I can hear a heartbeat. Palpitations: causes, diagnosis and treatment. Why can you feel a strong heartbeat when your pulse is normal?

And yet, if its symptoms appear, it is better not to postpone a visit to the doctor.

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Usually people who have encountered this problem complain that their heart seems to stop for a few seconds. In some cases, this may be accompanied by a feeling of a heartbeat, a feeling of lack of air. The reason for this extrasystoles is extraordinary heart contractions. An impulse arises in the heart, due to which one beat occurs earlier than necessary, and the next one at its proper time. Accordingly, the pause between contractions lengthens - this causes unpleasant symptoms.

Extrasystole is the most common type of arrhythmia. Extraordinary heart contractions periodically occur in 70-80% of people over 50 years of age. They also happen to young people, including athletes with a trained heart. Because of this, many people think that such rhythm disturbances are harmless. However, this is not quite true. Extrasystole can be caused by various reasons and, accordingly, have different consequences. Based on this, they make a decision about the study.

To treat or not to treat?

● No therapy needed. If interruptions in rhythm are isolated, they occur rarely, and the person has no other heart problems, there is really no need to treat extrasystole. In this case it is called functional. It can be caused by excessive consumption of coffee or alcohol, or stress. In women, cases of extrasystole are often observed during menstruation. People with vegetative-vascular dystonia are prone to the appearance of extrasystoles. By the way, they are especially difficult to tolerate extraordinary heartbeats.

In this case, it is enough for a person to lead a healthy lifestyle, be less nervous, give up stimulants like coffee and alcohol - and everything will return to normal by itself. Foods rich in magnesium and potassium will also help with this: cereals, lettuce, persimmons, dried apricots, citrus fruits.

● Taking medications is necessary if “fading” appears due to an existing heart disease: other types of arrhythmia, coronary disease or heart disease, cardiomyopathy, etc. Harmless, at first glance, extrasystoles in this case can seriously aggravate the course of the underlying disease and even pose a risk to life, leading to atrial or ventricular fibrillation. Therefore, they must be eliminated whenever possible.

As a rule, treatment is also necessary if a person has more than 200 extrasystoles per day.

Even if there is no heart damage, such frequent interruptions can worsen a person’s quality of life. In addition, during extrasystoles, the ejection of blood from the heart decreases, and because of this, the blood supply to many organs, including the brain, deteriorates.

● You need to treat, but not the heart. Sometimes heart failure itself does not require treatment, but is a sign of another illness, which in turn requires therapy. For example, extrasystoles often occur with hyperthyroidism - increased function of the thyroid gland. Its hormones, produced in excess, poison the body, and the heart reacts to this.

Small disruptions in rhythm are a reason to think about osteochondrosis of the cervical spine; they can be a sign of neurosis. In this case, it is enough to eliminate the main problem: compensate for disorders in the thyroid gland, remove muscle tension in the cervical region, and take a course of sedatives. After this, the heart, as a rule, begins to beat evenly.

So that there is no confusion

As you can see, there are many options, and determining on your own whether heart failure is dangerous is quite problematic. Cardiologists agree on one thing: if you periodically feel heartbeats and pauses following them, it is better not to guess, but to consult a specialist. This is also important because not everything that is perceived as cardiac arrest is actually extrasystoles. For example, many people often confuse heart pain (which almost always indicates a problem that requires treatment) or intercostal neuralgia with interruptions.

A banal ECG will help eliminate confusion - with frequent extrasystoles, such an examination will be enough to detect them. If fading occurs less frequently or, for example, only in the evening, it makes sense to conduct 24-hour Holter monitoring. A compact device that is attached to the body and records the heart rhythm will give answers to all questions.

It is important to know! exists! ...

Sometimes a person experiences a sensation of palpitations with a normal pulse. This is not to say that when our heart beats, it is bad, but if it beats too hard, it causes some kind of panic. After all, most people are accustomed to not hearing the work of their hearts.

It is especially unpleasant when the pulse is normal, but the heart seems to be bursting out of the chest. It hits the ribs, radiates into the ears, fingers, and so on. The question immediately arises: what is the reason for the feeling of heartbeat, and is this normal?

Etiology of the phenomenon

The main reasons for feeling a strong heartbeat are as follows:

1. Cardiovascular diseases. 2. Diseases associated with the endocrine system. 3. Mental disorders and other mental illnesses.

Now we need to look at each of them in more detail.

Cardiovascular diseases.

Most cases of increased heart rate are associated with diseases of the cardiac system. So it’s not surprising that when a person’s heart rate suddenly increases, doctors can identify the following diseases:

1. Extrasystole. This disease can develop during significant physical exertion, sudden changes in body position, and so on. Manifests itself in the form of extraordinary heart contractions. As a result, cardiac work is constant and occurs much more often than during normal contraction of the organ. 2. Atrial fibrillation can occur if the heart does not work correctly, that is, the heart muscles do not contract constantly, but in bursts. It turns out that at first it beats too slowly, and then too quickly, but with pain and shortness of breath. 3. Paroxysmal tachycardia, directly related to a significant increase in heart function. The heart rate can reach high values, usually from 110 to 170 beats per minute. These indicators are high enough for a person to feel that something is wrong with him.

