Reviewed by: Ming Chu (Jiangsu Provincial People's Hospital)
The most feared thing in life is to meet a deadline, racing against the clock, nervous and exciting, feeling that the next second the heart is going to jump out, "poof, poof, poof"...
A 9-year-old little girl in Hangzhou Xiaoyue was at home in a hurry to rush to work, suddenly felt a heartbeat like a wild horse out of reins, the examination found that the heart beat 30,000 times in one day, so that the doctors on duty were nervous...
A few months ago, Xiao Yue had a cold, fever and nasal congestion and runny nose for a while, but often felt palpitations inexplicably.
When I went to the hospital for a check-up, I found that Xiaoyue was a frequent ventricular premature beat, and there were more than 30,000 ventricular premature beats in the heart 24 hours, and the doctor prescribed some arrhythmia drug treatment.
Unexpectedly, in late August, Xiaoyue rushed to catch up with summer homework, rushing day and night, "panic disease" was committed again, even drugs were difficult to control, and finally the doctor took radiofrequency ablation to cure her premature beat.
"Early beat" is a disease that appears more and more in young people, but is not easy to detect.
Is it directly related to heart disease? Why do some people have premature heartbeats and don't find out for themselves?
What does it feel like to beat early?
We all know that normal heart beats are rhythmic, and the swirling and jumping ECG wavy lines are the best testimony, probably: bang ~ ~ da ~ ~ bang ~ ~ ~ jump, stop, jump, stop.
And "early beat", that is, the early beating of the heart, jumping in advance where it should stop.
It is probably: bang ~ ~ da ~ ~ ~ ~ ~ ~ ~ da ~ ~ ~ jump, stop, jump, jump ahead of time, extend the time to stop.
(Source: soogif)
People will feel a panic in between heartbeats, or it may be like the heart suddenly "clucking" and sinking. When severe premature beats occur, some people will also be accompanied by "chest tightness" or even "asthma".
And some friends who found out "early beats" during the physical examination are confused, as if they have not had these feelings?
Yes, everyone doesn't always feel the same when a heart beats prematurely, depending on individual sensitivity.
Some people are insensitive to premature beat symptoms, especially for children, and some people can't even get out of bed after premature beats.
Also consider the factor of tolerance, what does it mean? If the person's premature beats always exist, and the time period is long, there will be a feeling when symptoms first appear, and then slowly get used to it, and this feeling of early beats is not obvious.
Does premature beating in the heart necessarily have to be heart disease?
Heartbeat is a major event in life, suddenly stop jumping, is it heart disease?
The human heart is a very powerful muscle pump, and the size is about the size of your fist when you clench your fist.
It has left and right sides inside, each side with two upper and lower atrioventricular cavities. The upper part is called the atrium, and the lower part is called the ventricle. The atrium stores blood, and the ventricles are responsible for pumping blood out of the heart.
Image source: Tencent Medical Code
In the upper right corner of our right atrium there is a big man called "sinus node", which can send a normal heartbeat signal and transmit to the entire heart muscle, and is a commander-in-chief!
But just as the so-called "soldiers who don't want to be generals are not good cooks", there are always some troublemakers who want to usurp power and seize the throne and exploit loopholes in their hearts, and their appearance will make the heartbeat signal abnormal.
Therefore, when there is a special part of the heart that robs the command of the sinoatrial node, it sends a signal in advance, and there is an early beat, which is located on the atrium, we call it "atrial premature beat" (referred to as atrial morning beat), and if it is located on the ventricle, it is called "ventricular premature beat" (referred to as ventricular premature beat), which is located at the junction, that is, the atrioventricular junction premature beat.
Why is it that if we are good, there will be troublemakers who beat early on our hearts?
Premature beats can occur in normal people, sometimes just temporary excitement, to scare you.
High mood swings: tense, anxious times
Physical fatigue: there is no rest well, when the body is overdrawn
Excessive alcohol consumption: Alcohol consumption may also induce premature beats
Drug effects: Taking certain medications, such as antidepressants, antibiotics, etc., can also induce premature beats
Electrolyte disorders: diarrhea is severe, a large number of diuretics and other electrolyte disorders, such as low potassium, low magnesium can cause premature beats
In addition, premature beats can sometimes indicate severe disease.
