which such a disorder developed.

All of the above symptoms are characteristic of both adults and children, but in the second case the disease will be much more severe. It is for this reason that there are several emergency rules aimed at reducing heart rate, including:

• calling a medical team to your home;
• pressing on the area of ​​the carotid node;
• massaging both eyeballs in a circular motion;
• straining when taking a deep breath with your nose pinched;
• compression of the upper abdomen;
• pressing the lower extremities towards the anterior wall of the abdominal cavity;
• cold rubdowns.

Such measures should alleviate the patient’s condition before the doctors arrive.

Ignoring the symptoms can lead to heart failure or the consequences of the disease that led to such a heart rate disturbance - this is what sinus tachycardia is dangerous for.

Diagnostics

Despite the fact that this disease has quite specific symptoms, in order to make a diagnosis of sinus tachycardia, it is necessary to perform a whole range of diagnostic measures.

First of all, the cardiologist needs to:

• study the patient’s medical history and life history - in some cases this will help to establish the most likely causes of sinus tachycardia in a particular person;
• conduct a thorough physical examination aimed at studying the condition of the skin, assessing the frequency of respiratory movements and listening to the patient using special instruments;
• interview the patient or his parents in detail to establish the severity of symptoms and determine the severity of the disease.

Laboratory tests include:

• general clinical blood test - to identify possible anemia and the course of ailments that could cause sinus tachycardia;
• general urine analysis;
• blood biochemistry - for the final identification of the provoking disease;
• blood test for thyroid hormones.

The most valuable in diagnostic terms are the following instrumental examinations:

• EchoCG - for possible detection of structural changes in the heart;
• ECG is the main method for confirming the presence of sinus tachycardia;

In addition, consultation may be needed:

• pediatrician - if the patient is a child;
• psychotherapist;
• otolaryngologist;
• endocrinologist;
• obstetrician-gynecologist - in cases of detection of sinus tachycardia during pregnancy.

Only after studying the results of all diagnostic measures, the cardiologist will draw up an individual scheme for each patient on how to treat sinus tachycardia.

Treatment

Therapy for such a disease is based on eliminating the cause of its occurrence. Therefore, treatment may include:

• rejection of bad habits;
• balanced diet;
• good sleep;
• taking antibacterial agents - during infectious diseases;
• the use of drugs that suppress the active functioning of the thyroid gland;
• taking iron supplements internally;
• intravenous administration of special solutions that restore the full volume of circulating blood;
• oxygen therapy - to eliminate diseases of the bronchi or lungs;
• psychotherapy or auto-training.

Direct treatment of sinus tachycardia with medications is necessary only in cases where the patient has difficulty with palpitations. To do this, patients are recommended to take:

• beta blockers;
• sinus node if-channel inhibitors;
• tinctures based on plants such as valerian root, hawthorn or motherwort.

If the disease is severe in a woman during pregnancy, urgent stimulation of labor is necessary. Often, childbirth with sinus tachycardia is carried out by cesarean section.

The only consequence of this disease is the development of heart failure.

Prevention and prognosis

To prevent people from developing paroxysmal sinus tachycardia, the following general recommendations must be followed:

• complete abstinence from alcohol and nicotine;
• proper nutrition, enriched with vitamins and microelements necessary for the body;
• avoiding emotional and physical fatigue;
• body weight control;
• maintaining a moderately active lifestyle;
• ensuring sufficient sleep;
• timely diagnosis and treatment of cardiac pathologies;
• taking medications strictly according to the instructions of the attending physician;
• Regularly undergoing a full examination at a medical institution.

Physiological sinus tachycardia often has a favorable prognosis, but only if complex therapy is started in a timely manner. If the disease was caused by other ailments, then there is a high probability of developing life-threatening consequences.

If you think that you have sinus tachycardia and the symptoms characteristic of this disease, then a cardiologist can help you.

We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.

Sinus tachycardia during pregnancy: manifestations and dangers

During the period of bearing a child, a woman’s body undergoes serious changes that relate to physiological and biochemical processes. Due to the increased load, individual organs and important systems may suffer. It is especially difficult for the heart and blood vessels, which bear the bulk of the work. That is why failures are primarily noted on their part. Against this background, sinus tachycardia is often diagnosed during pregnancy.

Reasons for the development of pathology

If a pregnant woman experiences frequent heart palpitations, this may negatively affect the development of her baby. One type of tachycardia is the sinus form. In this condition, electrical impulses very often occur in the sinus node, which leads to contraction of the atrium on the right side up to 120 beats per minute.

Such a violation occurs due to metabolic changes, heart pathologies, intoxication of the body, and pregnancy. According to the international classification of diseases, sinus tachycardia is assigned an ICD-10 code.

There are physiological and pathological forms. The first is a reaction to external stimuli, and the second occurs against the background of sinus node dysfunction. As for pregnancy, in this condition a woman may experience tachycardia for the following reasons:

• excessive stress on the heart and central nervous system;
• hormonal changes;
• increased work of internal organs;
• increased tissue metabolism;
• change in the location of organs due to an enlarged uterus.

If the woman carrying the child is healthy, then moderate tachycardia may be a reaction to high physical activity. As a rule, after proper rest, the pregnant woman’s condition returns to normal.

The mechanism of development of tachycardia can also be triggered by physical activity in the presence of organic heart damage. This attack can occur as a result of an allergic reaction, infection of the body, bradycardia, fever, toxicosis, dehydration, stress, or drug overdose.

Is sinus tachycardia dangerous during pregnancy?

By understanding what sinus tachycardia can cause in pregnant women, what it is, and how to treat it, it will be possible to prevent serious consequences. A strong heartbeat is considered dangerous, which is accompanied by an increase in heart rate (HR) over 100 beats per minute. At such a moment, a woman may complain of discomfort in the chest area and heart pain.

A jump in heart rate dob/minute is extremely dangerous. In this case, the duration of the attack can be several hours or days. This condition may be associated with a focus of excitation within the conduction system, where impulses are regenerated. It often originates in the ventricles and atrium cells. In this regard, ventricular and atrial tachycardia are distinguished.

