This is a violation in the work of the heart of an innate character. Pathology can not bring anxiety. If there are significant disorders, treatment is required to avoid complications.
Features of the
violation The problem occurs during the transfer of the pulse from the sinus node. In the case where there are no deviations, the pulse generated by the main rhythm driver goes to the conducting system. Before entering the area of the ventricles, electrical impulses pass through the atrioventricular center, the purpose of which is to slow the signal transmission.
The atrioventricular center works in such a way that the contraction of the ventricles occurs after they receive the blood from the atria. The correct operation of the valves is ensured and this promotes normal blood circulation.
Wolff-Parkinson-White syndrome, in the text will be applied and the abbreviated name - WPW syndrome, indicates that there is an organic disorder in the structure of the heart. Between one of the ventricles and the corresponding atrium is a site through which electrical impulses pass into the conducting system, bypassing the atrioventricular node.
Fibers that create a bypass path for the pulses of the sinus node are called the Kent bundle. The situation with a change in the trajectory of the movement of impulses provokes violations of the rhythms of the heart. Pathology causes paroxysmal tachyarrhythmias:
- atrial fibrillation,
- atrial flutter,
- supraventricular reciprocal tachycardia.
This is because the pulses do not receive a delay in the signal at the atrioventricular node, which is necessary in order to coordinate the work of the heart chambers. The ventricles in such cases receive an impulse and are excited prematurely.
Anomaly is congenital in nature, but it can for the first time manifest itself at any age. Pathology is often present without signaling itself. According to statistics, the syndrome progresses in early childhood or in old age.
Distinctive features of the course of the disease in different age categories are not observed. It is noticed that representatives of a male have such pathology in one and a half time more often, than female.
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Do they take the army with Wolff-Parkinson-White disease? The diagnosis of WPW syndrome, confirmed by the results of the research, gives the patient the opportunity to be released from military service.
Classification of
Pulse path violation cases are divided into types:
- WPW syndrome - this is a manifestation of pathology, when a symptomatic tachycardia is detected due to the presence of an abnormal area by which pulses pass around the atrioventricular node, except for early ventricular excitation.
- The phenomenon of WPW is the same, but the consequences of pathology do not clinically manifest themselves. Abnormal excitation of the ventricles is recorded during examination.
Forms of
WPW syndrome manifests itself in such forms:
- Hidden - electrocardiographic recording does not show the presence of pathology. There is a tachycardia, which is diagnosed as a reciprocal atrioventricular arrhythmia. Retrograde motion of the pulse is observed at the atrioventricular compound( additional).
- Manifesting - a cardiogram registers the sinus rhythm, the presence of a constantly present delta wave, while there are temporary symptoms of atrioventricular tachycardia( reciprocal).
- Intermittent - revealed atrioventricular tachycardia( reciprocal), combined with cases of premature ventricular arousal( sinus rhythm).
Causes of
Pathology determines a congenital organic disorder in the structure of the heart. An abnormal path through which impulses are generated, generated by the main rhythm driver, is laid in the perinatal period.
Kent bundles at the site of the dislocation are:
- left-handed - located between the left ventricle and the atrium,
- right-sided - the same, but on the right side,
- paraseptal - located near the cardiac septum.
Next, let's talk about the symptoms of Wolff-Parkinson-White syndrome.
Symptoms of
Paroxysmal palpitations. The rhythm can be at equal intervals or uneven. Seizures are accompanied by:
- sensation that the heart is fluttering,
- with dizziness,
- with poor health.
At very high heart beat frequency, there may be:
- asthma attacks,
- loss of consciousness.
The frequency of seizures varies from several cases in the year to daily occurrences. The duration of the attack is also different, from instantaneous to several hours.
In very young children( newborns), if there is an attack of Wolff-Parkinson-White syndrome( phenomenon), then there is:
- sweating,
- weakness,
- refuse to eat,
- become whiny.
If in infancy with the help of ultrasound this pathology is revealed, but it does not bring the child any discomfort, the parents are armed with information to provide him with conditions with moderate loads and not to provoke exacerbations. Whether the Wolff-Parkinson-White syndrome can be detected on the ECG, as well as other diagnostic methods, the following section will tell.
Diagnostics
A specialist does a visual inspection, listens to how the heart works, and interrogates the patient for complaints. An abnormally frequent rhythm of cardiac activity can lead to suspicion that there are problems with heart health and it is necessary to undergo a more detailed examination.