To treat any of the above diseases, you need to see a doctor to be examined, get a diagnosis and a course of treatment.

For what reason does a person feel strong heartbeats?

Diseases associated with the endocrine system.

It is possible that disruption of the normal heartbeat is directly related to a disease of the endocrine system.

This mainly manifests itself in the form of the disease hypothyroidism, when a person’s thyroid gland does not produce the required amount of hormones.

This in turn affects the heart, which responds to this deficiency with tachycardia and other diseases.

It is worth noting that it will not be possible to shelve this disease, because the more time passes, the worse the situation with the heart becomes, and the end result may be death. To prevent this, you need to treat hypothyroidism in a timely manner.

But this is not all diseases associated with the endocrine system. It is quite possible for the above symptoms to appear during menopause, when women’s reproductive function disappears.

In this case, hormonal changes begin to occur in the body, which can cause strong heartbeats or a feeling of palpitations with a normal pulse.

Psychological disorders.

It is no secret that frequent psychoses and neuroses can cause interruptions in the functioning of a person’s heart. Mostly, such problems can affect young people who do not yet have a fully formed psyche.

At this age it is very easy to be subject to suggestion or self-hypnosis, as well as antisocial behavior.

Sometimes the cause of an increase in heart rate can be a simple overdose of drugs. In this case, you just need to reduce the dose of the drug, and everything will fall into place.

If you experience a strong heartbeat during your sleep, you should immediately consult a doctor to find out the cause of such nighttime anxiety.

It is better not to delay treatment, so that later it will not be too late to return the functioning of your heart to normal.

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It is important to know! An effective means for normalization heart function and blood vessel cleansing exists! ...

The feeling of your own heartbeat with normal pulse and pressure can occur at different periods of life, be a variant of the norm, or signal a malfunction in the endocrine, respiratory and cardiovascular systems. This condition is detected not only in adults, but also in children. Special diagnostic procedures make it possible to determine the etiology of the disease and select the most appropriate treatment tactics in each specific case.

Causes of loud heartbeat

An increase in the rhythm or intensity of heartbeats can be a natural reaction of the body to external stimuli or be a consequence of infectious lesions of the organ, pathological changes in the structure of its tissues or blood vessels. Thus, the causes of this pathology are divided into organic and physiological. The latter include:

severe fatigue; transitional age; pregnancy; stressful situations; excessive consumption of caffeine and alcohol; lack of sleep; treatment with medications that affect blood pressure; systematic overeating and obesity.

The occurrence of tachycardia in a child during adolescence is due to the rapid growth of the body, during which blood pressure readings may also fluctuate. During pregnancy, the load on the heart increases many times over, which must pass a much larger volume of blood through itself in order to provide the mother and fetus with sufficient oxygen. Such an instantaneous change entails changes in blood pressure, rhythm and heart rate.

If the cause of a loud heartbeat is the use of various doping drinks and drugs, then you should stop taking them, these symptoms will quickly disappear. In case of lack of sleep and stressful situations, proper rest is necessary; it is recommended to take light sedatives of herbal origin (tincture of valerian or motherwort). If an abnormal heart rhythm occurs as a result of prolonged treatment with medications, you need to inform your doctor about this and select other medications.

If for physiological reasons, to normalize the functioning of the heart muscle, it is enough to remove provoking factors, then for tachycardia and arrhythmia of an organic nature, only treatment of the underlying disease helps. The following pathologies can cause intense heartbeat without changing blood pressure and heart rate disturbances:

1. Atrial fibrillation. With this disease, a person feels a loud and erratic contraction of the heart muscle, which is caused by atrial or ventricular flutter. 2. Paroxysmal tachycardia. Accompanied by a sharp attack of rapid heartbeat, strong pulsation of the veins in the neck and head. 3. Extrasystole. Most often, it is with this pathology that a person clearly feels how loud the heart is beating with normal blood pressure and no increased heart rate. With extrasystole, the heart beats unevenly, extraordinary and premature contractions of the organ are observed, which cause an unpleasant sensation of a heavy foreign object in the throat or stomach.

The above diseases pose a serious threat to human life, since if left untreated for a long time they can lead to various complications and death. Rhythm failure and loud heartbeat indicate a critical condition of the cardiovascular system. These symptoms do not go away on their own, and therefore it is necessary to consult a cardiologist for advice as soon as possible.

Diagnostics

If a person notices frequent attacks of loud heartbeat, accompanied by pain or other negative symptoms, it is necessary to undergo simple diagnostic procedures, which include:

electrocardiogram; auscultation; chest ultrasound; X-ray.

The first two methods for assessing the condition of the heart are quite sufficient; the remaining methods are used if serious pathologies are detected or their presence is suspected. Auscultation involves listening to the patient using a stethoscope in different positions (sitting, standing, lying down), and an electrocardiogram is performed using a special electrical device that records contractions of the heart muscle and instantly produces a graphical record of the results. Both examinations are absolutely painless and as informative as possible.

