Short misfires or stumbles of the heart have been experienced by almost everyone. These so-called extrasystoles can occur for no apparent reason, but also in stressful situations. While they are usually harmless and disappear quickly, in other cases they can be the harbinger of serious heart disease. In such cases, appropriate treatment of the extrasystoles becomes essential.
What are extrasystoles?
Behind heart stumbles are usually rhythm disturbances of the heart in the form of extra beats, the so-called extrasystoles. Extrasystoles describe a grouping of cardiac arrhythmias that are also known in medical terminology by the abbreviation ES. They are characterized by so-called extra heartbeats, which are outside the regulated heart rhythm. These extra heartbeats originate from the ectopic excitation center of the atrium, the HIS bundle, the AV node or the ventricle, and thus not from the so-called sinus node of the heart as conventionally. As a rule, the normal rhythm of the heart is not affected by the extrasystoles, since these occur in the form of interpolated extrasystoles merely in addition to the regular heartbeat. In certain cases, however, extrasystoles also cause the onset of a pause. This so-called postextrasystolic pause continues until the normal heart rhythm resumes.
Causes
Extrasystoles occur when a disturbance occurs within the stimulus propagation in the heart. As a result of this disturbance, the ventricle and atrium of the heart work against each other for a short period of time, causing a noticeable, momentary cessation or stumbling of the heart. Disturbances from the atrium are called supraventricular extrasystoles, SVES for short, while disturbances in the ventricle develop as ventricular extrasystoles, VES for short. A variety of possible triggers exist for both types of extrasystoles. For example, both positive and negative stressful situations or emotions can cause a heartbeat. Likewise, overtiredness favors the development of extrasystoles. A deficiency of certain minerals such as potassium or magnesium, on the other hand, can cause the heart to stop beating for a short time. Excessive alcohol or drug consumption, as well as the use of specific medications such as antidepressants, can also cause extrasystoles. Other possible conditional factors represent caffeine and nicotine. Furthermore, extrasystoles may also occur in the context of health problems, which primarily include thyroid dysfunction or hormonal changes during pregnancy or menopause.
Symptoms, complaints, and signs
Depending on the type of extrasystoles, the course of the disease shows different symptoms. Supraventricular skips of the heart are hardly noticeable for the affected person, because the atrium still beats evenly to the ventricle here. In contrast, ventricular extrasystoles show different signs in the affected person, in that the misfires are felt in the throat or abdomen in the form of an unpleasant sensation. If the extrasystoles occur particularly frequently, they can also trigger dizziness or anxiety in the affected person in rare cases.
Complications
Usually, extrasystoles progress without complications and thus do not pose a major health risk. However, in clustered episodes, they represent an indication of the presence of severe cardiac damage. Extrasystoles that occur within the electrical conduction of impulses in the heart are considered particularly dangerous. They can cause ventricular fibrillation. If several extrasystoles occur in succession, they may reflect a precursor of severe cardiac arrhythmias. If cardiac dropouts and their causes are not treated, the risk of irreparable heart damage increases dramatically. Thus, external causes of the dropouts may condition a permanent cardiac arrhythmia. In conjunction with severe anxiety, vegetative dystonia may also develop as a result of cardiac stumbling, which means a malfunction of the autonomic nervous system.
When should you see a doctor?
Even though extrasystoles are usually harmless in nature, if certain factors are present, a visit to the doctor is essential. For example, if the extrasystoles manifest themselves over several minutes or whole hours, affected persons should consult a specialist immediately.Furthermore, medical advice must be sought in the event of accompanying symptoms such as shortness of breath, dizziness or impaired consciousness. In these cases, the extrasystoles have often already developed into cardiac arrhythmias, which in turn can result from serious vascular and cardiac diseases such as high blood pressure, atrial fibrillation, heart muscle inflammation or heart valve defects. The cardiologist, who specializes in the medicine of the heart, is considered to be the right person to contact if there are signs of cardiac strokes. If the extrasystoles are associated with extreme pain and a tremendous feeling of pressure in the chest area, urgent help in the form of an emergency physician must be obtained, as this may be a heart attack.
Diagnosis
To diagnose extrasystoles, the electrocardiogram, or ECG, is predominantly used during a medical examination. This instrument makes it possible to distinguish between pathological heart stumbles and progressive cardiac arrhythmias. For this purpose, it records the patient’s cardiac currents with the aid of electrodes, from which the time, location and degree of the extrasystoles can be determined. However, if a heartbeat occurs only sporadically, the ECG is usually unsuitable as a diagnostic tool. In this case, 24-hour ECGs can provide more accurate information about the individual type of extrasystoles. If the device measures more than 10,000 extrasystoles in a single day, the present cardiac stutter is considered to be in need of treatment. In addition, an exercise ECG enables explicit diagnostic results to be obtained by deliberately provoking cardiac stops through exertion. To do this, the patient must perform special fitness exercises on a bicycle ergometer or treadmill before his or her heartbeat and blood pressure are measured. Finally, echocardiography is also a suitable method for accurately detecting extrasystoles. This describes an ultrasound examination of the heart in which cross-sectional images of the organs and tissues are created. Subsequently, the attending physician can assess the image for the presence of certain features.