If a pregnant woman experiences palpitations, a drop in blood pressure, dizziness, increased sweating, nausea or a feeling of tightness in the heart area, then the help of medical specialists is required. Without adequate treatment, there is a high risk of serious consequences.

With increased heartbeat, the birth process may occur with complications. In addition, against the background of a persistent increase in heart rate, a woman may begin to give birth earlier than expected.

If attacks of tachycardia in a pregnant woman occur in the early stages, this can cause a miscarriage or the development of pathology in the fetus.

Symptoms

The main sign of tachycardia is an increased heart rate, which can be determined by measuring the pulse. If a value of more than 100 heart beats per minute was recorded in combination with characteristic symptoms, then you urgently need to seek medical help. So, a pregnant woman should definitely be wary of the following manifestations:

• weakness in the body;
• fast fatiguability;
• chest pain;
• attacks of nausea followed by vomiting;
• disruption of the gastrointestinal tract;
• dizziness, fainting;
• numbness of the limbs;
• increased anxiety and irritability.

If any of these signs appear, you should reduce your activity and try to calm down. At the same time, it is necessary to open a window or door in the room to ensure the flow of fresh air. If the attack drags on, you should not ignore it and let the situation take its course. Only qualified medical assistance will minimize the risks for the expectant mother and her baby.

Diagnostics

If there is an assumption regarding sinus tachycardia, the woman must undergo a series of diagnostic measures. Thanks to this, it will be possible to detect possible pathologies and prevent the development of consequences. First of all, a pregnant woman should visit a gynecologist. You will also need to donate blood and urine. Their analysis will allow you to estimate hemoglobin and the number of red blood cells.

In addition, laboratory test results will show whether the thyroid gland is normal. Very often, anemia in combination with disorders in the endocrine system leads to an increase in heart rate.

The patient still has to undergo an ECG, which will give an idea of ​​​​the work of the heart muscle. The conclusion of this study contains the position of the EOS (electrical axis of the heart), which can be vertical, horizontal, normal, deviated to the right or left side.

If necessary, Dopplerography or echocardiography will be prescribed, after which it will be possible to find out what kind of tachycardia we are talking about, and whether there are organic lesions in the heart and vascular system. The final stage will be a visit to a cardiologist, endocrinologist and neurologist.

Complex treatment

Treatment tactics are selected based on the reason why the heart rate increases. The essence of therapy is to eliminate the pathology that caused the tachycardia. This will improve the condition of the pregnant woman and eliminate relapses. To stabilize the heart rate, an integrated approach is used:

• It is extremely important to ensure complete rest for the woman in the first trimester of pregnancy. An increase in heart rate is often associated with hormonal changes in the body. Natural sedatives may be prescribed as treatment. These include valerian and motherwort. At the same time, it is recommended to take medications that help strengthen the heart and the body’s protective functions. Rosehip and hawthorn have similar properties.
• If tachycardia accompanies a pregnant woman throughout the second trimester, treatment is the same as in the early stages.
• The third trimester is very often characterized by a rapid heartbeat, because the growing fetus puts serious pressure on all the organs of a pregnant woman. Sedatives, vitamins, and minerals can be used for therapeutic purposes.

Any pills during pregnancy should be taken with extreme caution and be sure to consult a doctor. If more serious treatment is required, the patient may be prescribed the following drugs:

1. Sedatives. This group of medicines is made using medicinal plants. But at the same time they can be synthetic, such as Phenobatbital and Diazepam. They are prescribed for palpitations and VSD. The most popular of them are represented by such drugs as Novo-Passit, Magne B6, Persen, Concor. Thanks to the action of sedatives, it is possible to put the nervous system in order and reduce the number of attacks of tachycardia.
2. Antiarrhythmic. Prescribed only as prescribed by the attending physician. It is very dangerous to self-medicate at home, especially during pregnancy. Uncontrolled use of these drugs can cause adverse reactions. The most effective drugs in this group include Adenosine, Propranolol and Flecanil. Their action ensures normalization of heart rate.
3. Beta blockers. Suppress adrenaline-sensitive receptors. Most of them involve long-term use. Of this group of drugs, Timolol, Esmolol, and Atenolol are most often prescribed.
4. Calcium channel blockers. Provide blocking of channels involved in the mechanisms of heart contraction.

Ventricular tachycardia requires immediate treatment. To cope with a sudden attack, a woman should try to calm down and get some fresh air. The Validol tablet will help muffle the attack. When the patient is admitted to the hospital, she may be given the drugs Quinidine and Novocainomide. If a paroxysmal form of tachycardia is detected, intravenous administration of antiarrhythmic drugs is prescribed.

Preventive measures

Compliance with preventive measures will help prevent relapses. Their action is aimed at strengthening the body of a pregnant woman. For mild tachycardia, it is enough to increase the amount of fluid consumed and use relaxation methods to restore heart rhythm.

With frequent attacks that are long-term in nature, you cannot do without medical help. The specialist will select suitable sedatives and vitamin complexes to improve the functioning of the heart and blood vessels.

As for prevention, a woman should give up coffee, alcohol, and cigarettes while pregnant. It is recommended to increase fluid intake (juices, compotes, herbal infusions). It is advisable to exclude fatty and sweet foods from the diet. The basis of nutrition should be fresh fruits and vegetables, cereals, salads and other healthy foods.

The absence of nervous overload and stress is the key to a stable emotional background and protection from increased heartbeat. If the heart rate increases due to psycho-emotional disorders, the pregnant woman needs to saturate the body with potassium and magnesium, which is achieved by taking appropriate medications.

Etiology

Clinical manifestations

ECG identification of heart rate at rest - 90–130 per minute Each P wave corresponds to a QRS complex, the P–P intervals are equal to each other, but when combined with sinus arrhythmia they can differ by more than 0.16 s. With severe ST, the P waves can merge with the T waves preceding them, simulating atrial or atrioventricular paroxysmal tachycardia. Differential sign - vagal reflexes (massage of the carotid sinus, Valsalva maneuver) slow down the rhythm for a short time, helping to recognize the P waves.

