In my career as a cardiologist, every day has been a new challenge and an opportunity to learn. Especially in the face of arrhythmias, I often encounter many impressive cases, which not only add to my clinical experience, but also deepen my understanding of this seemingly insidious but extremely threatening condition. Today, I would like to share with you a story about arrhythmia, which is not only a medical case, but also a reminder about first aid awareness.
Just last month, a middle-aged man was admitted to the hospital with a sudden heart attack and chest pain. He described working in an office when he suddenly felt his heart "pounding in his chest", accompanied by a feeling of difficulty breathing. With these symptoms in mind, we immediately performed an ECG on him, which showed that his heart was beating unusually fast and he was diagnosed with tachycardia. Through further detailed examination and history, we found that he had a long-term hypertension problem that he usually neglected to manage. After being given appropriate medication control and monitoring, his heart rate gradually returned to normal, and we subsequently recommended further cardiac rehabilitation guidance.
Tachycardia: When the heart beats faster
What is tachycardia?
Tachycardia is an abnormally high heart rate, which is about 60 to 100 beats per minute in adults, and tachycardia is when the heart rate exceeds 100 beats per minute. This may not sound like a big deal, but prolonged tachycardia can lead to a lack of blood supply to the heart, leading to more serious heart problems.
Common symptoms
Symptoms of tachycardia include, but are not limited to:
The sensation of heartbeat is visibly enhanced
Chest pain
Dizziness or fainting
dyspnea
Increased fatigue
Real Story: Mr. Lee's Story
Mr. Lee experienced more than just a racing heart that day. He also felt bouts of vertigo and pressure in his chest. After an electrocardiogram (ECG), I noticed that his ECG waveform was significantly abnormal, which is a typical tachycardia signal. We immediately gave appropriate medication and ordered further cardiac function tests to determine the specific type of tachycardia and possible triggers.
Dealing with tachycardia
The first step in the management of tachycardia is to identify and remove potential triggers, such as excessive caffeine intake, psychological stress, or other health problems. Medication usually involves the use of β-blockers or calcium-channel blockers, which can effectively control the heart rate and reduce the burden on the heart.
Coping strategies in the family
For patients like Mr. Lee, I often advise them to do some simple self-management at home:
Learn relaxation techniques, such as deep breathing or meditation, to reduce stress-induced tachycardia
Monitor your heart rate and track your heartbeat with a smartwatch or heart rate monitor
In the event of tachycardia, try the "Valsalva maneuver" (holding your breath and exhaling forcefully, as if blowing up a balloon), which can sometimes help regulate your heart rate
Tachycardia, although it can be tricky to manage, can be managed effectively by most patients with appropriate medical intervention and lifestyle modifications. If you or someone close to you has experience tachycardia, don't forget to seek medical attention early to find a treatment plan that works for you. Like Mr. Lee, timely intervention can help him regain a normal, healthy rhythm of life.
Bradycardia: A slow-moving alarm
Recognize symptoms of bradycardia
Bradycardia may not cause any symptoms, but when they do, they may include:
Fatigue easily
Dizziness or fainting
dyspnea
Chest discomfort
Memory or concentration loss
Practical strategies for dealing with bradycardia
When bradycardia is associated with symptoms, management strategies become particularly important. Here are the steps we took to deal with this patient:
Detailed evaluation of the history and physical examination: Confirm any underlying factors that may be contributing to bradycardia, such as an underactive thyroid or the use of certain medications (such as β blockers).
An electrocardiogram (ECG) is done: Confirm the type of heart rhythm and heart rate and look for other heart abnormalities.
Adjust medications: If the patient is taking medications that slow the heart rate, consider adjusting the dose.
Pacemaker fitting: For those who have severe symptoms due to bradycardia, a pacemaker may need to be implanted to maintain an adequate heart rate.
Patient feedback
Through this series of diagnosis and treatment measures, the patient's quality of life has improved significantly. He no longer experienced dizziness and was able to participate more actively in his daily activities. This case highlights the importance of timely diagnosis and personalized treatment planning.
Bradycardia can be an alarm that we need to pay more attention to our body. By understanding basic information about bradycardia and strategies for coping with it, we can better protect our heart health. Seeking professional medical help in the event of any doubts or symptoms is key to staying healthy.
Diagnostic approach to arrhythmias
The role of electrocardiogram (ECG).
An electrocardiogram (ECG) records the electrical activity produced by the heart each time it beats. With an electrocardiogram, doctors can see if the heart's electrical activity is normal, whether the heartbeat is regular, and how fast the heart is beating. The results of an electrocardiogram can help doctors determine if the heart is tachy, brady, or other types of arrhythmias. For example, ventricular fibrillation appears as a series of rapid, irregular fluctuations on the ECG, whereas atrial fibrillation appears as a rapid rhythm without a pronounced P wave.
24-hour Holter monitoring
For intermittent arrhythmias, a single ECG may not be able to catch the abnormality. At this point, your doctor may recommend 24-hour Holter monitoring. This method of monitoring involves wearing a small ECG recording device that continuously records the heart's electrical activity for a day. This can help capture any arrhythmias that the patient is experiencing during daily activities.
Cardiac ultrasound
An ultrasound of the heart is a painless procedure that uses sound waves to capture images of the heart. This method can help assess the structure and function of the heart, such as the movement of the heart valves, the size and function of the ventricles. Cardiac ultrasound is very useful for determining the cause of arrhythmias, such as structural abnormalities in the heart.
Stress test
In some cases, your doctor may recommend stress testing if the arrhythmia may be related to physical activity. As people exercise on a treadmill or bike, doctors monitor the heart's response. This test helps assess whether the heart develops arrhythmias during a state of stress.
With these diagnostic tools, doctors can fully assess the patient's heart rhythm status and develop an appropriate treatment plan accordingly. Whether it's through initial screening on an ECG or an in-depth examination through Holter monitoring and cardiac ultrasound, these methods work together to ensure that patients receive an accurate diagnosis and timely treatment. When detecting signs of arrhythmias, seeking medical attention and having these tests done is a smart action that everyone should take.