LOWN Classification | Extrasystoles (tripping of the heart)

LOWN Classification

Simple VES Complex VES

  • Grade I: Monomorphic VES under 30 times per hour
  • Grade II: Monomorphic VES over 30 times per hour
  • Grade III: Polymorphic VES
  • Grade IVa: Trigeminus/Couplets
  • Grade IVb: Salvos
  • Grade V: “R-on-T phenomenon

Symptoms of ventricular extrasystoles

As in SVES, ventricular extrasystoles often lack symptoms. In some cases, a feeling of a heart stumble can occur. In the case of prolonged trigeminal or volley phases, a drop in the stroke volume of the heart may occur.Since the pause, which lies between two normal potentials and during which the heart fills with blood, is shortened by the extrasystole, the volume ejected by the heart is reduced. This can result in a short-term reduction in blood flow to the brain, which can lead to dizziness or even brief syncope (fainting spells).

Causes of ventricular extrasystoles

The occurrence of ventricular extrasystoles is usually an expression of damage to individual cells of the heart muscle, thus often indicating heart disease, e.g. coronary heart disease or cardiac insufficiency. They rarely occur in healthy hearts. The term “Holiday-Heart” syndrome refers to acute cardiac arrhythmia, which can occur, for example, after a weekend or vacation with increased to excessive alcohol consumption.

The reason why alcohol promotes cardiac arrhythmia and heart stumbling is not exactly clear. So far, only one study has proven that there is a clear connection. Which alcoholic beverages are worse and which are less harmful to health was not determined.

Several theses were put forward to explain the connection. Experts suspect that alcohol stimulates the sympathetic nervous system – the activating system – and inhibits the parasympathetic nervous system – the relaxing system – thus increasing the pulse rate and promoting damage to heart muscle cells. The dehydrating effect of alcohol (increased urination while drinking alcohol) disturbs the electrolyte balance of our body and could also be the reason for rhythm disturbances of the heart tissue.

Under the influence of alcohol the blood pressure increases – the development of high blood pressure (hypertension) and chronic heart failure is promoted. These illnesses are often the cause of heart stumbles or other cardiac arrhythmia. To a small extent, however, alcohol also has a protective effect on the cardiovascular system, if one can believe studies that have dealt with this topic.

However, a responsible approach to alcohol protects consumers from undesirable side effects and permanent damage. Under physical exertion, such as hard work or sport, the human organism is put into an activated state. In the process, the sympathetic nervous system, a part of the autonomic nervous system, is activated: blood pressure increases, the pulse rate speeds up, vessels constrict and the bronchial tubes of the lungs dilate to ensure stronger breathing.

The body prepares itself for a fight or flight through this stress reaction. This reaction is intended to protect the person from a potentially dangerous situation and to ensure the optimal use of physical abilities. As a result of these changes, however, unwanted breathing difficulties and dizziness, but also palpitations and heart palpitations can occur.

Particularly in people with poor general condition or poor fitness, too much strain from hard work or sport can lead to unpleasant symptoms. Except for the stress caused by physical activities, the organism can also be strained during illness. Serious illnesses weaken the organism and sensitize the patient to his or her own physical sensations.

This can lead to an increased perception of heart palpitations. In addition, inflammation of the heart or the pericardium can occur, which can also cause cardiac arrhythmia. Extrasystoles during or after sport can have various causes and are sometimes also promoted by sport.

On the one hand, there is a relative lack of oxygen in the tissue during exercise due to the increased consumption. This can promote heart stumbling. On the other hand, the sympathetic nervous system releases more adrenaline during sports activities.

Adrenaline makes the heart beat faster and stronger. It also lowers the excitation threshold that must be overcome to trigger a heartbeat. This lowered threshold therefore makes it easier to trigger another heartbeat, making it easier for an extrasystole to occur.

It is therefore possible that the heart beats too often for a short period of time, causing a heart stumble. Furthermore, a lack of magnesium and potassium can be responsible for extrasystoles during or after exercise. Taking a magnesiumpotassium mixture often helps here.

In many patients the extrasystoles then disappear again.If, however, other symptoms such as dizziness, feelings of fainting or unusually high pulse rate increases during sport are observed, a doctor should urgently be consulted. Diagnostic means such as resting ECG, exercise ECG and a heart ultrasound can provide information about the health status of the heart. The common cold is a fuzzily defined term for an infectious disease caused by viruses.

These can be very different viruses. The course of the disease can be further complicated by a bacterial infection, which can also occur. The respiratory tract is particularly affected by the common cold, especially the nasal mucous membranes, throat or bronchial tubes.