Differential diagnosis

Sinus tachycardia: Treatment methods

Treatment

Reduction

Did this article help you? Yes - 0 No - 2 If the article contains an error Click here 857 Rating:

Click here to add a comment to: Sinus tachycardia (Diseases, description, symptoms, folk recipes and treatment)

Diseases and treatment with folk remedies and medicines

Description of diseases, application and healing properties of herbs, plants, alternative medicine, nutrition

Sinus tachycardia

An increase in heart rate can be either a physiological reaction of the body or a sign of serious pathology.

Coding of sinus tachycardia according to ICD-10

Sinus tachycardia (heart rate more than 100 per minute) is one of the most common forms of paroxysmal tachycardia, sinus tachycardia code according to ICD 10 I47.1. Cardiologists and general practitioners use the code of this disease according to the International Classification of Diseases, Tenth Revision, to record morbidity and correctly complete medical documentation.

Causes

The occurrence of tachycardia should not always be regarded as a manifestation of the disease. An increase in heart rate is a normal reaction to strong emotions (both positive and negative), physical activity, and lack of oxygen. Sinus tachycardia is also a consequence of the following pathological processes:

• external or internal bleeding;
• anemia of any etiology;
• hypotension;
• high fever;
• hyperfunction of the thyroid gland;
• dysfunction of the left ventricle of the heart;
• cardiopsychoneurosis.

An increase in heart rate in the presence of the above diseases occurs at rest and is often accompanied by other unpleasant symptoms. Sometimes an increase in heart rate can be accompanied by arrhythmia (disturbance in the correct rhythm of heart contractions). An increase in heart rate can occur with atrial and ventricular blockade, Wolff-Parkinson-White syndrome.

Diagnosis and treatment

Paroxysmal tachycardia in ICD 10 has code I47 and belongs to the section of heart diseases. If there is an increase in heart rate at rest, you should consult a physician or cardiologist. A mandatory instrumental research method for patients with an increase in heart rate or rhythm disturbances is an ECG; echocardiography and a number of other studies are also additionally performed to determine the cause of the disease. Tachycardia and bradycardia (heart rate less than 60 per minute) are serious symptoms, so you should consult a doctor promptly.

Treatment depends on the cause that caused the increase in heart rate, the presence of rhythm disturbances, and concomitant diseases. You also need to limit the consumption of caffeine, alcoholic beverages, and quit smoking. Lifestyle modification gives good results for all patients, regardless of the stage and severity of the underlying disease.

Atrial tachycardia code according to ICD 10

Types, causes, symptoms and treatment of arrhythmia

Arrhythmia is a condition in which the frequency, strength and sequence of heart contraction changes. In the International Classification of Diseases, 10th revision (ICD-10), arrhythmia is assigned class 149 - Other cardiac arrhythmias. According to ICD-10, we can distinguish:

1. Ventricular fibrillation and flutter - 149.0 (ICD-10 code).
2. Premature atrial depolarization - 149.1.
3. Premature depolarization emanating from the atrioventricular junction - 149.2.
4. Premature ventricular depolarization - 149.3.
5. Other and unspecified premature depolarization - 149.4.
6. Sick sinus syndrome (bradycardia, tachycardia) - 149.5.
7. Other specified heart rhythm disturbances (ectopic, nodular, coronary sinus) - 149.8.
8. Unspecified rhythm disturbance - 149.9.

This ICD-10 class excludes unspecified bradycardia (code R00.1), arrhythmia in newborns (P29.1), as well as arrhythmia complicating pregnancy, abortion (O00-O07) and obstetric operations (O75.4).

In most cases, arrhythmia involves an abnormal heart rhythm even when the heart rate is normal. Bradyarrhythmia is an abnormal rhythm accompanied by a slow heart rate not exceeding 60 beats per minute. If the contraction frequency exceeds 100 beats per minute, then we are talking about tachyarrhythmia.

Types of arrhythmia and reasons for their development

To find out the causes of rhythm disturbances, it is necessary to understand the nature of the normal rhythm of the heart. The latter is provided by a conducting system consisting of a system of successive nodes formed from highly functional cells. These cells provide the ability to create electrical impulses passing along each fiber and bundle of the heart muscle. Such impulses ensure its reduction. The sinus node, located in the upper part of the right atrium, is responsible for the generation of impulses to a greater extent. Heart contraction occurs in several stages:

1. Impulses from the sinus node spread to the atria and the atrioventricular node.
2. At the atrioventricular node, the impulse slows down, allowing the atria to contract and pump blood into the ventricles.
3. Next, the impulse passes through the branches of the His bundle: the right one conducts impulses passing through the Purkinje fibers to the right ventricle, the left one - to the left ventricle. As a result, the mechanism of excitation and contraction of the ventricles is triggered.

If all structures of the heart function smoothly, the rhythm will be normal. Rhythm disturbances occur due to pathology of one of the components of the conduction system or due to problems with the conduction of impulses along the muscle fibers of the heart.

There are the following types of arrhythmia:

1. Extrasystoles are premature contractions of the heart, the impulse in which does not come from the sinus node.
2. Atrial fibrillation, or atrial fibrillation, is a heart rhythm disturbance caused by disordered excitation and contraction of atrial fibers.
3. Sinus arrhythmia is caused by an abnormal sinus rhythm, accompanied by alternating deceleration and acceleration.
4. Atrial flutter is an increase in the frequency of atrial contractions up to 400 beats per minute, combined with their regular rhythm.
5. Supraventricular tachycardia forms within a small area of ​​atrium tissue. Atrial conduction disturbance is observed.
6. Ventricular tachycardia is an acceleration of the heart rate coming from the ventricles, due to which they do not have time to fill with blood normally.
7. Ventricular fibrillation is a chaotic flutter of the ventricles, provoked by a flow of impulses from them. This condition makes it impossible for the ventricles to contract and, accordingly, further pumping blood. This is the most dangerous type of rhythm disturbance, as a person falls into a state of clinical death within a few minutes.
8. Sinus node dysfunction syndrome is a violation of the formation of an impulse in the sinus node and its transition to the atria. This type of arrhythmia can provoke cardiac arrest.
9. The blockade occurs against the background of a slowdown in the conduction of the impulse or its cessation. They can manifest themselves in both the ventricles and atria.

