Arrhythmias: Information on Causes, Diagnosis & Treatments

Arrhythmia Heart An arrhythmia is a fluttering in the chest caused by an abnormal heart rhythm. The individual may feel or hear a brief pause in their heart beat. Some arrhythmias last only a flash of a moment and do not change the patient’s overall heartbeats or can be too fast or too slow causing symptoms.

Most individuals who suffer mild cases arrhythmia never display any symptoms. Others feel dizzy or lightheaded especially when standing or sitting quickly. There are two forms of arrhythmias including tachycardia and bradycardia. Tachycardia arrhythmias occur when the heart rate beats too quickly (100 beats or more per minute), whereas bradycardia arrhythmias cause the heart to beat too slowly (60 beats or less per minute).

Who is At Risk for an Arrhythmia?

Both bradycardia and tachycardia arrhythmias are common in older men and women. This is because the elderly population tends to develop serious heart problems including heart disease that eventually result in an arrhythmia. Additionally, older individuals are usually more sensitive to dangerous side effects of the drugs they take, some of which are known to cause an arrhythmia. Even medicines prescribed by doctors to treat arrhythmias are known to cause arrhythmias in some people.

Children and adolescents are more likely to develop some types of arrhythmia compared to adults. These include Wolf-Parkinson-White syndrome and other paroxysmal supraventricular tachycardia (PSVT) conditions. PSVT conditions can cause the heart rate to start and end too suddenly.

Additionally, there are significant risk factors that are likely to cause an arrhythmia. These occur in individuals who have conditions or diseases known to weaken the heart muscle including:

  • Heart attack

  • Congenital heart defect that harms the heart’s function or structured

  • Narrowed or leaking heart valves that make the heart to heart

  • Abnormal heart tissue that has become too stiff or thick to function normally

  • Cardiomyopathy (heart failure) which is a weakening of the heart muscle caused by electrical signal changes

  • High blood pressure

  • Sleep apnea where the heart is deprived of oxygen due to stress

  • Diabetes which often leads to coronary heart disease and high blood pressure

  • Infections of the heart muscle that damage the pericardium (the sac surrounding the heart)

Individuals who have undergone certain heart surgical procedures or taken amphetamines or cocaine are at high risk, as are those with chemical imbalances including too much potassium or sodium in the bloodstream.

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Common Arrhythmia Causes

An arrhythmia is the result of the heart’s electrical signals that have been blocked or delayed that changes the heart rhythm. Arrhythmias often develop when the special nerve cells that provide the body’s electrical signals malfunction. If the electrical signals do not normally If there is a blockage or delay in how the electrical signal travels through the heart, an arrhythmia can develop over time.

Arrhythmias are also the result of an electrical signal coming from a different part of the heart that disturbs normal heart rate or adds to the signal being sent by the special nerve cells that control heart rate and rhythm. However, there are other factors that are known to cause arrhythmia. These include:

  • Smoking tobacco products

  • Excessive alcohol consumption

  • Taking over-the-counter drugs

  • Using prescription medications

  • Taking illegal drugs including amphetamines and cocaine

  • Consuming too much nicotine or caffeine

Not all risk factors that cause arrhythmia come from outside the body. Holding onto anger or emotional stress can cause the heart to work much harder than normal. As a result, the body’s blood pressure will rise especially when stress hormones are released. This normal body reaction often develops arrhythmias.

If the body experiences a heart attack while the patient is already dealing with other conditions the event cause significant damage to the electrical system of the heart. These other conditions can involve coronary heart failure, coronary heart disease, high blood pressure, and underactive or overactive thyroid gland, or rheumatic heart disease.

Congenital heart defects can also produce arrhythmias, especially in young children and adolescents. This includes Wolff-Parkinson-White syndrome.

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Common Symptoms

Most individuals suffering from an arrhythmia never display any symptom or present any indication that their heart is beating irregularly. However, the most common arrhythmia symptoms involve:

  • A slow heartbeat

  • A pause between heartbeats that is either felt or heard with a stethoscope

  • Palpitations that feel as though the heart is fluttering, skipping a beat, or beating much too fast or hard.

  • Irregular heartbeat

  • Sweating

  • Anxiety

  • Chest pain

  • Shortness of breath

  • The feeling of fainting or fainting

  • Lightheadedness, dizziness, and weakness

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Diagnosing Arrhythmias

Many arrhythmias, especially mild ones, are difficult to diagnose, this is especially true when the arrhythmia only presents itself occasionally. To accurately diagnose an arrhythmia, the doctor will usually collect a comprehensive family and medical history before performing a complete physical examination and reviewing the results from procedures and tests. Typically, more than the family practitioner will be involved when validating a diagnosis of an arrhythmia. Other specialists that usually are involved in diagnosing and treating the disease include a cardiologist, pediatric cardiologist, and electrophysiologist.

  • Taking a Family and Medical History – The doctor will ask various questions to determine if the patient is detecting a fluttering in their chest or feeling lightheaded or dizzy. The doctor will determine if the patient is a history of certain conditions and diseases handed down to the family or as a personal history. These include thyroid problems, diabetes, high blood pressure, and heart disease the doctor will usually look for a history of arrhythmias, family members who have died suddenly, or those who experience high blood pressure, heart disease or had other health problems or illnesses

The patient will need to reveal all the medicines they are currently taking including supplements and OTC (over-the-counter) drugs. As a part of the examination, the doctor will ask about health habits including smoking, alcohol consumption, physical activity or taking illegal drugs including cocaine and amphetamines. The patient must reveal if they have undergone long stretches of emotional stress or held in feelings of anger which are known to lead to arrhythmias.

  • Complete Physical Examination – The doctor will perform an exam by listening to the heart to determine rate and rhythm and detect any heart murmur. During the exam, the doctor can detect that the heart rate is beating too fast and look for any signs of arrhythmia including swollen feet or legs, heart failure, an enlarged heart, thyroid disease, or other condition.

  • Diagnostic Procedures and Tests – To accurately diagnose an arrhythmia, the doctor may require that the patient undergo diagnostic tests and procedures that include:
    • Electrocardiogram

    • Holter and event monitors

    • Blood and urine tests

    • Chest x-rays, echocardiography test, stress test, & electrophysiology study (EPS)

    • Tilt table testing

    • Coronary angiography

    • Implantable loop record

    • Heart catheterization

The results of these tests can better determine what triggers the arrhythmia to present itself.

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Treating an Arrhythmia

Treating arrhythmias depends on their cause and type. The doctor might recommend a pacemaker for individuals suffering from bradycardia arrhythmia. Any patient suffering from a tachycardia arrhythmia could take medications, have ablation therapy, wear an implantable cardioverter defibrillator, or undergo a ventricular aneurysm and coronary bypass surgery.

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Sources:

https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/diagnosis-treatment/drc-20350674

https://my.clevelandclinic.org/health/articles/arrhythmia

https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm

https://www.nhlbi.nih.gov/health/health-topics/topics/arr

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