Being told by your doctor that you have a cardiac arrhythmia can be disconcerting, especially when he or she refers you to a cardiologist for further evaluation. Arrhythmia is the collective term used to describe various types of abnormalities in heart rate and rhythm. Some types of arrhythmia are benign and require no treatment, while others must be controlled with medications or interventional treatment methods. Getting informed about the different types of arrhythmia, why they occur and how they are dealt with can provide you with a more positive outlook on your condition and motivate you to schedule that appointment with your cardiologist.
What Is Arrhythmia?
Arrhythmia is the general term used to describe an abnormal heartbeat. Your heart is made up of four chambers and four valves to keep the blood circulating in a sequential manner. These chambers and valves pump along at a steady rhythm in response to electrical impulses that initially signal from the sinus node. Any disruption in these electrical impulses or malfunction in any of the valves or chambers leads to arrhythmia. Some medical causes of arrhythmia include the following:
- Cardiovascular disease
- Disorders of the cardiac valves
- Changes in the cardiac muscle
- Electrolyte imbalances
- Post-operative healing from cardiac surgery
- Injury sustained to the heart during a heart attack
Substances and emotional states can also contribute to some arrhythmias. Some examples include the following:
- Alcohol consumption
- Caffeine consumption
- Cocaine use
- Weight loss pills
- Cold and cough medications
- Extreme fright or shock
- Elevated stress
Arrhythmias can be detected during a routine physical examination when a primary care physician listens to your heart with a stethoscope and when a standard electrocardiogram (EKG) is performed. Some arrhythmias can present sensations in the chest, such as fluttering, pounding or skipped beats, that are felt by the affected patient. You can also experience fatigue, dizziness or shortness of breath. Some arrhythmias, however, are considered to be silent because they present no such symptoms.
Heart Rate Arrhythmias
When a doctor checks your pulse rate, he or she is determining how many times your heart beats in one minute. Your pulse rate is higher when you are engaged in physical activity as your heart pumps more oxygenated blood throughout your body. At rest, your pulse rate is slower. The normal pulse rate for a resting adult ranges between 60 and 100 beats per minute. Arrhythmias that present as abnormal heart rates include the following:
- Tachycardia, in which the heart rate exceeds 100
- Bradycardia, in which the heart rate is below 60
Paroxysmal supraventricular tachycardia (PSVT), AV nodal re-entrant tachycardia (AVNRT) and accessory pathway tachycardia are all arrhythmias that originate from the atrial chambers, or upper chambers, of the heart. Ventricular tachycardia (V-Tach) originates in the ventricle chambers, or lower chambers, of the heart.
Heart Rhythm Arrhythmias
Heart rhythm is abnormal when it deviates from the continuous normal lub-dub beat. Some examples of heart rhythm arrhythmias include the following:
- Premature ventricular contractions (PVCs) are very common. Most people experience them, and they are usually benign. If you experience them frequently, however, it may be a sign of heart disease and should be evaluated by a cardiologist.
- Premature atrial contractions (PACs) occur when the heart's atrial chambers beat too early in the pumping process. PACs are usually not harmful.
- Atrial flutter and atrial fibrillation (A-fib) are caused when the atrial chambers of the heart fail to contract normally.
- Ventricular fibrillation is a life-threatening arrhythmia that occurs when the heart's ventricles fail to contract normally, resulting in the blood not getting pumped into the body. V-fib must be treated at once as a medical emergency.
- Long QT syndrome occurs when the heart's muscle does not release quickly enough after contraction or when the sinus node does not recharge quickly enough after firing electrical impulses. This can result in a life-threatening form of V-tach.
- Heart block occurs when the electrical impulse is delayed or blocked when it is en route from the sinus node or the atrioventricular node to the heart's ventricles, resulting in bradycardia.
Diagnostic Tests and Treatment
In addition to performing and evaluating an EKG, your physician will likely recommend other diagnostic tests to evaluate your heart's function and confirm which type of arrhythmia you have. Some diagnostic tests include:
- Ambulatory monitor, such as with a Holter monitor
- Stress test
- Cardiac catheterization
- Tilt-table test
Some arrhythmias, such as PACs and PVCs, will not require any treatment. Other types of arrhythmias may need to be treated with lifestyle changes, medications, pacemaker or defibrillator implantation, catheter ablation or heart surgery.
Syncopated rhythm belongs in your music library, not in your chest. Pursuing an evaluation from a cardiologist will grant you piece of mind if your arrhythmia is benign in nature. If you are diagnosed with a more serious arrhythmia, the doctor will discuss the treatment options that will put your heart back on track.
For more information, contact Orange Beach Walk-In Medical Care or a similar location.