What is it about ?
A heart rhythm disorder is a disturbance of the normal heart rhythm. The normal heartbeat is regulated by a bundle of nerve cells that produce a small electrical current. This system works as a pacemaker natural, which sends electrical impulses through the muscle of the heart (myocardium). These impulses stimulate this muscle, which contracts. The origin of a heart rhythm disorder can be in various places of the heart.
A heart rhythm disorder can consist of:
- one or more extra heartbeats ;
- from totally irregular heartbeats ;
- from too fast heartbeat ;
- from too slow heartbeat.
The term therefore refers to a wide range of conditions, which can be serious or mild.
In a young person, who has a normal tolerance to effort, who is not a victim of dizziness orfainting and who has no family history of severe cardiac arrhythmias or sudden death, an arrhythmia is usually not not serious and treatment is rarely needed.
On the other hand, a heart rhythm disorder can be serious if it is accompanied byfainting and if the palpitations last more than 30 seconds.
Here are some examples of common heart rhythm disturbances:
How to recognize them?
The 2 main characteristic signs are the disturbance of consciousness (fainting) and the feeling of palpitations. Sometimes it is also a question of dizziness,shortness of breath and a feeling of tightness in the chest. If your heart beats too slowly, you see black spots.
- It is important to distinguish between fainting resulting from a heart rhythm disturbance of fainting more harmless, which are often associated with heat or stress. Fainting due to a cardiac arrhythmia usually occurs during sports practice and is often preceded by palpitations or chest pain.
- When you have palpitations, you may have the impression that your heart is racing or that it is going to come out of your chest. You may also feel that your heart ‘skip a beat‘. This sensation is caused by heartbeats that are much too fast, followed by a brief stop. You can also have heartbeat without any regularity.
How is the diagnosis made?
Your doctor will always try to distinguish between trivial and serious heart rhythm disturbances by establishing a correct diagnosis.
Examination
He will start by asking you a few questions about the exact nature of your complaints:
- When did they start?
- How often do you perceive them?
- How long do they last: a few seconds or continuously?
- Does your heart skip a beat every now and then or does he always beat so irregular ?
- Is your heart beating too fast Where too slowly ?
- Do you tend to pass out ?
- Are the complaints triggered by exertion, coffee, stress, lack of sleep, …?
- Do any members of your family have arrhythmias or have they died suddenly?
Your doctor will also assess whether the medicines you are taking may be causing the heart rhythm disorder.
Exams
Your doctor will then do a basic exam of your heart, which is usually sufficient to make the diagnosis:
- blood pressure measurement;
- cardiac auscultation ;
- electrocardiogram (ECG) at rest ;
- possibly blood test, including in particular thyroid function tests.
Specialist orientation
In case of suspicion of serious illness or in case of doubt, the doctor will refer you to a heart specialist (cardiologist). This one will carry out some additional examinations, such as:
- a stress test under ECG ;
- a 24 hour ECG (Holter) ;
- a cardiac ultrasound (echocardiography) ;
- if necessary, an examination of the coronary arteries (coronary angiography).
What can you do ?
- Note precisely the characteristics of your complaints: how often do you suffer from them, at what precise moment, how long do they last, do they cause discomfort,…?
- Take your pulse for 1 minute. Do this preferably on the inside of the wrist, resting the fingertips on the artery. If the pulse is irregular, greater than 140 or less than 50, see your doctor.
- Limit your intake of coffee and caffeinated energy drinks, as they can trigger heart palpitations.
What can your doctor do?
Your doctor will first check whether treatment is necessary and / or desirable. It depends on the cause.
- If the heartbeat is fast, but steady, he may prescribe drugs that slow the heart rate.
- If the heart rate is too slow and that there is a risk of cardiac arrest, a pacemaker sometimes needs to be implanted.
- Certain heart rhythm disturbances (e.g. atrial fibrillation) are accompanied by a risk of thrombosis. The doctor will consider whether it is necessary to prescribe anti coagulants.
- The extra heartbeats (extrasystoles) are only treated when they are accompanied by symptoms or when they are too frequent.
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