The causes of arrhythmia include:

1. Organic organ damage: congenital or acquired defects, myocardial infarction, etc.
2. Violation of the water-salt balance caused by intoxication or loss of potassium (magnesium, sodium) by the body.
3. Thyroid diseases: due to increased thyroid function, the synthesis of hormones increases. It increases metabolism in the body, which increases heart rate. When the thyroid gland produces insufficient hormones, the rhythm weakens.
4. Diabetes mellitus increases the risk of developing cardiac ischemia. With a sharp drop in sugar levels, the rhythm of its contractions is disrupted.
5. Hypertension provokes thickening of the wall of the left ventricle, thereby reducing its conductivity.
6. Consumption of caffeine, nicotine and narcotic substances.

Symptoms

Each type of rhythm disorder is characterized by certain symptoms. During extrasystoles, a person practically does not feel any discomfort. Sometimes a strong shock may be felt coming from the heart.

With atrial fibrillation, symptoms such as chest pain, shortness of breath, weakness, darkening of the eyes and characteristic bubbling in the heart area are observed. Atrial fibrillation can manifest itself in the form of attacks that last several minutes, hours, days, or be constant.

Symptoms of sinus arrhythmia are as follows: increased (slow) pulse, extremely rarely, pain in the left side of the chest, fainting, darkening of the eyes, shortness of breath.

With atrial flutter, blood pressure rapidly drops, the heart rate increases, and dizziness and weakness are felt. There is also an increase in pulse in the neck veins.

As for supraventricular tachycardia, some people who have a similar heart rhythm disorder do not feel any symptoms at all. However, most often such arrhythmia is manifested by increased heart rate, shallow breathing, profuse sweating, pressure in the left side of the chest, throat spasm, frequent urination and dizziness.

With unstable ventricular tachycardia, symptoms such as palpitations, dizziness, and fainting are observed. With persistent arrhythmia of this type, there is a weakening of the pulse in the neck veins, impaired consciousness, and an increase in heart rate up to 200 beats per minute.

Ventricular fibrillation is characterized by cessation of blood circulation with all the ensuing consequences. The patient immediately loses consciousness, he also experiences severe convulsions, absence of pulse in large arteries and involuntary urination (defecation). The victim's pupils do not react to light. If resuscitation measures are not implemented within 10 minutes after the onset of clinical death, death occurs.

Sinus node dysfunction syndrome is manifested by cerebral and cardiac symptoms. The first group includes:

• fatigue, emotional instability, amnesia;
• feeling of cardiac arrest;
• noise in ears;
• episodes of loss of consciousness;
• hypotension.

• slow heart rate;
• pain in the left side of the chest;
• increased heart rate.

A dysfunction of the sinus node may also be indicated by a disorder of the gastrointestinal tract, muscle weakness, or insufficient amount of urine excreted.

Symptoms of heart block include a decrease in heart rate to 40 beats per minute, fainting, and convulsions. Possible development of heart failure and angina pectoris. The blockage can also cause the death of the patient.

Signs of arrhythmia cannot be ignored. Rhythm disturbances significantly increase the risk of developing serious diseases such as thrombosis, ischemic stroke and congestive heart failure. Selection of adequate therapy is impossible without preliminary diagnosis.

Diagnostics

First of all, the cardiologist examines the complaints of a patient who suspects a heart rhythm disorder. The following diagnostic procedures are indicated for the subject:

1. Electrocardiography allows you to study the intervals and duration of the phases of heart contraction.
2. Daily monitoring of electrocardiography according to Holter: a portable heart rate recorder is installed on the patient’s chest, which records rhythm disturbances throughout the day.
3. Echocardiography allows you to study images of the chambers of the heart, as well as evaluate the movement of the walls and valves.
4. Exercise testing makes it possible to assess rhythm disturbances during physical activity. The subject is asked to exercise on an exercise bike or treadmill. At this time, the heart rhythm is monitored using an electrocardiograph. If physical activity is contraindicated for the patient, it is replaced with medications that stimulate the heart.
5. Tilt table test: performed when there are frequent episodes of loss of consciousness. The person is fixed on a table in a horizontal position, and the pulse and blood pressure of the subject are measured. The table is then moved to a vertical position, and the doctor re-measures the patient's pulse and blood pressure.
6. Electrophysiological study: electrodes are inserted into the heart cavity, thanks to which it is possible to study the conductivity of the impulse through the heart, thereby determining the arrhythmia and its nature.

Treatment

This type of heart rhythm disorder, such as ventricular fibrillation, can cause instant death. In this case, the patient is indicated for immediate hospitalization in the intensive care unit. A person is given an indirect cardiac massage. Connection to a ventilator is also shown. Ventricular defibrillation is performed until the rhythm disturbances are eliminated. After restoring the rhythm, symptomatic therapy is indicated, aimed at normalizing the acid-base balance and preventing a recurrent attack.

If disturbances in the rhythm of heart contractions do not threaten a person’s life, we can limit ourselves to drug therapy combined with a healthy lifestyle. Heart rhythm disturbances are corrected with antiarrhythmic drugs: Ritmonorm, Etatsizin, Quinidine, Novocainamide. For any cardiac arrhythmia, medication is indicated to prevent the formation of blood clots. These include Aspirin Cardio and Clopidogrel.

It is also worth paying attention to strengthening the heart muscle. For this purpose, the doctor prescribes Mildronate and Riboxin. The patient may be prescribed calcium channel blockers (Finoptin, Adalat, Diazem) and diuretics (Furosemide, Veroshpiron). Correctly selected drugs can stop the progression of arrhythmia and improve the patient’s well-being.

If heart rhythm disturbances provoke heart failure and threaten serious consequences for a person’s life, including death, the decision is made in favor of surgical treatment. For arrhythmia, the following types of operations are performed:

1. Implantation of a cardioverter-defibrillator: implantation of an automatic device into the heart that helps normalize the rhythm.
2. Electropulse therapy: delivering an electrical discharge to the heart to normalize the rhythm. The electrode is inserted through a vein into the heart or esophagus. External use of the electrode is also possible.
3. Catheter destruction: an operation that involves eliminating the source of arrhythmia.

