Symptoms, Causes, Diagnosis, & Treatment

Written by Heidi Godman

• Heart Basics
• Symptoms
• When to See a Doctor
• Causes
• Diagnosis
• Treatment
• More

Generally, it is normal to have a slower heart rate when you’re resting. It can be a sign of good health. But if it’s too slow, it could be a symptom of a condition called bradycardia.

Normally, your heart beats 60 to 100 times a minute when you’re at rest. But with bradycardia, it goes down to less than 60 beats a minute.

This might not cause a problem for some people. But it could be a clue that you have an issue with the electrical system in your heart. You need to see a doctor who can figure out why it’s beating slowly and if you should get treatment.

Electrical signals travel through the heart’s four chambers — two on the top called the atria and below them, the two ventricles. These signals prompt it to beat in a steady rhythm. But pulses don’t always fire off as they should.

This creates what’s called arrhythmias, or abnormal heartbeats.

Some conditions cause the heart to beat too fast or to flutter. With bradycardia, it’s the opposite. The electrical problem slows down the time in between heartbeats.

You may simply have a slower-than-normal heart rate that doesn’t cause any symptoms. The electrical activity may be working fine, just a little slower than it does in most people. You wouldn’t even be diagnosed with this condition.

And even with bradycardia, you may never notice any symptoms or need treatment. But that’s not always the case.

The biggest concern is your heart isn’t doing well enough at pumping blood to all the organs and tissues that need it. When this happens, the following may develop:

• Lightheadedness or dizziness
• Confusion or a hard time concentrating
• Fainting
• Shortness of breath (with or without chest pain)

You may also find that you tire out easily with even just a little activity.

If you check your heart rate and it’s regularly below 60 beats per minute, be aware of those symptoms.

If you have no other symptoms, you probably don’t need to see a doctor right away. You may exercise a lot, and a slow heart rate could be a sign of how fit you are. But, bring it up at your next appointment.

If you or a loved one notices mild to medium symptoms, go to a doctor quickly.

If you or a loved one faints, has chest pains or trouble breathing, call 911.

Tiredness, trouble concentrating, or breathing harder may just seem like part of growing older. But sometimes it’s more than that.

Be sure to tell your doctor about all your symptoms. If you wear out more easily now than you did a month or year ago, let them know.

The chances of getting bradycardia increase as you get older, though that’s true of most heart conditions. The causes of bradycardia can vary greatly from one person to the next.

The abnormal rhythm can show up after a heart attack or as a side effect of heart surgery. Other things that can lead to it:

• Certain medications, such as those to treat high blood pressure and other arrhythmias, or abnormal heartbeats
• A congenital defect, or problem you’re born with
• Thyroid disease, an imbalance of hormones in the body
• Obstructive sleep apnea, when your breathing pauses many times throughout the night

Bradycardia can be a little hard for doctors to figure out, because it’s not always present all the time. Your heart can go in and out of slow rhythms.

Your doctor will be able to make the diagnosis if you’re having a bout of bradycardia during a test called an electrocardiogram. Often called an EKG, it’s a way to measure your heart’s electrical system.

If your heart rate appears normal, but you have had symptoms of bradycardia, your doctor may have you wear a 24-hour monitor.

Your doctor will ask about your personal and family health histories, as well as any symptoms you’ve had.

If your doctor decides that you have bradycardia, the treatment plan will be based on the likely cause of the problem.

For instance, if the cause is hypothyroidism, or low thyroid function, treating that may take care of the heart rate issue.

If there is no clear physical cause, your doctor may change medications that might be slowing your heart. Beta blockers are sometimes prescribed to relax your heart muscle. But if they cause you to have a really slow heart rate, your doctor might lower the dosage or give you a different drug.

If these approaches don’t work and your condition is serious enough to put your brain and other organs at risk, you may need a pacemaker.

A surgeon will put this small device into your chest. It has thin, flexible wires, called leads, which extend to the heart. They carry small electrical charges that help keep the heart pumping at a steady rate.

If you have been given a pacemaker, listen to your doctor’s instructions about how it operates and any signs it might not be working.

