Arrhythmia according to ICD 10. Paroxysmal atrial fibrillation: clinical picture, diagnosis, treatment, emergency care. How long do people live with this diagnosis?

Paroxysmal atrial fibrillation or PMA, paroxysmal atrial fibrillation (ICD-10 code: I48) is a common disorder of atrial contraction. It is a condition in which the heart rhythm remains correct, and the heart rate (HR) fluctuates between 120-240 beats/min. The problem is quite common and is often a manifestation of other types of pathologies.

Features of the condition

PMA attacks usually begin suddenly and also stop suddenly; their duration can last from a couple of minutes to several days.

More often, older people (60 years or more) are affected by this disease - more than 6% of the population.
The number of patients with PMA who have not reached their 60th birthday is less than 1%.

Typically, PMA is not easily tolerated due to high heart rate, because the “engine” has to work under increased load. If the pathology takes on a permanent form, then there is a possibility of appearance in the atria, as well. People with this type of arrhythmia are 5 percent more likely to have ischemic stroke.

Is the group indicated for paroxysmal atrial fibrillation? Disability is not given for PMA alone, but it is prescribed for the development of certain diseases associated with arrhythmia.

Electrocardiogram for paroxysmal atrial fibrillation

Forms

It is customary to distinguish three forms of violation:

ventricular In this case, there is a pronounced deformation of the QRST, there are frequent cases of changes in the contour of the isoelectric line, and violations are also possible heart rate;
atrial. Patients have a conduction disorder of the Hiss bundle branch (right);
mixed. Has manifestations of the previous two forms.

If the cause of PMA has not been established, then we are dealing with its idiopathic form, which is more common in young people.

A well-known specialist will talk about the features of the paroxysmal form of atrial fibrillation in the video below:

Classification

Based on the frequency of atrial contractions, the following types of PMA can be distinguished:

direct flickering, when the heart rate is more than 300 per minute;
fluttering, in which the heart rate does not exceed the “200” mark.

Depending on the frequency of ventricular contraction, experts distinguish the following forms:

tachysystolic. The ventricles contract at a frequency of more than 90 per minute;
Bradysystolic. The reductions are less than 60;
normosystolic (intermediate).

If attacks of PMA are repeated, this indicates the presence of a recurrent form.

The paroxysmal form of atrial fibrillation also has its own causes, which we will discuss later.

Causes

One of the main reasons for the appearance of PMA is considered to be the presence of diseases of the cardiovascular system (CVS) in the patient, namely:

heart failure;
heart defects, both and (especially often) which are accompanied by expansion of the chambers;
essential hypertension with an increase in the mass of the heart muscle (myocardium);
inflammatory heart diseases, such as, and;
and/or ;
, and .

The following can also cause the development of PMA:

lack of potassium and magnesium in the body due to electrolyte disturbances;
endocrine system disorders (eg thyrotoxicosis);
diabetes;
severe infectious diseases;
pathologies of the lungs with compensatory changes in the structure of the heart;
postoperative condition.

In addition to diseases, the development of PMA is also influenced by:

taking cardiac glycosides, adrenergic agonists;
nervous exhaustion;
frequent stress.

The next section will tell you about the symptoms of the paroxysmal form of atrial fibrillation (atrial fibrillation).

Symptoms

The symptoms of the disease vary from case to case. Thus, some patients experience only discomfort in the area of the heart. But for most people the symptoms are as follows:

sudden attack of heartbeat;
severe general weakness;
lack of air;
coldness of the upper and lower extremities;
sweating;
sometimes trembling.

You may also experience pale skin and blue lips (cyanosis).

If we are talking about a severe case, then the following may occur:

dizziness;
loss of consciousness or fainting state;
panic attacks or similar less dramatic conditions, because a person’s condition sharply and severely worsens, which can cause him strong fear in all my life.

But you shouldn’t immediately panic, such symptoms are typical for many ailments, and without an ECG, the doctor will not be able to determine their exact cause.

At the end of an attack of PMA, the patient usually experiences increased intestinal motility and copious urination. When there is a decrease in heart rate below critical level, then the patient may have a severe deterioration in the blood supply to the brain. This can manifest itself in the form of loss of consciousness, and sometimes cessation of breathing; the pulse cannot be determined. In this case, urgent resuscitation is required.

Diagnostics

As already mentioned, the first and main diagnostic method is electrocardiography. Signs of paroxysmal atrial fibrillation on the ECG will be the absence of the P wave in all leads, instead chaotic f waves are observed. The R-R intervals will vary in duration.

With ventricular PMA, an ST shift remains for several days after an attack. as well as a negative T wave. And, since there is a high probability of a small-focal one, monitoring the patient over time is simply necessary.
If an atrial form of ACA is observed, then the electrocardiogram will indicate a noticeable deformation of the R wave.

Also for the diagnosis of PMA can be used:

Holter monitoring.
An exercise test on an electrocardiogram will help reveal the true heart rate.
The doctor should also listen to the patient's heart using a stethoscope.
The patient may be prescribed ultrasonography heart (ECHO-CG), with the help of which the size of the atria and the condition of the valve apparatus are determined.
Transesophageal ultrasound of the heart, which is rarely performed due to the lack of special equipment, will help doctors more accurately determine the presence/absence of blood clots in the atrial cavity.

The next section will tell you what treatment the paroxysmal form of atrial fibrillation (atrial fibrillation) requires.

Treatment

Treatment of PMA depends, first of all, on the timing of the attack.

If it is less than 2 days old (48 hours), doctors do everything possible to restore sinus rhythm.
If more than 48 hours have passed, complications of an embolic nature are too likely. Therefore, doctors direct treatment to control heart rate, through, for example, anticoagulants (warfarin), which prevent the formation of blood clots by thinning the blood. After three weeks, the specialist returns to the issue of restoring the rhythm.

Therapeutic and medicinal

Most often, medications such as:

digoxin, helps control heart rate;
cordarone, characterized by the presence of a minimal number of side effects from its use;
procainamide, which, when administered rapidly, sometimes causes a sharp decline pressure.

These medications are given intravenously in a hospital setting or by emergency physicians. Typically this treatment is effective in 95% of cases.

During attacks of paroxysmal atrial fibrillation, the doctor may prescribe the patient to take propanorm, which is in tablet form and can therefore be used by the patient independently.

Electropulse therapy

If the previous method is ineffective, the doctor may prescribe electropulse therapy (electric discharge).

The procedure is as follows:

The patient is put under anesthesia;
Two electrodes are installed under the right collarbone and near the top of the “motor”;
The specialist sets the synchronization mode on the device so that the discharge corresponds to the contraction of the ventricles;
Sets the required current value (100-360 J);
Produces an electrical discharge.

In this way, the conduction system of the heart is rebooted, and the effectiveness of the method is almost 100 percent.

Operation

Surgical intervention is indicated for people with frequent relapses of PMA and consists of cauterizing foci of pathological excitation of the heart muscle with a laser. To carry out treatment, a puncture is made in the artery using special catheters.

Read on to find out whether the paroxysmal form of atrial fibrillation (atrial fibrillation) can be treated with folk remedies.

About a unique method of treatment surgically The paroxysmal form of atrial fibrillation will be described in the video below:

Folk remedies

First of all, consult your doctor before taking any folk remedy. These could be:

Hawthorn and his alcohol tinctures with motherwort and valerian. Mix 3 bottles of each product in one bowl, shake well, and place in the refrigerator for a day. After a day, start taking 1 teaspoon three times a day 30 minutes before meals.
Lemon. Cut 0.5 kg of fruit, pour honey, add 20 apricot kernels to the mixture. Use 2 times a day (morning and evening) 1 tablespoon.
Adonis grass. Boil 0.25 liters of water in an enamel bowl. Reduce heat to low, add 4 grams. herbs, boil the mixture for 3 minutes. Cover the finished drink with a lid and leave for at least 20 minutes in a warm place. Take a tablespoon three times a day.

Emergency care for paroxysmal atrial fibrillation

As such, the doctor can:

administer medications:

ajmaline (gilurythmal);
procainamide;
rhythmylene.

It is not advisable to use these drugs when pronounced violations hemodynamics, so as not to aggravate the condition. Therefore, electropulse therapy can be used, as well as intravenous digoxin.

An attack of PMA can be relieved on your own:

Squeeze your abdominals;
Hold your breath;
Press down on your eyeballs.

If this technique does not help, call an ambulance immediately.

Disease prevention

First of all, it is necessary to prevent such heart ailments as heart failure and arterial hypertension. In addition to this you need:

reduce (or better yet eliminate) the consumption of alcoholic beverages;
exclude serious physical activity, it is better to replace it with leisurely walks in the park;
Eliminate fatty and spicy foods from your diet, give preference to foods rich in magnesium and potassium.
As preventive measures The following medications may also be prescribed:
sulfate,
asparaginate (pr. "Panangin").

Complications

As already mentioned, the most frequent sight complications of PMA are the development of heart failure, as well as the appearance of blood clots (eg thromboembolism). Such ailments can cause and lead to cardiac arrest, and with it death. PMA is especially dangerous for diabetics and patients suffering from high blood pressure.

About the prognosis for the medical history " atrial fibrillation, paroxysmal form of atrial fibrillation" is given, read at the end of the article.

Forecast

In general, the prognosis cannot be called negative, especially if an attack of PMA has not provoked more serious illnesses. At proper treatment a person is usually able to live more than 10 years (sometimes 20).

The incidence of ischemic stroke in people with PMA is about 5% per year, that is, every 6th stroke occurs in patients with atrial fibrillation.

The following video will tell you about another very unusual method of treating atrial fibrillation:

Criteria for classifying a patient as a model	· Feeling of heartbeat. · ECG signs atrial fibrillation (absence of P wave, f wave (F).
Classification* 1	Newly diagnosed - any newly diagnosed episode of MA, regardless of the duration and severity of symptoms. Paroxysmal AF - duration is limited to 7 days, characterized by restoration of sinus rhythm, usually within 48 hours. Persistent AF lasts more than 7 days and requires drug or electrical cardioversion to stop it. Long-term persistent AF is defined when the arrhythmia continues for ≥ 1 year and a cardiac rhythm control strategy is selected (a strategy of restoring sinus rhythm and maintaining it using antiarrhythmic therapy and/or ablation). Permanent form of AF is diagnosed in cases where the patient and doctor consider it possible that the arrhythmia may persist, or when previous attempts at cardioversion or cardiac surgery have been unsuccessful.
Complications	· Cardiogenic (arrhythmic) shock. · OKS* 3 . · Acute heart failure (cardiac asthma, pulmonary edema)* 4. · Frederick's syndrome* 5. · Morgagni-Adams-Stokes attack* 5. · SSSU* 5 . · Acute cerebrovascular accident.
Formulation of a detailed diagnosis* 2	· Hypertonic disease Stage III with predominant damage to the heart. Arterial hypertension II degree, risk 4. Atrial fibrillation, persistent course. Stage II B CHF, FC II, decompensation. Cardiac asthma. · Valvular heart disease. Mitral valve insufficiency II degree. Atrial fibrillation. Paroxysm of atrial fibrillation from (date). CHF stage III, FC III, decompensation. Pulmonary edema. Dilated myocardiopathy. Atrial fibrillation, paroxysmal course. Paroxysm of atrial flutter from (date), tachysystolic variant. CHF stage III, FC III, decompensation. Pulmonary edema. · Toxic ethanol myocardial dystrophy. Atrial fibrillation detected for the first time. Paroxysm of atrial fibrillation from (number), tachysystolic variant. Chronic alcoholism. · IHD. PIX from (year). CHF stage III, FC III. Atrial fibrillation, permanent form atrial fibrillation, normosystolic variant. Ventricular tachysystole from (number). · IHD. OKS bp ST. Complicated paroxysm of atrial fibrillation, tachysystolic variant. Atrial fibrillation detected for the first time*.

Medical measures to diagnose a disease or condition.

Instrumental research methods.

Medical services for the treatment of disease, condition and treatment monitoring.

Medical service code	Name of medical service	Note
A05.10.007	Electrocardiographic data monitoring	For all teams.
A11.12.002	Catheterization of the cubital and other peripheral veins	For all teams.
A11.12.003	Intravenous administration medicines	For all teams.
А12.09.005	Pulse oximetry	For all teams.
A20.30.026	Inhalation of oxygen through a mask (catheter)	At SpO2< 90% для всех бригад.
A11.08.009	Endotracheal intubation, tracheal sanitation	For specialized teams if transfer to mechanical ventilation is necessary
А11.08.011	Air duct installation.	For all teams in case of respiratory depression and auxiliary ventilation.
A11.12.001	Catheterization of the subclavian and other central veins	If peripheral venous access is not possible for specialized teams.
A16.09.011	mechanical ventilation	For specialized teams when complications develop (arrhythmogenic shock, pulmonary edema) and there is no effect from routine therapy.
A17.10.001	Electrical pulse therapy (EPT) for pathology of the heart and pericardium	For all teams if complications develop (arrhythmogenic shock, pulmonary edema) and there is no effect from routine therapy.
Type of rhythm disturbance	Pulse energy (J)	Synchronization (if technically possible)
monophasic	biphasic
Atrial fibrillation	200 J increasing to 360 J	100 J increasing to 360 J	Yes
Atrial flutter	50 - 100 J	25 - 50 J	Yes