Lifestyle

People who have heart rhythm disturbances must follow all recommendations of their cardiologist. Controlling body weight, limiting the consumption of salty, fatty and smoked foods, moderate physical activity and quitting smoking and alcohol will help enhance the effectiveness of treatment. It is also important to monitor your blood pressure daily. Patients with arrhythmia should be regularly examined by a cardiologist and have an electrocardiogram performed at least once a year. All medications must be taken in consultation with your doctor.

Heart defect - patent foramen ovale

Patent foramen ovale (PFO) is a gap in the wall formed between the right and left atria. Normally, such an open gap functions during embryonic development and completely closes during the first year of the child’s life. If this does not happen, we begin to talk about an anomaly, which is assigned code Q21.1 in ICD 10.

• Causes
• Symptoms
• Diagnostics
• Treatment
• Complications and prevention

On the left atrium side, the opening is covered by a small valve, which is fully matured by the time of birth. When the baby's first cry occurs and the lungs open, there is a significant increase in pressure in the left atrium, under the influence of which the valve completely closes the oval window. Over time, the valve firmly adheres to the wall of the interatrial septum, so the gap between the atria closes.

Most often, in half of children, such valve growth occurs during the first year of life. This is the norm. But if the valve size is insufficient, the gap may not close completely, that is, some hole will remain, the dimensions of which are determined in millimeters. Because of this, the atria are not isolated from each other. Then the child is diagnosed with an open window, which is otherwise called MARS syndrome.

Cardiologists classify it as a minor anomaly of cardiac development.

But it often happens that such an anomaly becomes known by chance. For an adult, this may come as a surprise. They get scared, thinking that this is a serious vice and their life will soon end. Some young people believe that because of this they will not be allowed into the army. Are there reasons for such concerns? To understand this, you need to understand the causes, symptoms and other factors associated with LLC.

Causes

So, a patent foramen ovale is an opening, measured in millimeters, that forms between the atria. Through it, blood can flow from one atrium to another. Most often it comes from the left atrium to the right. This is due to the fact that the pressure in the cavity of the left atrium is higher. When a diagnosis is made, the following formulation is often given: LLC with left-right reset.

But LLC is not an atrial septal defect, although in accordance with ICD 10 they are assigned one code. A defect is a more serious pathology. MARS syndrome is not a congenital heart defect or a septal defect. And the differences are not only in the structure and development of the heart, but also in the causes, symptoms, treatment and other factors.

The reasons for this condition of the oval window are not always precisely known. It is believed that a hereditary predisposition can lead to this condition. Of course, it’s unlikely that anything can be done about this factor. But there are other reasons that largely depend on the woman who carries a new life within herself; their presence becomes especially important during the period of carrying a child in the womb:

• smoking;
• malnutrition;
• toxic poisoning with drugs;
• alcoholism and drug addiction;
• stress.

Unfortunately, today more and more women are starting to lead a bad lifestyle and continue to do so even during pregnancy. At the same time, they do not think at all that their baby will suffer. A patent foramen ovale is just one consequence, which can be considered not very serious compared to others, which can be, for example, a heart defect.

A patent oval window may develop due to poor environmental conditions.

LLC can develop for other reasons: poor environmental conditions, congenital heart disease, connective dysplasia, prematurity. If these reasons occur at a time when a woman becomes pregnant, you need to be prepared for the consequences that relate to the development of the baby or the organs of his body.

It has been noted that MARS syndrome often occurs with other cardiac malformations. These include open aortic disease, as well as congenital defects of the mitral and tricuspid valves.

Several other factors can contribute to window opening:

• very strong physical activity, which is especially true for athletes who engage in weightlifting, diving, and strength sports;
• manifestations of pulmonary embolism in those patients who have thrombophlebitis of the lower extremities and pelvis.

Symptoms

Although the abnormality is often detected in adults during testing for other conditions, it is best to do this early because other heart problems may be detected. Thanks to the identified symptoms, an adult or a child’s parents can seek medical help in time, undergo an examination, after which a diagnosis will be made: LLC with left-right discharge, and a code will be noted in accordance with ICD 10.

By the way, all children under one year of age are prescribed a heart ultrasound, which makes it possible to identify LLC. If the size of the defect is more than three mm, most likely, some signs will be observed that allow certain conclusions to be drawn:

• cyanosis of the nasolabial triangle or lips in a child when he cries a lot or screams;
• frequent colds, bronchitis, pulmonary inflammation;
• slowdown in psychological or physical development, which may even indicate that the oval window is open even by two or three mm;
• attacks of loss of consciousness;
• fast fatiguability;
• feeling of lack of air.

The latter signs are observed when the size of the anomaly exceeds three mm. If the doctor suspects that a child has PFO, he will refer him for examination by an experienced cardiologist and an ultrasound scan. This way the dimensions of the defect are clarified and it turns out that they exceed three mm. All this allows you to understand whether there is cause for concern. By the way, the size of an open window can reach 19 mm.

Cyanosis of the nasolabial triangle may indicate a patent oval window measuring more than three mm

There are practically no specific symptoms in adults. A person may complain of severe pain in the head area. A preliminary diagnosis in accordance with ICD 10 can be made on the basis of almost the same signs that were listed above. There may also be impaired mobility of body parts and periodic numbness of the limbs.

It is important to understand that an open oval window is not a death sentence! The heart is still functioning well, of course, it all depends on what concomitant diseases, heart defects, and so on are present, but in itself PFO does not pose a very serious danger, although the consequences can be very unpleasant, but this will be discussed later. To diagnose PFO with left-right shunting and designate the code according to ICD 10, it is necessary to conduct an examination.

Diagnostics

First, the doctor collects general data about the patient’s health, anamnesis, and complaints. This will help identify the causes and possible complications. A physical examination is also carried out, that is, the doctor examines the skin, determines body weight, measures blood pressure, and listens to heart sounds.

Then a general blood test, urine test, and biochemical blood test are prescribed. These tests help identify comorbidities, cholesterol levels, and other important factors.