If, after going through all the diagnostic procedures, the cardiologist has not identified the true cause of the loud heartbeat, but it is systematic, a more thorough study of the problem is required. Hypothyroidism and other endocrine diseases can cause similar symptoms, the determination of which requires not only an external examination of the patient, but also a biochemical blood test.

In addition to visiting an endocrinologist, you should also pay attention to cured or indolent diseases of the respiratory system (chronic asthma, pneumonia). Often, pulmonary thromboembolism is accompanied by the same symptoms as heart diseases (shortness of breath, darkening of the eyes, arrhythmia, a feeling of heaviness in the chest, fainting), so it is better to visit a physician and ask for a referral for an x-ray of the lungs.

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Treatment and prevention

If during the examination pathologies of the endocrine, respiratory or cardiovascular systems were identified, then treatment will be aimed at eliminating the underlying disease and alleviating its symptoms. If a loud heartbeat is not provoked by organic damage to the heart, its nearby tissues or blood vessels, as well as infectious diseases of various origins, then a person needs:

increase the duration of night rest; give up bad habits (including drinking energy drinks, soda and sweets in large quantities); reduce the intensity of physical activity, and in case of complete absence, on the contrary, increase it; avoid stressful situations; follow a diet based on the principles of healthy eating.

In most cases, it will be useful to use sedatives in the form of decoctions and infusions, which you can prepare yourself according to traditional medicine recipes. Such drugs have a general strengthening effect, help normalize blood pressure and improve the functioning of the heart muscle. Do not forget that many homemade medicinal products are very similar in their pharmacological properties to medications, which means they have a rather strong effect on the body. In view of this, the dosage and course of administration must be agreed with your doctor in order to avoid unpleasant consequences.

In other cases, you can purchase tablets available without a doctor’s prescription at any pharmacy and drink them according to the instructions. Preference should be given to mild sedative herbal medications without the risk of side effects.

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It often happens that there is a feeling of palpitations with a normal pulse. Such manifestations also occur in healthy people, but sometimes they indicate the presence of cardiovascular disease. To find out, you need to contact a qualified specialist who can make the correct diagnosis.

Why can you feel a strong heartbeat when your pulse is normal?

The feeling of a strong heartbeat with a normal pulse is typical for children under the age of 7 years.

There are many reasons why a similar condition may occur with a normal pulse. Among them are:

diseases of the heart and blood vessels; problems with hormones; other reasons. Return to contents

Diseases of the heart and blood vessels

The most common cardiovascular diseases that cause palpitations with a normal pulse are presented in the table:

Normally, a person does not feel his own heartbeat.

Palpitation is a state in which a person is aware of every beat of his heart. This may be caused by the heart having a hard time pumping blood, or by the heart beating too slowly, too fast, or irregularly.

This article explores the causes of heart flutters, methods of diagnosing and treating the disease.

Review

The manifestations of palpitations can vary greatly depending on how the person is feeling.

General descriptions include:

1. Vibration

2. Missed or extra rhythm (also known as ectopic beats)

3. Feeling like after a workout

4. Increased heart rate

5. “Heavy” heart beats

Palpitations can also be felt in the neck, throat, abdomen and ears.

For some people, the heartbeat lasts only a few seconds, while for others it can last for a minute in a single episode.

In general, it is not common for people to experience heart palpitations. But in most cases it is harmless and does not signal a serious problem.

Common reasons

Many things can cause the sensation of heart palpitations. Some of the most common reasons can be broken down into categories:

Emotional factors

These include:

1. Anxiety
2. Stress
3. Panic
4. Nervousness

Drug treatment

Some medications can cause heart palpitations. These include:

1. Inhalers for asthma
2. Antihistamines
3. Thyroid hormone replacement drugs
4. Antiarrhythmic drugs
5. Antibiotics
6. Antidepressants
7. Antifungal drugs
8. Some cough medicines
9. Some herbal or dietary supplements

Diseases

Diseases can cause heart palpitations. These include:

1. Hyperglycemia
2. Anemia
3. Low blood sugar
4. Low Potassium Levels
5. Dehydration
6. High temperature and fever
7. Blood loss
8. Shock
9. Low levels of oxygen or carbon dioxide in the blood

Hormonal changes

Hormonal changes are another possible cause of heart flutters. Hormonal changes can be caused by:

1. Menstruation
2. Pregnancy
3. Menopause

Heart diseases

Palpitations may be caused by heart disease:

1. Arrhythmia
2. Coronary artery disease
3. Heart valve problems
4. Heart failure
5. Heart defects at birth
6. Hypertrophic cardiomyopathy (when the muscle wall of the heart becomes thick and enlarged) or other types of cardiomyopathy

Lifestyle

Lifestyle factors that can cause heart flutters include:

1. Caffeine (found in tea, coffee and energy drinks)
2. Alcohol
3. Smoking
4. Physical activity
5. Drugs (such as cannabis, cocaine, heroin, ecstasy and amphetamine)
6. Spicy food

Complications

While most cases of heart fissures are harmless. But if they are a sign of heart disease, serious complications can arise.