Treatment and therapy
The treatment method for extrasystoles depends on their particular cause. If there is no pathological cause of the heart stutter, therapy is not mandatory. In this case, there are often only ventricular extrasystoles in the affected person, in which the heart is basically working healthily. If the dropouts still bother the patient, treatment can be resorted to. In this context, the cardiologist usually prescribes low-rated beta blockers, since the ventricular extrasystoles often occur due to stress. If, on the other hand, the heart palpitations develop as a result of a disease, the treatment of this disease comes to the fore. For this purpose, drugs such as beta blockers are usually used to relieve the heart. Their mode of action is based on their blood pressure-lowering and stabilizing function. The use of certain antiarrhythmic drugs is also conceivable. Once thyroid dysfunction has been identified as a causative factor in cardiac stuttering, treatment with medication is also required. In the case of narrowed vessels, again a stent is used, which represents an implant for opening vessels and hollow organs. However, not all types of extrasystoles respond to this or a drug therapy form, so that the implementation of a so-called catheter ablation is considered as a further treatment approach. In advance, examination results must show that the conduction disturbance originates from a specific location in the heart. In the course of a catheter ablation, the treating surgeon then places a catheter at the disturbed site of the heart. The special site is then heated and obliterated by a radiofrequency current of about 65 degrees. After the procedure, the catheter is removed and the remaining wound is dressed with a pressure bandage. If the diagnosed cause of the extrasystoles poses a risk of sudden cardiac death, the affected person is often fitted with a defibrillator, which independently detects dangerous disturbances in the heart rhythm and terminates them via an electric shock.
Outlook and prognosis
The prognosis of extrasystoles depends on the nature of their occurrence and individual treatment. Only short-lasting dropouts, for example, are considered to have a good prognosis because the heart’s rhythm stabilizes independently in these cases.The prognosis is more negative for frequent extrasystoles that occur several times a day. This is because these heart stumbles are a possible precursor to serious cardiac arrhythmias. Thus, extrasystoles can develop into atrial fibrillation, which causes irreparable damage to the heart muscle without appropriate treatment. If frequent heart palpitations are due to a deficiency of certain minerals, the extrasystoles will quickly heal on their own if the deficiency is corrected. The prognosis is worse in the presence of concomitant symptoms such as dizziness, high blood pressure or impaired consciousness, as external or organic factors may be the cause of the extrasystoles. In this case, a persistent cardiac arrhythmia may develop in the affected person if treatment of the cardiac irregularity and its causes fails to occur. In turn, if the dropouts are associated with severe anxiety, there is a risk of vegetative dystonia, which without treatment means an unfavorable prognosis for the extrasystoles.
Prevention
Extrasystoles can be caused by a variety of different factors, which can often be specifically prevented by adherence to certain principles. Crucial to the absence of extrasystoles is a healthy lifestyle. This should be characterized primarily by regular exercise and a balanced diet. In particular, very fatty and sweet foods should be avoided as far as possible. In the case of overweight, this must be urgently reduced in order to come closer to a healthy lifestyle. In addition, the daily drinking intake must always be adequate. Also sufficient sleep and rest phases are indispensable for an optimal prevention of heart strokes. It is also beneficial to avoid or reduce harmful substances such as caffeine, tobacco and alcohol. The use of drugs should be completely avoided. It is also useful to minimize stressful situations in everyday life and at work, which can be promoted by learning special relaxation methods for self-control. Through this, future stress factors can be specifically avoided.
Aftercare
The options for aftercare prove to be very difficult with extrasystoles and are not available to the affected person in most cases. The patient must have this cardiac complaint treated by a physician in the first instance to prevent further complications and, in the worst case, death. For this reason, early diagnosis of the extrasystoles is very important. In most cases, those affected by this condition have to take medication. It is important to take these medications correctly and regularly to avoid further heart problems. If there are any unusual feelings in the heart, a doctor must be consulted immediately. In general, a healthy lifestyle with a healthy diet also has a positive effect on the course of this disease. The affected person should also not smoke and likewise not consume alcohol. If the extrasystoles are treated by surgery, it is advisable for the affected person to rest and take care of his body after this procedure. The patient should refrain from exertion or other stressful activities. It is possible that the extrasystoles may limit the life expectancy of the affected person.
Here’s what you can do yourself
If the cause of the extrasystoles is not dangerous, a variety of measures exist that can already be used to curb the heart palpitations independently. For example, consumption of harmful substances such as nicotine, alcohol, or caffeine should be significantly reduced. The introduction of sufficient sleep and rest phases is also useful in counteracting existing extrasystoles. The same applies to relaxation methods such as meditation or autogenic training. It is important to consistently take prescribed medications for blood pressure, thyroid or heart to allow them to work successfully in the presence of extrasystoles. Finally, the consumption of special medicinal plants and herbs can also reduce the occurrence of heart palpitations by balancing out stress. Medicinal plants include valerian, nettles, lavender, lemon balm, St. John’s wort, hops and passion flower. These can be consumed in the form of tea or tablets and calm not only the heart but also the entire circulation of the affected person.