Patients often complain of pain in the throat and when swallowing, an accompanying cold that can be accompanied by a feeling of pressure in the head, as well as headache and aching limbs. They may also experience feelings of weakness and exhaustion. In some cases fever also occurs.

During an infectious disease the body is therefore under increased stress. As a result, during an infectious disease, extrasystoles may occur more frequently, which can be perceived by the sufferer as a heart stumbling. During a cold, sufferers often have a heightened perception of physical complaints and are more likely to notice extrasystoles.

If heart stumbling and breathing difficulties such as shortness of breath occur more frequently after the disease has healed, it is possible that heart muscle inflammation is present and is responsible for the symptoms. Since the stomach and heart are very close to each other, they can also influence each other. For example, stomach complaints can also cause heart stumbling and other heart complaints.

The diaphragm separates the heart and the stomach spatially from each other. If there is a diaphragmatic hernia, the stomach can slide up into the chest and displace the heart. This happens mainly after meals.

This displacement affects the function of the heart and can cause a stumbling heart, a pulse that is too fast (tachycardia) or a feeling of tightness in the chest (angina pectoris). This special form of diaphragmatic hernia and the resulting heart symptoms are also called Roemheld Syndrome. Besides a diaphragmatic hernia, Roemheld’s syndrome can also be caused by excessive eating, strong gas production from bloated food (e.g. cabbage) or lactose intolerance.

To treat the syndrome, one should in any case take care not to eat food that bloats the stomach and intestines (depending on which foods are not tolerated) or not to eat excessively. If a diaphragmatic hernia is the cause, surgery may have to be considered. Back problems – especially in the area of the cervical spine but also in the thoracic spine – can also cause heart stumbling.

This is because the nerves of the sympathetic nervous system (vegetative nervous system), which control the heartbeat, run close to the spine. If these are irritated or injured, they can be misdirected and trigger, for example, extra beats and thus heart stumbling. If blockages occur in the area of the thoracic spine, the thorax can become constricted.

If the thorax is not mobile, the heart can also suffer and be displaced or constricted. This irritation can then be the cause of the heart stumbling. Even if back problems or blockages in the spine have been detected, a direct heart problem that could cause the heart stumbling should be ruled out by the doctor.

Persons affected by a heart stumble report that their heart stumble is dependent on the location and position. It can appear and disappear again depending on the position. In these persons, the heart stutter probably occurs mainly when lying down, but activities such as bending down or rapidly changing position are also mentioned.

The position on the left side is mentioned particularly frequently, which, according to those affected, leads to perceptible heart stumbling, which can also disappear again after repositioning. Causes for the fact that the heart stumbling can occur depending on the position and especially when lying down cannot often be exactly limited. Possible explanations for position-dependent heart flutter could be provided by the spinal column.

Nerve fibres arise between the 2nd cervical vertebra and the 4th thoracic vertebra, which can influence the activity of the heart.In the case of spinal problems between these vertebrae, but especially between the 2nd and 4th thoracic vertebrae, functional heart complaints can be observed relatively frequently, for example intermittent cardiac arrhythmia, which can be accompanied by heart stumbling. If a cardiac stumbling is repeatedly perceived while lying down, the heart should definitely be examined. In most cases, however, these are harmless extra beats that can occur from time to time in everyone.

Another important and frequent cause of heart flutter can be stress. This is based on the physical stress reaction with which the person reacts to high mental and physical stress. During a stress reaction the vegetative nervous system is activated – the system that unconsciously controls physical reactions.

It is characterized by the sympathetic and parasympathetic nervous systems. If the body is under stress, the sympathetic nervous system is active. Increased adrenaline and other stress hormones are released.

Adrenaline not only makes the heart beat stronger and faster, but also makes it react more easily to stress hormones, making it easier to trigger a new heartbeat. This can ultimately lead to extra beats. These are then perceived as heart stumbles.

Heart flutter does not always occur under stress and not in every person and can sometimes occur in healthy people. Therefore a heart stumbling is completely normal from time to time. However, if the heart flutter persists for a longer period of time, the stress should be reduced and a doctor should be consulted who can rule out an organic cause.

The function of the stress hormones is basically to adapt the body to increased stress and to provide stored energy reserves to prepare the person for a fight or flight. In doing so, they influence various organs of our body, including the heart. They inhibit digestion and salivation, dilate the bronchial tubes of the lungs to make breathing easier under high stress and constrict the blood vessels.

At the heart there is increased blood pressure and accelerated heartbeat. In this context, breathing difficulties, dizziness, palpitations and even heart stumbling can occur. Studies have shown that high levels of adrenaline in the blood can promote the occurrence of extrasystoles and the associated heart stutter.