Complications include:

1. Fainting
2. Stroke
3. Supraventricular tachycardia
4. Atrial fibrillation
5. Ventricular tachycardia
6. Ventricular fibrillation
7. Cardiac arrest
8. Heart failure.

Diagnostics

Palpitations, which are harmless, often go away quickly and occur rarely. Treatment is not necessary in such cases.

However, in some situations it is necessary to talk to your doctor about the sensations of heart fluttering:

1. If a person has heart disease
2. If your heartbeat does not improve or gets worse
3. If symptoms are severe
4. If the person has other health problems

Of course, palpitations come and go and often don't occur in a doctor's office. Therefore it is important to write down:

1. Your feelings
2. How often do they happen?
3. When they happen

The doctor will examine the patient, study the medical history and prescribe an ECG.

Treatment and prevention

Treatment for palpitations will depend on the symptoms and the cause.

In general, treatment falls into three categories:

Preventive

Lifestyle changes and avoiding triggers can help reduce or stop heart palpitations. These changes include:

1. Reduce caffeine intake
2. Stop smoking
3. Quitting alcohol
4. Proper nutrition
5. Exercise
6. Avoiding medications that may cause palpitations
7. Reduce stress and anxiety (yoga, meditation, breathing exercises)

Drug treatment

A doctor may decide that a person needs to take a prescription antiarrhythmic drug, such as a beta blocker.

Beta blockers slow your heart rate, in addition to lowering your blood pressure.

Medical procedures

Three main types of medical procedures are used in cases of palpitations:

1. Catheter ablation
2. Synchronized cardioversion
3. Implantation of a pacemaker or defibrillator

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2016-11-07 16:36:17

Natalya asks:

Hello, Mikhail Valentinovich!
Thank you very much for the consultation!

Mikhail Valentinovich, I’m at a dead end... I went through a lot of tests, MRI of the brain and MRI of the cervical spine, X-rays of the spine, twice Holter ECG monitoring (I do all the tests in private clinics, there is no possibility in the clinic) - there are no diagnoses and no treatment...

For the second time in 2 years I am undergoing Holter ECG monitoring, but there are attacks (increased heartbeat (intermittent), dizziness, compression in the heart and thyroid gland, increased blood pressure, feeling of lack of air, cold sweat, during the day - unsteadiness when walking and weakness in the legs ) cannot be caught. These attacks happen 2-3 times a month (maybe during the day, maybe at night, unexpectedly).

Monitoring was carried out by Holter SDM3 (3-channel, with 3 leads) - this is the best that is available in our regional center in private clinics. And the interpretation of the monitoring is different... What are the characteristics of this Holter ECG model? What are "unusable QRS"? Does Holter SDM3 determine the nature of arrhythmia?

Secondarily, Holter monitoring reveals “During the day, regardless of the frequency of sinus rhythm, the different amplitudes and polymorphism of the T wave are recorded. Against the background of sinus tachycardia, ST segment depression of 0.5-1 mm is recorded.” Is this ischemia? Or is it related to long-standing persistent hypertension?

Previously, my thyroid hormone T4 sometimes increased. In 2004, T4 was increased = 16.3 dl/ml (normal 4.2 - 12.0 dl/ml) - was taken to the endocrinology clinic. Anaprilin and several other dietary supplements were prescribed (the diagnosis was not indicated on the card..., all prescriptions were written on pieces of paper). Then I took Mercazolil (maintenance dosage), but I cannot tolerate a higher dosage due to severe dizziness and unsteadiness when walking. In 2006 (after taking medications) I took a test at a private medical facility. center: T4 is normal, although the symptoms of hyperthyroidism remain (accelerated heartbeat, increased blood pressure, a feeling of compression in the heart and in the thyroid gland (diffuse goiter), emotionality, increased sweating, shine in the eyes, gastrointestinal disorders). These symptoms have accompanied me from the age of 22 until today (I am now 46). With the advent of menopause, the symptoms doubled. In 2015, she took tests for thyroid hormones + parathyroid hormone (surprisingly, T4 was normal, and parathyroid hormone was elevated (?)):
07/04/2015 thyroid hormones: free T4 (FT4) - 15.02 pmol/l (normal 9.0 - 20.0 pmol/l); Free T3 (FT3) - 4.42 pmol/l (normal 4 - 8.3 pmol/l); antibodies to thyropyroxidase - 6.5 lU/ml (normal up to 50 lU/ml); TSH - 1.63 mIU/ml (normal 0.25 - 5.0 mIU/ml)
12/7/2015 (parathyroid hormone - increased) - 74.8 pg/ml (normal 15.0 - 65.0 pg/ml) (!)

Why, despite normal T4 levels, do I still have symptoms accompanying hyperthyroidism? Can continuous use of beta blockers (since 2001) affect the result of a thyroid hormone test?
What could be associated with such a symptom as lack of air (the feeling that breathing and heartbeat are out of tune) - with hypertension or ischemia?
Compressive pain in the heart area (no more than 15 minutes) what can be associated with? Is it from high blood pressure, from an accelerated heartbeat, or ischemia? I used Nitroglycerin a couple of times, it was easier, but a severe headache appeared... The clinic told me to be careful, not to experiment, because of the presence of cerebrovascular insufficiency in the IVB...