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Atrial Flutter: Symptoms, Causes, Tests, Treatments

Written by WebMD Editorial Contributors

• What Happens in Atrial Flutter?
• What Are the Risks of Atrial Flutter?
• Are There Types of Atrial Flutter?
• Who Gets Atrial Flutter?
• What Causes Atrial Flutter?
• What Is the Difference Between Atrial Flutter and Atrial Fibrillation (AFib)?
• Atrial Flutter Symptoms
• When to Seek Medical Care for Atrial Flutter
• Atrial Flutter Exams and Tests
• Goals of Atrial Flutter Treatment
• Procedures That Treat Atrial Flutter
• Atrial Flutter Medications
• Atrial Flutter Care at Home
• Living With Atrial Flutter
• Complications
• Next Steps and Beyond
• More

Atrial flutter is a problem with the way your heart beats. Such problems, whether in the rhythm or speed of the heartbeat, are known as arrhythmias.

Your heartbeat is a sort of electrical circuit. Sometimes the signals cause it to go awry. Atrial flutter results from an abnormal circuit inside the right atrium, or upper chamber of your heart. It beats extra fast, about 250-400 beats per minute. A normal heartbeat is 60-100 beats per minute.

The beat slows down when the signals reach the AV node, a bundle of cells in the upper wall of muscle between the ventricles, your heart’s lower chambers. It usually slows the beats by a fourth or a half, or down to somewhere between 150 and 75 beats per minute.

An abnormally fast heart rate is called tachycardia. Because atrial flutter comes from the atria, it is called a supraventricular (above the ventricles) tachycardia.

The main danger with atrial flutter is that your heart doesn’t pump blood very well when it beats too fast.

• Vital organs like the heart muscle and brain may not get enough blood, which can cause them to fail.
• Congestive heart failure, heart attack, and stroke can result.

With proper treatment, atrial flutter is rarely life-threatening. Complications of atrial flutter can be devastating, but treatment almost always prevents them.

Paroxysmal atrial flutter can come and go. An episode of atrial flutter usually lasts hours or days.

Persistent atrial flutter is more or less permanent.

You’re more likely to get this condition if you’ve had:

• Heart failure
• A heart attack
• High blood pressure
• Heart valve problems
• Long-term lung disease
• Diabetes
• Thyroid disease
• Alcohol abuse
• Another serious illness

Doctors don’t always know. In some people, no root cause is ever found. But atrial flutter can result from:

• Diseases or other problems in the heart
• A disease elsewhere in your body that affects the heart
• Substances that change the way your heart transmits electrical impulses

Heart diseases or problems that can cause atrial flutter include:

• Ischemia: Lower blood flow to the heart due to coronary heart disease, hardening of the arteries, or a blood clot
• Hypertension: High blood pressure
• Cardiomyopathy: Disease of the heart muscle
• Abnormal heart valves: Especially the mitral valve
• Hypertrophy: An enlarged chamber of the heart
• Open-heart surgery

Diseases elsewhere in your body that affect the heart include:

• Hyperthyroidism: An overactive thyroid gland
• Pulmonary embolism: A blood clot in a blood vessel in the lungs
• Chronic obstructive pulmonary disease(COPD): A condition that lowers the amount of oxygen in your blood

Substances that may contribute to atrial flutter include:

• Alcohol (wine, beer, or hard liquor)
• Stimulants like cocaine, amphetamines, diet pills, cold medicines, and even caffeine

Atrial flutter is closely related to AFib, another arrhythmia. Symptoms like a racing heart and dizziness are common with both conditions. About one-third of people who have AFib also have atrial flutter.

In atrial flutter, electrical impulses don’t travel in a straight line from the top of your heart to the bottom. Instead, they move in a circle inside the upper chambers. As a result, your heart beats too fast, but still in a steady rhythm.

In AFib, the electrical signals that travel through the atria are fast and disorderly, which makes them quiver instead of squeezing strongly. This causes the heart to beat too fast and in a chaotic rhythm.