Furthermore, physical and psychological stress can affect sleep patterns and recovery. People under stress may also suffer from sleep disorders or sleep deprivation and exhaustion. Mental stress factors can be, for example, the workplace, great responsibility, conflicts with the partner or the social environment, serious events such as the death of a relative, or financial problems and can be perceived as very stressful.

Physical stress, such as a serious illness or other situations that place great strain on the body, can also trigger a stress reaction. In particularly stressful phases, it can help to actively relax in order to avoid damage to the body and to be able to deal with the stress better. It has been shown that these factors are also related to heart stumbling and can promote the occurrence of heart stumbling.

The high consumption of coffee and the caffeine contained in it, which is often associated with stress, can also promote the occurrence of heart flutter. In the long term, long-term exposure to stress can be harmful to the heart. In addition to the heart stumbling, in the long term there is a chronically high blood pressure and deposits in the blood vessels, the so-called arteriosclerosis.

This in turn increases the risk of dangerous secondary diseases such as heart attack or stroke, which can be fatal in the worst case. Heart stumbling can also be caused by drugs that affect the heart. These include various drugs such as digoxin, a still rarely prescribed drug for chronic heart failure, the so-called tricyclic antidepressants, or drugs such as cocaine.

You should always consult a doctor to find out exactly which drug is responsible for the heart stuttering and not stop taking the drugs of your own accord. Heart muscle inflammation, damage to the heart valves and other heart diseases can also be causes of heart stumbling, as can magnesium and potassium deficiency.Menopause is the time when a woman goes from a sexually mature state to a hormonal dormant state and loses her fertility. During this time, there are strong hormonal changes that have direct effects on the woman’s body.

Since many women have always been healthy before, the newly appearing symptoms are often shocking and disturbing. A number of symptoms that are characteristic of the changeover phase, such as hot flushes, sleep disturbances and irritability, include cardiac arrhythmia. Often, the mood swings caused by the hormone reduction mate with heart flutter and can trigger anxiety and panic attacks.

These heart complaints can also manifest themselves as palpitations, palpitations or heart palpitations. Due to the steadily decreasing oestrogen level, which is caused by the reduced production by the ovaries, an unusual oestrogen deficiency occurs. This hormone deficiency mainly affects the autonomic nervous system.

Since the autonomic nervous system controls the heartbeat, an extra beat can therefore occur from time to time, which is perceived as a heart stutter. Since in rare cases organic damage to the heart can also cause the stumbling, a doctor should be consulted. This doctor can then check whether the stumbling is actually caused by menopause or whether there is some other cause for the stumbling.

For the therapy of (post)menopausal complaints, mainly natural remedies are administered in order to keep the burden on the body as low as possible. Hormone replacement therapy is only recommended if the symptoms are severe and requires medical supervision. A number of symptoms that are characteristic of the conversion phase, such as hot flushes, sleep disorders and irritability, include cardiac arrhythmia.

Often the fluctuating mood caused by the hormone reduction couples with heart stumbling and can trigger anxiety and panic attacks. These heart complaints can also manifest themselves as palpitations, palpitations or heart palpitations. Due to the steadily decreasing oestrogen level, which is caused by the reduced production by the ovaries, an unusual oestrogen deficiency occurs.

This hormone deficiency mainly affects the autonomic nervous system. Since the autonomic nervous system controls the heartbeat, an extra beat can therefore occur from time to time, which is perceived as a heart stutter. Since in rare cases organic damage to the heart can also cause the stumbling, a doctor should be consulted.

This doctor can then check whether the stumbling is actually caused by menopause or whether there is some other cause for the stumbling. For the therapy of (post)menopausal complaints, mainly natural remedies are administered in order to keep the burden on the body as low as possible. Hormone replacement therapy is only recommended if the symptoms are severe and requires medical supervision.

As already mentioned, heart stumbling also occurs from time to time in healthy people and is therefore not always proof of a pathological process. Above all, people tend to perceive an extra heartbeat of the heart in rest rather than in everyday life, when they are in motion and distracted. Therefore, a heart stumbling is also more easily registered at night than during the day.

During stressful phases, heart stumbling at night can be triggered by the autonomic nervous system, which reacts more sensitively during such times. However, if the heart stumbling at night lasts longer (several minutes to hours) or if other symptoms such as shortness of breath occur, a doctor should be consulted. This doctor can rule out the possibility of a serious heart defect requiring treatment by using suitable means (heart ultrasound, exercise ECG and long-term ECG).