Ventricular Tachycardia

Ventricular Tachycardia

Cardiac arrhythmias occur when the heartbeat becomes irregular due to increased or decreased impulses. Ventricular tachycardia is a dangerous form of cardiac arrhythmia. It arises in the ventricles of the heart and is always a serious emergency.

What is ventricular tachycardia?

Ventricular tachycardia is a form of cardiac arrhythmia. It occurs when the ventricles of the heart send extra impulses, resulting in more than 120 heartbeats per minute. In most cases it arises from existing coronary heart disease. Depending on the speed of the heartbeat, it can lead to ventricular flutter or even ventricular fibrillation. Therefore, ventricular tachycardia should be treated by an emergency physician as soon as possible, otherwise it can be fatal within a few minutes. For all you need to know about immune complex vasculitis, please visit phonecations.com.

Causes

Ventricular tachycardia is usually caused by coronary artery disease. This, in turn, is usually a narrowing of the coronary arteries (vessels that supply the heart with oxygen-rich blood). These constrictions in turn mean that the heart muscle can no longer be properly supplied with blood.

The bottlenecks themselves express themselves as a feeling of pressure and a tightness in the chest as well as heart pain, which can occur both under stress and at rest. Coronary heart disease is favored by several factors. Smokers, people who are overweight and predominantly male people of advanced age fall into the risk group. Existing diseases such as diabetes, increased blood fat levels ( cholesterol ) or high blood pressure and coronary heart disease in first-degree relatives are also considered major risk factors. External influences such as stress, lack of exercise and an unhealthy diet also have a damaging effect on the blood vessels.

In addition to coronary heart disease, there are other possible causes of ventricular tachycardia. First and foremost are myocardial diseases ( cardiomyopathies ), which are based on a functional disorder of the heart. Cardiomyopathies are usually associated with an enlargement of the heart, which has a decisive influence on the heart rhythm.

The ventricular tachycardia can also result from an existing myocarditis (myocarditis) or an existing long QT syndrome (prolonged QT interval in the ECG ). It can also result from congenital or acquired heart defects that affect how the heart works. In addition, they are also caused by the effects of certain medications, a pulmonary embolism and the derailment of certain electrolytes (e.g. potassium ).

Symptoms, Ailments & Signs

Ventricular tachycardia rarely occurs in healthy people. People with pre-existing conditions are mostly affected. For example, an existing hyperthyroidism and an overdose with digitalis can promote disease. Organic heart damage also promotes arrhythmia. The following symptoms can escalate to cardiac arrest. There is then a risk of death.

In the early stages, patients regularly complain of dizziness and fainting. In addition, complaints in the chest area become noticeable. Patients often describe that they feel their own heartbeat and that it has an unusual frequency. Experts usually diagnose an accelerated heartbeat in this context.

In addition, there are psychological signs. Those affected complain of anxiety states that take on life-threatening forms. Sudden sweating and immediate weakness of the entire body characterize the condition. Respiratory symptoms also appear in the context of ventricular tachycardia. These range from mild breathing difficulties to respiratory arrest.

Patients get insufficient air and gasp for it; if the condition is left untreated for a long period of time, breathing stops altogether. Difficulty breathing can regularly lead to cardiac arrest. Those affected should therefore immediately consult a doctor or alert an emergency service.

Complications

The most dangerous complication of ventricular tachycardia is the threat of ventricular fibrillation. Since a heart rate is reached that exceeds 320 beats per minute, the patient’s life is in acute danger. Due to the speed of the heartbeat, the heart does not have enough time to fill up with blood between beats, and the heart muscle is exhausted due to the extremely high workload.

If the oxygen-enriched blood is not pumped into the aorta in sufficient quantities, the heart will soon lack important nutrients because the blood circulation is interrupted. A vicious circle begins, which brings the heart more and more out of its natural rhythm, because the contractions no longer come about in this state. In ventricular fibrillation, the heart stops pumping and just trembles. If this emergency is not treated quickly, the heart will become completely exhausted, resulting in cardiac arrest.

Another complication concerns patients suffering from long QT syndrome. If they experience cardiac arrest after ventricular fibrillation, attempts at resuscitation cannot reverse it. There is a final cardiac arrest after which the patient can no longer be resuscitated.

When should you go to the doctor?

If palpitations, tachycardia or heart palpitations persist for several days, a doctor should definitely be consulted for clarification. People who suffer from diabetes or high blood pressure should measure their blood pressure and pulse several times a day and note the values ​​so that they can be presented to the doctor treating them if necessary.

People in whom the cardiac arrhythmia persists for a long time and in whom dizziness, shortness of breath or an oppressive feeling of anxiety are added to the symptoms of ventricular tachycardia should not hesitate under any circumstances.

Passers-by who see an unconscious person or relatives who are in the vicinity at the time of the emergency situation should immediately call an ambulance for help. The affected person could experience ventricular tachycardia. If help arrives quickly enough, it can save her life! Even if the unconsciousness lasts only for a short time, those affected are by no means out of danger.