How to take Bisoprolol correctly according to Holter ECG data (I publish the data from the previous consultation below)?
I have been taking Lozap 50 since 2010, and for more than 6 months now I have been coughing (especially if my back rests against the back of a chair) - could this be related to taking Lozap, or something else?
Do I need to be tested for lipoproteins in fractions? What laboratory tests should I undergo?

I would be grateful for your advice!

PREVIOUS CONSULTATION:
October 17, 2016
Natalya asks:
Good afternoon
Please advise based on Holter data in combination with symptoms and other examination data. Woman 46 years old. There are attacks: increased heartbeat (intermittently), dizziness, compression in the heart area, increased blood pressure, a feeling of lack of air, cold sweat, during the day - unsteadiness when walking. I take it with Bisoprolol. I also take Lozap 50 (hypertensive treatment, level 2), but it causes a cough. What can be replaced? Sometimes the legs and feet swell (mainly in the summer). What is this connected with?
In September, I underwent Holter ECG monitoring (Holter was installed at home; there were no pronounced attacks of palpitations; I performed a moderate exercise, which can be performed if coordination is impaired; the following symptoms were noted - at times, imbalance and short-term (but frequent) dizziness, a feeling of pressure in the heart area, persistent increase in blood pressure (after physical activity there is a sharp increase in blood pressure), a feeling of lack of air, unsteadiness when walking (after moderate physical activity) and loss of coordination).

Data from Holter ECG monitoring on September 12-13, 2016:
Average heart rate 80/min. Sleep 6 hours 50 minutes Heart rate during sleep is 69/min., while awake 85/min. Circadian index 1.24.
Rhythm:
Tachycardia >110 00:28:07 maximum heart rate 125/min. (12.09.16 21:51:51)
Arrhythmia 00:00:17
Bradycardia (QRS: total 102330, ventricular (V) 234, supraventricular (S) 481, unfit (A) 462.
Minimum R-R 200 (13.09.16 02:50:54)
Minimum R-R(NN) 232 (09/13/16 10:24:38)
Maximum R-R 2317 (13.09.16 02:02:35)
Maximum R-R(NN) 1190 09/13/16 10:55:51)
During 24-hour monitoring, sinus rhythm is recorded with a frequency from 60 at night, up to 64 to 112 beats during the day. per minute The tendency of sinus rhythm to normosystole during the day, insufficient decrease in frequency at night, with a moderate increase in rhythm frequency during physical and emotional stress. In the evening, rare single atrial extrasystoles were recorded, and at night, rare single ventricular extrasystoles occurred. Throughout the day, regardless of the frequency of sinus rhythm, the different amplitudes and polymorphism of the T wave are recorded. Against the background of sinus tachycardia, ST segment depression of 0.5-1 mm is recorded.

The Holter monitoring report is accompanied by 8-page cardiograms.

I didn’t even suspect that I could have a pulse below 60 beats/min. (perhaps this is due to the rather long-term use of beta blockers)... Maximum heart rate 125 beats/min. It was precisely in a state of rest - while watching TV. Now I don’t know how to take Bisoprolol, because there can be both tachycardia (more than 120 beats/min) and 56 beats/min. Therefore, I decided to take Bisoprolol in emergency cases...

And this Holter shows the same thing: “During the day, regardless of the frequency of sinus rhythm, the different amplitudes and polymorphism of the T wave are recorded. Against the background of sinus tachycardia, ST segment depression of 0.5-1 mm is recorded.” Is this ischemia? Or is it related to long-standing hypertension? Or with concomitant diseases: tendency to hypocalcemia; insufficiency of cerebral circulation in the VBB against the background of osteochondrosis of the cervical (4 protrusions, deforming arthrosis, straightened lordosis, osteophytes, dehydration) and thoracic (except for osteochondrosis and osteophytes, deformation of the Th8 vertebral body (probably due to hypocalcemia)) parts of the spine. Previously, the T4 hormone sometimes increased (the thyroid gland is enlarged), but now the cardiac, stomach, and neurological symptoms are the same (weight is normal), and the T4 hormone is normal. Can chronic long-term use of beta blockers “mask” the test result? Do beta blockers reduce metabolism?
In addition, on MRI of the brain: Ventricular system - moderate deformation of the anterior horns of the sides of the bodies S = 4.7 mm, D = 4.2 mm. Brain substance: Pronounced focal changes in both hemispheres are detected, expressed somewhat more subcortically. There is a slight deformation of the corpus callosum. Convexital subarachnoid spaces are slightly expanded in the projection of the poles of the heights of the lobes.
On MR angiograms (without IV contrast enhancement): ICA on the right = 3.6 mm, on the left = 3.5 mm; vertebral artery right = 2.2 mm, left = 2.2 mm, basilar artery = 2.5 mm. Uneven narrowing (spasm) of the branches of the SMA.