- Electrocardiography - recording electrical impulses of cardiac activity is the main way to detect the syndrome.
- Holter monitoring - monitoring a patient for some time with a constant recording of heart pulses. The research is carried out by fixing a portable device on the patient's body. The value of the information obtained is also that the patient keeps a diary with the indication of the time for their studies, mental and physical loads. Thus, it is revealed, with what factors the rhythm disturbances coincide.
- Electrophysiological study( cardiac EEG) is carried out in two ways:
- endocardial - procedure is performed in a hospital in X-ray therapy;
- transesophageal - the study is conducted in the outpatient clinic.
Specialists receive full information:
- on the operation of the conductive system,
- on pulse anomalies,
- , causes of arrhythmia,
- , information on the possibility of applying the method of treatment - catheter ablation.
- Echocardiography - using the method you can learn about the abnormalities of the heart structure, vices. Information will help to understand the causes of arrhythmia.
- Urine and blood tests - the results will show what the general condition of the patient is.
Treatment of Wolff-Parkinson-White syndrome
The patient care tactics are developed based on such indicators:
- survey data,
- patient age,
- complexity of arrhythmia manifestation,
- generally accepted recommendations for arrhythmologists.
Therapeutic
If the frequency of contractions caused ventricular fibrillation, then their defibrillation is performed. The procedure is performed in the intensive care unit.
Medicated
In order to prevent attacks of tachycardia specialist can select a patient antiarrhythmic drugs. Practice their use by intravenous administration.
It should be eliminated such means:
- cardiac glycosides,
- calcium channel blockers,
- β-blockers.
Operation
In cases where conservative methods do not bring significant improvement, consider the possibility of surgical intervention. Indications for this are the facts:
- after taking medications against arrhythmia still have attacks of tachycardia,
- more often than once in seven days, ventricular fibrillation occurs,
- when the expert believes that the patient is undesirable to be long on medications;
- the patient has severe seizures, which are accompanied by weakness and loss of consciousness;
- if the diagnosis has confirmed the possibility for this patient to carry out the operation.
The procedure is called: radiofrequency ablation. To the anomalous section( the bundle of Kent) a thin tube is conducted. It gives a pulse, which causes the destruction of the bypass path for the passage of the sinus pulse. The conductor to the heart is carried along the vessels, the entrance is made through the femoral mains.
Folk remedies
Some folk recipes are shown with WPW syndrome, however, one should not do anything without consulting a cardiologist.
- Brew a teaspoon of dried mint in a glass of boiling water. Drink in the morning before breakfast in small sips. Do this every morning for at least a month.
- To eat figs how much it would be desirable. It is an excellent antiarrhythmic.
- It is useful to chew the peel from the lemon. The clove of garlic, used on an empty stomach with bread, is also a good remedy.
- A tablespoon of dried flowers of marigold is brewed like tea in half a glass of boiling water. Take during the day for four receptions.
Prevention
The disease occurs due to an organic disorder in the structure of the heart. Preventive measures to prevent disease are not provided.
If the cardiogram shows that the patient has WPW syndrome, but there is no sign of impairment, then it is necessary to be under the supervision of a specialist. Children who have a syndrome in their infancy are given a regime with limited loads.
If the specialist does not prescribe a child for treatment, then it is necessary to visit the cardiologist regularly. Specialists recommend to undergo an examination of the relatives of the person in whose cardiogram the syndrome of WPW appeared.
Complications of
With WPW syndrome, it is possible to develop a situation where the impulse goes along the bypass, crosses the atrioventricular node - and the pulse cycles on this path. This circulating impulse takes over the management of the ventricles and atria.
A high frequency of contractions develops - up to 240 beats per minute. The atria withstand the load, and with the ventricles, there is a fibrillation. Such a patient needs an ambulance - defibrillation, which is provided in the intensive care unit.
Forecast
If the presence of an anomalous path in the transmission of a pulse does not bring the patient any discomfort, then this phenomenon is not dangerous for life. Manifestations of rhythm disturbances, expressed clinically, may present a different threat to life.
Atrial fibrillation is the cause of sudden death. Statistics show that less than half the percentage of people suffering from WPW syndrome have a lethal outcome. Attacks of tachycardia do not carry a life-threatening component.
Even more useful information about WPW syndrome, as well as other rhythm disorders in children, will be told by E. Malysheva in the following video: