Tachycardia is a condition in which the heart rate exceeds 100 beats per minute. Under normal circumstances, the heart beats 60 to 100 times per minute. The condition of the acceleration of the heart rate is normal when a person is exercising, or is the body's response to stress, trauma, and disease. This condition is called sinus tachycardia.
The heart rate is regulated by electrical signals that are sent through the heart tissue. Tachycardia is abnormal when the atria or chambers of the heart beat faster, even when they are at rest. There are several types of abnormal tachycardia based on the place and cause, namely tachycardia in the atrium or atrial (atrial fibrillation and atrial fibrillation). atrial flutter), and tachycardia in the chambers of the heart or ventricles (ventricular and supraventricular tachycardia).
For this abnormal tachycardia, it often does not cause symptoms or complications. But if left untreated, this condition can interfere with heart function, leading to serious complications, such as heart failure
Causes of Tachycardia
The human heart rate is regulated by a natural pacemaker called the sinoatrial node which is located in the right atrium of the heart. This node produces electrical signals that trigger each heartbeat. Tachycardia occurs when there is a disturbance in the electrical signals that regulate the heartbeat to pump blood. The disturbance can be caused by:
- Medical conditions; anemia, hyperthyroidism, hypertension or hypotension, fever.
- Strenuous exercise.
- Electrolyte disturbance.
- Side effects of medications, such as salbutamol or azithromycin.
- Smoking habit.
- Caffeine consumption.
- Drug abuse.
- Too many alcoholic drinks.
- Experiencing stress or fear.
In certain cases, the cause of tachycardia cannot be ascertained.
In addition to the various causes above, old age conditions and a family history of heart rhythm disorders can also increase a person's risk of suffering from tachycardia.
Types of Tachycardia
The next type of tachycardia occurs in the atria or atria of the heart. These types consist of:
- Atrial fibrillation. In this type of tachycardia, the electrical impulses in the atria or the upper chambers of the heart are chaotic. As a result, the signal occurs rapidly, irregularly, and contractions in the atria become weak.
- Atrial flutter. This condition occurs when the circuits in the atria become chaotic, so that the heart beats faster, but has a regular rhythm and the atrial contractions become weaker. Patients with this type of tachycardia also often experience atrial fibrillation.
The other three types of tachycardia occur in the ventricles of the heart. The three types are:
- Tachycardia ventricle. This condition occurs when the electrical signals in the ventricles occur abnormally, so that contractions cannot occur efficiently to pump blood throughout the body
- Ventricular fibrillation. Ventricular fibrillation occurs when electrical signals become fast and chaotic, so that the ventricles vibrate but are not effective at pumping blood. This condition can occur during or after a heart attack, and is classified as fatal.
- Supraventricular tachycardia. This condition occurs when an abnormal acceleration of the heart rate originates from above the ventricles, causing overlapping signal cycles in the heart.
Symptoms of Tachycardia
During tachycardia, the heart rate and pulse become fast, so the patient can feel:
- Heart beat.
- Chest pain (angina).
- Fatigue
- Hard to breathe.
- Dizzy.
- Faint.
In some cases, tachycardia causes no symptoms. However, if this condition is left untreated, serious complications can occur. These include heart failure, stroke, or cardiac arrest. With medication and medical procedures, tachycardia can be controlled. Tachycardia conditions that cause complications, depending on the cause and type of tachycardia experienced.
Tachycardia diagnosis
The diagnosis of tachycardia can be made through questioning and answering the patient's medical history and family, physical examination, and tests or supporting examinations.
The cardiologist will ask for a history of the appearance of symptoms, diseases and medications that the patient has or is currently undergoing, as well as a family history of disease, especially regarding a history of heart disease. On physical examination, the doctor will listen to the heartbeat and rhythm of the heart, so that the speed and regularity can be assessed, and if found, other abnormal heart sounds, such as heart murmurs.
To confirm tachycardia and investigate further causes, the doctor will need to carry out several supporting tests, including:
- Electrocardiography (ECG). In an EKG, several tiny sensors are attached to the patient's chest, as well as the patient's wrists and feet, to record the pattern of the heart's electrical activity. This examination can show the type of tachycardia experienced by the patient. To get more accurate heart rate data, doctors can ask patients to wear a heart activity recorder for 24 hours (Holter monitoring).
- Blood test. In this test, the number of red blood cells and thyroid hormone levels in the body will be calculated.
- Heart scan. This test is done to check for abnormal conditions that cause tachycardia. This examination can be done with chest X-rays, echocardiography (USG of the heart), CT scan, MRI, to cardiac angiography.
- stress test. The patient will be asked to walk to run on the machine treadmills, while the activity of the heart is observed closely, one of them with an EKG machine or also known as an EKG treadmill.
- Electrophysiological test. The doctor will insert a small tube with an electrode at the end into a vein in the patient's arm, neck, or groin, and then direct it to several points in the heart. This test is to determine the location of heart circuit problems by mapping the distribution of electrical signals with each heartbeat.
- Tilt table test. Patients will be asked to take drugs that make the heart rate increase. After that, the patient will be asked to sleep on a special table, then the table is upheld, so that the patient's position is like standing. The doctor will observe the response of the patient's nervous system and heart to this change in position.
Tachycardia Treatment
Tachycardia which is characterized by an accelerated heart rate does not always require treatment, depending on the type and cause.
For patients who experience sinus tachycardia, the doctor will treat according to the cause of the condition. If the cause is stress, then the patient needs to make lifestyle changes to reduce stress. Meanwhile, if the cause is a medical condition, the patient will be given treatment according to the underlying cause. For people with supraventricular tachycardia, doctors can recommend reducing alcohol or caffeine consumption, getting enough rest, and stopping smoking.
For patients with tachycardia accompanied by heart rhythm disturbances, treatment is needed to slow the heart rate in the form of:
- Vagal maneuver. The doctor will perform this maneuver by pressing the neck area. This pressure will affect the vagus nerve, which will help slow the heart rate.
- Drug administration. Doctors can give antiarrhythmic drugs, such as calcium antagonists or beta blockers, to bring the heart rate back to normal. In addition, doctors can also prescribe blood-thinning medications, because people with tachycardia are at high risk of developing blood clots.
- Cardioversion. In this procedure, an electric shock is delivered to the heart. The electric current will affect the electrical impulses in the heart and normalize the rhythm of the heartbeat.
- Ablation. In this procedure, a small tube or catheter is inserted through the groin, arm, or neck. This catheter will be directed into the heart, and will release radiofrequency energy or clotting to destroy the abnormal electrical pathways.
- Insertion of a pacemaker. A small pacemaker will be implanted under the skin. This device will emit electrical waves that help the heart beat to normalize.
- Implantable cardioverter (ICD). This device is inserted when an episode of tachycardia is experienced and is at risk of cardiac arrest and is life-threatening. This device is installed in the chest and is in charge of monitoring the heart rate, then sending electrical waves when needed.
- Surgery. Heart surgery is needed to remove the abnormal electrical pathways that trigger the tachycardia.
Tachycardia Prevention
In essence, the prevention of tachycardia is to maintain heart health. These efforts include reducing the risk of heart disease in the form of:
- Quit smoking.
- Control the consumption of alcoholic beverages or drinks containing caffeine.
- Maintain ideal body weight, and normal blood pressure and cholesterol levels.
- Exercise regularly and eat a healthy diet.
- Avoid using NAPZA.
- Be careful in taking over-the-counter medicines, and make sure to always follow the instructions for use.
- Try not to stress the mind.
- Check your health to the doctor regularly.