Some people have no symptoms at all with atrial flutter. Others describe:

• Palpitations (rapid heartbeat or a pounding or fluttering sensation in the chest)
• Shortness of breath
• Anxiety
• Trouble exercising
• Confusion
• Tiredness

People with heart or lung disease who have atrial flutter may have these and other, more significant symptoms:

• Angina pectoris (chest or heart pains)
• Feeling faint or lightheaded
• Fainting

Call your doctor:

• If you have any of the symptoms of atrial flutter
• If you’re taking medication for atrial flutter and you have any of the signs and symptoms described
• If you’ve been diagnosed and are being treated for atrial flutter, go immediately to a hospital emergency department if you:
  • Have severe chest pain
  • Feel faint or lightheaded
  • Faint

When you tell them your symptoms, your doctor will probably suspect an arrhythmia. Because other conditions can cause similar symptoms, the doctor will want to rule out the most dangerous ones. Also, you can’t get treatment until the doctor knows your specific arrhythmia type. These tests can tell a lot about what’s happening with your heart:

Electrocardiogram(EKG)

• Your medical team places small patches on your chest to measure and record the electrical impulses that control your heartbeat.
• The EKG highlights problems in these impulses and abnormalities in the heart.
• The tracings can help pinpoint the type of arrhythmia and where in the heart it comes from.
• An EKG also shows signs of:
  • Heart attack
  • Heart ischemia
  • Conduction problems
  • Abnormal heart enlargement, called hypertrophy
  • Problems with levels of chemicals, like potassium and calcium, in your heart tissue
• If you don’t have symptoms, your doctor might give you this test if they find signs of atrial flutter when you’re at the doctor’s office for something else.

Holter monitor/ambulatory EKG

• You might get this test if you have atrial flutter symptoms but get a normal EKG result. That can happen because arrhythmia comes and goes. Or you may just have premature heartbeats, which aren’t dangerous.
• This test can help your doctor find out if you have a significant arrhythmia and what type.
• You’ll wear the monitor around your neck for a few days while you go about your normal activities.
• It’s connected to EKG electrodes attached to your chest.
• The device records your heart rhythm on a continual basis for 24-72 hours.

Event monitor

• It’s a smaller device that you wear for a longer time.
• You can turn it on when you feel something abnormal.
• Sometimes the doctor can implant an event recorder under the skin, and it can be worn for several weeks or months.

Echocardiogram

• This safe, painless ultrasound test uses sound waves to make a picture of the inside of your heart while it’s beating and between beats. It can find problems with blood flow or damage to your heart muscle.
• It identifies heart valve problems, checks how well your ventricles work, and looks for blood clots in the atria.
• It uses the same technique doctors use to check babies in the womb.

Blood tests

• These tests can check for other causes of a heart rhythm problem, such as thyroid disease.

The goals are to control the heart rate, restore a normal sinus rhythm, prevent future episodes, and prevent stroke.

Control your heart rate: The first treatment goal is to control the ventricular rate.

• If you have serious symptoms, like chest pain or congestive heart failure related to the ventricular rate, the doctor will lower your heart rate rapidly with IV medications or electrical shock. (This is called cardioversion.)
• If you have no serious symptoms, you may get medications by mouth.
• Sometimes you may need a combination of oral drugs to control your heart rate.
• You might need surgery to control your heart rate or rhythm, but this is rare.

Restore and maintain a normal rhythm: Some people with newly diagnosed atrial flutter go back to a normal rhythm on their own within 24-48 hours. The goal of treatment is to convert the atrial flutter to a normal sinus rhythm and make sure it doesn’t come back.

• Not everyone with atrial flutter needs anti-arrhythmic medication.
• How fast your arrhythmia returns and the symptoms it causes partly determine whether you’ll get anti-arrhythmic drugs.
• Medical professionals carefully tailor each person’s anti-arrhythmic medications to produce the desired effect without creating unwanted side effects, some potentially deadly.

Prevent future episodes: You can do this by taking daily medication to keep your heart beating at a safe and comfortable rate.

Prevent stroke: This devastating complication of atrial flutter happens when a piece of a blood clot formed in your heart breaks off and travels to the brain, where it blocks blood flow.