Diagnosis

Ventricular tachycardia can be diagnosed using an electrocardiogram (ECG). Each curve recorded by the device gives the doctor an overview of all the activities of the heart muscle fibers. The ECG records the length and duration of various phases that the heart goes through during each pump beat.

For this purpose, several electrodes are attached to the patient’s chest, which transmit the impulses to the ECG device. The latter records the surges and displays them as wavy lines. Typical signs of ventricular tachycardia are distorted, wide ventricular complexes that last longer than 0.14 seconds. These occur independently of the atrial action. Doctors speak of an AV dissociation because the said independence shows that the ventricles and atria are no longer working synchronously with each other.

If the AV dissociation is not complete, the ECG records a normal spread of excitation in the ventricle (QRS complex). These segments, which occur as part of a ventricular tachycardia, are also referred to as a “capture beat”.

Treatment & Therapy

The treatment of ventricular tachycardia depends on its cause. If it is caused by an organic disorder of the heart (e.g. myocarditis or cardiac insufficiency ), this must be corrected with medication or surgery. In the case of drug therapy, a precise distinction must be made as to whether cardiac insufficiency is present. Parallel to the ongoing emergency medical treatment, the patient’s breathing should be secured by administering oxygen via a nasal tube.

If cardiac arrest occurs as a result of severe ventricular tachycardia, immediate cardioversion using a defibrillator must be performed. The emergency doctor gives the heart electrical shocks to stimulate it and get it beating again.

If the patient is unconscious, the doctor must defibrillate without the time-consuming connection of an ECG in order to be able to save the patient’s life in time.

Outlook & Forecast

Ventricular tachycardia is common in people who have had a history of structural heart disease. Heart attack patients are an example. If the ventricular tachycardia persists more than three months after the heart attack, these patients have the worst prognosis.

Expressed in numbers, the mortality rate (mortality) within one year after the infarction is 85%. On the other hand, if ventricular tachycardia occurs in people who have not previously had heart disease, there is no increased risk of death compared to the general population.

Prevention

Since ventricular tachycardias are life-threatening emergencies, the cause must be determined as quickly as possible so that they do not occur again in the future. Diseases of the heart must be treated and stressful situations must be avoided.

If ventricular tachycardia often recurs in a patient despite all therapeutic measures, implantation of a defibrillator is possible. These small systems are called “implantable cardioverter-defibrillators” (short: ICD). They are able to recognize ventricular tachycardia and treat it automatically with small current surges.

However, to prevent the device from having to intervene frequently, catheter ablation should be attempted to prevent frequently recurring tachycardias. This method removes tissue that is sending incorrect impulses to the heart, causing the rapid heart rate.

Aftercare

Follow-up care of the patient is of great importance when the causes of the ventricular tachycardia are diseases of the myocardium or coronary artery disease. Antiarrhythmic drugs are prescribed as drug therapy in order to reduce the excitability of the heart. If these do not help, catheter ablation is performed.

A catheter is inserted through the patient’s groin into the heart. Pathological heart muscle cells that trigger abnormal excitation or pathological pathways are destroyed with the help of electric shocks. The heart then beats again in its physiological rhythm. The success of this treatment is permanent in most cases and is monitored by a long-term ECG.

If the risk of recurrent ventricular tachycardia, which may be fatal, is too high, the patient is given an implantable cardioverter-defibrillator. This is inserted under the skin of the chest and is connected to the atria and ventricles of the heart by probes. He continuously monitors heart activity. If the defibrillator detects a dangerous arrhythmia, it uses a direct current pulse to bring the heart back to its normal rhythm.

The patient can positively influence their aftercare by preventing their heart rate from increasing unnecessarily. Coffee, nicotine and stressful situations must be avoided. Instead, the focus is on moderate exercise and relaxation exercises, such as yoga.

You can do that yourself

As already mentioned, ventricular tachycardia arises in most cases due to existing heart diseases. In addition to medical treatment, these heart patients can do a lot themselves to prevent tachycardia. Above all, excessive stress should be reduced. Stress can be managed particularly well through physical activity, because so-called happiness hormones are released through exercise, which contribute to relaxation.

Gentle activities such as a long walk in the fresh air are also suitable for beginners. In the case of emotional distress, relaxation exercises such as yoga or meditation should also be tried. If this does not achieve sufficient relaxation, you should not hesitate to seek psychological help. Emotional distress causes, among other things, high blood pressure, which in turn can lead to tachycardia.

You should also pay attention to a healthy, balanced diet, as being overweight also puts a lot of strain on the heart. In addition to being overweight, eating high-fat food carries the risk of the cholesterol level rising and with it the fat content in the blood. This settles in the inner walls of the blood vessels and can lead to dangerous constrictions, which can no longer optimally supply the heart with blood.

In addition, if you have a heart condition, you should avoid consuming nicotine and caffeine. While caffeine has a stimulating effect and raises the heart rate, smokers with nicotine inhale pure poison that hits both the heart and lungs.

Ventricular Tachycardia