All this allows you to accurately assess the patient’s health status, his heart, determine the size of the anomaly in millimeters, and so on.

Thanks to such important studies, the doctor makes an accurate diagnosis and determines the code in accordance with ICD 10. What treatment is prescribed if an open foramen ovale with left-right collection or another similar diagnosis is detected?

Treatment

What to do if you suspect problems with the oval cardiac window? Go to the doctor immediately! This rule applies to everyone who discovers at least some health problems. What to do after visiting a doctor? Follow his recommendations and appointments.

The scope of treatment measures is determined depending on the symptoms and concomitant diseases. Although the ICD 10 abnormality code is atrial septal defect, patent foramen ovale with left-to-right shunt is a different condition.

If there are no obvious disturbances in cardiac function, the doctor gives the patient recommendations that are aimed at properly organizing the daily routine, limiting physical activity, and observing nutritional rules. Taking medications for asymptomatic anomalies is not advisable. General strengthening procedures may be prescribed, such as exercise therapy, treatment in sanatoriums and others.

For minor complaints about the functioning of the heart and blood vessels, vitamins and means to strengthen the heart muscles may be prescribed.

If there are minor complaints about the functioning of the heart and blood vessels, treatment based on taking vitamins and drugs that strengthen the heart muscle can be prescribed. At the same time, it is important for the patient to limit himself in terms of physical activity. If, in a PFO with a left-to-right shunt and a significant size of the anomaly in millimeters, the symptoms are clearly expressed and there is a risk of blood clots, the following may be prescribed:

• disaggregants, anticoagulants, these drugs prevent the formation of blood clots;
• endovascular treatment, when a patch is applied through a catheter to the oval window, stimulating the opening to close with connective tissue; this patch resolves on its own after a month.

After surgery, antibiotics are prescribed to prevent the possible development of infective endocarditis. Thanks to endovascular treatment, a person returns to a full life, in which there are practically no restrictions.

Under no circumstances should you prescribe medications yourself. Each remedy has contraindications and side effects. For these and other reasons, every prescription should be made by a physician. When a diagnosis is made: a patent foramen ovale in the heart, in accordance with ICD 10, it is important for the patient to know what complications there may be.

Complications and prevention

Of course, the likelihood and form of complications depends on many factors. But it is important to understand that complications are rare. In fact, the following diseases can develop:

• renal infarction;
• stroke;
• myocardial infarction;
• transient cerebral circulatory disorder.

If an open foramen ovale is detected, it is necessary to regularly see a cardiologist and perform an ultrasound of the heart.

This occurs because a paradoxical embolism develops. If we talk about forecasts, then in most cases everything is favorable. Those who have been diagnosed with LLC in accordance with ICD 10 need to be regularly monitored by a cardiologist and undergo an ultrasound of the heart. It is necessary to abandon sports that constantly subject the body to very strong physical stress.

It is important for every woman who is planning to have a baby or has already become pregnant to remember that she can prevent her unborn child from developing a heart abnormality. You cannot smoke, drink, take drugs or do anything that could somehow affect the health of the fetus in the womb.

As a result, we can say that LLC is an anomaly, which in itself does not pose a very serious danger, unless we are talking about the fact that there is an accompanying defect or other serious defect. It all depends on various factors. But the health of every person is very often in his hands! Every day you need to think about your health and your loved ones!

Paroxysmal tachycardia (I47)

Excluded:

• complicating:
  • abortion, ectopic or molar pregnancy (O00-O07, O08.8)
  • obstetric surgical interventions and procedures (O75.4)
• tachycardia:
  • NOS (R00.0)
  • sinoauricular NOS (R00.0)
  • sinus NOS (R00.0)

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Tachycardia code according to ICD 10

IMPLANTS

The information posted on the site is for informational purposes only and is not official.

Sinus tachycardia

Sinus tachycardia: Brief description

Sinus tachycardia (ST) is an increase in heart rate at rest of more than 90 per minute. During heavy physical activity, the regular sinus rhythm normally increases to 150–160 per minute (in athletes - up to 200–220).

Etiology

Sinus tachycardia: Signs, Symptoms

Clinical manifestations

Sinus tachycardia: Diagnosis

Primary Menu

Purpose of this stage: arrhythmias preceding circulatory arrest require the necessary treatment to prevent cardiac arrest and stabilize hemodynamics after successful resuscitation.

The choice of treatment is determined by the nature of the arrhythmia and the patient’s condition.

It is necessary to call an experienced specialist for help as soon as possible.

I47 Paroxysmal tachycardia

I 47.0 Recurrent ventricular arrhythmia

I47.1 Supraventricular tachycardia

I47.2 Ventricular tachycardia

I47.9 Paroxysmal tachycardia, unspecified

I48 Atrial fibrillation and flutter

I49 Other heart rhythm disorders

I49.8 Other specified cardiac arrhythmias

I49.9 Heart rhythm disorder, unspecified

physiological sequence of heart contractions as a result of dysfunction of automaticity, excitability, conductivity and contractility. These disorders are a symptom of pathological conditions and diseases of the heart and related systems, and have an independent, often urgent clinical significance.

In terms of the response of ambulance specialists, cardiac arrhythmias are clinically significant, since they represent the greatest degree of danger and must be corrected from the moment they are recognized and, if possible, before transporting the patient to the hospital.

There are three types of periarest tachycardia: tachycardia with wide QRS complexes, tachycardia with narrow QRS complexes and atrial fibrillation. However, the basic principles for treating these arrhythmias are common. For these reasons, they are all combined into one algorithm - the algorithm for the treatment of tachycardias.

UK, 2000. (Or arrhythmias with sharply reduced blood flow)

Sick sinus syndrome,

(Atrioventricular block II degree, especially atrioventricular block II

degree type Mobitz II,

Third degree atrioventricular block with wide QRS complex)

Paroxysmal ventricular tachycardia,

Torsade de Pointes,

Tachycardia with a wide QRS complex,

Tachycardia with a narrow QRS complex,

PZhK - extrasystoles of high danger according to Lawn (Lawm)

during diastole. When the heart rate is excessively high, the duration of diastole is critically reduced, which leads to a decrease in coronary blood flow and myocardial ischemia. The rhythm frequency at which such disturbances are possible is more than 200 per minute for narrow-complex tachycardia and more than 200 per minute for wide-complex tachycardia.

tachycardia more than 150 per minute. This is explained by the fact that wide-complex tachycardia is less tolerated by the heart.