• Medical conditions that happen together, such as congestive heart failure and mitral valve disease, greatly raise the odds of having a stroke.
• If you have persistent atrial flutter, you might need a blood-thinning drug to prevent your blood from clotting.

The first step in treatment is to restore a normal rate and sinus rhythm. There are two ways to do this: medication and defibrillation.

Electrical cardioversion: The doctor gives your heart a shock to regulate your heartbeat. They’ll use paddles, or they’ll stick patches called electrodes onto your chest.

First, you’ll get medicine to make you fall asleep. Then, your doctor will put the paddles on your chest, and sometimes your back. These will give you a mild electrical shock to get your heart’s rhythm back to normal.

Most people only need one. Because you’re sedated, you probably won’t remember being shocked. You can usually go home the same day.

Your skin may be irritated where the paddles touched it. Your doctor can point you toward a lotion to ease pain or itching.

Radiofrequency ablation: This is a type of catheter ablation most often used for atrial flutter. Your doctor puts a thin, flexible tube into a blood vessel in your leg or neck. Then they guide it to your heart. When it reaches the area that’s causing the arrhythmia, it sends out radiofrequency energy (similar to microwave heat) that destroys those cells. The treated tissue helps get your heartbeat regular again.

The choice of medication depends on how often atrial flutter happens, the root cause, your other medical conditions and overall health, and the other drugs you take. The classes of medications used in atrial flutter are:

Heart rate medicines: The most common way to treat atrial fibrillation is with drugs that control your heartbeat. These slow your rapid heart rate so your heart can pump more effectively. Options include digoxin (Lanoxin), beta-blockers, and calcium channel blockers.  

Digoxin belongs to a class of medications called cardiac glycosides. It works by affecting certain minerals (sodium and potassium) inside heart cells. This reduces strain on the heart and helps it maintain a normal, steady, and strong heartbeat.

Beta-blockers slow your heart rate. They include:

• Atenolol (Tenormin)
• Bisoprolol (Zebeta, Ziac)
• Carvedilol (Coreg)
• Metoprolol (Lopressor, Toprol)
• Propranolol (Inderal, Innopran)
• Timolol (Betimol, Istalol)

Others are known as calcium-channel blockers. They also slow your heart rate and cut the strength of contractions. They include:

• Diltiazem (Cardizem, Dilacor)
• Verapamil  (Calan, Calan SR, Covera-HS, Isoptin SR, Verelan)

Heart rhythm medicines: They slow the electrical signals to bring your heartbeat into what’s called a normal sinus rhythm. These treatments are sometimes called chemical cardioversion:

Sodium channel blockers, which slow your heart’s ability to conduct electricity:

• Flecainide (Tambocor)
• Propafenone (Rythmol)
• Quinidine

Potassium channel blockers, which slow the electrical signals that cause AFib:

• Amiodarone (Cordarone, Nexterone, Pacerone)
• Dofetilide (Tikosyn)
• Sotalol (Betapace, Sorine, Sotylize)

Anticoagulants: These drugs make your blood less able to clot. This lowers the odds that a blood clot will form in the heart or in a blood vessel and lead to a stroke.

• Apixaban (Eliquis)
• Dabigatran (Pradaxa)
• Enoxaparin (Lovenox)
• Heparin
• Rivaroxaban (Xarelto)
• Warfarin (Coumadin, Jantoven)

Most people known to have atrial flutter will be taking prescribed drugs. Avoid taking any stimulants. Talk to your doctor before taking any new medications, herbs, or supplements.

An irregular heart rhythm can affect how well you can work, exercise, and do other activities. To manage it, follow the treatment plan your doctor prescribes. Medicines and other therapies can help control symptoms, like shortness of breath and palpitations, and lower your odds of having a stroke or heart failure.

It’s also important to eat right. Your doctor or a dietitian can help you plan a healthy diet. If you’re overweight, losing some pounds may help you control symptoms.

Exercise can also help you manage your heart rhythm. Ask your doctor what types of activities are safe for you, and how to get started in a new program.

Atrial flutter means your heart doesn’t pump blood as well as it should. When blood flow slows, clots are more likely to form. If one travels to the brain, it can cause a stroke.