What are the above symptoms associated with (increased heartbeat (intermittently), dizziness, compression in the heart area, increased blood pressure, feeling of lack of air, cold sweat, during the day - unsteadiness when walking + loss of coordination of movements) - are they cardiological, neurological, or endocrinological? violations? These symptoms have been “haunting” me since I was about 19 years old... An ECHO CG (done about 9 years ago) revealed only a slight thickening of the interventricular septum and thickening of the anterior leaflet of the mitral valve and a stroke volume of 45 ml.

And one more thing... In 2001, I had to get very nervous (they made it worse), after which a long-term increase in blood pressure appeared to 175/110 mm Hg. with tachycardia, dizziness, weakness in the legs; astringency, mainly in the left hand; pain in the cervicothoracic spine. Without X-rays and other types of examination (MRI in 2001 was unrealistic), a diagnosis of VSD was made; were prescribed Corvitol, Barboval, Laminaria due to an enlarged thyroid gland...

In July 2016, she became nervous, and her blood pressure increased to 198/103 mm Hg. Art., I was shaking terribly and there was pressure in my chest (I took 25 mg of Lozap and 0.5 tablets of Bisoprolol, brought my blood pressure down to 158/98 mm Hg, the pulse returned to normal; it was possible to bring it closer to normal after another 25 mg of Lozap ". Please tell me, is it harmful to increase blood pressure above 180 mm Hg systolic in case of cerebral circulatory failure?

I would be very grateful for your advice!

November 07, 2016
Mikhail Valentinovich Bugaev answers:
Cardiac surgeon of the highest category
information about the consultant
Hello. First of all, you still need to try to record an ECG (using Holter monitoring) during attacks, only then can we talk about proper treatment. Moreover, you say that they are frequent, but during the monitoring they were not present. Frequent dizziness is usually associated with brain problems; also see a neurologist. Drugs to control hypertension, such as bisoprolol, are taken not when blood pressure increases, but regularly, daily, in order to prevent its increase.

Answers Bugaev Mikhail Valentinovich:

Hello. It is better to consult an endocrinologist regarding thyroid hormones, not a cardiac surgeon. The same as for antihypertensive therapy - see a cardiologist. As for rhythm disturbances, the tasks remain the same - to record them on an ECG. Unfortunately, the possibilities for this are not so great - either Holter monitoring or other methods of outpatient diagnostics, now there are devices that are given to the patient, and the patient himself connects the device at the time of an arrhythmia attack in order to record an ECG, which is then transferred to the doctor. Information about such devices can be obtained, in particular, from the manufacturer: http://www.solvaig.com. I think you need bisoprolol - both in terms of treating hypertension and stopping tachycardia. It is also prescribed for coronary heart disease, if one is diagnosed. You really should be careful with nitroglycerin, as it can dramatically reduce blood pressure. If it quickly relieves constriction pain, you may want to consider taking a long-acting nitrate. They are taken no longer than 1-1.5 months.

2011-12-24 09:04:20

Naum asks:

Hello!
I am 35 years old. For a year and a half now I have been tormented by: pain in the left side of the chest (mostly a nagging pain that lasts for many hours from the side of the lower rib and then spreads upward), sometimes on the contrary, just below the collarbone, also sometimes on the side of the left shoulder blade and radiates to the left arm (as if goosebumps by hand). Sometimes it lasts 10 hours. Sometimes it lasts 30 minutes - 1 hour.
In addition - a feeling of incomplete inspiration, a lump in the throat, abdominal pain, a feeling of intestinal perilstatics, bloating, twitching of the muscles on the back for 1-3 minutes several times a day, there is a feeling of stuffiness in the ears, usually the left ear, there is numbness in the feet and hands And also panic attacks: first some kind of incomprehensible anxiety, then a wave of heat from the pelvic area to the chest or head, after which the heartbeat begins to 120 - 130, which is relieved with Corvalol. Or it goes away on its own within 20 - 30 minutes. If the attack drags on, the pressure rises to 160/100. Then within 10 minutes it returns to normal. The average blood pressure during this time is 125/80, not counting these attacks. I measure my blood pressure 3-5 times a day. During physical activity, if I focus on my heart and measure the heartbeat with my hand, shortness of breath and unpleasant sensations appear in the head, as if my head is spinning, my ears are stuffy, and I even had darkening in my eyes twice. If I don't pay attention, then everything is fine. Shortness of breath also appears if I focus on my breathing (this happens at rest and during physical activity, for example after climbing to the fifth floor, sometimes to the third floor). It all started last year after the death of a loved one (grandmother) plus two colds in a row. It all started with the inability to swallow saliva, then a feeling of incomplete inspiration, then a panic attack with blood pressure rising to 160/100, pain on the right side of the chest. They admitted me to the hospital (during the tests, everything was normal: general and biochemical blood test, total cholesterol 4.8, echocardiography without pathologies, ECG - SRBC, general urinalysis was normal, blood pressure was normal), I felt great. Treatment was carried out with piracetam, ambroxol, and some kind of analgesic. After discharge it all started again. Then everything intensified with the death of my father. About 8 months ago, extrasystole appeared.
In the summer I did Holter - 2900 single supraventricular extrasystoles, tachydependent obliquely ascending depression of the ST segment up to 2.78 mm with a pulse of 139 - 168, at this time I did 50 push-ups and 50 squats in 2 minutes, before that I smoked three cigarettes within an hour, the last one in 10 minutes before exercise, increasing the QT interval. After these results, I started having panic attacks again. I was diagnosed with IHD. Silent ischemia. They admitted me to the hospital, where they prescribed isoptin and cardiomagnyl. I felt normal, but the extrasystole did not go away (it felt like it). I was discharged from the hospital - again panic attacks, pain and everything else. Then we tried phenozepam in treatment - 1t 1mg at night and after two doses absolutely all pain, bloating, etc. went away. Even the shortness of breath in almost all cases went away and the sensations of extrasystole disappeared. I tried to catch it by measuring the pulse - the pulse was normal. Although before this, the pulse was immediately visible. A month and a half ago, in another city, they did an echocardiography and colorectal dosage test - without pathologies, but the protocol says a hyperkinetic type of left ventricular ejection. VEM test, initial ECG - pronounced sinus arrhythmia (at that moment I felt some kind of strong fear before the test). I didn’t complete the test itself (my nose was completely blocked, I was breathing through my mouth and my throat was very dry). The pulse at the time of completion was 178. No significant ECG changes were detected, the test for ischemia was negative. The pressure change is normal. The increase in heart rate is moderately accelerated. During the recovery period, at 1 minute there was an episode of supraventricular extrasystoles and one paired supraventricular extrasystoles. The load was 150 W. I took a test for total cholesterol - 4.77 HDL-C - 1.07 LDL-C - 3.13 VLDL-C - 0.57 KA -3.46 Trigcerides - 1.27. They also did an MSCT scan of the abdominal organs, everything was normal, except for the left adrenal gland - diffuse hyperplasia. Complete blood count - elevated leukocytes 9.5*10^9 Another blood test - creatinine, AST, ALT, glucose is normal. The general blood test was all normal. After that, the cardiologist was busy and went with the test results to another center - there the cardiologist said that there was no coronary artery disease, that I had VSD.
Today, if you take phenozepam, everything almost goes away, if you stop taking it, everything returns. I tried afobazole - it didn’t help. Corvalol only relieves panic attacks.
Now the question is - what do I have: neurosis, VSD, IHD or all together?
I apologize for such a long description - I tried not to miss anything.

Answers Bugaev Mikhail Valentinovich:

Hello. Of course, there is no ischemic heart disease, there is hypochondria in its pure form. Try to take your mind off illness. You need a good psychotherapist. Your extrasystoles do not need treatment.

2011-01-21 15:34:19

Elena asks:

Good afternoon! Help me understand the diagnosis of heart disease based on the results of examinations. I am 45 years old, I have been feeling unwell, especially for the last six months: arrhythmia, frequent heart palpitations, a feeling of heaviness in the heart area, weakness.
History: 1997 - surgery to remove the uterus and appendages - oncology. Hernia of the cervical spine, portrusions in the thoracic spine.
Tests for tumor markers and hormones (taken in October 2010) were normal.

Holter from 11/11/2010: A total of 115,178 QRS complexes were recorded, of which 5,921 were classified as artifacts. The main rhythm is sinus. Average heart rate 79 beats/min, Max. Heart rate-141 beats/min. (8h.01min.), Min. Heart rate-49 beats/min. (6 hours 02 minutes). Normal QRS complexes - 108497, aberrant complexes - 0.
Dynamics of the ST segment (channel V5). The ST segment level was determined at a distance of 80 ms. from point j. 6 episodes of ST segment depression of more than (-1.0) mm were recorded, with a total duration of 30 minutes, with a heart rate at the beginning of the episode averaging 109 beats/min. Max. cont. episode 7 min. 30 sec. at 12.41 min. Max. ST depression -1.3 mm at 03:43. No episodes of ST segment elevation of more than (2.2) mm were detected.
Ventricular ectopic activity: Registered in a number of 754 VES, on average 33.6 VES/hour, which amounted to 0.65% of the total number of QRS complexes. Ventricular ectopic activity is multifocal (2 types). Single VES -712, Bigeminy (number of VES) -4, Paired VES (couplets) - 19, VT runs -0.
Supraventricular ectopic activity: Single NVES -6, Paired NVES (couplets) - 0, SVT runs -0.
Pauses - not registered
Conclusion. Signs of chronic coronary insufficiency in FG II (periods of horizontal displacement of the ST segment during physical activity with an increase in heart rate of more than 110). Ventricular extrasystole of III, IVA gradations according to Zonn.

Echo-ECG from 10.25.2010: Moderate degenerative changes in the valves of the mitral valve. I-II Art. Additional ZSMK chord. Additional Chords of the left ventricle. Hyperkinit.cord.syndrome.

