Cardiac Arrhythmia

Cardiac Arrhythmia

Cardiac arrhythmia is caused by conditions where in the heart, the electric activity is irregular, faster or slower than the normal activity. The normal activity of the heart is highly hampered by this condition. Cardiac arrhythmia can cause heart attacks and sudden deaths. In extreme cases there is variations in the heart beats. Some cardiac arrhythmia can cause missing of heartbeats and tachycardia. However these symptoms are nothing about which one should be alarmed. In cardiac arrhythmia, people can experience sinus arrhythmia that is mild acceleration along with normal rhythm of the heart movements occurring by breathing normally. The normal resting of the heart beats ranges from 60 to 100 beats per minute in an adult. The heart beats are controlled by sinoatrial node or sinus node that is an area in the upper chamber of the human heart. The specialized cells contains spontaneous electrical activity which starts the normal heart beats in an individual.

In cardiac arrhythmia, tachycardia is when the heart beats faster than the rate of of 100 beats per minute. However the age of an individual is very important in determining this factor. For instance, a younger individual has a faster heart beat compared to older individuals. The sinus node inside the heart has an increased rate of activity when an individual is exercising or doing something that requires exertion of physical activities. The development of faster activities of the sinus nodes are known as sinus tachycardia. When the activity reaches to extreme levels then cardiac arrhythmia occurs. In cardiac arrhythmia, the ventricles of the heart experiences such tachycardia for a longer time and then causes the reaction. The palpitations felt under such conditions are tachycardia.

Tachycardia in cardiac arrhythmia can cause lowering of the blood pressures. This in turn leads to dizziness, fainting or lightheaded sensations. When tachycardia is rapid, the pumping function of the heart is hampered. In extreme cases, tachycardia lead to sudden death. However most of the tachycardia suffered by an individual is not very harmful. The rise in adrenaline too causes tachycardia. The cause of tachycardia can be stress or induced substances like intake of caffeine, alcohol and amphetamines. People suffering from overactive thyroid gland (hyperthyroidism) too suffer from tachycardia in cardiac arrhythmia.

People suffering from cardiac arrhythmia should restrict from the agents or activities that cause tachycardia. While the fast movements are called tachycardia, the slow beating of the hearts are known as bradycardia. In this type of cardiac arrhythmia, the heart beats less than 60 beats per hour. The causes of bradycardia are supply of low oxygen, blockage in the heart and electrolyte abnormalities. A pacemaker is required when this condition causes symptoms implantation. In both tachycardia and bradycardia, medical attention needs to be paid. Another form of cardiac arrhythmia is known as fibrillation. In this condition, there is quivering motion inside the heart muscle because of disunity in contractile cell function. There are two types of fibrillation like atrial fibrillation in the atrium and ventricular fibrillation in the ventricles. The ventricular fibrillation is more life threatening than atrial fibrillation.

Heart palpitations at night

Why do we have heart palpitations at night?

Before we discuss the matter of heart palpitations at night, we have to clarify the meaning of the word “palpitation” in general. Palpitations refer to irregular heart beats, usually the heart beats to fast, or with pauses from time to time and gives us an abnormal sensation, sometimes associated with dizziness, light-headed sensation, shortness of breath, chest pain etc.
We all had palpitation at least once in our life, and this doesn’t mean we have a heart disease, because these symptoms occur in healthy people during exercise or associated to stress, smoking, coffee. Even so, if the palpitation persist or are associated with shortness of breath, chest pain, fainting, dizziness, a doctor should be consulted as soon as possible.
Some patients complain they have heart palpitations at night, which prevent them from falling asleep or wake them up in the middle of the night.

Heart palpitations at night -causes:

Normal heart rate for an adult is 60-90 beats/minute. If the heart rate is higher the 90 beats per minute, then the condition is called tachycardia and can provoke palpitation. Not only rapid heart rate can cause palpitation but also irregular heart beats, known as arrhythmia, which is the main cause behind palpitation. Why some patients experience heart palpitations at night, during rest, when heart labor is smaller?
Heart palpitations at night can be determined by one of the following cause:

• too much stress and anxiety gathered during the daytime. It is a habit now that every time we go to sleep, we think again at the daily problems and try to find a solution, as it is said night is a good adviser. If your mind is concerned about certain problems happening in your life, you may be lying down and think about it over and over again, but the emotions and the psychical tension can generate palpitation.
• excessive consumption of caffeine before sleeping can generate insomnia and palpitation, if you drink a lot of coffee, especially before sleeping, you may consider giving up.
• smoking
• alcohol consumption
• medication-some drugs used to treat different diseases (like asthma, heart diseases, high blood pressure, cold) can determine palpitation: pseudoephedrine used in cold medication, theophylline for asthma etc.
• pregnancy
• fever-it is well known that body temperature elevation is associated with rapid heart beats and sometimes with palpitations
• vigorous exercise before sleeping
• breathing problems determined by lung diseases determine a low level of oxygen in the body, which can lead to heart palpitations at night
• heart problem-patients with heart failure may develop paroxysmal nocturnal dyspnea (shortness of breath that occurs suddenly during night in patient with left heart failure) and palpitations, forcing them to wake up and search for an open window to get fresh air
• hyperthyroidism (a higher level of thyroid hormones can determine irregular or rapid heart beats)
• elevated blood pressure

If I have heart palpitations at night-how can my doctor discover if there is something wrong in my body?
Yes it is possible. For patients that have these symptoms only during night it is difficult to  diagnose them during a simple medical visit, but if a special device called holter ecg is used, then this is no longer a problem. Holter ECG is a portable medical device that the patient “wears” for 24 hours and it records heart activity during this period of time.
Heart palpitations at night-treatment
Heart palpitations at night can be treated only after proper tests are made in order to establish the correct diagnosis. In many cases, palpitations have no serious cause and a short time treatment associated with a life style change can be the “cure”.
Special precaution in patients with heart palpitations at night:

• avoid consumption of alcohol, coffee, drugs (marijuana, cocaine) or smoking
• avoid stress and anxiety-there are many types of techniques used against anxiety (psychotherapy, sports, taking vacation, travelling etc.)
• sometimes medication is needed in order to control anxiety
• respect your hours of sleep
• avoid if possible the intake of medication that stimulate palpitations

Heart palpitations at night can be very uncomfortable, but sometimes a simple change in the  daily habits can make them disappear.

What is exertional dyspnea?

Exertional dyspnea basics

When we hear talking about   exertional dyspnea or in other words “shortness of breath” one must think to the difficulty of breathing when is doing an exercise or easier said, lack of comfort in breathing. But isn’t it normal to experience some kind of dyspnea when we are exercising? Apparently not! In the next article I’m going to explain what is exertional dyspnea, when it appears, when we say this condition is pathological or not and what causes it.
The word “dypnea” is originally composed from two greek words: “dysp” which means hard, heavy, difficult and “pnoia” that means breathing. If we combine these two words we have “hard breathing”also said dyspnea. Dyspnea is a breathing disorder characterized by changing the pace and intensity of respiratory movements.
Exertional dyspnea is frequently overlooked because it can occur to healthy people and is frequent confused with fatigue. It isn’t always a pathological symptom. You can experience exertional dyspnea when you are exercising more than your body is used to, if you have a weight problem (you weigh to much or you are obese), if you are an active smoker, or if the air around you is polluted.
Exertional dyspnea becomes pathological and that means that we should worry and go see a doctor when even if we make the same exercise as we did before we feel like our lungs aren’t getting enough air.

 But how does exertional dyspnea appear ?

Dyspnea due to illness can occur when there is an imbalance between tissue oxygen demand, and the amount of oxygen that the body can provide. Many diseases can give exertional dyspnea , the most common being:

• anemia (lack of blood) - Shortness of breath is accompanied by pale skin

• disease with increased energy consumption (as in cancers with different locations, hyperthyroidism, and uncompensated diabetes
• lung disease (dyspnea by lack of oxygen) of various causes, dyspnea is accompanied by coughing and / or wheezing and  sputum
• heart disease – exertional dyspnea occurs first and then it can occur during  rest or lying down, the patient can also feel palpitations and chest pains
• serious liver disease (cirrhosis) - liver as “laboratory” of the body, shortness of breath occurs in cirrhosis by multiple mechanisms
• severe kidney disease - shortness of breath occurs with changes in fluid and electrolyte balance or anemia (erythropoietin synthesized by  kidney, substance that stimulates the bone marrow to manufacture red blood cells that are the cells that  transport oxygen around the body)
• hypertension – exertional dyspnea  occurs by forcing the heart and the  blood vessel
• obesity (fat in the chest and abdomen pressed, preventing the movement of breath, plus a larger amount of tissue needs a greater amount of oxygen).

As you can see there are many conditions that can  manifest as exertional dyspnea, some of them  really serious diseases and that’s why is very important to go see a doctor whenever you notice changes in your breathing rhythm or you experience respiratory problems.