A fast heartbeat also makes the heart muscle weaker over time. This can lead to heart failure — when your heart can’t pump out enough blood to supply your body.

Atrial flutter does raise your chance of having a stroke. But if you don’t have other heart disease, your outlook is generally quite good. If it happens once without serious heart or lung disease, you may never have it again. If you do have other heart disease, your atrial flutter may come back. If that happens, you should see a heart specialist called a cardiologist.

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Heart rhythm disorder: symptoms and types.

Treatment of cardiac arrhythmias in Ryazan

Main symptoms of cardiac arrhythmia

In many cases, a person learns about a problem with the heart muscle by chance, during a routine examination. This is explained by the fact that the problem does not manifest itself in any way, proceeding asymptomatically. Therefore, an ordinary user can diagnose a rhythm disorder only in a progressive stage.

Visible symptoms of rhythm disturbance fall into two categories: slow or fast heartbeat. Signs also have two degrees – from barely noticeable to intense. An important indicator is the pulse rate. In the normal state, this figure is 60-80 beats per minute. The heart beats smoothly, without acceleration and deceleration. A violation of the heart rate is considered a result with a higher or lower number per minute.

Other symptoms of arrhythmia include:

• feeling of tightness, heaviness in the sternum;
• short thumping in the chest;
• respiratory failure and lack of oxygen;
• fatigue;
• weakness without cause;
• dizziness;
• pre-syncope.

There are heart pains with different manifestations: cutting, stabbing, pressing. In some cases, visual acuity decreases, darkening in the eyes occurs, headaches progress. If the rhythm is disturbed, there is increased anxiety, inexplicable fear, panic attacks.

If you experience one or more of these symptoms, you should immediately make an appointment with a specialist.

Types of arrhythmia

There are several types of normal rhythm disturbances:

• Sinus tachycardia. The main symptoms are high frequency. It can occur against the background of stress or active sports loads. The number of beats exceeds 100 per minute.
• Sinus bradycardia. This type is characterized by a smaller number of contractions per minute. The number of strokes is less than the 60 contractions established by the norm, as a rule, during sleep in the elderly. Often, a similar type of violation occurs in people against the background of food poisoning or indicates the presence of diseases.
• Atrial fibrillation. This type is characterized by a chaotic contraction of the heart muscles, sometimes going beyond the normal, sometimes decreasing to the minimum.

Methods of treatment of cardiac arrhythmias

As you can see, the list of factors for the development of pathology and the occurrence of cardiac arrhythmias is quite extensive, and everyone can fall into the risk zone. For timely detection of the problem, it is recommended to undergo regular medical examinations, and if a problem is detected, immediately begin treatment.

Before starting treatment, the specialist needs to find out the clinical picture. At this stage, it is important not to be silent about the symptoms that arise, any violations of the usual rhythm, possible attacks. Frank information will help to more accurately establish the diagnosis and choose a treatment regimen. In addition to collecting an anamnesis, additional laboratory tests and analyzes help to establish the causes and identify problems.

First of all, it is necessary to reduce physical activity, replace intense workouts with gentle ones. For example, walking or cycling, therapeutic exercises will make the treatment more effective. However, before doing this, you need to consult with a specialist.

A comprehensive method for the treatment of cardiac arrhythmias consists of several points. Among them:

1. Medication – special drugs to normalize the heart rhythm.
2. Vitamin complexes – for comprehensive support of the body.
3. Anti-anxiety drugs – reducing stress and anxiety.
4. Diet – exclusion of fried, spicy, smoked foods. Replacing them with steam dishes, adding greens and other useful vitamins to the diet.

In advanced cases and when treatment is ineffective, heart rhythm pathologies are eliminated by surgical intervention.

Factors provoking arrhythmia

There are several dozens of causes provoking the disease. The main stimulus for rhythm disturbance is the pathology of the cardiovascular system. Among them are congenital and acquired defects, myocardial infarction, coronary heart disease, cardiosclerosis, stroke, diabetes mellitus, genetic predisposition, infectious diseases. Diseases affecting the nervous system can provoke rhythm disturbance. Among them are craniocerebral injuries of varying severity, vegetovascular dystonia, neuroses, constant stress, neoplasms in the brain.