Electrocardiogram dated January 18, 2011 (while taking allopinin, preductal, cardiomagnyl, Mildronate injections - 10 pcs. for 1.5 months)
Heart rate, bpm -72; R-R max., ms – 854; R-R min. ms – 796; R-R avg. ms – 830; P, ms – 108; Р-R(Р-Q), ms – 141; QRS, ms -106; QT, ms – 390; QTс, ms – 428; QRS axis - 77
Conclusion: Vertical position of the electrical axis of the heart. Violation of intraventricular conduction. Diffuse muscular changes in the myocardium with manifestations of hypoxia in the posterolateral region of the left ventricle. The presence of HKN cannot be ruled out.
How serious is this? Is there any way to treat this and how to improve the quality of life?

Palpitations - a feeling that the heart is beating too quickly or is beating too hard - is a reason to consult a doctor.

is a patient complaint about the subjective sensation of a rapid, arrhythmic or heavy heartbeat. Normally, we do not notice our heartbeat. But any deviation from the norm becomes immediately noticeable. Patients typically describe palpitations as the following: the heart pounding too hard (or “loudly”) in the chest, the heart “jumping” out of the chest, pounding, “jerking,” “spinning,” or “fluttering.” Increased heartbeat may be accompanied by a feeling of pulsation in the neck, temples, pit of the stomach or fingertips. Palpitations may also be accompanied by pain in the heart area, a feeling of tightness in the chest or difficulty breathing. Such symptoms may indicate heart pathology, but in most cases, complaints of increased heartbeat with accompanying symptoms, instrumental studies do not reveal signs of heart damage.

Heartbeat should be distinguished from. Tachycardia– this is an objective increase in heart rate. The normal heart rate for an adult at rest is 60-80 beats per minute. If more than 90 beats per minute are recorded, then tachycardia is diagnosed. However, the patient may not feel that his heartbeat is rapid.

Common causes of heart palpitations

Even a healthy person can feel increased heartbeat. This is most common for people with increased nervous sensitivity. The following can lead to heart palpitations:

• significant physical effort;
• rapid rise to altitude;
• physical activity in a hot and stuffy environment (lack of oxygen leads to increased heart function);
• sharp mental stress (fear, excitement, etc.);
• consuming large amounts of foods high in caffeine (coffee, tea, Coca-Cola);
• certain medications (in particular, cold remedies);
• digestive disorders (for example, as a result of which the diaphragm appears slightly elevated).

Palpitations may be felt when the temperature is high (patients with a fever often feel palpitations).

Increased heart rate and high blood pressure

Rapid heartbeat is often accompanied. In this case, the more often the heart contracts, the higher the pressure in the arteries. The dependence here is exactly that... Therefore, it is wrong to consider high blood pressure as the cause of increased heart rate. Another thing is that increased blood pressure, accompanied by a general deterioration in well-being, can make you notice how hard your heart is beating.

Rapid heartbeat and increased blood pressure can be caused by the same reasons. In this case, therapeutic measures aimed at normalizing blood pressure will also help normalize the heartbeat.

Increased heart rate and low blood pressure

An increased heart rate is quite possible even with low blood pressure. A sharp decrease in pressure can be observed during shock conditions (traumatic, infectious-toxic, psychogenic and other types of shock). The body responds by speeding up the contraction of the heart muscle to restore blood pressure. A similar compensatory nature of increased heartbeat also occurs with large blood loss.

Rapid heartbeat with normal blood pressure

However, increased heartbeat can be felt regardless of blood pressure. The pressure may be low or normal, but the patient complains of palpitations. This is possible with vegetative-vascular dystonia and a number of other diseases. You should not try to determine what you are sick with, much less begin treatment only on the basis of comparing your heartbeat and blood pressure. In all cases when you are concerned about increased heart rate, you must undergo an examination as prescribed by your doctor.

When is palpitations a reason to see a doctor?

A rapid heartbeat is a reason to see a doctor if it:

• too intense;
• is protracted (does not go away for a long time);
• occurs with less and less exposure to the above factors;
• occurs independently of the above factors;
• is uneven in nature (arrhythmia can be assumed - a violation of the heart rhythm).

In these cases, rapid heartbeat may be a manifestation of serious disorders and diseases, such as:

• anemia (low hemoglobin and iron in the blood);
• tetany (a condition caused by a lack of calcium);
• endocrine diseases;
• heart pathologies.

However, as a rule, in the case of myocarditis, other heart diseases, and hyperthyroidism, palpitations are not the main complaint. With such diseases, first of all, they complain of pain in the heart area and.

It is necessary to react promptly if, against the background of increased heartbeat, pale skin and sweating are observed. In this case, you should call an ambulance.

How can a doctor help with a strong heartbeat?

If you complain about palpitations, you should contact a general practitioner or cardiologist.

When a patient complains of increased heartbeat, it is first necessary to establish its cause - whether it is of physiological or pathological origin. For this purpose, laboratory and instrumental studies may be prescribed, including (), radiography of the heart. After identifying the cause of the increased heart rate, a course of treatment is prescribed aimed at eliminating pathological factors. Normalization of the heartbeat is achieved through treatment with antiarrhythmic drugs. Such drugs should not be taken on your own; they should be prescribed by a doctor in accordance with the condition of your body, established on the basis of a medical examination. Otherwise, the treatment result may be negative.