Rhythm disturbances are not a nosological form. They are a symptom of pathological conditions.

Rhythm disturbances act as the most significant marker of damage to the heart itself:

a) changes in the heart muscle as a result of atherosclerosis (HIHD, myocardial infarction),

d) myocardial dystrophies (alcoholic, diabetic, thyrotoxic),

d) heart defects,

Causes of arrhythmias not associated with heart damage:

a) pathological changes in the gastrointestinal tract (cholecystitis, peptic ulcer of the stomach and duodenum, diaphragmatic hernia),

b) chronic diseases of the bronchopulmonary apparatus.

c) central nervous system disorders

d) various forms of intoxication (alcohol, caffeine, medications, including antiarrhythmic drugs),

e) electrolyte imbalance.

The fact of the occurrence of arrhythmia, both paroxysmal and constant, is taken into account in

syndromic diagnosis of diseases underlying cardiac arrhythmia and conduction disorders.

The treatment for most arrhythmias is determined by whether the patient has adverse signs and symptoms. About the instability of the patient's condition

In connection with the presence of arrhythmia, the following indicates:

Signs of activation of the sympathetic-adrenal system: pallor of the skin,

increased sweating, cold and wet extremities; increasing signs

disturbances of consciousness due to decreased cerebral blood flow, Morgagni syndrome

Adams-Stokes; arterial hypotension (systolic pressure less than 90 mmHg)

Excessively fast heart rate (more than 150 per minute) reduces coronary

blood flow and can cause myocardial ischemia.

Left ventricular failure is indicated by pulmonary edema, and increased pressure in the jugular veins (swelling of the jugular veins), and liver enlargement is

indicator of right ventricular failure.

The presence of chest pain means that the arrhythmia, especially tachyarrhythmia, is caused by myocardial ischemia. The patient may or may not complain about

increased rhythm. May be noted during examination “carotid dancing”

The diagnostic algorithm is based on the most obvious characteristics of the ECG

(width and regularity of QRS complexes). This allows you to do without indicators,

reflecting the contractile function of the myocardium.

Treatment of all tachycardias is combined into one algorithm.

In patients with tachycardia and unstable condition (presence of threatening signs, systolic blood pressure less than 90 mm Hg, ventricular contraction rate more than

150 per minute, heart failure or other signs of shock) recommended

immediate cardioversion.

If the patient’s condition is stable, then according to the 12-lead ECG data (or

one) tachycardia can be quickly divided into 2 options: with wide QRS complexes and with narrow QRS complexes. In the future, each of these two variants of tachycardia is divided into tachycardia with a regular rhythm and tachycardia with an irregular rhythm.

In hemodynamically unstable patients, ECG monitoring is given priority during rhythm assessment and subsequent transportation.

Assessment and treatment of arrhythmias is carried out in two directions: the general condition of the patient (stable and unstable) and the nature of the arrhythmia. There are three options

Antiarrhythmic (or other) drugs

Pacemaker (pacing)

Compared to electrical cardioversion, antiarrhythmic drugs act more slowly and convert tachycardia to sinus rhythm when used. Therefore, drug therapy is used in stable patients without adverse symptoms, and electrical cardioversion is usually preferred in unstable patients with adverse symptoms.

What is paroxysmal tachycardia

Heart rhythm is associated with the work of the whole body; if the function of any internal organs is disrupted, this can cause failure of myocardial contractions.

Most often, the electrical conductivity and contractile function of the heart suffer due to disruption of the autonomic nervous system, the thyroid gland and adrenal glands, which are responsible for the production of hormones, and damage to the tissue of the heart muscle itself.

Heart rhythm can change during a temporary painful condition, with any chronic pathology.

• All information on the site is for informational purposes only and is NOT a guide to action!
• Only a DOCTOR can give you an ACCURATE DIAGNOSIS!
• We kindly ask you NOT to self-medicate, but to make an appointment with a specialist!
• Health to you and your loved ones!

In a healthy heart, an electrical impulse is generated in the sinus region, then sent to the atria and ventricles. Tachycardia, which is a type of arrhythmic condition, is characterized by rapid contraction of the heart muscle, and impulses may be incorrectly formed and propagated.

In some cases, tachycardia is the body’s reaction to an external stimulus or internal changes, which is not a pathology, but sometimes it poses a threat to health.

Paroxysms are attacks of cardiac arrhythmia that can last several seconds, minutes, hours, and very rarely days. With paroxysmal tachycardia, the heart rate can reach 140–200 or more beats per minute, while the sinus rhythm is regular.

Paroxysms develop due to the fact that the electrical signal encounters an obstacle in its path, then the areas located above the obstacle begin to contract. They become ectopic foci, places where additional stimulation occurs.

In another case, the electrical signal has additional paths for the impulse to pass through. As a result, the ventricles and atria contract more often than necessary, while they do not have time to relax, fully take in blood and push it out. Therefore, an attack of paroxysmal tachycardia causes disruption of blood flow, oxygen starvation of the brain and other organs.

Clinical signs of pathology and the location of formation of ectopic foci influence the course of the disease, so it can be characterized by three main stages:

According to the mechanism of development of foci of electrical impulse excitation, paroxysmal tachycardia can be:

The ectopic focus can be various parts of the heart muscle, depending on this, the pathology can be:

• there is no stable rhythm of contractions;
• the atria contract much less frequently, and the ventricles contract more frequently;
• the condition is considered the most dangerous because it quickly causes heart failure and can provoke cardiac arrest;
• it is usually preceded by organic pathology of the heart muscle and various myocardial diseases;

According to the International Classification, paroxysmal tachycardia has an ICD 10 code - I47.

