تعريف

Bradycardia is an abnormally slow heart rate. In adults, it is defined as a heart rate of less than 60 beats per minute. Different types of bradycardia are collectively referred to as bradyarrhythmias. They include:

  • Sinus bradycardia—an unusually slow heartbeat due to heart disease, a reaction to medication, or harmless causes, such as excellent fitness or deep relaxation
  • Sick sinus syndrome—an unusually slow heartbeat due to a malfunction of the sinoatrial node, which is the heart’s natural pacemaker
  • Heart block (atrioventricular block or AV block)—an unusually slow heartbeat due to a slowing or blocking of electrical impulses in the heart’s conduction system

بطء القلب

أسباب

Bradycardia may be caused by:

  • Normal responses to:
    • Deep relaxation
    • Being in excellent physical shape
  • The heart’s natural pacemaker developing an abnormal rate or rhythm
  • The normal electrical conduction pathway being interrupted
  • جزء آخر من القلب يتولى دور جهاز تنظيم ضربات القلب

عوامل الخطر

Risk factors that increase your chance of getting bradycardia include:

  • زيادة العمر
  • قصور الغدة الدرقية
  • Taking certain medications used to treat:
    • ضغط دم مرتفع
    • مرض الزهايمر
    • مرض قلبي
    • Heart failure and arrhythmias
  • Exposure to certain toxins
  • Cardiac disease, such as:
    • نوبة قلبية
    • Wearing out of the heart’s conduction system
    • فشل القلب الاحتقاني
    • Heart valve failure
    • Heart conditions that are inherited or present at birth
  • Electrolyte imbalances
  • توقف التنفس أثناء النوم
  • Lupus or other collagen vascular diseases (rare)
  • Head injuries
  • انخفاض حرارة الجسم
  • نقص سكر الدم
  • Infectious diseases, such as:
    • الخناق
    • الحمى الروماتيزمية
    • Viral myocarditis
    • مرض لايم
    • Chagas disease

الأعراض

Some types of bradycardia produce no symptoms. Others may cause noticeable symptoms, such as:

  • Fainting or loss of consciousness
  • Dizziness or light-headedness
  • ضعف
  • Mild fatigue
  • Irregular heart beat
  • ضيق في التنفس
  • ألم في الصدر

Serious forms of bradycardia, such as complete heart block, are medical emergencies. They can lead to loss of consciousness or sudden cardiac arrest.

التشخيص

The doctor will ask about your symptoms and medical history. A physical exam will be done. Your heart will be examined with a stethoscope.

  • Your doctor may need you to have blood tests. These tests will look for problems that may explain the bradycardia.
  • Your doctor may need to test your heart function. This can be done with:
    • تخطيط القلب الكهربي
    • مخطط صدى القلب
    • A portable, continuous heart rhythm monitor that you wear as you perform normal daily activities
    • ممارسة اختبار الإجهاد
    • المسح النووي
    • تصوير الأوعية التاجية

العلاج

Treatment may not be required if you do not have cardiac symptoms and conditions. Your doctor may choose to monitor your heart rate and rhythm instead.

قد يشمل العلاج ما يلي:

  • Stopping any medications that slow the heart rate
  • Diagnosing and treating any underlying conditions
  • Medication to temporarily increase your heart rate
  • An artificial pacemaker to establish and maintain a normal heart rhythm

الوقاية

To help prevent bradycardia:

  • Treat conditions that might lead to bradycardia.
  • Carefully follow your doctor’s directions when using medications, especially those that can cause bradycardia.
  • Check with your physician or pharmacist before using any over-the-counter medication or natural supplement. Make sure it does not interact with your other medications.
  • Follow general advice for preventing heart disease, including:
    • الحفاظ على وزن صحي.
    • Consult with your doctor about a safe exercise program.
    • تجنب التدخين.
    • Eat a healthy diet that is low in saturated fat and rich in whole grains, fruits, and vegetables.
    • Treat your high blood pressure and/or diabetes.
    • Treat your high cholesterol or triglycerides.
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