List of medicinal products for medical use registered on the territory of the Russian Federation, indicating average single doses.

Code	Anatomical-therapeutic-chemical classification	Name medicinal product	Dose	Notes
А12СX	Other minerals		To slow heart rate and/or restore sinus rhythm.
Asparkam	10 ml	IV slowly 10 ml.
Panangin	10 ml	IV slowly 10 ml.
B01AB	Heparin group		One of the drugs during cardioversion.
Enoxaparin sodium	100 mg	1 mg/kg s.c., not more than 100 mg
30 mg	Additional 30 mg IV bolus
Heparin sodium	ME	70 IU/kg IV bolus (not more than 4000 IU); then infusion of 12 IU/kg/h.
В05СВ	Sodium chloride		Basic solution for infusion
Sodium chloride	200 ml	IV drip 200 ml.
B05XA	Electrolyte solutions		To slow heart rate and/or restore rhythm. Drug of choice for ethanol myocardial dystrophy.
Magnesium sulfate	2.5 g	IV slowly up to 2.5 g.
C01AA	Digitalis glycosides		For clinical manifestations of CHF to reduce the frequency of ventricular contractions (VFR).
Digoxin	0.25 mg	IV slowly 0.25 mg.
C01BD	Antiarrhythmic drugs, class III		In patients with organic heart damage. and/or clinical manifestations of CHF. To slow heart rate and/or restore rhythm.
Amiodarone	300 mg	IV 150-300 mg. (injection rate 5 mg/kg/min.)
C01BA	Antiarrhythmic drugs, class IA		In patients without organic heart damage. To slow heart rate and/or restore rhythm. One of the drugs.
Procainamide	1 g	IV 100 mg by monitoring ECG and blood pressure until the effect is achieved.
C01BC	Antiarrhythmic drugs, class IC		In patients without organic heart damage. To slow heart rate and/or restore rhythm. One of the drugs.
Propaphenone	140 mg	IV 1-2 mg/kg slowly.
C01CA	Adrenergic and dopaminergic drugs		With cardiogenic (arrhythmic) shock.
Against the background of a normo/tachysystolic variant of AF.
Norepinephrine	4 mg	IV infusion of 0.5-5 mcg/kg/min under the control of blood pressure and heart rate.
Epinephrine	1 mg	IV infusion 1 mg per 200 ml. physical solution at a rate of 5-10 mcg/min. under the control of blood pressure and heart rate. If norepinephrine is ineffective!
	With bradysystolic variant of MA.
Dopamine	200 mg	IV infusion 5-10 mcg/kg/min under the control of blood pressure and heart rate.
C07AB	Selective beta blockers		To reduce heart rate in patients without clinical manifestations of CHF. Drug of choice for ACS!
Metoprolol	15 mg	IV 5 mg (1-2 mg/min.) with an interval of 5 minutes. until the effect is achieved
C08DA	Phenylalkylamine derivatives		In patients without clinical manifestations of CHF against the background of severe COPD. To slow heart rate and/or restore rhythm.
Verapamil	5-10 mg	IV 5-10 mg slowly.
N01AH	Opioid analgesics		Basic before EIT.
Fentanyl	0.1-0.2 mg	IV in fractional doses of 50 mcg to 0.2 mg.
N05BA	Benzodiazepine derivatives		Sedation before EIT.
	Diazepam	20 mg	IV 20 mg.
N01AX	Other drugs for general anesthesia		When carrying out EIT by specialized teams.
Propofol	200-300 mg	Induction: 40 mg/10 sec before the anesthesia clinic (total dose no more than 1.5-2.5 mg/kg).
Ketamine	100-300 mg	IV 1-2 microns/kg. The highest dose is 300 mg.
N02BA	Salicylic acid and its derivatives		One of the drugs for any type of cardioversion.
Acetylsalicylic acid	160-325 mg	The average loading dose is 250 mg. chew.
Cardiomagnyl	75-300 mg	The average loading dose is 225 mg. chew.
V03AB	Antidotes		In case of respiratory depression due to the administration of narcotic analgesics or for recovery from anesthesia.
Naloxone	0.4-2.0 mg	IV initial dose - 0.4 mg, if necessary, repeated at intervals of 3-5 minutes until spontaneous breathing is restored, maximum dose - 2.0 mg.
V03AN	Medical gases	Oxygen	10 l	Insufflation 5 l/min. w/w mask at SpO2< 90%.; ИВЛ.

Performance criteria.

Restoration of sinus rhythm or reduction of heart rate to target values 80-110 beats per minute. with tachysystolic variant.

· Restoration of sinus rhythm or transition of the correct form of AFL to the incorrect form or MP.

· Stabilization of blood pressure within 100-110 mmHg. for systolic in arrhythmic shock.

· Relief of complications.

Tactical algorithm.

· In case of arrhythmic shock, pulmonary edema, linear and paramedic teams call a specialized team if the patient is at home, and at the same time carry out intensive therapy.

· When a cardiac arrhythmia occurs for the first time, paramedic teams call a specialized team if the patient is at home, and at the same time carry out intensive therapy.

· Hospitalization in a specialized hospital.

· With repeated uncomplicated paroxysms of AF with restoration of sinus rhythm by prehospital stage in persons who do not have severe cardiovascular pathology, emergency hospitalization is not required.

_______________________

*Notes

4. Atrial fibrillation (AF) includes atrial fibrillation and atrial flutter. Emergency therapy (except EIT) and tactics do not depend on the type of MA.

5. Classification of forms of MA. During MA, its various forms can be combined and interchanged. The diagnosis includes the form that is determined during the patient’s hospitalization (see examples of detailed diagnoses).

6. If paroxysm or relapse of AF is complicated by ACS, then this complication in the diagnosis it comes first and is the main diagnosis (see the corresponding protocol).

7. Acute heart failure (cardiac asthma, pulmonary edema), acute coronary syndrome, acute disorder cerebral circulation - see relevant protocols.

8. SSS, Frederick's syndrome - see protocol for bradycardia/bradyarrhythmia and conduction disturbances.

9. Indications for emergency treatment and hospitalization.

Newly diagnosed MA, regardless of its form.

Paroxysmal form of AF/AFL lasting up to 48 hours, regardless of the presence of manifestations significant violations hemodynamics and threatening conditions and heart rate (see above).

Paroxysmal form of AF/AFL lasting more than 48 hours, accompanied by ventricular tachysystole and/or clinical manifestations of significant hemodynamic disturbances and threatening conditions (see above).

Persistent form of AF/AFL, accompanied by ventricular tachysystole and/or clinical manifestations of significant hemodynamic disturbances and threatening conditions (see above).

A permanent form of AF/AFL, accompanied by ventricular tachysystole with clinical manifestations of significant hemodynamic disturbances and threatening conditions (see above).

Irregular heart rhythm or arrhythmia is the most common disease. An abnormal heart rhythm indicates a change in the normal sequence of heart contractions, namely a disorder of the functions of contractility, conduction and excitability. The pathology complicates the course of many heart diseases.

Classification of arrhythmia

According to the International Classification of Diseases (ICD) 10, arrhythmias are assigned code 149. This pathology develops due to existing organic myocardial lesions, impaired water-salt balance or intoxication of the body. Depending on the cause of occurrence, mechanism of development, manifestation clinical picture, prognosis and method of treatment, the ICD 10 code varies.

Normally, in a healthy person, with each contraction of the heart, the atria should first contract, and then the ventricles

Heart rhythm disturbances are accompanied by changes in heart rate. The rhythm is irregular. The following types are distinguished from the cause that caused changes in the functioning of the heart:

automaticity;
conductivity;
excitability.

Below is a table that shows the forms of arrhythmia.

Table of arrhythmia forms

ICD codes for cardiac arrhythmia are divided depending on the type of arrhythmia. IN medical practice distinguish:

bradycardia;
tachycardia;
heart block.