The heart muscle may respond with an increased rhythm to problems of other organs, including:

• thyroid disease;
• adrenal lesion;
• diseases of the respiratory organs;
• peptic ulcers.

It is worth noting other factors that cause disruptions in the heart rhythm. In adolescence, heart rhythm problems often occur in girls during the premenstrual period. Pathology is also observed in women during childbearing, as well as during climate change. Bad habits not least have a detrimental effect on the heart muscle. These include not only smoking and alcohol abuse, but also excessive consumption of drinks containing caffeine.

Preventive measures

Simple preventive measures can help keep your body in top condition. Both before the detection of pathology and after its treatment, the recommendations will be the same:

• Give up smoking and alcohol.
• Reduce consumption of coffee and other caffeinated beverages.
• Do not ignore non-intense exercise.
• Avoid stressful situations.
• Adhere to healthy eating habits and have regular check-ups.

Heart rhythm disturbances

Normally, a person does not feel the work of the heart. During physical exertion, there may be a feeling of palpitations, some shortness of breath. Normally, in a calm state, the heart rate is from 60 to 80 per 1 minute. In the presence of heart disease, myocardial infarction, the frequency of 80 may be undesirable, in this case it tends to a rarer rhythm (60-70 per 1 min). The contractions of the heart follow at regular intervals.

However, with the appearance of irregular contractions, an accelerated or very rare rhythm, the appearance of other symptoms indicate the occurrence of an arrhythmia.

Heart rhythm disturbances can be quite harmless and do not lead to heart failure or other complications. Conversely, there are life-threatening arrhythmias that require immediate treatment.

An arrhythmia can only be diagnosed by a doctor after an ECG, although other investigations may be required.

Know that an arrhythmia should be treated if it is life-threatening or threatening to cause complications (with or without symptoms), or if it is relatively “safe” but the patient feels it, feels uncomfortable.

Make an appointment for appointment with a cardiologist at the Medical Dynasty clinic: +7 (8452) 67-48-28, 73-40-80

Causes of arrhythmias

Chronic diseases of the cardiovascular system. When symptoms of arrhythmia appear, the main importance is attached to ischemic processes in the myocardium, myocarditis, myocardial infarction, congenital and acquired defects. In people over 40, atherosclerosis plays an important role. The deposition of cholesterol in the form of plaques on the walls of blood vessels does not allow them to retain their elasticity properties.

Pathology of the nervous system.

Violation of metabolic processes in the form of hypokalemia or hyperkalemia.

Hormonal changes associated with thyroid diseases (hypothyroidism and thyrotoxicosis).

Some environmental factors (or active human activities) adversely affect the body. They cause a heart rhythm disturbance, the symptoms of which may not bother a person for a long time. External factors include:

• Age over 40 years. Most often, people in this category begin to feel unpleasant symptoms in the region of the heart, which are characteristic of arrhythmias.
• Intense physical activity, severe stress. Therefore, professional athletes are at risk of cardiovascular disease.
• Traumatic brain injury results in damage to the central or autonomic nervous system.
• Any symptom can have a negative effect on the heart. It is not recommended to drink more than 3 cups of coffee. Due to the content of a large amount of caffeine, acceleration of contractions is noted, blood pressure rises. Changes in the state of the cardiovascular system can lead to arrhythmia.
• Under the influence of anesthetics, the load on the myocardium increases. This becomes one of the reasons for the disruption of his work.

Make an appointment for an appointment with an endocrinologist at the Medical Dynasty clinic: +7 (8452) 67-48-28, 73-40-80

Treatment

Treatment of arrhythmia can only be prescribed by a doctor (arrhythmologist, cardiologist, therapist!)

It can be either conservative (medication) or surgical.

If the therapy is successful and the condition returns to normal, then folk remedies can also be prescribed. For this, medicinal herbs are used, which are mixed in a certain ratio. Valerian root, lemon balm, motherwort and anise are widely used.