Pulsation of the aorta. Normally, aortic pulsation is not observed. The appearance of aortic pulsation in the jugular fossa is observed with a pronounced expansion of the aortic arch, its aneurysm. This pulsation is called retrosternal. In addition, with an aneurysm of the ascending aorta, pulsation may appear in the 2nd intercostal space on the right at the edge of the sternum.
Trembling of the chest ("cat's purr") noted above the apex of the heart during diastole with mitral stenosis and above the aorta - during systole with stenosis of the aortic mouth. The mechanism of this phenomenon can be explained by the formation of eddy currents of blood when passing through the narrowed opening of the mitral or aortic valves.
epigastric pulsation determined with hypertrophy and dilatation of the right ventricle, abdominal aortic aneurysm, aortic valve insufficiency. Normally, it is barely visible. Pulsation of the liver can be true - with insufficiency of the tricuspid valve or transmission - with an increase in the right ventricle. To distinguish a true pulsation from a false one, you can use a simple trick: put closed index and middle fingers on the liver area. With a false pulsation, they remain closed, with a true one, they periodically (in the phase of the systole of the right ventricle) diverge.
When examining and palpating the lower extremities in patients with right ventricular heart failure, both visually and palpation-symmetrical edema are detected. They are dense, appear by the end of the day, the skin above them is cyanotic. With varicose veins of the lower extremities, especially with thrombophlebitis, local edema is detected on the affected limb (asymmetric).
With damage to the arteries of the lower extremities (obliterating endarteritis, atherosclerosis), the skin is pale, sometimes flaky. The limbs are cold to the touch. Pulsation on a.dorsalis pedis and a. tibialis posterior decreases or disappears completely.
Percussion of the heart
When starting percussion of the heart, it is necessary to clearly understand where exactly its sections are projected onto the chest. In particular, the right contour of the heart in its upper part from the II to III ribs is formed by the superior vena cava. The lower part of the right border of the heart corresponds to the edge of the right atrium, which is projected from III to V ribs in the form of an arc spaced from the right edge of the sternum by 1-2 cm. At the level of the V rib, the right border of the heart passes into the lower one.
The left border of the heart at the level of the 1st intercostal space is formed by the aortic arch, at the level of the 2nd rib - the 2nd intercostal space - by the pulmonary artery arch, in the projection of the 3rd rib - by the auricle of the left atrium, and from the lower edge of the 3rd rib to the 5th intercostal space - by the arch of the left ventricle.
Percussion of the heart determines the size, configuration, position of the heart and the size of the vascular bundle. Allocate the right, left and upper borders of the heart (Fig. 33,34,35). Percussion of the part of the heart covered by the lungs produces a dull percussion sound - this is an area of relative cardiac dullness. It corresponds to the true boundaries of the heart.
Rice. 33. Determination of the right border of relative cardiac dullness
We start defining it by finding the right boundary. To do this, first find the lower border of the lung on the right (see lung percussion). Then, from the found border of the lung, they rise one intercostal space higher in order to percussion the desired right border of the heart from a clear pulmonary sound to dullness above the zone of relative cardiac dullness.
Fig.34. Determination of the left border of relative and absolute cardiac dullness
Rice. 35. Determination of the upper limit of relative and absolute stupidity
In a healthy person, as is known, bottom line of the right lung along the midclavicular line is located on the VI rib, therefore, skipping the V intercostal space, the right border of relative cardiac dullness is determined in the IV intercostal space on the right. In this case, the finger-plessimeter is placed parallel to the supposed right border of the heart, but perpendicular to the ribs and intercostal spaces. Percuss with quiet percussion from the right midclavicular line to the sternum. Finger-hammer strikes are applied to the skin fold of the nail phalanx of the plessimeter finger. The boundary is marked along the edge of the finger facing the clear sound (i.e., along the outside). Normally, this border is located in 4 intercostal spaces by 1 - 1.5 cm, outward from the right edge of the sternum or along the right edge. It is formed by the right atrium.
Before definition left border relative cardiac dullness find the apex beat. If it is in the 5th intercostal space, then the definition of the border starts from the 5th intercostal space, if it is in the 6th intercostal space, then from the 6th intercostal space. The finger is placed 2 cm outward from the apex beat and percussed towards the sternum. If the apex beat is not palpable, then the finger-plessimeter is placed in the 5th intercostal space along the anterior axillary line and tapped inwards with quiet percussion until a dull sound is heard. Here the border is formed by the left ventricle, is located 1-2 cm medially from the left mid-clavicular line and coincides with the apex beat. In the 4th intercostal space, the border is also formed by the left ventricle and is located 0.5‑1 cm medially from the border identified in the 5th intercostal space. In the 3rd intercostal space, the border is 2‑2.5 cm outward from the left edge of the sternum. It is formed by the auricle of the left atrium. At this level, there is the so-called "waist of the heart" - a conditional border between the vascular bundle and the arch of the left ventricle on the left.
Constant discomfort in the heart and strong pulsation
Floor: not specified
Age: not specified
Chronic diseases: not specified
Hello! I was 21 years ago when I came from the army I was engaged in the gym after half a year, for the first time, pains in the heart area began to bother me, at first I didn’t pay attention to them periodically, but just in case I stopped exercising in the gym, it was such that when I took a deep breath I felt such pain the feeling that something broke under the heart and let go, when the pains resumed, they went to the hospital, they had an ecg and a fluorography, they said it was normal, this summer the pains were usually after sleep some kind of unpleasant sensation in the left chest or shoulder, but when I walked around during I didn’t feel pain for a day and physically didn’t affect it in any way. Summer passed in October, the deterioration began more significant and protracted; at first, such an ailment floats in the head as if everything is happening in reality and there is no clear consciousness; all sensations became somehow weak; usual, my blood pressure is 100 to 60 or 110 to 70, chest pain became almost constant, gave to the left arm, woke up in the morning from pain and stiffness of the left thoracic region, noticed that when you take a warm bath, the pain lets go a little and not for long, went again to the cardiologist sent for echo kg, Conclusion: Additional chord in the cavity of the left ventricle, myocardial contractility is preserved. Severe tachycardia. Magne B6 and afobazole were prescribed. I also had a little cold, there was no temperature. The heart was beating like in dynamics (walking, studying) ... So at rest, 90-100 beats are strong and the feeling is that it is tearing strongly. The pulse was felt throughout the body (stomach head arms). I continued to do the usual things, although I felt that now everything was more difficult ... And then somehow, at school, when I was sitting at rest, I felt very bad that I was about to lose consciousness, there seemed to be a failure in my chest or a stop for a second or two .. I thought something with my heart, got up in a panic, walked out, literally stormed me, I moved a lot, because if I stopped, it seemed like I would fall. I went to the hospital in a minibus again, it began to repeat again, only my heart was still beating at a wild speed, as if it would fly out now, I wanted to get out already, but it got easier, my heart didn’t beat so only weakness was in the hospital they did an EKG, they said it was normal. I did blood and thyroid tests and everything was normal. Once at home I had such an attack again, I got up so as not to lose consciousness, the sensation was incomprehensible, I began to move, as I thought it would be easier at school, but I couldn’t lay down for a long time, it became even worse, I was talking some kind of nonsense, my tongue became numb, a shiver appeared in my body, it became cold it looked like a microstroke, an ambulance arrived, but by that time it got better, the doctor said to do an examination of the spine, measured the pressure and left. .. Then finally I fell ill for 2 weeks, I didn’t even go to school, it was scary that everything would happen again, I always slept a little, I moved everything in bed, weakness ... I was examined by a neurologist, he says signs of panic attacks, prescribed fluoxetine, vitamin injections, adaptol, pantogam, did an additional echocardiography: Now they found prolapse of the anterior leaflet of the valve of 1 degree with regurgitation of 1 degree, the leaflets are thickened ... Strange, but the chord was not revealed ... And before, they didn’t talk about prolapse either ... Passed the stress test Conclusion: The test negative exercise tolerance is very high . Normotonic type of reaction to the load. Rhythm disturbances are not induced. VP 5 min. Resting ECG: normal, tachycardia. As the doctors say, there’s nothing terrible, they said to drink Magne 6 and turnout after 2 years ... Holter also did not reveal any violations, only episodic migration of the pacemaker through the atria and tachycardia, the doctor said there was nothing to worry about ... But with prolapse, people write on the Internet there is no pain or sometimes and it is congenital and as a result of stress there or what? They say it's not scary if the prolapse is congenital, this is the structure of the heart, but they didn't tell me that it's congenital, but was it acquired in my friend? And how to recognize it? And what is the difference between acquired and congenital anterior leaflet prolapse? And what makes your heart hurt all the same in your opinion? I also noticed different pains ... It hurts the heart like a colitis or presses, if not the heart, then somewhere in the left shoulder or behind the shoulder ... Then in the back area where there is a hump, or the left arm, or all together then horror and still the heart beats somehow it pulsates strongly .... When I went out into the street, I go and go and bang such a state as deafened, but my heart did not beat strongly these times ... Doctor that this is prolapse, so what does it work ????????? Or neurosis???? Previously, everything was perfect, and even in the army, there were also physical and psychological stresses, but it wasn’t like that ... Even if there was this prolapse from birth, maybe it had nothing to do with it. Now it’s easier for me and there doesn’t seem to be any panic attacks, but this discomfort in the chest got to the throat and always hurts, I forgot what calmness in the left chest means .... Everything is strange, there is still pain when pressing on the rib in the region of the heart or along the rib ... Like intercostal neuralgia, but it doesn’t fit either ... What else would you advise to undergo what additional examinations doctor? Sorry for making you read so much (((((((but I will wait for your answer))))
22 answers
Don't forget to rate the doctors' answers, help us improve them by asking additional questions on the topic of this question.
Also do not forget to thank the doctors.
Hello! I would advise you to find a good neurologist. All your troubles are due to problems with the spine (intercostal neuralgia or osteochondrosis, you have to figure it out here). All the symptoms you describe are neurological in nature. And tachycardia is already a consequence of a constant, prolonged pain syndrome. As for the results of ECHOCG .. They may differ if you have been examined on different devices and / or by different doctors. Mitral valve prolapse has nothing to do with your pain, you can believe me (I have it too) :) MVP is a slight "sagging" of the mitral valve leaflets due to their elasticity, usually detected at a young age (when tissues grow); calling it congenital or acquired is not entirely correct, because this condition is often temporary, appears at a young age and goes away in old age. Moreover, the first degree is the most minimal. And then, the heart is behind your sternum, physically it cannot hurt for longer than 30 minutes, it does not react when you press on the chest. In addition, according to the results of all examinations of the heart, you have excellent results, so why not examine other organs in the same detail? The very fact that your pains were in a hot bath suggests that the pain is of a muscular nature. Magne B6, adaptol and no "heart" drugs will help you. Contact another neurologist, buy an orthopedic mattress and pillow and be healthy!!!
Temirkhan 2013-07-03 17:33
I also have the same condition, only + with a body temperature of 37.4 for three years already (with excitement), I went to a neurologist, he did not reveal any pathologies, and the cardiologist was diagnosed with mitral valve prolapse of the 1st degree with regustation of the 1st degree. I also worked out in the gym, can a physical. Loads affect prolapse? Previously, I did not feel any pain in the chest area, there was no dizziness ((
Hello. Mitral valve prolapse of the 1st degree cannot affect your life in any way, loads with it are not contraindicated. Body temperature is alarming. If it occurs only with excitement, try to contact a psychotherapist, he will teach you relaxation and meditation. If the temperature is constant or at some time of the day, you need to look for the cause. Mostly inflammatory.
Vitaly 2013-12-03 16:05
Hello, your problems are not related to the heart, you have a different disorder, it’s not about the nerves, I had it, I can say it will get worse, the problem is solved quickly, in just three months and everything is fine with your psyche, there will be a desire I can help!!!
Victory victory 2014-09-03 07:44
Vitaly tell me the solution to the problem
Alexander 2014-03-03 02:19
Guys this is probably gall
Timur Klimashevich 2014-05-06 21:11
You know,! I first caught such a state 2.5 years ago, the same state, a little roof. Let's go! Also after serious exertion, then everything seemed to calm down, but my heart is still very naughty and it seems to me getting worse and worse, but the doctors say everything is normal, shortness of breath appeared, something similar to tachycardia, in general, trouble! If anyone has been diagnosed please let me know!
Alexander 2015-01-11 18:48
I have a complete similar situation. Changed 4 hospitals and there is no sense. With pain in the heart, dizzy, numb legs, it seems that right now I will lose consciousness. Sometimes it even feels like I'm going to die. I suffer for a year and 2 months. The heart itself is said to be normal. I drank a lot of pills (painkillers, nicotinic acid, grandaxin, magnesium and much more, vitamin injections, warming up, nanoplastic, etc. Nothing helps. Help, I want to return to professional sports
Hello. It's most likely neurological. Address to the neurologist and the psychotherapist.
Yuri 2015-02-10 01:58
Hello, the symptoms are very similar to mine, too, they practically only give to the shoulder and arm and fingers and veins, as if from the inside, it pricks, sometimes aching dull pain under the armpit and there is a pulsation in the stomach and in the hand on the fingers near the head, I just feel the pulse . I did echo and doppler and hotler, everything is practically normal, everyone says that this is most likely not a heart. But the reason has not been found. It has been going on for 2.5 years, sometimes it subsides for a month, then it starts again. By the way, over time, the intervals between exacerbations of pain are getting smaller and this is frightening. If someone solved the problem, unsubscribe. And to what doctors to descend and what researches to make. Thanks in advance. Yuri is 29 years old. Sometimes the pulse quickens at night.
Hello. Try going to a neurologist.
Alexander 2019-11-06 23:58
That's the problem, we won't get an answer. I have been running around with such problems since the age of 11, but from what and why all this is happening I have not received an answer. At home, you can already open a pharmacy, so many medicines have accumulated. Doctors drive only to each other and each supposedly heals, and you still like fools want to believe that it will help and you are treated, replenishing their pocket.
Give at least one positive treatment with similar symptoms. People ask a question and not just one person, there are many of us. Find the answer, Give an example of at least one patient how you helped him. You can only run towards each other. Gather a council, answer here. Once again I will repeat to you not one patient wrote. But from all you unsubscribed supposedly helped.
Arturs 2015-06-17 13:36
Hello! Three months ago I began to feel my pulse in my chest. There were extrasystoles, there was also noise in the head and ringing in the left ear. Sleep disturbance, arrhythmia, tachycardia. If I linger a little with sleep, then the pressure jumped. There were crises of hypertensive type, with severe tachycardia up to 160, during an attack. Constant in addition to feeling a pulse in the chest, discomfort. If I suddenly get up from a sitting position, then my pulse slows down a lot and a strong pulsation begins in my head and chest, and there is a feeling of loss of consciousness. At the same time, before going to bed, the tremor disturbs both the limbs and the feeling of a second pulse. I went around all the doctors, a neurologist, a cardiologist, a psychotherapist, and so on. As a result of the bypass of a lot of doctors, it was revealed: PMK 1 st, dystonic type of heartbeat, tachycardia 80-90 beats per minute, gastro-bulbitis, insufficiency of the cardia of the stomach, chronic gastritis, non-ulcerative dyspepsia on the background of hr. Gastritis, VSD, NSC, hernia of the esophagus 1st degree, gallbladder polyps, chronic prostatitis, osteochondrosis of the thoracic and cervical region, with instability in the cervical region, rhino-sinusitis. I went through a course of treatment in the department of gastro-enterology, lay in the neurology department, and everyone answers unequivocally: I overworked, I was overtired, I need to treat my nerves. After the treatment, it became much better, the pressure stopped jumping, and the tachycardia disappeared, but there was a feeling of palpitations in the chest and a ringing in the head. Tell me what else I need to check to rule out pathologies and so on. Can problems with hormones, circulatory disorders of the head, osteochondrosis and everything in this vein give such symptoms? There is no time to lie in hospitals and be examined. My family therapist cannot say anything sensible, he has not come across similar cases.
2016-10-28 09:02:09
Christina asks:
Good afternoon. I am 27 years old, having once again done a fluorography, in the conclusion it is written that the heart is enlarged in all sizes, I did an ultrasound - everything is within the normal range, the EKG shows the load on the left ventricle, the tests are all good. They are worried: shortness of breath and pulsation, also chronic tonsillitis. Please tell me on flur. the heart is enlarged, but not on ultrasound?
Responsible Medical consultant of the portal "site":
Hello Christina! Given the symptoms, most likely changes in the heart are still present. It is necessary to take all the tests and conclusions and go to a face-to-face appointment with a cardiologist. An examination by an ENT doctor is also indicated to determine if treatment for chronic tonsillitis is indicated for you, including removal of the palatine tonsils. Take care of your health!
2016-02-19 23:06:24
Juliana asks:
Hello! What can the pulsation in the body mean, which occurs periodically in different places ... now in the arm, then in the leg, in the stomach, somewhere near the heart, in the head? It can be difficult to fall asleep at night because of it. In addition to this, my heart rate is almost always around 90-100 ... it worries me. Can it be given by “female” hormones that I can’t put in order in any way? The last time I had an ultrasound of the heart and a cardiogram was 2 years ago. The cardiologist did not say anything intelligible, only that a small prolapse of the meter valve with my complexion is not dangerous. I did not notice anything special on the cardiogram. He prescribed a small dose of a beta-blocker to slow his pulse. Now I have almost reduced it to a minimum (Egilok - 15 mg per day) and I drink panangin, the pulse is still often around 90 ... Do I need to do something about it? And the pulsation in the body can be connected with this? I am 32 years. Thanks.
2016-02-10 14:01:59
Andrew asks:
Good afternoon, I am 37 years old, male, on November 21, 2015, there was a hypertensive crisis 200/120, I was admitted to the hospital, an examination was carried out, from what I understood, my renin is elevated, since that time, subject to all prescribed pills, pressure rises up to 155 are observed every day \90 and heartbeat quickens, presses in the chest, sometimes I can’t sleep, pulsations in the ears, head, body, appetite is very bad, I eat through force, at the moment I take Orifon-Retard 1 tab in the morning, Vazar 80 mg in the evening, Nebilet before I took it, periodically I drink Carvalol from the state, when the captopress is really bad, the condition does not normalize day by day, I used to run 3 km and ride a bike 10 km every other day, and now I can’t run 20 meters - my heart jumps out, help with advice or personal experience, I'm losing my mind from such a state
Responsible Bugaev Mikhail Valentinovich:
Hello. An absentee selection of antihypertensive drugs is not possible, you should be examined by a cardiologist and advised on an individual set of drugs. I think you can't do without beta-blockers in your case.
2015-05-19 14:42:57
Maria asks:
Good afternoon!
On April 29, I was in the shower and leaned over to pick up the washcloth. At that moment, a sharp sharp pain arose in the area of the shoulder blades. I couldn't move them apart, it was hard to breathe. This went on for 20-25 minutes. Then the pain receded. During the day, I had a hard time bending over. By the evening the pain receded, and the next day it was almost gone. But after a few days, my shoulder blade began to hurt, under it, the pain was in my left arm. Pain in left ribs. The pain is felt in the middle and at the bottom of the chest. Mostly dull aching. If you put your hand between the shoulder blades in front there is not much pain. Often cloudy in the head, but quickly passes. At this moment, it seems that breathing stops and the heart stops beating. Passes quickly. Feeling out of breath. Feeling of constriction, heaviness in the chest. It is felt in lying, sitting and standing positions. Periodically I feel a pulsation in the field of edges. Such attacks almost every day. Went to the doctor, did an EKG. ECG is normal. Pressure 90/60-110-70. Pulm 70. Previously, there were no problems with the heart. The doctors say that the heart is fine. But I still worry. 25 years. Height 170. Weight 50kg.
Responsible Bugaev Mikhail Valentinovich:
Hello. The pains described are more likely to be related to the spine, it is worth going to a neurologist. Regarding palpitations and apparent cardiac arrest, you need to do daily Holter ECG monitoring in order to see the work of the heart at these moments.
2015-03-18 05:59:47
Olga asks:
Good afternoon.
Complaints of weakness, flies in the eyes, periodic pressing pains in the heart during exercise, lack of appetite, dizziness, dry skin.
History of the disease: Suffers from chronic anemia on the background of non-specific ulcerative colitis for about 40 years. She was treated on an outpatient and inpatient basis in October 2014. Periodically takes a totem, sorbifer durules. Deterioration of well-being during the last 2 weeks, when the above complaints intensified. She applied for medical help at the CRC, was examined, and was sent to the hospital in a planned manner.
Anamnesis of life: more than 40 years - ulcerative colitis, constantly taking salofalk 500 mg, 2 tons * 2 r. per day, the last hospitalization for this disease was 5 years ago (AMOKB No. 1), blood pressure rises for many years to 190 - 210/100 -110 mm. rt. st, constantly taking Egilok 50 mg 2 r / d, arifon 1 t / day, chronic venous insufficiency 2 tbsp. In June 2014 - an accident, subcapsular hematoma of the spleen. Diabetes mellitus type 2. Pensioner. Has no bad habits. Tuberculosis viral hepatitis denies. Drug intolerance: denies. Epidemiological history: Contact with infectious patients denies. Everyone in the family is healthy. There were no blood transfusions. There were no tick bites or other insect bites. He drinks boiled water and milk. I did not swim in open water.
Objectively: Temperature 36.3. Condition is unsatisfactory. In the mind, the contact answers questions correctly, in full, the voice is quiet, the speech is correct. The pupils are equal, they react well to light. The gait is sluggish, in the Romberg position it sways. Correct physique, subcutaneous fat - normal. The constitution is normosthenic. The musculoskeletal system is not changed. The skin is clean, dry, pale in color with a yellowish tinge, turgor is reduced. Peripheral l / nodes (submandibular, cervical, axillary, inguinal) are not enlarged, painless. The thyroid gland is not enlarged. The isthmus is palpated. Chest of the correct form. Lungs: NPV - 18 per minute. With percussion of the lungs, the sound is pulmonary, the same sonority on both sides. Auscultatory breathing is vesicular, no wheezing. The region of the heart is not changed, the boundaries of relative cardiac dullness: the upper one is at the level of 3 m/ribs; right - the right edge of the sternum; left - 1 cm medially from the left midclavicular line. Heart: heart rate 78 per minute. BP on the right arm 170/90 mm Hg. BP on the left arm 160/90 mm Hg. Heart sounds are muffled, the rhythm is correct. Tongue wet, densely lined with white coating. The abdomen is soft and painless on palpation. The lower edge of the liver along the edge of the right costal arch. The spleen is not enlarged. There are no peripheral edema. S-m Pasternatsky negative on both sides. The pulsation of the vessels of the lower extremities is preserved, weakened. Urination painless, free. The chair is periodic, not always decorated.
PRELIMINARY DIAGNOSIS:
Main: Anemia of mixed genesis (iron, folate deficiency, on the background of a systemic disease), of moderate severity.
Background: Nonspecific ulcerative colitis.
Concomitant: Secondary arterial hypertension 2 tbsp. atherosclerosis of the aorta. Sideropenic cardiomyopathy. Diabetes mellitus type 2, compensated. Planned: - Carrying out antianemic, detoxification therapy,
COLONOFIBROSCOPY from 17.03.2015
Aware of the nature of the study /a/, warned of a possible biopsy /a/. Consent received.
Conclusion: Chronic external and internal hemorrhoids without visible exacerbation. The tone of the anal sphincter is reduced. Catarrhal sigmoiditis?/UC? (the mucosa of the entire sigmoid colon is hyperemic, edematous, against the background of general hyperemia there are areas of brighter hyperemia, in places there is viscous mucus on the mucosa, the lumen of the sigmoid colon is somewhat narrowed, it is a tube, there are no folds). A separate biopsy was performed in the proximal and distal parts of the s-gut. When performing a biopsy, the mucosa is structureless, fragmented. In the proximal part of the s-colon, at the place of transition to the descending one, there is a wide diverticulum, which is a continuation of the intestinal lumen, the mucosa in it is the same as in the entire sigmoid colon. Chronic hypotonic colitis / folds throughout the colon are smoothed out / without visible exacerbation. In the rectum and behind the sigmoid, to the caecum, without inflammatory and organic changes. The result of histological examination after 7 days.
COLONOFIBROSCOPY from 03.10.2014
Aware of the nature of the study /a/. Warned about a possible biopsy /a/. Consent received.
Conclusion: Erosive catarrhal sigmoiditis / mucosa of the sigmoid colon throughout, edematous, eroded along the entire perimeter,
in some areas in the form of a cobblestone pavement /. Biopsy performed. Further to the dome of the caecum and in the rectum without features. The result of histology after 7 days.
Could you give your opinion.
Thanks.
Responsible Vasquez Estuardo Eduardovich:
Hello Olga! Any chronic problems, even if managed to control, tend to develop further, and you have several of them. With age, the body struggles not so actively with such problems, even with all our desire and strict implementation of the recommendations of doctors. My conclusion can simply repeat the main diagnoses that are already familiar to you: UC, anemic syndrome. ischemic heart disease with atherosclerosis. Hypertonic disease. Periodic consultations at the place of residence and further implementation of medical recommendations, both in order to get rid of problems, and in order to reduce the likelihood of complications and the emergence of new processes.
2015-03-12 10:04:59
Volodya asks:
Good afternoon, my name is Vladimir, I'm 23 years old.
I am addressing you with such a problem: somewhere a little more than 3 weeks ago, I hit my head, but there were no obvious symptoms of a stroke of the brain, neither loss of consciousness nor nausea, in short, just pain from a blow, I did not go to the doctor. , I sat at home, spent a lot of time at the computer (now I already know that it’s in vain) I tried physical education a couple of times, but my head started to hurt right away, I stopped it, so nothing bothered me.
2 weeks later I had to go to the village for 2 days where I was a little physically stressed out, after these 2 days my temperature rose a little 37.5 The pressure went down and most importantly my head began to throb and make noise in my left ear. I decided it was time to visit a doctor. I came we talked to the neurologist, he sent it for testing and to the ophthalmologist (I don’t understand the analyzes, but as I understand it, everything was more or less normal, + a slight pulsation on both sides), he returned to the doctor, he looked at the tests and said most likely there was a coward Well, he prescribed a course of treatment: magnesia 25% -5.0 ml for 3 days
piracetam 20%-5.0ml 7 days
thiotriazoline 2.5%-2.0ml 10 days
vinpocetine tablets (20 pcs) 1 pc per day
well, of course, rest, peace, no stress, he said it should pass if it doesn’t pass then come for a more thorough examination.
Already 7 days have passed and so far everything is as before and the pulsation and noise in the ear have not gone anywhere. The temperature is 36.9-37.5. blow) the noise resembles breathing that occurs in parallel with pulsation, the pulsation has been happening constantly for about 9-10 days, the whole head is pulsating, not excluding the eye or vision, I don’t know how to correctly say with each pulsation of the eye, or at least the screen in front of the eyes, what I see is a little twitching (very little pleasant sensation) more acutely felt when I go to bed. It takes about 3 hours to get stuck, because of the pulsation and the inconveniences associated with it. Well, in general, I don’t know if you understood something from what I wrote here, but still, if you understand and have something to advise on how to get rid of this pulsation , I'll be very thankful.
Responsible Gusak Andrey Vasilievich:
2015-03-04 16:09:18
Fuad asks:
Hello! I’m 35 man. 2 months ago I had a panic attack, suffocation, checked my thyroid gland, then I started to hear the heart rhythm, I did an EKG, everything was fine, the neuropathologist prescribed tranquilizers, I drank for 5 days, I stopped, I decided to overcome it myself, it seems that my condition is improving, but at least a day I feel a pulsation in the body, mainly in the abdomen and hearts and I hear the rhythm of the heart and there is a feeling of the rest of the food in the throat. Do I need to check the blood vessels and which doctor should I contact? Thank you in advance
2014-10-11 09:12:01
Asks Olga, 28 years old:
Good afternoon, I'm asking for advice from a doctor. I am 28 years old, diagnosed by MRI - cavernous angioma of the spinal cord at the level of the Th8 vertebra, dimensions 20x8x8 mm. 1) What method of treatment is better to choose, because the symptoms have gone?
2) which hospital and which doctor with experience in treating this pathology can be contacted to get a positive result and avoid disability?
3) Is it likely that cyber or gamma knife surgery, or embolization or some other method, will help, given the localization of the tumor?
Symptoms: reducing pains in the ribs, aggravated by 5-6 o'clock in the morning + numbness of the fingers on the left leg, pulsation in the thoracic region of the back, jumps in blood pressure up to 100/60. Over the past 3 years, these pains did not bother, but there were shooting pains in the right or in the left leg, she took anti-inflammatory painkillers + injections. Since 2008 occasionally (2-3 times a year) reduced the chest around the heart.
Responsible Lirnik Sergey Villenovich:
Good evening Olga. 1. Symptoms which you describe, not absolutely correlate with tumor localization. 2. You need a consultation with a neurologist and a neurosurgeon. Vascular surgeon Lirnik S.V.
Responsible Lirnik Sergey Villenovich:
Once again, good afternoon, Olga. I think you're not describing the problem correctly. You can give recommendations only after reading the MRI or CT data (which you did) and after examining the patient. Vascular surgeon Lirnik S.V.
2014-09-25 13:47:38
Oksana asks:
Hello. I am 29 years old, female. floor. It all started six months ago. Sometimes hands go numb, dizziness, headaches in the forehead, stuffy ears (as when climbing mountains), while the pressure is 110/70 (for me this is the norm, there are no jumps. An unpleasant feeling of whining in the chest, a lump in the throat and in the chest, sometimes a feeling of constriction in the esophagus.Sometimes not a strong pressure or burning sensation in the region of the heart., a feeling of lack of air (I want to take a deep breath, I yawn).Sometimes I feel a heartbeat, throbbing in the neck.Feeling of coldness in the chest, spreading throughout the body.Did an ECG , conclusion: 1. Sinus arrhythmia, heart rate 64 beats/min, interval RR (sec) - 1.06-0.84); Heart rate (beats / min) - 57-72);
2. vertical position of the electrical axis of the heart 76 degrees,
3.ECG voltage reduced
4. Moderate myocardial changes
ExoCS results:
1. Sinus rhythm,
2. Rotation of the heart around the longitudinal axis clockwise (shift of the transition zone to the left)
E20KS-N, FV -N.
Blood test:
glucose 4.34
hemoglobin 149g/n
erythrocytes 4.6
leukocytes 8.4
SHOE 2 mm/year
neutrophils 2%, 58%, eosinophils 3%, lymphocytes 28%, monocytes 9%, total protein 68.4, thymol test 0.88, total cholesterol 4.95, beta-liproproteins 3.1, total bilirubin 12.7, direct 1.4, AlAT 0.21, AsAT 0.28.
FGDS:
The mucosa is pale pink, hyperemic in the lower third, the Z-line is 40 cm from the incisors, the cardia closes.
In the stomach, a moderate amount of mucus, liquid, peristalsis is satisfactory, Mucous hyperemic in the antrum, pylorus rounded, duodenum without deformation,
PH-1.3, Helicobacter pylori test positive
Conclusion: reflux esophagitis LA:A, erythematous gastroduodenopathy (no stomach pain, no bloating, sometimes iron taste in the mouth in the morning, but rarely, sometimes nausea is weak)
Ultrasound of the gastrointestinal tract:
Liver: not enlarged, homogeneous, vascular system unchanged, intrahepatic bile ducts not dilated.
Gallbladder: dimensions V - 80x23, smooth contours, irregular shape, with an inflection, wall 2 mm, bile stasis.
Pancreas: dimensions 23x17x22, the echostructure is homogeneous, the contour is even, the echogenicity is preserved.
Spleen: normal, correct, size 108 mm, contour is even, echogenicity is preserved, vein diameter is 5 mm, Kidneys are not enlarged, homogeneous.
Thyroid:
Analyzes TSH 0.969 T4total 112.1, T3total 1.84, . Ultrasound of the thyroid gland - 16x14x42, left 15x12x43, the thyroid gland is not enlarged, the parathyroid glands are not visualized.
What could be the cause of such symptoms, reflux, or maybe the heart, maybe osteochondrosis, but the spine does not bother? How to treat all this and whether such symptoms are life-threatening. Help me please.
Heart rate is an important component that indicates the functioning of the body. During normal operation, a person does not feel muscle contraction. The sensation of pulsation in the region of the heart becomes noticeable for a number of reasons. In this case, control over the body may be lost, balance may be disturbed, and muscle weakness may be present. People with various pathologies of the cardiovascular system should know why the rhythm can go astray, what is the danger of such a manifestation and how to prevent the disease.
Causes
Each person feels a pulsation in the region of the heart with a different number of beats. Some observe at 100 contractions per minute, others only from 120 to 130 times. In medicine, there are several main causes of increased heart rate:
Most causes are not diseases. Pathological abnormalities that cause pulsation in the region of the heart are observed due to the influence of external factors. Physical activity, emotional experiences or addictions cause a rapid heartbeat. This is a normal reaction of the heart muscle. The body tries to provide enough blood to all organs and tissues. If a characteristic symptom occurs at rest, you should contact a cardiologist for a diagnosis. Such a sign is a deviation from the norm and indicates a failure in the work of the heart.
There are many reasons for the occurrence of tachycardia. It can be cardiosclerosis, myocardial dystrophy, arrhythmia. Disorders in the work of the endocrine or nervous system. Lack of iron in the body (anemia). Hypoxia, hypertension or congenital heart disease.
Symptoms
Attacks of increased heartbeat are often accompanied by concomitant symptoms:
- a person feels pain in the chest;
- there is a feeling of lack of air in the lungs, deep breaths are required;
- there is noise in the ears or completely in the head;
- pulsates in the region of the heart, in the temporal zone, in the fingers and toes, on the neck.
The above symptoms may be temporary or permanent. In case of periodic occurrence during stress or excitement, do not panic. The symptoms will go away on their own. If signs are observed without external factors of influence, it is required to consult a doctor. During normal functioning of the organ, pulsation should not be felt.
First aid
If a person for the first time observes the characteristic signs of frequent contraction of the heart muscle, or attacks occur very rarely, then you should be aware of the first steps to facilitate the work of the organ. First of all, it is required to provide fresh air access to the room (open the window, open the door, ventilate). Then release the neck and chest from squeezing clothes (remove the scarf, unfasten the collar). The face and neck are rinsed with cold water.
In the absence of access to water, you can wipe your face with a damp cloth. You should take a comfortable body position in which you can relax. The best option is to lie down and try to breathe evenly and deeply. If necessary, take special drugs that relieve an attack of tachycardia. Valerian infusion provides a good and quick result (20 drops of medicine are added to 50 ml of drinking water). Tincture calms the nervous system, lowers the heart rate.
Treatment Methods
To relieve an attack of heart pulsation, an eye massage is allowed. This procedure takes 5 to 7 minutes. It is necessary to attach the phalanges of the fingers to the closed eyelids and press a little, hold for 10 - 15 seconds, then release. Massage is carried out until the attack subsides.
As medicines, drugs based on herbs or chemicals are prescribed. Atenolol, Sedasen, Digoxin, Preductal are widely used. Among folk recipes, St. John's wort, hawthorn, motherwort, valerian are used. In cases of attacks of pulsation of the heart muscle, you should contact the doctor and find out the cause of the disease.
It is not recommended to self-treat and drink drugs uncontrollably. A serious approach to therapy will ensure recovery and prevention of relapse.
Inspection. There is no visible pulsation in the region of the heart, the base of the heart, the jugular fossa, and the epigastric region. Positive venous pulse, Mussy's symptom, "carotid dance" were not detected.
Palpation. The apical impulse is located 1.5 cm medially from the left mid-clavicular line, of medium strength, limited. The heart beat is not palpable.
Systolic and diastolic tremors are not palpable. Epigastric pulsation is palpated; it is due to pulsation of the abdominal aorta.
Percussion.Relative dullness of the heart:
Borders of relative dullness of the heart: right - on the right edge of the sternum (IV intercostal space); left - in the V intercostal space, 1 cm outward from the mid-clavicular line; upper - at the level of the III intercostal space along a line located 1 cm outward from the left sternal line.
The diameter of the relative dullness of the heart is 12 cm.
The width of the vascular bundle is 6 cm.
The configuration of the heart is normal.
Absolute dullness of the heart:
Borders of absolute dullness: right - along the left edge of the sternum; left - 1 cm medially from the left border of relative dullness of the heart; upper - at the level of 4 ribs.
Auscultation. Heart sounds during auscultation are muffled, rhythmic. III and IV heart sounds are not heard. Pathological cardiac and extracardiac murmurs are not heard. Heart rate (HR) 80 per minute.
Vascular examination
Examination of the arteries: moderate aortic pulsation in the jugular fossa, aortic pulsation to the right and left of the sternum is absent. The pulsation of the temporal, carotid, radial, popliteal arteries, arteries of the dorsal foot is not changed, rigidity, pathological tortuosity is absent.
Arterial pulse: the same on both radial arteries. The pulse rate is 80 beats per minute, rhythmic, moderate filling and tension. Arterial pressure 130/70 mm. rt. Art.
Digestive system
Oral examination:
1. The tongue is moist, covered with a white coating.
2. Teeth: dentures, etc. missing
Abdominal examination:
Pancreas: not palpable.
The abdomen is symmetrical, participates in the act of breathing. Abdominal circumference - 90 cm. There is no protrusion of the navel. There are no dilated saphenous veins. Scars, striae, hernial formations are absent.
Auscultation. Bowel sounds are not heard. Percussion
Over the entire surface of the abdominal cavity, a tympanic percussion sound is determined. Ascites is not determined by the fluctuation method.
Palpation. Superficial approximate palpation: the abdomen is soft, there is no pain, no muscle tension, the presence of a hernia of the white line, umbilical hernia was not detected. Shchetkin-Blumberg's symptom is negative. Superficially localized tumor formations are absent. Methodical deep sliding palpation according to Obraztsov - Strazhesko: the sigmoid colon is palpated as a painless, dense, smooth cylinder, about 2-3 cm in size, rumbling is not detected. Caecum: elastic consistency, painless, about 3 cm in size. Transverse colon: soft elastic consistency, painless, easily displaced, does not growl, size 5-6 cm. 2-3 cm in size, greater curvature and pylorus are not palpable.
urinary system
Inspection. When examining the kidneys in the lumbar region, redness, pain on palpation and a feeling of unsteadiness (fluctuation) were not detected. When examining the area of the bladder - swelling in the suprapubic region is not detected.
Percussion. Pasternatsky's symptom (tapping in the lumbar region) is negative on both sides.
Palpation. The kidneys are not palpated. On palpation in the kidney area, pain was not detected. The bladder is not palpable.
Endocrine system
There is no visible enlargement of the thyroid gland. On palpation, its isthmus is determined in the form of a soft, mobile, painless roller. There are no symptoms of hyperthyroidism or hypothyroidism. There are no changes in the face and limbs characteristic of acromegaly. There are no weight disorders (obesity, malnutrition). Skin pigmentation characteristic of Addison's disease was not found. The hairline is developed normally, there is no hair loss.
