Any parent should take care of the health of their child from the first years of life, so even the slightest disturbance in the condition of a small organism should cause concern, especially if they concern the functioning of the heart. Serious cardiac diseases are not that common, but arrhythmia in children is quite common, and it is important to understand in time whether it is dangerous or not. To identify the causes of the pathology, you need to consult a doctor as soon as the first symptoms appear in order to make a diagnosis and, if necessary, prescribe treatment.
Cardiac arrhythmia is a collective name for various pathologies that are characterized by disruption of the normal heartbeat rhythm. This happens as a result of a malfunction in the body’s conduction system. This is a long network consisting of many nodes, between which nerve impulses are sequentially transmitted, contractile hearts. If pathological changes occur in one of the nodes, the impulse has to “look for” a bypass path, as a result of which the heart rate changes.
The types of arrhythmia in children do not differ from the types of this pathology in adults. The most susceptible to heart rhythm disturbances are newborns and children aged 4-5, 7-8 and 12-14 years. It is important to immediately establish the reasons for such changes, since in some cases arrhythmia is considered normal occurrence and is not associated with more serious diseases.
Sinus arrhythmia
The main node of the conduction system that generates nerve impulses is the sinus, and in a healthy person, heart contractions are repeated at regular intervals. Sinus arrhythmia is characterized by deviations associated with both rhythm disturbances and changes in heart rate that arise due to pathologies of the sinus node.
Moderate sinus arrhythmia is the most favorable option of all possible violations rhythm of heart contractions. In most cases, this pathology does not require treatment; you just need to constantly monitor the child’s condition from the first years of life with the attending physician in order to notice the occurrence of complications in time, if they occur.
Sinus arrhythmia in children it can be constant or occur in the form of attacks of heart palpitations.
Sinus arrhythmia includes several types of heartbeat disorders. Most often, tachycardia (rapid contraction rhythm), bradycardia (slow rhythm) or extrasystole (single irregular impulses) occurs. All of them are treatable and in most cases are temporary.
Atrial fibrillation
Atrial fibrillation in childhood occurs quite rarely, but such cases still occur, and this pathology is considered the most serious of all types of heart rhythm disturbances. The name of this condition appears due to the fact that very frequent contractions of the heart muscle are observed, as a result of which it seems that it is flickering.
The human heart has four sections (chambers) - two atria and two ventricles; in a normal state, a healthy person observes the coordinated work of all these elements, impulses are transmitted sequentially along the chain. With atrial fibrillation, coherence of work is lost, each chamber works separately. As a result, chaotic, frequent and ineffective contractions of the heart occur, the frequency of which can reach 350-600 beats per minute. This pathology is very dangerous for a child, so it needs to be urgently treated from the first years of life to prevent serious complications. In this case, you must contact ambulance at each occurrence of an attack of atrial fibrillation, in order to eliminate ailments and prevent their development. In especially severe cases, such an attack can even lead to coma or death.
Respiratory arrhythmia
Respiratory arrhythmia is a subtype of sinus arrhythmia, but disturbances in heart rhythm do not occur spontaneously or in the form of attacks. This pathology manifests itself in the fact that when you inhale, the heart begins to beat much faster, and when you exhale, on the contrary, it slows down. Respiratory arrhythmia in adolescents and children – common occurrence, but in adults such a disorder is rare.
This type of heart rhythm disturbance is not as dangerous as, for example, atrial fibrillation, and often goes away by adulthood. Despite this, the child should be regularly examined by a doctor, starting from an early age, in order to detect the slightest changes in the condition. In addition, if necessary, the specialist may prescribe this or that therapy or prevention, which must be followed.
Why does pathology occur?
Before you start doing anything to eliminate the symptoms of arrhythmia in a child, you need to identify the causes of its occurrence. Pathological disturbances in heart rhythm that go beyond the normal range in most cases are not an independent pathology, but a sign of a more serious disease. First of all, the attending physician must conduct an examination to identify possible cardiac pathologies, which include:
- individual characteristics of the body associated with changes in the conduction system;
- congenital and acquired heart defects;
- myocarditis;
- pericarditis;
- heart injuries accompanied by hemorrhage;
- malignant heart tumors;
- abnormal development of the heart;
- vegetative-vascular dystonia.
In addition, diseases of other systems and organs can also affect the occurrence of arrhythmia in a child. In particular, it is necessary to check the endocrine and respiratory system, as well as hormone balance. Often the causes of tachycardia lie in the presence infectious diseases(angina, bronchitis, intestinal infections). Prenatal factors should not be excluded, for example, an unhealthy pregnancy or premature birth (prematurity).
How does the disease manifest itself?
Children's arrhythmia, as a rule, has symptoms that are immediately inexplicable, and it is not always clearly expressed. In some cases, signs of heart rhythm disturbances are revealed only when scheduled inspection at the cardiologist. With any type of arrhythmia, general symptoms can be observed, for example:
- interrupted, weak sleep;
- crying for no apparent reason;
- shortness of breath and difficulty breathing during any physical activity;
- increased sweating;
- loss of appetite or complete refusal of any food;
- insufficient weight gain;
- cyanosis of nails and lips;
- pale skin;
- lethargy or hyperactivity.
Children over the age of four can complete the picture by describing additional symptoms that they experience during arrhythmia attacks. This could include chest pain, darkening of the eyes, dizziness, pronounced weakness, rapid fatigue, long rest after physical activity, etc. In any case, even if one suspicious sign appears, you should consult a doctor, since the child’s health is very fragile, and It is necessary to stop any diseases at the stage of their inception.
To monitor your heart rate, simply check your pulse regularly; this can be done manually or using a heart rate monitor. However, it should be taken into account that children have different norms for heart rate values. For newborns, the norm is 140 beats per minute, for children from 1 year to 3 years – 120 beats, from 3 to 5 years – 110 beats, from 5 to 10 years – 100, over 10 years – 90 beats. In adolescence, as a rule, the heart rate normalizes and is, as in adults, in the range from 60 to 80 beats per minute.
How to treat pathology
If a child has problems with the heart rhythm, it is necessary to contact a pediatrician or pediatric cardiologist. As a rule, in this case, the doctor conducts a general examination and interview of the young patient and his parents, after which he gives a referral for electrocardiography (ECG). This simple examination allows you to identify all existing disorders and monitor whether there are any abnormalities in the functioning of the heart muscle.
If a child's arrhythmia is within normal limits, it does not need to be treated; it will go away on its own by adolescence. It is enough just to ensure that the child eats properly, receives all the substances necessary for the growing body, does not fall under the influence of negative factors, and is engaged in physically active activities. The heart, like any muscle in the body, needs training, so the child must engage in some kind of sport or at least regular physical exercise. In most cases, active children do not even need this, since they train in a unique way while playing with their peers.
When a pathological arrhythmia is detected in a child, parents need to understand what to do next in order to stop the disorder and prevent negative consequences. It is important to remember that self-medication in this case is unacceptable; therapy should be prescribed exclusively by the attending physician. Any independent actions are likely to cause harm, but not benefit.
Treatment of arrhythmia in children should be based on eliminating the disease that caused the development of heart rhythm disturbances. Most often, therapy is carried out on an outpatient basis using medicines And medical procedures. Hospitalization is required only in extreme cases when the arrhythmia is associated with serious illness.
Drug treatment is based in most cases on taking medicines, restoring the balance of electrolytes in the heart muscle. In addition, specialized antiarrhythmic drugs may be prescribed. In addition to this, the doctor may prescribe medications that improve the nutrition of the heart muscle. If a child is bothered by severe symptoms, such as pain, insomnia, weakness or increased fatigue, specialized remedies are prescribed to eliminate ailments. They can be used symptomatically, that is, only when attacks occur, or as a separate treatment course.
If such treatment does not bring results, surgery may be prescribed. During it, the cause of arrhythmia is eliminated, that is, directly the pathology that causes disturbances in the functioning of the heart. If the heart rhythm disturbance is not associated with other cardiac diseases, cauterization may be prescribed, which is performed using modern radio wave ablation and cryoablation techniques. In this case, the part of the myocardium that causes problems with heartbeat is directly cauterized. In particularly serious cases, when there is a risk of the child's heart stopping, a pacemaker may be installed.
It is better not to use traditional medicine at all in the treatment of arrhythmia in children, even if the remedies seem absolutely harmless and have been repeatedly tested on adults. Any substances that are inappropriate for a child can disrupt the overall picture of his condition and aggravate the situation, causing complications. In consultation with your doctor, you can only adjust your diet by including healthy foods and, if possible, eliminating as much as possible. junk food. Also, in some cases, it is permissible to use herbal medicine for general strengthening of the body, but also only after consultation with a doctor.