Bradycardia is a decrease in heart rate. Bradycardia has a code according to ICD 10 - 149.8. It is characterized by a heart rate of less than 60 beats/min. Tachycardia – increased heart rate (more than 90 beats/min.). Increased heart rate ICD 10 is indicated under code 147.1. Heart block develops as a result of aging of the heart muscle. It represents a complete stop of the passage of excitation impulses. Heart block is assigned code 145 according to ICD 10.

Atrial fibrillation, what is it?

Atrial fibrillation (AF) is a violation of the rhythm of heart contractions, which is accompanied by frequent and sudden excitation (250–650 beats/min) throughout the entire cycle. With MA, the effect of “flickering” of tissues is created. In medical practice, this pathology is called atrial fibrillation. Arrhythmia code according to ICD 10 – 148. Atrial fibrillation most often develops in people over 50 years of age.

Such fibrillations lead to exhaustion of the heart muscle, which can no longer work effectively.

The prerequisites for the development of MA are:

age;
organic diseases;
chronic diseases;
alcohol abuse.

IN at a young age atrial fibrillation develops against the background birth defects valve apparatus, high blood pressure, coronary disease, cardiosclerosis. TO causal factors also include:

thyroid diseases;
poisoning with chemicals or drugs;
stress;
obesity.

MA can be recognized by rapid heartbeat, heart pain, shortness of breath, increased sweating, increased urination, dizziness and inexplicable feeling panic and fear. Without treatment, atrial fibrillation begins to progress. Attacks become frequent and prolonged. This can lead to heart failure, thromboembolism and complete cardiac arrest.

Attacks of arrhythmia are usually accompanied by a feeling of interruptions in the heart and an arrhythmic pulse

To reduce heart rate, doctors prescribe beta blockers. To prevent the development of a stroke, anticoagulants are prescribed. At severe course diseases is carried out surgical treatment. There are two methods:

Pacemaker implantation.

Sinus arrhythmia

Sinus arrhythmia (SA) is a violation of the rhythm of the heartbeat and the frequency of its contractions. In SA, contractions occur at different intervals. The reason may be:

myocardial infarction;
heart failure;
heart defects;
myocarditis;
drug overdose.

Sinus arrhythmia can develop against the background vegetative-vascular dystonia, with hypothermia, thyroid dysfunction, hormonal imbalance, anemia, increased stress and during pregnancy. Depending on the heart rate, symptoms may vary. With increased frequency, pain in the chest, pulsation in the temples and a feeling of lack of air are observed. With slow heart contractions, patients complain of weakness, drowsiness, and dizziness.

Treatment is prescribed by a cardiologist depending on the individual characteristics of the body. The patient is prescribed Novopassit, motherwort tincture, and Corvalol. In severe cases, therapy is carried out with tranquilizers and antipsychotics.

Heart failure can develop quite quickly and manifest itself as hypertrophy of the myocardial walls, which will aggravate existing ischemia

Paroxysmal arrhythmia

With paroxysmal atrial fibrillation (PAF), an attack of rapid heart rate with a regular rhythm and a frequency of 120–140 beats/min is observed. Paroxysmal atrial fibrillation is characterized by a sudden nature. In medicine, there are 3 forms of it:

Ventricular. It is characterized by a clear deformation of the QRST complex, an altered isoelectric line, and an abnormal heart rhythm.
Atrial. Recognized by deformation of the R wave and impaired conduction right leg Hiss bundle.
Mixed.

The prerequisites for PMA are:

rheumatic heart disease;
sepsis;
thyrotoxicosis;
pneumonia;
diphtheria;
the effect of diuretics taken.

The attack begins suddenly and is often accompanied by noise in the head, dizziness and chest pain. Sometimes it may be accompanied by nausea, sweating, and flatulence. If emergency assistance is not provided to the patient in a timely manner, blood pressure may drop and the person will lose consciousness. As a result of prolonged paroxysm, ischemia of the heart muscle and heart failure can develop.

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION

ON APPROVAL OF THE STANDARD OF MEDICAL CARE FOR PATIENTS WITH AFIBLIAR ARRHYTHMIA

In accordance with Art. 38 Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens of July 22, 1993 N 5487-1 (Gazette of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 33, art. 1318; 2004, N 35, art. 3607)

I ORDER:

1. Approve the standard medical care sick atrial fibrillation(Application).

2. Recommend to the heads of state and municipal medical organizations to use the standard of medical care for patients with atrial fibrillation when providing outpatient care in 2007.