People with organic heart disease will have premature beats, such as hypertensive heart disease, coronary heart disease, pulmonary heart disease, heart valve disease, and endocrine disease Hyperthyroidism, etc. can cause premature beats, especially like myocardial infarction, myocarditis, cardiomyopathy and other serious damage to ventricular muscle function diseases are more likely to cause premature ventricular muscle function.
What tests should be done to confirm the diagnosis?
Occasionally there are a few times of heart clucking, or a feeling of panic, do not be too nervous, as mentioned above may be caused by emotional agitation, tobacco, alcohol and coffee, etc., the heart has no organic lesions, rest well, the mood calms down and the early beat will naturally disappear [1].
Image source: Stand Cool Helo
However, if it often clucks and giggles, affecting normal life or work, it is still recommended to go to the cardiologist to do a record of heartbeat and other examinations.
The common electrocardiogram and holter electrocardiogram, which are generally well known, can only record the ventricular early onset during the examination.
If the chamber does not have a seizure during this period, it will not be detected no matter how many times it has had previous seizures.
Therefore, many friends usually do not feel anything, but after doing an electrocardiogram examination during a physical examination, they found that they had early beats, because during the examination, your premature beats occurred, and they were also captured
Doctors generally recommend another 24-hour Holter, electrodes attached, and a small thing called Holter in their clothes for further observation.
It's a portable Holter monitor that can be "packed" at any time ~ it can continuously record how many times your heartbeat has occurred in total in a 24-hour period, and what kind of premature beats it is, and by the way, it can also monitor whether other arrhythmias are present at the same time.
Continuous recording also provides a reference for the next diagnosis or treatment, or the administration of antiarrhythmic drugs, radiofrequency ablation or pacemaker implantation in those with indications for surgery [2].
Young people who are overdrawn, pay attention!
Emotional excitement, nervous tension, fatigue, excessive smoking and drinking, etc., are one of the important triggers for the occurrence of premature beats, so look down, many urban young people have been recruited?
@from Jane Yang: I am 26 years old, recently worked overtime and stayed up late, always feel chest pain ~ ~
@ Girl: Hey, every day 996, but also sulking, panic can't do it, I'm afraid of sudden death!
The overdrawn weak body will cause "heart tiredness", once encountered virus invasion, such as viral cold, etc., and then accelerate the development of the disease and even destroy the body, the common "sudden death" in the news is not impossible!
Of course, premature beats do not all mean that there is a problem with the heart, but it gives you a tip to pay attention to protecting the heart!
So, all you have to do is find the trigger and prescribe the right medicine.
For example, if you have an early beat after staying up late at night and lack of sleep, then hurry up to make up for sleep. If you are restless, then tell yourself that the body is the most important, calm the mood; if you drink too much, then quit drinking ~ ~ find the cause, naturally can be targeted to prevent early beats!
Of course, physiological premature beats can be completely normal exercise! Healthy lifestyle can not be lost ah ~ and for pathological premature beats need treatment, then listen to the doctor, maintain a good attitude!
Seeing this, it is estimated that many friends have buzzed in their brains: It's over, my heart just seems to have that feeling.
Cough, don't scare yourself! Your early beat may not be, "heart disease" is a bit ~~
Finally, here's a knock on the blackboard summary:
Normal people almost all have premature beats. It's small in number and barely felt.
Premature beats are more frequent: thousands of times, or even 10,000 or 20,000 times, if there is no symptom, you can follow up after examination, take medication or adjust your lifestyle.
If the symptoms are more obvious, the drug can not be controlled, or the number is particularly large, affecting the heart function, or there are obvious underlying diseases, such as coronary heart disease, etc., can be treated by radiofrequency ablation, a considerable proportion of patients can be cured!
bibliography:
[1] Chan AK, Dohrmann ML. Management of premature ventricular complexes. Mo Med. 2010; 107(1):39-43
[2] Cardiac Electrophysiology and Pacing Branch of Chinese Medical Association, Cardiology Committee of Chinese Medical Doctor Association. Chinese expert consensus on ventricular arrhythmias. Chinese Journal of Cardiac Pacing and Electrophysiology. 2016; 30(4):283-325.
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