Sinoaurikulyarnaya or sinoarthrial blockade - a kind of violation of intracardiac conduction. This condition is characterized by a slowed down rate or a complete stop of the transfer of the heart pulse from the sinus node to all atria. Feeling at the same time - interruptions or sinking of the heart, short-term dizziness, general weakness.
Features of the disease
Sinoauric blockade is one of the varieties of weakness syndrome of the sinus node. In this case, there is a blocking of the electric impulse between the atria and the sinoatrial node. This disorder is characterized by a temporary asystole of the atria and the loss of one or more single ventricular complexes.
Sino-arthritic blockade is rare, and if it develops, it is more often in men( 65%).You can detect the disease at any age.
The following section will tell you about what a sinoauric blockade of 1, 2, 3 degree and type is.
Degrees and types of the sinoauric blockade of
Sinoauric blockade occurs in the 1st, 2nd and 3rd degree.
- 1st degree is difficult to detect on an electrocardiogram. Heart impulses at the same time are generated less often than necessary and fully reach the atria. Sinus bradycardia can speak of a sinoauric blockade.
- 2nd degree can already be considered on the ECG.Not all pulses reach the atria and ventricles. On a cardiogram, this is indicated by the appearance of Samoilov-Venkerbach periods. When one cardiac cycle occurs, the increased R-R interval is equal to the two main R-R intervals. Sometimes there is a blocking of every 2nd pulse, which follows a normal contraction. This is a 2: 1 synoauric blockade. In such cases, they talk about allorhythmia.
- The third degree of the sinoauric blockade is the blocking of all pulses from the sinus node. This can lead to asystole and death of the patient. The role of the driver assumes an atrioventricular node, conducting ventricular or atrial systems.
Causes of
The main reasons for the development of the sinoauric blockade include:
- organic damage to the myocardium;
- increased vagal tone;
- lesion of the sinus node itself.
The disease is most common in patients with:
- heart disease;
- ischemic heart disease( infarction, atherosclerotic sclerosis);
- myocarditis.
Sinouauric blockade can also develop because of:
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- intoxication with adrenoblockers, cardiac glycosides, preparations K, quinidine;
- conducting defibrillation;
- with a reflex-enhanced tone of the vagus nerve.
Symptoms
Sino-uric blockade of the 1st degree does not manifest itself in any way. Auscultatory it is possible to reveal absence of the subsequent cardiac contraction through two-three normal cycles.
Clinical manifestations of blockade of the 2nd degree will depend on the frequency of sinus pulse prolapses. With infrequent fallouts of the heart contractions, the patient may be noted:
- dizziness;
- chest discomfort;
- general weakness;
- shortness of breath.
The symptomatology of the sinoauric blockade, characterized by the absence of several cycles of cardiac contractions, looks like this:
- feeling of heart sinking;
- tinnitus;
- sharp bradycardia.
With sinouauric blockade with organic damage to the myocardium, cardiac insufficiency develops.
Diagnostics
Basic examination methods:
- electrocardiography,( ECG) signs of the sinoauric blockade are well visible on it;
- heart ultrasound.
After carrying out electrocardiography, it is necessary to distinguish sinoaurikulyarnuyu blockade from sinus bradycardia and arrhythmia, atrial extrasystole, blockade atrioventricular 2 nd degree.
In case of confirmation of sinus bradycardia, samples are taken with the introduction of atropine. After it in patients, the rate of heart rhythm increases by 2 times, then sharply decreases by 2 times. There is a blockade. In the case of normal functioning of the sinus node, the rhythm will gradually increase.
Treatment
Sino-uric acid blockade of the 1st degree of treatment does not require any. Restoring normal cardiac conductance helps treat the underlying illness or refrain from taking medications that contribute to the disorder.
- In blockade, which developed due to vagotonia, it is effective to use subcutaneously or intravenously atropine.
- To stimulate the automatism of the sinus node, drugs-sympathomimetics are used. This is ephedrine, alupten, isadrin.
- To improve the metabolism of the heart muscle, prescribe cocarboxylase, ribaxin, ATP.In case of overdose with these drugs, headache, nausea, insomnia, twitching of limbs, vomiting are possible.
Patients are contraindicated to take cardiac glycosides, beta-blockers, antiarrhythmic drugs of quinidine, K salt, cordarone, preparations of rauwolfia.
If a sino-arthritic blockade significantly worsens a patient's health, asystole attacks occur, physicians temporarily or permanently stimulate the atria to install a pacemaker.
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Prevention
Due to the poorly understood disease such as the sinoauric blockade, prevention itself does not exist. The main thing that should be done is to eliminate the causes of cardiac conduction abnormalities and to be constantly observed in the cardiologist( arrhythmologist).
Complications of
The negative consequences of the sinoauric blockade are due to the slowed rhythm caused by organic damage to the heart. Usually, the disease produces or exacerbates chronic heart failure, promotes the development of ectopic arrhythmias and ventricular arrhythmias.
Forecast
The way the sinoauric blockade will continue to manifest itself will depend entirely on the underlying disease. Great importance is also played by the degree of conduction and the presence of other pathologies of rhythm.
- The disease, which does not manifest itself at all, basically does not cause any disturbances in hemodynamics.
- In the case of the development of Morgagni-Adams-Stokes syndrome, the prognosis is usually unfavorable.