3. Recognize the Order of the Ministry of Health and Social Development of Russia dated November 22, 2004 as no longer in force. N 246 “On approval of the standard of medical care for patients atrial fibrillation «.

Deputy Minister V. I. STARODUBOV

Approved by the Order of the Ministry of Health and social development Russian Federation dated October 5, 2006 N 698

STANDARD OF MEDICAL CARE FOR PATIENTS WITH AFibrillation

1. Patient model

Nosological form: atrial fibrillation(atrial fibrillation)

ICD-10 code: I48

Phase: primary diagnosis

glaucoma

Glaucoma – insidious disease, sneaking up unnoticed. Obvious symptoms of glaucoma do not appear immediately, which makes it difficult effective treatment due to late presentation of the patient. In this section we will tell you about ways to diagnose glaucoma,

Glaucoma - Types Glaucoma - Causes Glaucoma - Symptoms Glaucoma - Diagnosis Glaucoma - Treatment Glaucoma - Prevention Glaucoma - Description Glaucoma is a complex disease, depending on many factors and the specific characteristics of the damage.

The term glaucoma (translated from Greek as the green color of the sea) is found in the works of Hippocrates dating back to 400 BC. However modern ideas knowledge about glaucoma began to emerge only in the middle of the 9th century. Currently the term

Well-known domestic glaucomatologist Professor A.P. Nesterov in his monograph “Glaucoma” rightly notes: “...at present good methods There is no cure for glaucoma. We can only talk about more or less satisfactory methods. TO

There are eye diseases that develop unnoticed, but ultimately lead to complete loss of vision. A classic example is glaucoma. Glaucoma is chronic illness eyes, which increases intraocular pressure. If eye pressure

What is called “glaucoma” today? Glaucoma (from the Greek - the color of sea water, azure) is a serious disease of the organ of vision, named after the greenish color that the dilated and motionless pupil acquires at the stage of the highest development of the painful

Glaucoma (ancient Greek γλαύκωμα - “blue clouding of the eye” from γλαυκός - “light blue, blue”) is a large group of eye diseases, characterized by constant or periodic increase intraocular pressure with subsequent development of typical defects

Treatment of glaucoma with folk remedies can always be combined with the prescription of the attending physician. Here you will find the most effective traditional methods and methods of treating glaucoma from folk and alternative medicine. Glaucoma is a broad group of eye diseases that

Paroxysmal atrial fibrillation ICD 10

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION ORDER October 5, 2006 TREATMENT FOR 180 DAYS ——————————— * Anatomical-therapeutic-chemical classification. TREATMENT FOR 180 DAYS ———————— ——— *Anatomical-therapeutic-chemical classification. N 698 ON APPROVAL OF THE STANDARD OF MEDICAL CARE FOR PATIENTS WITH AFibrillation In accordance with Art. 38 Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens of July 22, 1993 N 5487-1 Gazette of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 33, art. 1318; 2004, N 35, art. 3607 I order 1. Approve the standard of medical care for patients with atrial fibrillation. Recommend to heads of state and municipal medical organizations use the standard of care for patients with atrial fibrillation when providing outpatient care in 2007. The order of the Ministry of Health and Social Development of Russia dated November 22, 2004 is declared invalid.

N 246 “On approval of the standard of medical care for patients with atrial fibrillation.” Deputy Minister V.

I. STARODUBOV APPROVED by order of the Ministry of Health and Social Development of the Russian Federation dated October 5, 2006 N 698 STANDARD OF MEDICAL CARE FOR PATIENTS WITH AFibrillation 1. Patient model Age category adults Nosological form atrial fibrillation atrial fibrillation ICD-10 code I48 Phase primary diagnosis Stage everything stages Complications any complications Conditions for the provision of outpatient care 1.1. Patient model Age category adults Nosological form atrial fibrillation atrial fibrillation ICD-10 code I48 Phase stable constant form Any stage Complications without complications Conditions for the provision of outpatient care 2.1. DIAGNOSTICS 2.

**Approximate daily dose. **Approximate daily dose. ***Equivalent course dose. ***Equivalent course dose. Patient model Age category adults Nosological form atrial fibrillation atrial fibrillation ICD-10 code I48 Phase stable paroxysmal form Any stage Complications without complications Conditions of provision outpatient care 3.1. Example Incorrect IHD. Example Incorrect IHD. Example Incorrect IHD. Example Incorrect IHD.