Further forecast
The consequences of arrhythmia that occurs in childhood can be different, it all depends on the degree of the disease and the individual characteristics of the child. Heart rhythm disturbances, which are normal, usually go away by adolescence, so there is no need to worry about them. However, in modern conditions, where active games with peers are gradually replaced by “communication” with gadgets, not all children get rid of pathology without outside help. In some cases, even in adulthood, a person remains with childhood sinus arrhythmia due to the fact that at one time he did not sufficiently train his heart muscle.
Pathological arrhythmia in children does not have such a positive prognosis, especially if it is associated with other cardiac diseases. Moreover, the later the treatment of the disease begins, the more serious the consequences will be; heart problems can become chronic, and all that remains is to muffle the symptoms throughout life.
However, such complications can only occur in advanced cases when inappropriate treatment was selected or was not carried out at all. If you notice signs of heart rhythm disturbances in the early stages, you can get rid of the problem without any consequences. Modern medicine pays close attention to cardiology, especially children’s, so in the vast majority of cases the resulting pathology can be quickly and effectively eliminated.
Diseases associated with work disorders cordially- vascular system, unfortunately, not only adults, but also children suffer. Heart rhythm problems in a child can lead to pathological processes in adulthood if left untreated.
Sinus arrhythmia in children is a phenomenon that requires observation by a pediatrician. Abnormalities in heart rate, strength and consistency in children in most cases are not dangerous, but can sometimes lead to the development of heart failure and even death.
The heart consists of sections that are independently capable of generating impulses of various frequencies. Each of them can work offline. But the sinus section is the only one that is capable of contracting at a frequency of 60 times per minute, and therefore is maximally responsible for the stable functioning of the heart muscle.
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Classification
Heart rhythm disturbances may manifest as:
| Sinus tachycardia |
|
| Slow heart rate | Sinus, which occurs after severe stress, emotional overexcitation, severe nervous tension. |
|
Sinus arrhythmia in children is classified as follows:
Depending on the severity of sinus arrhythmia, there are two types:
Norms
The existing norms for a child's heart rate are developed solely for approximate comparison based on average indicators.
After all, each person is unique, so it is impossible to say that a child is sick if his heart rate (HR) does not coincide with the data in the table. Whether the heart rate is normal or not can only be determined for a particular patient by a doctor.
The average heart rate in children varies in a range and is presented in the table:
Safe arrhythmia
The respiratory form of arrhythmia is not dangerous; it appears under the influence of external factors when the child instinctively holds his breath. Such factors may be:
The older the child becomes, the more his nervous autonomic system matures, and sinus arrhythmia is less likely to appear.
However, the presence of arrhythmia in children is not a normal physiological condition, so consultation with a specialist is necessary. This condition may indicate serious heart pathologies.
Reasons
The causes of arrhythmia can be either acquired or congenital and vary depending on the forms of sinus arrhythmia:
| Breathing form | The causes of respiratory arrhythmia in children are:
The respiratory form is the least dangerous and does not require medication, however, to eliminate it, it is necessary to remove the factors that provoke it. |
| Other forms | If the respiratory form of arrhythmia occurs under the influence of external stimuli, then a form not associated with breathing can be observed for a number of reasons:
|
Connection with sports
Detection of the respiratory form of sinus arrhythmia in a child on an electrocardiogram (ECG) is not a contraindication to sports. It is enough to find out what provoked its appearance and eliminate it.
Other forms need to consult a doctor before engaging in those sports that require significant physical activity. Some types of physical activity are limited.
If a child is professionally involved in sports, then he needs to be examined at least once every three months (including ECG and 24-hour monitoring). To be allowed to compete, permission from the attending physician is required.
Diagnostics
A phonendoscope is a device with which a pediatrician determines the heart rate.
On ECG sinus Arrhythmia is determined by lengthening (slowing the heartbeat) or decreasing (increasing heart rate) the RR interval between the apexes of the ventricular complexes.
Sensations during sinus arrhythmia in children
Sinus arrhythmia in children 7 years of age or older does not cause any discomfort other than rapid breathing.
There are signs that are a reason to pay attention to the child’s condition and urgently consult a doctor:
- difficulty breathing;
- pain in the heart area;
- dizziness;
- fatigue;
- weakness;
- swelling;
- dyspnea;
- blue discoloration of the nasolabial triangle;
- fainting.
Treatment
If you suspect a child has sinus arrhythmia, you should visit a specialist - a cardiologist. The doctor will prescribe the following types of examination:
- Ultrasound of the heart;
- clinical analysis blood;
- blood biochemistry;
- general urinalysis.
Most likely, the child will be registered and required to undergo examination every six months to keep his heart function under control.
The respiratory form of arrhythmia in a child is not treated, but sports activities may be limited for a while.
Severe sinus arrhythmia requires treatment, first of all, of the reasons that caused it:
- antibacterial therapy for infectious causes;
- therapy of heart disease (surgical method);
- prescription of cardiac glycosides in case of heart failure;
- other treatment methods.
Observation table
For personal convenience and to help the attending physician monitor the child's condition, it will be useful for parents to keep a health chart.
| Events | Frequency | |
| Consultation with specialists | Pediatrician, cardiologist | Once every six months |
| Other specialist doctors (neurologist, cardiac surgeon, ENT specialist, neurologist) | According to indications | |
| Survey | General blood test | Once every six months |
| ECG | Once every six months | |
| Ultrasound of the heart, electroencephalography, phonocardiography and other additional methods | According to indications | |
| Vaccination | Medical drain during development, | |
| Physical education classes | For persistent arrhythmia | Exemption from classes |
| After arrhythmias caused by infectious diseases | Preparatory group for 1 year | |
Prevention
Prevention of heart rhythm disturbances in children consists of a healthy lifestyle, namely:
- in a balanced diet;
- moderate exercise, hardening;
- in the absence of stress.
Children should spend more time in the fresh air, go swimming, and do exercises in the morning. Parents also need to understand that a child’s nervous system is much weaker than that of an adult. That’s what childhood is for: relaxing carefree, walking and playing with peers.
There is no need to overburden your child with additional activities after school. It is worth listening to the wishes of your child and allowing him to do what he really wants.
Heart - unique organ human body. Each of its departments is capable of working autonomously, that is, if, for example, the sinus department fails, the rest will continue to work fully, taking on the entire load.
Sinus arrhythmia is not a diagnosis, but a condition that appears in response to external stimuli. Systematic disturbances in the functioning of the sinus region can lead to the development of pathologies of the heart muscle in children in adulthood, so it is necessary to protect the child’s fragile nervous system.
Every person worries about the health of their child, and when he is diagnosed with sinus arrhythmia, the worries only increase. Nowadays, there are many cases where heart pathologies are detected in children, and this cannot be treated indifferently. A child’s body is developing and needs strength, and complications of illnesses do not allow the heart to pump blood to all the still small organs.
If you notice an abnormal heartbeat in a child, you should contact a specialist, since the disease detected in the early stages is the key to the health of your baby. I would like to tell you what kind of disease this is, its causes, symptoms.
If you have children or are planning to have them, then this article is just for you. Sinus arrhythmia in a child does not always require treatment. It may disappear with age.
Sinus arrhythmia in a child First of all, parents should know that the normal rhythm of the heartbeat is called sinus, since it is formed due to the work of the sinus node, the second name of which is “pacemaker”, since it is it that sets the rhythm of heart contractions.
During normal operation of this node, the heart contracts at a frequency characteristic of a certain age, and the intervals between heartbeats are the same. For example, for newborns, a normal sinus rhythm will have a rate of about 140 beats per minute, and for children 7 years old - about 100 beats per minute.
If a child experiences sinus arrhythmia, there is either a change in the intervals between heartbeats or a change in the heart rate. Sinus arrhythmia is a cardiac pathology characterized by interruptions in the heart rhythm and expressed by a violation of the rhythm of beats and an incorrect sequence of contractions of the heart muscle.
Special close attention required by sinus arrhythmia in patients childhood, since over time this disease can contribute to the development of heart failure and hypertension.
The causes may be the child’s hereditary predisposition, inflammatory processes and neoplasms in cardiac tissues, mitral valve prolapse, and pathologies of the nervous system. In addition, the development of the disease is facilitated by severe illnesses suffered by the baby. viral infections and chemical intoxication.
It should be remembered that the heart rate is at different ages varies and as the body ages, heart rate decreases. The PES standards are presented below:
- Newborn - 110–170.
- up to 1 month - 105–170.
- up to 1 year - 102–162.
- up to 2 years - 94–155.
- Range 2-4 years - 90–140.
- Range 4-6 years - 85–125.
- Range 6-8 years - 75–120.
- Range 8-10 years - 68–110.
- Range 10-12 years - 60–100.
- Range 13-15 years - 60–90.
When they talk about sinus rhythm, mean that the heart functions normally. This is a normal state of a healthy person: the heart performs a certain number of beats per minute at regular intervals.
What is sinus arrhythmia in children and how to recognize it? The point is that clear symptoms This disease manifests itself during a severe stage, and at first you may not notice the emerging problem.
It all starts with the fact that the intervals between heart contractions are unstable, although the number of contractions per minute is within the normal range, but sometimes it can slightly increase or decrease. The younger the child, the more often he is diagnosed with sinus arrhythmia. The reason is the baby’s nervous system is not fully formed.
The risk group includes:
- premature babies;
- those with increased intracranial pressure;
- children with increased body weight may experience malaise during physical activity, this is also associated with malfunctions of the heart.
At certain age periods physical development The development of a child and the formation of his autonomic system occur at different speeds. As a result of this discrepancy, the heart works in an increased mode, its rhythm changes, the child feels a strong heartbeat and difficulty breathing.
In addition, the main causes of sinus arrhythmia are:
- An infection that has entered the body.
- Genetic predisposition.
- Myocardial damage (myocarditis).
- A complication after a sore throat, leading to damage to the heart muscle.
- Vegetative-vascular dystonia.
- The presence of a tumor in the heart (benign or malignant).
- Inflammatory diseases.
- Stress, severe fear.
- Poisoning.
- Heart defects (congenital or acquired).
- Violation hormonal levels in adolescence.
Classification
There are two types of arrhythmia in children. Respiratory arrhythmia - occurs due to the immaturity of the child’s nervous system. It manifests itself as a reflex increase in heart rate when inhaling, and a decrease when exhaling. Affected by this violation:
- overweight children with rickets;
- babies with postnatal encephalopathy;
- premature;
- children in the age period from 6 to 7 years, from 9 to 10 years, when the nervous system “does not keep up” with the growth of the body.
As the autonomic nervous system matures, such arrhythmia most often passes without consequences. Arrhythmia, which is not associated with breathing, develops as a complication of infectious diseases, rheumatism, against the background of diseases thyroid gland, heart (myocarditis, congenital defects), blood vessels ( vegetative-vascular dystonia).
The nature of the disorder can be constant or paroxysmal. The condition requires correction. In children, there are several peak periods during which arrhythmia may appear:
- from 4 to 8 months
- from 4 to 5 years
- from 6 to 8 years
- adolescence.
Sinus arrhythmia in children can be of two types. Respiratory. It is associated with respiratory movements: the heart rate increases when inhaling and decreases when exhaling. The reason for this is often an imbalance of the nervous autonomic system.
Fortunately, this type of disease does not particularly affect your well-being, so specific treatment is not required.
Arrhythmia not related to breathing. It does not occur often, and its causes are usually diseases of the heart, thyroid gland, and infectious diseases.
Sinus arrhythmia can be classified according to severity. There are two of them in total.
- Severe arrhythmia in a child.
- Moderate arrhythmia.
Occurs in older people. The clinical manifestations of this degree are quite obvious. It is also combined with other heart diseases, such as cardiosclerosis and rheumatism.
If severe arrhythmia is combined with bradycardia, special attention should be paid to this. This often happens with neuroses. Must be applied special treatment.
It affects children, including the age limit of 6 years, and adolescents. It manifests itself weakly or has no signs at all. There is usually no treatment, but herbal sedatives can be prescribed if desired.
In addition to all this, arrhythmia can be divided into other types.
- Sinus tachycardia.
- Sinus bradycardia.
- Extrasystole.
At the same time, the contractions that appear in the sinus node increase. It occurs due to a reaction caused by myocarditis, although the causes can be very different. In children, this may be intoxication of the body, rheumatic heart disease, infections or oxygen deficiency.
Childhood thyrotoxicosis is also associated with tachycardia. The connection is manifested in hormonal changes. The causes of arrhythmia may lie in fever, intoxication and emotional or psychological agitation.
At the same time, the number of heart contractions decreases. Bradycardia in children is more pronounced if psycho-emotional arousal has been experienced.
Occurs in twenty percent of healthy children. The origin of this type is usually benign and does not require serious treatment. However, there are types of extrasystole that can be life-threatening for the child. In any case, you need to see a doctor.
Moderate arrhythmia in a child
Moderate sinus arrhythmia in a child is not dangerous if its cause is immaturity of nervous regulation, as is the case with respiratory arrhythmia. However, even trained children may develop seemingly causeless sinus arrhythmia, and in this case, a visit to a cardiologist is mandatory.
Each case of arrhythmia in a child must be subject to observation and strict control, because if sinus arrhythmia occurs without an obvious reason, especially if the child makes complaints, which will be discussed below, it is necessary comprehensive examination body.
Regular observation by a cardiologist is the key to timely diagnosis of the transition of a moderate arrhythmia in a child into something more serious. Often respiratory arrhythmia is detected during a routine examination, but sometimes the child makes specific complaints.
If the child is too young to be able to formulate a complaint about feeling unwell or pain, sufficiently observant parents themselves can notice changes in the child’s behavior if they look closely at the baby. When the heart stops working, the child may experience cyanosis (blue discoloration) or pale skin.
It is also accompanied by shortness of breath, which may manifest as younger age intermittent, “choking” crying. Such cases of arrhythmia can appear at any time of the day, and therefore the child is characterized not only by anxiety during the day, but also by sleep disturbance at night. The baby loses his appetite or continues to eat, but with great reluctance.
Also, if you look closely, in some cases you can see the pulsation large vessels. Older children may lose consciousness when a cardiac arrhythmia occurs or complain of dizziness.
Also at this moment, the pressure may decrease, and some children feel the heart skip a beat or, conversely, make a strong push.
Of course, each of the listed complaints in itself seems to be a reason for a visit to the doctor, and if there is a combination of several of them, most likely the child suffers from something more serious than mild sinus arrhythmia.
First of all, after the examination, the child will be sent for electrocardiography, and then two scenarios are possible: the baby can continue to be monitored on an outpatient basis or be sent to hospitalization.
In case of hospitalization, tests include a clinical blood and urine test, an ultrasound examination of the heart, an echocardiogram, and a chest x-ray. In general, each diagnostic case is individual, and further tactics are determined by the attending physician.
The phenomenon is not permanent, i.e. may appear constantly or be paroxysmal. Its main reasons are considered:
- Heart tumor.
- Myocarditis.
- Congenital cardiac anomies.
Quite often, non-respiratory arrhythmia manifests itself after a long-term infectious disease. There is no pain, only periodic palpitations. If the baby is diagnosed with non-respiratory sinus arrhythmia, then the parents will need to take him to the ECG procedure to control pathology.
This pathology practically does not occur in adults. Respiratory arrhythmia in children is very often detected already in the maternity hospital, during the first mandatory examinations. Its peculiarity is that when you exhale, the heart rate slows down, and when you inhale, it speeds up.
If the disease manifests itself at a later age, then it can be confirmed by going to an electrocardiogram. Causes of respiratory arrhythmia:
- Rickets 1 year of life.
- Congenital disorders of the heart.
- Hormonal imbalance during puberty.
To make an accurate diagnosis, the results of studies on an ECG machine and an echocardiogram are used. Currently this type arrhythmias are detected quite often in children. Often the cause of its occurrence is heavy stress, both physical and emotional. Therefore, parents need to take into account the frantic rhythm modern life and take care of your baby.
Parents of “sports” children, faced with arrhythmia in their child, immediately ask two questions:
- Is sport to blame for the disease?
- Is it possible to continue playing sports?
Without a child’s genetic predisposition to such pathologies, no sports loads are not capable of provoking such cardiac pathology. As for further sports activities, medicine does not limit such activities in any way.
The only consequence for the child will be regular visits to a cardiologist and a quarterly ECG. Regular confirmation of heart rhythm disturbances, whatever their cause, categorically denies the possibility of engaging in professional sports.
How does a heart rhythm disorder affect a child?
Sinus arrhythmia of the respiratory type is not capable of causing serious concern to the child. The maximum is a feeling of rapid heartbeat. The child’s complaints about the inability to breathe normally, fatigue, a general feeling of weakness and frequent dizziness should make parents wary: sinus arrhythmia cannot be accompanied by such symptoms.
This clinical picture is more typical of fairly serious heart diseases. You should talk to your cardiologist about these symptoms in your child. The same should be done in case of severe cyanosis of the nasolabial triangle, shortness of breath and repeated fainting.
First you need to count the number of heartbeats. This can be done by placing your hand on the baby's chest near the left nipple. If you can’t calculate it this way, calculate this indicator using your pulse. Grasp your wrist with your hand so that four fingers are on inside wrists, and thumb on the outside.
In addition to counting the number of heart contractions, you can also estimate the size of the intervals between beats. If the pauses between blows are different, then we can confidently talk about sinus tachycardia or bradycardia.
Sinus arrhythmia in a child - possible consequences of the disease
Characteristic of arrhythmia frequent change heart rhythm can lead to serious consequences:
- A disturbance in the functioning of the heart, which results in a reduction in blood volume production.
- Due to incorrect functioning of the myocardium, the brain is primarily affected.
- Patients often experience dizziness, fainting, loss of consciousness may occur, and quite unexpectedly.
- Due to a decrease in the ability of the heart muscle to contract, coronary blood flow is disrupted. As a result, pulmonary edema and acute heart failure develop.
Delay in treatment can cost a child's life. Since in some cases the arrhythmia is almost asymptomatic for some time, for safety reasons the amount of physical activity should be preventively reduced.
An important point in the prevention and early diagnosis of the disease are systematic checks for possible abnormalities in the functioning of the heart.
The cause of the disease may be associated with activity in the conduction system of the heart, a disturbance in transformation, in the conduction of nerve impulses. The reason is also associated with structural changes in cardiac tissue (developmental defects) and disturbances in the nervous regulation of the heart.
This arrhythmia is observed in various conditions of the body, both physiological and pathological:
- Physiological conditions most often are physical activity, stressful situations.
- If this arrhythmia occurs while the patient is at rest, then you should think about the presence of some pathological condition of the body.
This may be a disease of the cardiovascular system, namely:
- coronary heart disease (myocardial infarction), arterial hypertension, bacterial endocarditis,
- myocarditis, pericarditis,
- endomyocarditis,
- cardiac malformations (stenosis and insufficiency of the heart valve apparatus),
- diseases endocrine system(diffuse toxic goiter, adrenal tumor, hyperthyroidism,
- neuro-circulatory dystonia (asthenia), respiratory diseases (pneumonia, bronchitis, tonsillitis),
- hyperthermia,
- increased tone of the sympathetic nervous system,
- diseases of the digestive system (intestinal infection), which lead to electrolyte imbalance.
hyperparathyroidism, blood diseases such as anemia, diseases of the nervous system (neuroses),
Symptoms
Sinus arrhythmia in a child is usually accompanied by characteristic symptoms:
- frequent fainting;
- pain in the heart area;
- fatigue;
- shortness of breath;
- cyanosis in the area of the nasolabial triangle;
- gag reflex, nausea;
- lethargy;
- temperature changes (fluctuations within minor limits);
- there are interruptions in the functioning of the heart (shortening or increased heartbeat);
- feeling unwell even with little physical activity;
- pallor;
- dizziness, etc.
This pathology in the functioning of the heart can be hereditary, or it can develop against the background of various health problems, excess weight, underdevelopment of internal organs, an unformed autonomic system, etc.
Sinus arrhythmia is not always expressed in unpleasant symptoms. However, you can suspect it in a child if you complain of pain in the heart area, constant fatigue and depression, dizziness, and poor tolerance to physical activity.
And frequent shortness of breath and swelling of the face and a bluish tint of the nasolabial triangle may indicate more serious pathologies than SA.
Arrhythmia can be detected by the number of beats, by placing your palm on the left side of the child's chest, or by feeling the pulse on the wrist. It is especially important to capture the frequency and depth of heart contractions - this is most indicative of sinus arrhythmia.
As for infants, they, of course, do not have the opportunity to complain about feeling unwell, but you can suspect arrhythmia in a baby by a very small weight gain, shortness of breath, bluish skin, pallor, causeless anxiety and bad sleep and appetite.
Of course this indirect signs, but conducting an ECG for a baby with similar manifestations will be very helpful. In a child in the first year of his life, sinus arrhythmia may have the following symptoms:
- very restless state of the baby;
- often the skin has a pale appearance with a tint of blue;
- the child eats poorly and often completely refuses to eat;
- dyspnea;
- child's sleep problems.
In children 1-10 years old and in adolescence, the signs of sinus arrhythmia have some differences from the symptoms that appear in a child in the first year of his life:
- rapid fatigue from performing even minor physical activity;
- loss of consciousness;
- a feeling of interruptions in cardiac activity.
Severe sinus arrhythmia in adolescents 15-17 years old has additional signs:
- paroxysmal tachycardia. This is a short-term increase in heart rate. The indicator reaches 180 beats in 1-2 minutes;
- dizziness. Impaired heart function affects the oxygen saturation of the blood. Due to the drop in the indicator, dizziness occurs. Severe sinus arrhythmia in adolescents may be accompanied by loss of consciousness;
- sharp drop blood pressure;
- periodic seizures;
- heart rate slowing to 30 beats per minute or cardiac arrest;
- pallor or sharp redness of the skin on the face with tachycardia.
What parents need to know
Parents should remember that respiratory sinus arrhythmia is not a disease and does not require treatment. This functional state, associated with an imbalance of the ANS, the predominance of vagal tone or hormonal changes in adolescence, as the child grows older, the heart rhythm normalizes.
Non-cyclic respiratory arrhythmia is pathological condition, requiring thorough examination, finding out the cause of its occurrence. Treatment for this form should be aimed primarily at the disease that caused the arrhythmia.
If there are any signs of rhythm disturbance on the baby's ECG, parents should definitely visit a cardiologist, undergo the examination prescribed by him, find out the cause of sinus arrhythmia, and if the doctor recommends treatment, then follow all the doctor's recommendations.
Timely examination and treatment for pathological sinus arrhythmia will prevent heart failure and other problems of the heart and blood vessels that develop with age.
When diagnosing sinus arrhythmia in children, the following studies are performed:
- Electrocardiography, which is the gold standard for determining rhythm disturbances. This study is performed on all children annually, and also if the baby plans to play sports.
- Ultrasound of the heart also allows us to judge the condition of this organ. This diagnostic method is required when enrolling children in sports sections.
- Daily ECG monitoring is performed infrequently and only if serious sinus arrhythmia is suspected.
If no changes are found during the examination, then the baby will usually be allowed to play sports, including professional ones. If sinus arrhythmia is detected, its cause must be determined.
If this condition is physiological and falls within 10% of the average contraction frequency, then there are also no contraindications to professional sports. Otherwise, certain restrictions are imposed on playing sports, the severity of which depends on the specific case:
- If you have serious congenital heart defects, it is not recommended to engage in sports;
- at functional disorders associated with a disorder of the autonomic nervous system, moderate physical activity, sports and hardening can improve the condition of the heart and strengthen the body as a whole.
Most main method Diagnosis of arrhythmia is an ECG, which provides reliable information about the type of arrhythmia. More detailed information can be provided by daily monitoring of the heart rhythm if severe arrhythmia, tachycardia or extrasystole is suspected.
Additional methods:
- general clinical analysis of blood, urine;
- thyroid hormones;
- biochemical analysis blood (blood sugar, total cholesterol, antistreptolysin);
- Ultrasound of the kidneys, adrenal glands;
- Ultrasound of the heart;
- throat swab for flora.
Pathology on ECG in children
Sinus arrhythmia is detected in children based on the results of an ECG study. And this happens relatively rarely. This violation as such, it does not pose a threat to the life or health of the child, but still requires correction. There are respiratory arrhythmias and those not associated with breathing.
The last option is a very serious manifestation. But the first case is sometimes not the result of the true state of affairs, but a consequence of an incorrectly performed ECG. For example, a child was lying on a cold oilcloth, reflexively holding his breath, and this disrupted the heart rhythm.
To eliminate troubles, it is necessary to repeat the procedure, in comfortable conditions. With sinus arrhythmia, unlike normal arrhythmia, the number of heart beats per minute remains within the normal range, only the intervals between beats change - they can be shortened or lengthened. Sinus arrhythmia in children can vary in severity and, accordingly, in type.
Treatment
If research has shown that there is no serious consequences, there are no additional deviations that could be caused by arrhythmia in children, treatment may not be prescribed yet. Doctors will simply give some recommendations, the implementation of which parents must strictly monitor:
- exclusion of excessive physical activity, only moderate physical activity;
- enriching the diet with foods rich in vitamins, minerals and microelements that are beneficial for the functioning of the heart and the entire body as a whole;
- frequent use food with reduced portion sizes;
- systematic leisurely walks in the fresh air;
- minimizing stressful situations.
Usually, by already adhering to the listed rules, parents can notice a significant improvement in the baby’s condition. Full recovery may soon occur. But if arrhythmia in a child is accompanied by pain in the heart, abnormalities shown by test results, you need to ask about immediate treatment.
Otherwise, complications may develop, such as disturbances in the development of the circulatory system, atrial fibrillation, cardiomyopathy, and heart failure.
To avoid such consequences, you need to contact an experienced doctor whose specialization is pediatric cardiac diseases, including arrhythmia in children.
Treatment methods:
- There is no need to treat physiological or functional types of arrhythmias. Parents with functional types of arrhythmias should pay attention to the child’s daily routine, correct, balanced, fractional meals, reducing physical activity and time spent at the computer and TV.
- When treating clinically significant sinus arrhythmia, drug, conservative and surgical treatment methods are used. You should also take into account various concomitant pathologies of organs that can cause sinus arrhythmia, and, if necessary, carry out complex therapy.
- Traditional treatment arrhythmias involves the use of antiarrhythmic drugs or antiarrhythmic drugs (AAP), the essence of which is to reduce cardiac activity or increase cardiac conduction.
The following drugs are used:
- Procainamide or procainamide:
- Orally: initial dose 15-50 mg/kg/day in 4-8 doses, maximum dose up to 4 g/day,
- Intramuscularly: initial dose – 20-30 mg/kg/day in 4-6 doses, maximum dose 4 g/day,
- Intravenous: 3-6 mg/kg/day, but not more than 100 mg over five minutes, maintenance dose 40-80 mg/kg/day, maximum dose 2 g/day.
- Orally: 1/2-1 mg/kg/day in 3-4 divided doses, maximum dose 14-16 mg/kg/day,
- Intravenously: 10-100 mg/kg/day slowly over 10 minutes.
- anaprilin,
- novocainamide
- Verpamil,
- amiodarone,
- Quinidine - orally at a dose of 6 mg/kg 5 times a day.
At drug treatment sinus arrhythmia should pay attention to dosage, contraindications, and unwanted effects drugs.
A surgical minimally invasive intervention is also used - implantation of a pacemaker under the skin in the area (subclavicularis), the essence of which is as follows: an electrode is inserted through the subclavian vein into the right parts of the heart, where the pacemaker is located; if there is a disturbance in the conduction system of the heart, the pacemaker registers these disturbances and corrects them.
Radiofrequency ablation or cryo-ablation: the essence of this method is the destruction or destruction (by high-frequency energy or freezing) of that part of the conduction system of the heart, which is the source of sinus arrhythmia.
Take vitamins for the heart: such as (ascorbic acid (C), pyridoxine (B6) polyunsaturated fatty acids(F). This group Vitamins help strengthen the walls of blood vessels and the heart, and also prevent the development of ischemia and promote the removal of cholesterol.
Vitamins that ensure the elasticity of the muscle and vascular wall, such as thiamine (vitamin B1) prevents rhythm disturbances, rutin (vitamin P) – helps increase the elasticity, strengthening, strength of the vascular wall, silicon and others.
There is a so-called reflex method in treatment, the essence of which is reflex stimulation of the central nervous system on the activity of the heart (pressure on eyeballs fingertips and hold for 5 minutes, massage the side surfaces of the neck).
Nutrition
Young children who have been diagnosed with sinus arrhythmia should eat a healthy diet. Parents must ensure compliance general recommendations specialists. It is necessary to exclude from the daily diet those foods that can provoke metabolic disorders, which will result in rapid weight gain.
This is especially true for products with preservatives, taste improvers, and also containing large amounts of saturated fat.
- dried apricots;
- zucchini;
- nuts;
- pumpkin, etc.
Portions for babies should be kept small (the volume of food will be compensated by the frequency of meals increased to 6), and the last feeding should be no later than 2 hours before bedtime.
A number of drugs created on the basis of plant materials can also normalize the heartbeat. Most of these remedies can be easily prepared at home or purchased at a pharmacy. It should only be noted: before using this or that drug, you must definitely consult with your doctor.
For a child with arrhythmia, the following treat will be useful:
- 2 parts dried apricots;
- one part at a time walnuts and raisins;
- lemon.
Solid ingredients are ground in a blender and combined with honey. The finished mix is stored in the cold. A child should eat up to two tablespoons of the product per day, depending on age.
The following juices will be extremely useful:
- pear;
- grape
These fruits should also be added to porridge or dessert dishes.
It should be noted that a remedy such as inhalation is quite effective. A mixture of the following oils is prepared for it:
- mint;
- Melissa;
- carnation;
- eucalyptus;
- nutmeg;
- thyme;
- needles;
- lavender;
- fennel;
- anise;
- cinnamon.
It will be useful to give your child lemon balm tea for two weeks. If the rhythm is disturbed due to problems with nerves, use a water-based infusion of valerian. Rosehip decoction also helps. It is recommended to bathe very young children in a bath with the addition of valerian root tincture.
- long walks in the fresh air;
- good sleep (the child should not go to bed late);
- morning exercises (you need to do exercises after waking up constantly);
- visiting the swimming pool;
- lack of stress and other nervous conditions;
- healthy balanced diet(the emphasis should be on vegetables, fruits, lean meats, fish);
- yoga classes, breathing exercises (under the supervision of experienced instructors), etc.
Every young patient should understand that this pathology may not go away with age, so it is extremely important to constantly monitor your condition. To do this, it will be enough to visit a cardiologist regularly and undergo hardware diagnostics.
It is easier to rule out causes and take preventive actions than to miss the disease or treat it for a long time. Therefore you should:
- monitor your diet: increase the amount of food you eat plant based, do not feed the child at night, cook in small portions;
- do not overwork, but do not exclude physical activity: make sure you do light exercises, take you swimming;
- recommended fresh air;
- try to remove the causes of arrhythmia: poisoning, viral diseases, and so on;
- avoid any stress and anxiety.
Of course, the child does not always understand the danger of the disease, so it is up to the parents to ensure that all recommendations are followed in order to cure the disease.
Sinus arrhythmia This type of arrhythmia is characterized by the presence of unequal intervals between individual heartbeats. Typically, with sinus arrhythmia, there is a natural alternation of periods of increased or slow heart function. In most cases, the heart rate changes in connection with the phases of breathing: at the height of inhalation, the rhythm becomes faster, during exhalation it slows down. Therefore, sinus arrhythmia is sometimes called respiratory arrhythmia. Sinus arrhythmia is based on reflex fluctuations in the tone of the vagus nerve against the background general increase its tone; in this case, sinus arrhythmia is often combined with bradycardia.
Sinus arrhythmia or otherwise respiratory arrhythmia Respiratory arrhythmia is often observed as physiological phenomenon, especially at a young age. More severe degrees of sinus arrhythmia occur in children and especially adolescents (the so-called juvenile arrhythmia) due to the pronounced lability of the autonomic nervous system characteristic of this age. Severe sinus arrhythmia in combination with bradycardia often occurs in neuroses. At the same time, we must remember that the cause of sinus arrhythmia can also be organic disease hearts. In such cases, its presence indicates involvement in pathological process sinus node. This should include sinus arrhythmia in rheumatism. In more rare cases, it is caused by myocardial ischemia due to coronary atherosclerosis.
Symptoms of sinus arrhythmia
Most often, patients do not experience any unpleasant sensations; sometimes they complain of palpitations or cardiac arrest. Sinus arrhythmia on the ECG is manifested by the fact that the intervals (R - R) between heartbeats periodically lengthen or shorten. The P–Q interval remains normal. Thus, the excitation wave arises in the usual place and spreads along the usual paths. The difference in the duration of the intervals between individual heart contractions can only be explained by the arrhythmic occurrence of impulses in the sinus node.
Sinus tachycardia
This term refers to the increase in heart rate up to 90 - 100 beats per minute or more due to the acceleration of the process of generating impulses, which is the result of an increased influence on the heart of the sympathetic nervous system or a weakening of the influence of the parasympathetic. Sinus tachycardia occurs under the influence of various factors.
Causes of sinus tachycardia The causes that reflexively cause an increase in heart rate can be physiological factors - muscle work, food intake, increased temperature environment, mental excitement. In addition, sinus tachycardia can be caused by various pathological factors: anemia, infectious-toxic effects, increased excitability of the central nervous system during neuroses, increased metabolism due to endocrine disorders (thyrotoxicosis), reflex effects from other organs, pharmacological effects (atropine), etc. . In addition, an increase in heart rate is observed in heart failure due to the well-known Bainbridge reflex. Subjectively, tachycardia is expressed by a feeling of palpitations.
Sinus tachycardia is characterized by a sequence and normal form both atrial waves and ventricular complexes of the electrocardiogram. However, due to the shortening of diastole, the P wave sometimes partially overlaps the preceding T wave or can completely merge with it. With severe tachycardia, a decrease in the height of the T wave often occurs.
Sinus bradycardia
This is a decrease in heart activity to 60 - 40 beats per minute as a result of a slowdown in the production of impulses by the sinus node. The causes of sinus bradycardia are various factors that inhibit the activity of the sinus node either directly or through reflex stimulation of the vagus nerve or inhibition of the sympathetic nervous system. Physiological bradycardia is usually observed during sleep.
Occasionally, bradycardia occurs with a frequency of 40–45 per minute in completely healthy individuals. To a greater or lesser extent, bradycardia is often expressed in athletes, in whom it serves as a manifestation of the heart’s adaptation to muscle strain(long-term) due to an increase in the stroke volume of the heart. In these cases, bradycardia is an expression of good training. Among the pathological factors, myxedema should be noted, as well as processes leading to increased intracranial pressure - cerebral hemorrhages, meningitis, brain tumors. Bradycardia is observed with acute nephritis, parenchymal hepatitis, during the recovery period after acute infections, with rheumatism, in patients suffering from peptic ulcers, with neuroses. Bradycardia can be caused by reflex stimulation of the vagus nerve by acting on receptors located in the carotid sinus and in the aortic wall. When pressing on the carotid artery, a sharp slowing of the pulse is obtained (Chermak reflex).
Reflex effects You can cause reflex bradycardia by applying pressure to the eyeballs. Bradycardia can also be caused by pharmacological effects, for example, during treatment with digitalis and reserpine. The waves and complexes of the electrocardiogram with sinus bradycardia are distinguished by their normal shape and sequence, but there is a prolongation of diastole.
A clinical sign that allows one to distinguish sinus bradycardia from complete atrioventricular block. which is accompanied by bradycardia is normal reaction to physical activity and changes in body position - increased heart rate when standing up and under the influence of muscle work.
Treatment of sinus arrhythmia The most correct and productive treatment is: a healthy lifestyle, exercise aquatic species sports or swimming in the pool, using the right and healthy products for normal heart function, try not to be nervous, try not to take anything to heart, so as not to aggravate the situation and find yourself a quiet activity (hobbies, yoga, walks in the forest). It is also necessary to visit specialists for a thorough examination and prescription of medications (in such cases, a sedative and exercise therapy are usually prescribed).
Sinus arrhythmia in children: causes, symptoms, treatment of the disease
The most important organ of the human body is the heart; its job is to deliver all nutrients through the bloodstream to the tissues and organs of the whole body. The work of the heart is controlled by the autonomic nervous system; normally, heart contractions occur at regular intervals, this allows for an uninterrupted supply to all cells human body necessary substances.
Irregular formation of an impulse in one of the nerve ganglia heart disease is called a rhythm disorder, or arrhythmia.
Sinus arrhythmia often occurs in children of any age; its treatment depends on the cause of the disease, the age of the child, and the severity of clinical manifestations. Sinus arrhythmia in a child can manifest itself as a decrease or increase in heart rate, sometimes a failure in the sequence of contractions.
Causes of sinus arrhythmia in children
Severe sinus arrhythmia in children in most cases goes away on its own with age, but cases are recorded in which arrhythmia affects the development of severe cardiac diseases. In order to prevent this scenario, it is necessary to correctly diagnose and first of all identify the cause of the disease. Pediatricians identify several main factors that lead to the disease.
- Heredity. Sinus arrhythmia may appear in children if their parents currently have or had a similar pathology in childhood.
- Congenital or acquired malformations of the heart muscle.
- Past acute infectious diseases. Often, pathogenic microbes penetrate the heart muscle and cause inflammation - myocarditis or endocarditis, which affects the contractility of the organ.
- Poisoning with toxic and medicinal substances.
Sinus arrhythmia in children: the causes of arrhythmia may be associated with a surge in hormones during adolescence. At this time, the teenager experiences a lot of positive and negative emotions, which affects the functioning of the autonomic nervous system. Congenital anomalies of the development of the heart are associated with intrauterine development of the fetus. Heart defects can appear in a child if the mother suffered a serious infectious disease during pregnancy, abused alcohol or smoking; a lack of microelements and vitamins can also cause developmental abnormalities.
Often, moderate sinus arrhythmia in children is recorded after infectious diseases associated with the loss of a large volume of fluid during dyspeptic disorders, vomiting, and high fever. In these conditions, the water-electrolyte balance is disturbed and there is a failure in the contraction of the heart muscle. Usually this rhythm disturbance goes away after recovery. normal functioning all organs.
Severe sinus arrhythmia in a child may appear suddenly after excessive physical exertion for his age, severe fear, anxiety, or psycho-emotional stress. The risk of developing rhythm disturbances also depends on the age of the child; sinus arrhythmia is most often recorded at 4-8 months, from 4 to 5 years, at 6-8 years and in adolescents. During these age intervals, it is advisable to do a cardiogram of the heart, which will immediately show whether there is a problem.
Symptoms of sinus arrhythmia
Young children will not explain what is bothering them, so parents should always pay attention to changes in the child’s well-being. In infants, the occurrence of arrhythmia may be accompanied by the following clinical signs:
If you notice such symptoms, you should contact your local pediatrician. Not always similar signs they talk about heart problems, but a thorough diagnosis will help to identify any disease in the early stages, which will undoubtedly affect the positive success of treatment.
Older children with sinus arrhythmia can explain their feelings themselves and complain about:
- Severe fatigue, reluctance to play games;
- Discomfort in the heart area, expressed by pain, compression, interruptions;
- Dizziness, sudden weakness, darkening of the eyes.
Parents may notice that the child begins to eat less, jump and play outdoor games, and tries to avoid physical activity. In children, the disease can also manifest itself as sudden fainting; if such attacks are repeated repeatedly, then it is necessary to undergo an examination as soon as possible. In 5% of cases, fainting occurs precisely because of disturbances in the functioning of the entire cardiovascular system. Severe sinus arrhythmia in a child requires a comprehensive examination, based on the results of which a decision on treatment is made.
How to treat a disease in a child?
Sinus arrhythmia can cause serious illnesses heart disease, some of which lead to disability. A pediatrician or pediatric cardiologist will prescribe an instrumental examination - ECG, ultrasound of the heart, 24-hour monitoring, detailed blood tests.
In order to return the heart to normal rhythm, in most cases it is not necessary to take strong medications; it all depends on the cause of the heart disorder. After diagnosis, it is necessary to review the child’s daily routine:
- Reduce physical activity. But parents should understand that physical inactivity also has a negative effect on the heart, so light physical activity must be alternated with quiet games or rest;
- Limit time playing on the computer, watching TV shows;
- Meals should be fractional. Reception large quantity eating at one time provokes a load on the heart, you should not eat just before bedtime;
- Avoiding caffeine-containing drinks;
- Night sleep should be complete.
Treatment of sinus arrhythmia in children is carried out based on what rhythm disturbance is detected. For tachycardia, drugs are used that increase heart rate; for bradycardia, drugs that increase cardiac contractility are used. For vegetative-vascular dystonia, sedatives are prescribed; usually in adolescence, these drugs help eliminate the arrhythmia.
Treatment of each child is strictly individual and must be carried out under the constant supervision of a doctor. Moderate sinus arrhythmia in a child can be resolved in one course of treatment and will not negatively affect the condition of the entire body. A timely examination and compliance with the course of treatment prescribed by a doctor excludes the development of severe pathologies and allows the child to return to normal life after drug therapy. Early detection of heart defects will allow surgery, the prognosis of which depends on the stage of the disease.
CARDIAC ARRHYTHMIAS
Cardiac arrhythmias can be congenital or acquired, arising from organic damage heart (inflammatory, dystrophic changes in the myocardium) or (which often happens in children) under the influence of various extracardiac factors (impaired autonomic, humoral regulation, etc.).
Sinus tachycardia- an increase in the number of heartbeats generated in the sinus node. Its cause may be an increase in sympathetic or suppression of parasympathetic influences on the sinus node; it can occur as a normal reaction during physical exertion, as a compensatory reaction in case of myocardial damage, hypoxic conditions, in the presence of hormonal changes (thyrotoxicosis), in children of asthenic build with a “hanging” heart. So-called constitutional tachycardia (associated with impaired autonomic regulation) is possible. An ECG with sinus tachycardia is characterized by a shortening of the R - R, P - Q, Q - T intervals, an enlarged and slightly sharpened P wave.
Sinus tachycardia can occur in the form of paroxysms, however. Paroxysmal tachycardia is characterized by a gradual (rather than sudden) normalization of the rhythm.
Prognosis and treatment. Persistent and significant tachycardia, especially against the background of damaged myocardium, is not favorable and can contribute to the appearance or worsening of heart failure. In these cases, it is necessary to use maintenance doses of cardiac glycosides in combination with fi-blockers (Trazicor - 10-20-40 mg per day, Obzidan - 0.5 mg/kg per day).
Sinus bradycardia- reduction in the number of heartbeats generated in the sinus node. Its causes are an increased influence of the vagus or decreased influence of the sympathetic nerve, changes in the sinus node itself caused by myocardial damage, the action of various medicinal substances. Bradycardia can be a consequence of reflex effects on the sinus node (for example, with jaundice), effects on the centers of the vagus nerve (brain tumors). Athletes experience adaptive bradycardia. There are known cases of familial bradycardia and bradycardia during hunger. It may occur under the influence of drugs (glycosides, quinidine, 6-blockers). On the ECG, the duration of the R - R interval is increased, the amplitude of the P wave is slightly reduced, the T wave and the P - Q interval are slightly increased, and diastole is prolonged. Bradycardia does not have any particular effect on hemodynamics. With a rapid change in rhythm and severe bradycardia, dizziness and loss of consciousness may occur. In these cases, aminophylline is used.
Sinus arrhythmia is characterized by different durations of heart contractions (the difference between the R - R intervals is more than 0.05 s). In most cases, it is associated with different effects of the vagus nerve on the sinus node during inhalation and exhalation - the so-called respiratory arrhythmia. When you hold your breath, it disappears. Respiratory arrhythmia is typical for healthy children and is most pronounced in preschool and school age. The disappearance of respiratory arrhythmia in children - a rigid rhythm - is an unfavorable sign indicating changes in the myocardium.
Extrasystole
The most common type of arrhythmia. The extrasystolic impulse occurs prematurely in relation to the main rhythm. The reason for this is considered to be the presence of a pathological focus in the heart. It can be an area of both damaged and normal myocardium, subject to increased influences of the autonomic nervous system. The impulse, normally born in the sinus node and covering the heart, does not penetrate the pathological focus (unilateral blockade) and returns to it through the re-entry mechanism (reentry) only when the entire heart is already covered in excitement and entry into the affected area is free. Since the myocardial cells surrounding this focus can already perceive excitation by this time, the returning sinus impulse itself becomes its source. As a result, an extrasystolic complex occurs prematurely, before the birth of the next impulse in the sinus node. Extrasystoles are differentiated from parasystoles, the occurrence of which is also associated with the presence of a pathological focus in the myocardium, but unlike the extrasystolic focus, this focus is not passive, but has pathological automatism, i.e., the ability to generate an impulse, as a result of which parasystole is characterized by the presence of two sources of rhythm in the heart - sinus node and pathological focus, which can be located in different parts of the myocardium. If the impulse generated in the pathological focus is able to be perceived by the myocardial cells surrounding this focus, parasystole occurs.
Parasystoles. as well as extrasystoles, they can be ventricular and supraventricular. In the differential diagnosis of ventricular extra- and parasystoles, the duration of the pre-ectopic interval (from the beginning of the QRS complex of sinus contraction to the beginning of the QRS complex of extrasystolic contraction) is important; it is constant during extrasystole and different during parasystole. Extrasystoles disrupt the regularity of the basic rhythm not only due to their premature appearance, but also due to the appearance after them of an extended post-extrasystolic pause (in all cases, with extrasystoles, one sinus contraction falls out, because the extrasystole either discharges the sinus node and the next sinus contraction is born through certain time, or an impulse is normally generated in the sinus node, but it is not realized, since the surrounding myocardium, excited by the previous extrasystole, does not perceive it). Extrasystoles and parasystoles can occur rhythmically (after each normal contraction - bigeminy, after two normal contractions - trigeminy, etc.) or randomly. They can occur in children with a healthy heart (if the focus of the normal myocardium is overexcited) - neurogenic or extracardial (functional) extrasystole, they can have a reflex origin (in the presence of focal infection), and less often occur due to organic damage to the myocardium.
The differential diagnosis of extrasystoles of organic and functional origin is difficult and should be based on a comprehensive study.
Clinical picture. Children suffering from extrasystole and parasystole often do not show any complaints; sometimes they experience cardiac arrest or a stroke in the heart area. On auscultation - arrhythmia, heart sounds periodically occur prematurely. 1 extrasystole tone can be increased (little blood in the left ventricle). On FCG it is widened, sometimes split, and the first tone can be split. The ECG is of greatest diagnostic importance, with the help of which the diagnosis and location of the pathological focus are established. In all cases, the criterion is the ECG features of the structure of the extrasystolic complex.
Treatment. Extrasystoles are late (occur in the middle or closer to the end of diastole of the previous normal contraction), single, and in the absence of signs of myocardial damage do not require treatment. Early extrasystoles (layered on the end of the T wave of the previous contraction), frequent or occurring against the background of damaged myocardium, require treatment. It is important to create a calm environment for the child. Sedatives are advisable. Among the antiarrhythmic drugs, cordarone is prescribed (from 1/2 to 3 tablets per day, depending on the age of the child). When the extrasystoles are eliminated, maintenance treatment with cordarone is carried out (1/2 treatment dose with two days off per week) for a long time, for 6 months. Pulsnorma (one tablet 1-3 times a day), rhythmodan (based on daily dose for adults 300-400 mg). Rhythmilen and etmozin are used. Obzidan and Trazicor can be prescribed, less often - procainamide orally 0.1-0.25-0.5 g 2-3 times a day. If extrasystole occurs as a result of an overdose of digitalis drugs, a 5% solution of unithiol is prescribed intramuscularly at 1 ml/10 kg of weight.
Shroxysmal tachycardia
Shroxysmal tachycardia is often associated with the presence of additional, abnormal pathways of the cardiac conduction system, which is not always detected during a routine ECG study
Clinical picture. During an attack, children experience anxiety, turn pale, noticeable cyanosis appears, shortness of breath, and pulsate. jugular veins; Sometimes there are abdominal pains (simulating appendicitis), in epigastric region. In rare cases, the liver becomes enlarged. The pulse is small, often uncountable. Blood pressure is reduced, embryocardia is detected on auscultation,
Treatment. Mechanical action aimed at stimulating the vagus nerve (pressure on the eyeballs, carotid sinuses, an attempt to induce vomiting, straining at the height of a deep breath). Medicines used include seduxen, potassium chloride - 10% solution, one teaspoon, dessert spoon, one tablespoon every 2 hours (background), intravenous cardiac glycosides (digoxin) in a saturating dose using the rapid digitalization method. If the attack is not relieved, a 10% solution of novocainamide is administered intravenously in a dose of 1.0-5.0 ml (pre-administer 0.1-0.3 ml of a 1% solution of metazone) or isoptin 0.3-0.4 ml for newborns, 0.4-0.8 ml for children under 1 year old, up to 1.2 ml for 1-5 years old, up to 1.6 ml for 5-10 years old, up to 2.0 ml for children under 14 years old. If there is no effect, obzidan is administered intravenously - 1 mg (1 ml of 0.1% solution), then this dose can be repeated at intervals of 2 minutes (based on maximum dose for adults 10 mg). If the attack continues, electropulse therapy is indicated. For frequently recurring attacks (against the background of WPW syndrome), cryocoagulation is prescribed, laser therapy. After the attack is relieved, maintenance therapy with coodaone is given.
Atrial fibrillation
Atrial fibrillation manifests itself in two forms: atrial fibrillation and atrial flutter. It is believed that their occurrence is based on the circular movement of the excitation wave (reentry mechanism), which occurs against the background of myocardial damage and heart defects. During atrial fibrillation, of the huge number of impulses arising in them, the AV node perceives and can conduct only a part. As a result, ventricular contractions appear unevenly and frequently - the tachyarrhythmic form, and in the presence of AV block, the number of ventricular complexes conducted by the AV node decreases - the bradyarrhythmic form of atrial fibrillation. Atrial flutter differs from fibrillation in a coordinated ectopic atrial rhythm with a smaller number of waves (250-300 per minute), some of which are delayed by the AV node (functional block), which ensures the correct ventricular rhythm. Atrial fibrillation can be persistent or occur periodically. Paroxysms are possible.
Clinical picture. The onset of an attack is accompanied by anxiety and fear. Characterized by different sonority of tones, alternation of short and long pauses, and pulse deficit. The tachysystolic form is the least favorable, since due to irregular contraction the ventricles often work idle.
Treatment. For treatment that should be carried out against the background of anticoagulant therapy, cardiac glycosides are indicated (rapid digitalization). If there is no effect, novocainamide is administered intravenously (for doses, see Paroxysmal tachycardia).
Pulsnorm is effective; you can use quinidine in a dose of 0.02-0.05-0.1 g up to 6 times a day for 2-3 days with a dose reduction in the next 2-3 days. Ethmozin is recommended. If ineffective, use electropulse therapy. Once a normal rhythm is established, long-term maintenance treatment with cordarone is carried out (prescribed with two days off per week).
Heart blocks
Heart blocks are disorders in the conduction of cardiac impulses through the conduction system. They can be partial (slowdown of conduction) or complete (there is a complete interruption in the passage of the excitation wave). Depending on the level at which conduction is impaired, blockades are distinguished: sinoatrial, intraatrial, atrioventricular, intraventricular (bundle branch block and blockade of the terminal branches of the conduction system). The cause of heart block is often the increased influence of the vagus nerve (functional block). They can also be caused by myocardial damage. In particular, intraventricular blocks (bundle branch blocks) are more often associated with myocardial damage (myocarditis, myocardiosclerosis).
Most heart blocks have no clinical manifestations and diagnosis is made using an ECG. Only with complete AV block is significant bradycardia observed (the number of ventricular contractions is less than 70 per minute), dizziness and loss of consciousness occur (Morgagni-Adams-Stokes attacks). In the absence of ECG data, children with complete AV block are often considered healthy, suggest bradycardia, or look for neurological pathology.
Complete AV block may be congenital ( birth defects AV node, congenital heart disease) and acquired (often after heart surgery, with inflammatory changes in the area of the AV node).
Treatment of blockades comes down to treating the underlying disease. During an Adams-Stokes attack, emergency care is needed: the patient is given an external cardiac massage, an artificial pacemaker is connected, atropine or adrenaline 0.1-0.5 mg of a 1% solution is injected under the skin. Oxygen is prescribed. For frequent attacks, implantation is indicated artificial driver rhythm. WPW syndrome is diagnosed on the basis of characteristic ECG changes and is often combined with attacks of paroxysmal tachycardia, which differs from the WPW phenomenon, in which there are no attacks of paroxysmal tachycardia. On the ECG, the P-Q interval is shortened (less than 0.1 s), the QRS complex is lengthened (more than OD-0.12 s), there is a delta wave (additional flat wave) at different knees of the R wave (ascending or descending), and it is secondarily changed T wave (smoothed or negative), the RST segment is shifted downward. WPW syndrome is associated with the transmission of excitation, normally generated in the sinus node, not only in the usual way, but also in a roundabout way through additional sections of the conduction system (bundle of Kent, James, Maheim), which contributes to premature conduction of the impulse from the atria to the ventricles. Since the impulse comes to the ventricles in different ways (normal and shortened through additional paths), deformation of the ventricular complex occurs asynchronously: the earlier abnormal impulse excites part of the ventricular myocardium (on the ECG - delta wave), the normal impulse wave merges with it, resulting in The QRS complex widens and becomes distorted. VVPW syndrome can be congenital or detected immediately after birth, sometimes later, when a congenital predisposition is realized under the influence of unfavorable conditions. May be persistent or unstable.
The surgical operating table is used for different types of operations.
In pediatric practice, sinus arrhythmia is far from a rare condition and is formed for several reasons, for example, with the irregular formation of an impulse that triggers the contraction of the heart, or with its incomplete conduction through the heart muscle. It turns out that the main trigger for the formation of arrhythmia is malfunction of the sinus node.
Doctors have identified several periods when the development of arrhythmia is most likely: the age group from 4 to 8 years and adolescence.
The cause of sinus arrhythmia can be congenital, less commonly acquired, malformations of the heart, functional malfunctions in the autonomic nervous system that regulates heart contractions.
In addition, arrhythmia must be considered as a symptom of certain pathologies of the heart and systems associated with cardiac activity. For example, congenital malformations, tumor processes and even poisoning. In adolescents, the cause of arrhythmia can be a hormonal surge (adolescence), emotional fatigue (including positive emotions).
In addition to sinus arrhythmia, other heart rhythm disturbances are observed in children:
bradycardia is a slowing of the heartbeat, which is characterized by a decrease in the production of impulses in the heart by approximately 20-30 beats per minute compared to the age norm. Most often it occurs after a child has suffered psycho-emotional overstimulation.
Sinus arrhythmia in children sometimes occurs due to a change in body position from horizontal to vertical; in this case, cardiac arrhythmia serves as a compensatory response of the body to acute orthostatic hypotension (vertical sinus arrhythmia).
If sinus arrhythmia in children manifests itself as pronounced, there are disturbances in heart rhythms, signs of rheumatism - this may indicate serious pathologies of the cardiovascular system.
Symptoms
Most often, arrhythmia is detected by chance, because its manifestation does not have disturbing symptoms; moreover, children sometimes cannot clearly formulate their feelings, or simply do not attach importance to a rapid heartbeat.
It is customary to distinguish general symptoms characteristic of any type of arrhythmia, and specific ones characteristic of each type. Sinus arrhythmia has many varieties, so the set of symptoms is varied.
To the number common symptoms include the appearance of shortness of breath after physical exertion, a feeling of interruptions in the heart when running, and increased fatigue. In rare cases, and only with pathological arrhythmias, fainting may occur.
With extrasystole ( premature contraction heart), the child may talk about a sinking heart, followed by a strong jolt. With tachycardia ( rapid heartbeat) sudden attack strong heartbeat, after which dizziness and decreased blood pressure may occur.
In the case when arrhythmia is a concomitant disease, symptoms appear that are characteristic of the underlying disease.
Diagnosis of sinus arrhythmia in a child
The disease can be suspected based on complaints from parents or the child. But still, more often, the diagnosis of the disease occurs by chance - based on the results of an ECG. It is this type of study that allows you to diagnose any type of arrhythmia.
If the fact of arrhythmia is confirmed, the pediatrician prescribes a consultation with a cardiologist, and in the future, it is this doctor who deals with the treatment. Based on the ECG results, the cardiologist can prescribe a more detailed examination with mandatory laboratory tests. To exclude serious pathology, additional research methods are prescribed - daily monitoring ECG, EchoCG, blood tests (full chemical and general), urine tests. If there is a suspicion of a connection between arrhythmia and disorders of the nervous system, a consultation with a neurologist is scheduled.
Complications
In most cases, respiratory arrhythmias turn out to be a physiological feature of the child, and cannot cause any complications or pathologies. But in the presence of concomitant pathology, complications may arise, including the formation of cardiovascular failure.
Treatment
What can you do
Treatment tactics depend on the type, severity and presence of concomitant diseases. As a rule, no serious treatment is required. But everyone has restrictions on playing sports. Before sending your child to any section, consult a cardiologist.
It is especially strictly necessary to adhere to a proper diet - obesity and excess weight are an aggravating factor for proper operation hearts. It is recommended to eat small portions, easily digestible food, maximally balanced in vitamin and mineral composition, as well as correct proportion main food components (proteins, fats, carbohydrates). The diet should be based on foods additionally enriched with potassium and magnesium. How to properly recommend a dairy-vegetable diet.
It is necessary to minimize or completely stop the consumption of fatty drinks containing caffeine. It is also forbidden to eat before bedtime, because... a loaded stomach can affect certain receptors and disrupt the functioning of the sinus node in the heart.
What does a doctor do
If the arrhythmia is pathological in nature and is a symptom of another, serious pathology, the doctor prescribes comprehensive treatment of the underlying pathology and symptomatic therapy. The main goals of therapy are to eliminate all provoking and aggravating factors.
Doctors may prescribe antiarrhythmic drugs, sedatives, and multivitamins. In severe cases, surgical treatment may be prescribed for conditions that may threaten the child’s life.
Prevention
Specific measures there is no prevention. But the best “cure” for arrhythmia is a healthy lifestyle. Implying sports, proper nutrition, and the absence of bad habits.
You will also learn how untimely treatment of sinus respiratory arrhythmia in children can be dangerous, and why it is so important to avoid the consequences. All about how to prevent sinus respiratory arrhythmia in children and prevent complications.
And caring parents will find on the service pages complete information about the symptoms of sinus respiratory arrhythmia in children. How do the signs of the disease in children aged 1, 2 and 3 differ from the manifestations of the disease in children aged 4, 5, 6 and 7? What is the best way to treat sinus respiratory arrhythmia in children?
Take care of the health of your loved ones and stay in good shape!
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