Heart failure periodically occurs in healthy people under the influence of stress or meteorological factors. Pathological causes: symptom - rhythm and conduction disturbances (extrasystole, AV blockade, bradycardia), vegetovascular dystonia, taking certain cardiotropic drugs. For diagnosis, instrumental methods are used - EchoCG, ECG, MRI and radiography, laboratory studies - assessment of markers of myocardial necrosis, analysis of acute phase parameters, lipid profile. Antiarrhythmic, metabolic, anti-inflammatory drugs are used to relieve the condition.
Short-term discomfort in the precordial region is possible with a strong fright, which is an absolutely normal situation. After the elimination of the provoking factor, the unpleasant sensations disappear without a trace. Single extraordinary heart contractions, which are clinically manifested by fading, are observed in 5-15% of absolutely healthy people. Their onset is provoked by nervous or physical overstrain, a sharp change in the weather.
This type of arrhythmia most often causes heart failure. Patients describe their sensations as a momentary "cardiac arrest" or talk about missing one heart beat. Given the type of extrasystole, the symptom can be single or repeated several times in a row. The most dangerous condition is when fading is felt in the form of regular episodes that follow after every 2-3 heart beats.
The symptom is accompanied by a sharp deterioration in the condition. Patients complain of sudden dizziness, weakness, shortness of breath. Fading of the heart with extrasystoles is characterized by a feeling of anxiety, lack of air. The skin becomes very pale or reddened. Depending on the etiological factor, extrasystole of functional, organic and toxic genesis is distinguished.
Fading of the heart is felt with atrioventricular blockade, when the conduction of excitation from the atria to the ventricles is disturbed. With 1 degree AV block, these symptoms are very rare. Small pauses in cardiac contractions are characteristic of blockade of the 2nd degree. The most pronounced fading of heart contractions is at grade 3 of the disease, when the atria and ventricles work in different rhythms.
A combination of a symptom with constant weakness, a decrease in working capacity and physical activity is characteristic. Fading is accompanied by severe dizziness and shortness of breath, sometimes the attacks end in fainting. Clinical signs do not depend on the nature, activity and time of day. AV blockade occurs in congenital heart defects, organic myocardial damage, and intoxication.
Heart failure is a common manifestation of bradycardia. The symptom, unlike extrasystoles, is not a single one, but lasts for several hours or days. If a person listens to his feelings, he notices that the heart begins to beat much less frequently. In this case, uniform long pauses arise between beats, which are interpreted as fading.
Bradycardia is manifested in a number of cardiac diseases: coronary heart disease, myocarditis and pericarditis, congenital and acquired defects. A short-term decrease in the rhythm is observed with reflex action - a blow to the neck or chest, being in very cold water, squeezing the neck with a tie or tight collar. Bradycardia occurs with hypothyroidism, fulminant hepatitis, hyperkalemia.
With VVD, the symptom develops due to violations of the nervous regulation of the cardiovascular system. Fading is more often noted with excitement, fear, stress. For vegetative-vascular dystonia, short-term interruptions in the work of the heart are characteristic, which are then replaced by tachycardia. Symptoms are supplemented by shortness of breath and weakness, dizziness, excessive sweating.
Complaints of a sinking heart are a typical symptom of a masked form of depression. Symptoms usually appear in the early morning hours. In addition to fading, patients complain of nagging pain, discomfort, an unreasonable feeling of fear - the so-called "precordial longing". During the day and in the evening, these manifestations are not so intense or disappear altogether. With masked depression, other complaints are also disturbing: sleep disturbances, hypochondriacal and panic disorders.
Many drugs that are used to treat cardiac patients can cause arrhythmias. Failing of the heart often provokes the intake of beta-blockers, cardiac glycosides, diuretics. A decrease in the rhythm, combined with unpleasant sensations in the work of the heart, is observed with an incorrect dosage of calcium and potassium solutions, which is accompanied by the development of hyperkalemia.
Even if heart failure is a rare episode, it serves as a reason for contacting a cardiologist. Percussion can be determined by the expansion of the boundaries of the heart. During auscultation, the deafness of heart sounds, the presence of functional or organic noises are heard. To find out the cause of the symptoms, the doctor needs to obtain data from instrumental and laboratory research methods. As a rule, apply:
When a sinking heart appears, a person should immediately sit down, take a comfortable position. With rare heart contractions, it is better to lie on your back, slightly raising your legs. Fresh air must be provided by opening a window or door. Usually the state of health is normalized in a few minutes. If the patient feels worse, complains of pain in the precordial region or fainting, urgent medical attention is required.
Effective treatment can be started only after establishing the causes that provoke heart failure. Patients with severe illness receive intensive parenteral therapy in a hospital or intensive care unit, but in most cases outpatient treatment is sufficient. To eliminate the root cause of the symptom, normalize the work of the heart and regulate the rhythm of heart contractions, prescribe:
Surgical interventions are indicated only for diseases refractory to conservative therapy. In case of life-threatening arrhythmias, the pathological focus of excitation in the conduction system of the heart is destroyed, and antitachycardiac devices are implanted. To normalize the heart rhythm, temporary or permanent ventricular electrical stimulation is used.