Causes

Provoking factors can be of organic and inorganic origin:

• Additional paths through which electrical impulses can travel. This is typical for congenital pathology. Through additional impulse conduction beams, the electrical signal is reset ahead of time. As a result, the ventricles may be excited prematurely, but more often the signal returns and supraventricular tachycardia occurs. The mechanism of additional excitation can form in the atria or atrioventricular node.
• Toxic drugs, especially overdose of cardiac glycosides or antiarrhythmic drugs.
• Neurotic diseases (psychosis, stress, neurosis, neurasthenia).
• Alcohol and drugs.
• Diseases of the thyroid gland (hyperthyroidism) and adrenal glands (tumor), when the function of hormone production is disrupted.
• Diseases of internal organs (gastrointestinal tract, kidneys, liver).

The onset of paroxysm can be triggered by a stressful situation, taking a large amount of alcohol, excessive influence of nicotine on the body, a sharp jump in blood pressure, or an overdose of medications.

Symptoms

A characteristic sign of the pathology is sudden paroxysms that begin with a shock to the heart. An attack of arrhythmia can last several seconds or days, and the contraction frequency reaches 140–250 per minute.

During an attack you may experience:

• dizziness;
• noise in the head;
• cardiopalmus;
• angina pain;
• pale skin;
• cold sweat;
• low pressure;
• VSD phenomena;
• polyuria.

Very often, arrhythmia is confused with an anxious psycho-emotional state. The difference between a panic attack and paroxysmal tachycardia is that during an attack there appears a “lump in the throat” and fear of an uncertain nature, which can be described as an obsessive state. This is not the case with paroxysms.

We will talk about the causes of tachycardia at night and after sleep in this article.

Diagnostics

It is not difficult to make a diagnosis of paroxysmal tachycardia using an ECG. It must be carried out during an attack.

• correct sinus rhythm is observed, with a contraction frequency of 140–250;
• the P wave has a reduced amplitude and may be deformed;
• sometimes it is negative in whole or in part, in which case another part is positive;
• a wave is drawn before each ventricular QRS complex, which has a normal location.

The doctor may prescribe additional diagnostics using cardiac ultrasound, 24-hour ECG monitoring, bicycle ergometry, cardiac MRI, and coronary angiography.

Treatment of paroxysmal tachycardia

In most cases, patients are hospitalized in a hospital, especially if there is heart failure. In the idiopathic form, attacks are controlled with antiarrhythmic drugs. Patients with a frequency of attacks of more than 2 per month are subject to planned hospitalization and in-depth examination.

Before arriving at the hospital, the ambulance team is obliged to provide the patient with first aid and administer one of the antiarrhythmic drugs that are effective for any form of paroxysmal tachycardia:

If the attack lasts a long time and is not controlled by drugs, electropulse therapy is performed.

After the attack has stopped, patients should undergo outpatient treatment under the supervision of a cardiologist who provides antiarrhythmic therapy according to an individual regimen.

Anti-relapse therapy is used for patients with frequent attacks. Beta blockers are prescribed along with antiarrhythmic drugs to reduce the risk of developing atrial fibrillation. Cardiac glycosides are prescribed to patients for continuous use.

In severe cases, patients are prescribed surgical treatment:

• destruction (destruction) of additional pathways or ectopic foci;
• radiofrequency ablation;
• installation of a pacemaker.

First aid

First you need to establish the cause of the attack. The patient is examined, anamnesis is taken, an ECG is examined, and only after that antiarrhythmic therapy is prescribed; it can be repeated only after half an hour.

If the administration of drugs 3 times does not produce results, proceed to electrodefibrillation to prevent the development of heart or coronary failure due to a sharp drop in pressure.

First aid for supraventricular tachycardia includes “vagal” methods, when, by acting on the vagus nerve, the heart muscle is given an “order” to reduce contractions.

• strain;
• take a deep breath, holding the air;
• massage the eyeballs for several minutes;
• try to induce vomiting.

You can also press on the carotid artery. But all these methods cannot be applied to older people. It is best if the first aid technique is carried out under the supervision of specialists. Next, the patient is given Verapamil; if it is ineffective, Obzidan is given after 2 hours.

Lifestyle

A healthy lifestyle helps prevent the development of pathology, when alcohol and nicotine addiction are excluded, coffee and strong tea are consumed in moderation. It is also necessary to monitor your psycho-emotional state and not allow the body to be subjected to prolonged physical and mental stress, which leads to fatigue and stress.

It is better to exclude animal fats and junk foods (fried, salty, smoked, sweet) from the diet; eat more vegetables and fruits, fermented milk products, and cereals. It is necessary to reduce weight to normal, which helps reduce the load on the heart and blood vessels.

Complications

Supraventricular paroxysmal tachycardia rarely leads to complications. Serious relapses and even death can cause ventricular paroxysms.

Ventricular tachycardia can result in pulmonary edema, acute heart failure, heart attack, ventricular fibrillation, pulmonary embolism, ischemic stroke, thrombosis of the renal arteries and lower extremities.

Forecast

In the future, the health of a patient with paroxysmal tachycardia depends on the form of the pathology, the duration of the attacks, the location of the ectopic foci, the factors that caused the development of paroxysms, and the condition of the myocardial tissue.

With supraventricular supraventricular tachycardia, patients do not lose their ability to work, although the pathology rarely goes away over the years. In this case, tachycardia usually develops against the background of various organic myocardial diseases, therefore, in the first case, the treatment method is directed to the underlying pathology.

The worst prognosis is ventricular tachycardia, the cause of which is myocardial pathology, because damage to the heart muscle over time leads to the development of ventricular fibrillation.

If the patient has no complications, he can live for years with a diagnosis of paroxysmal tachycardia, being on constant antiarrhythmic therapy.

Patients with various heart defects and those who have experienced clinical death are susceptible to a lethal outcome in the ventricular form.

How to treat sinus tachycardia in a child - read here.

Features and methods of treating pregnancy with paroxysmal tachycardia are described in this article.

Prevention

Timely diagnosis and treatment of the underlying disease, elimination of provoking factors, and taking sedative and antiarrhythmic drugs are used as preventive measures for the development of paroxysms.

In some cases, surgical treatment and implantation of a pacemaker are necessary.

Patients with a high risk of death are prescribed beta blockers, antiplatelet agents, and antiarrhythmics for life.