Angina pectoris 2–3 FC. Post-infarction cardiosclerosis. It turns out that these are 3 different diagnoses, not one. Correct IBS. Correct IBS. Correct IBS. Correct IBS. Angina pectoris 3 FC; post-infarction cardiosclerosis. Coronary heart disease is a delineated nosological form, represented by a number of possible syndromes. Thus, angina pectoris can be a manifestation of both atherogenic ischemia and aortic stenosis and, for example, coronaryitis.

That is, the abbreviation IHD in the diagnosis requires decoding, since it is not a complete diagnosis in itself. This means that you cannot put a period after the abbreviation IHD. A colon is always included, and forms of IHD according to WHO are listed with a small letter separated by a semicolon. In addition, often in the disclosure of the diagnosis under discussion one can encounter incorrect use of the accepted taxonomy.

Each diagnostic formula is self-sufficient and regulated by certain definitions. Well, by at least Such a hybrid of domestic and foreign approaches as “stable exertional angina” causes a smile. Acute transmural infarction of the lateral wall of the left ventricle from. Correctly depending on the period of writing the epicrisis of coronary artery disease.

Transmural infarction or Q-infarction of the lateral wall of the left ventricle, acute/subacute stage.

Electrical activity the atria is chaotic in nature, and the pulse frequency is per minute, which does not allow for their coordinated contraction.

Diagnostics

Paroxysmal arrhythmia

mixed.

first discovered;
paroxysmal;
constant;
persistent;
long-term persistent.

mild symptoms;

Paroxysmal atrial fibrillation code according to ICD 10

Diffuse cardiosclerosis: causes, symptoms, treatment

Any heart pathology entails various consequences that can lead to the development of complications. One of these diseases is diffuse cardiosclerosis, accompanied by relatively uniform scarring of all myocardial fibers. Such growths connective tissue on the heart muscle appear at the site of muscle cell death (for example, in the area of infarction).

Myocardial death in diffuse cardiosclerosis occurs gradually. As it spreads, the patient’s condition worsens: angina attacks become more pronounced, work ability deteriorates, arrhythmia, heart defect or aneurysm, etc. may develop. The lack of adequate treatment when myocardial sclerosis spreads can lead to severe disability and death of the patient. In this article we will talk about the causes, symptoms, principles of diagnosis and treatment of this condition.

Causes

One of the causes of diffuse cardiosclerosis is atherosclerotic plaque.

The proliferation of connective tissue in cardiosclerosis occurs in places where myocardial fibers die, which occurs as a result of various heart pathologies. The main causes of the development of diffuse cardiosclerosis in most cases are coronary heart disease or atherosclerosis coronary arteries. Also to defeat muscle fibers Other conditions and diseases may also result:

arterial hypertension;
arrhythmias;
rheumatism;
myocarditis;
myocardial hypertrophy or dystrophy;
poisoning with salts of heavy metals;
heart injuries;
diabetes;
obesity;
alcoholism;
previous operations on the heart and brain;
improper use of medications;
frequent stress;
elderly age.

Often initial stages diffuse cardiosclerosis are completely unnoticeable and can only be detected during a specialized cardiological examination (for example, during an Echo-CG or ECG). This disease is also characterized by periods of relapse and long-term remission (sometimes it can last several years). That is why it is extremely important that people with heart disease are aware of the signs of this pathology and can promptly suspect the onset of the development of cardiosclerosis.

Symptoms

The diffuse form of cardiosclerosis manifests itself with symptoms that are characteristic of impaired contractility of the heart muscle and heart failure:

At the beginning of the disease, the patient feels its appearance only after impressive physical exertion, but as the growth of scar tissue progresses, this symptom begins to manifest itself even after minor or habitual actions and at rest.
Cough. This symptom is caused by pulmonary edema, which develops against the background of hemodynamic disturbances and heart failure. This cardiac cough, in most cases, is dry and appears after physical activity or while lying down. Subsequently, the patient may experience attacks of cardiac asthma.
Pain in the heart, increased or decreased heartbeat, arrhythmias (atrial fibrillation, paroxysmal, blockade, etc.). These symptoms are caused by the inability of the myocardium to function normally. At first they are weakly expressed and manifest themselves after physical activity, but subsequently they progress and can appear at rest.
Loss of consciousness. This symptom is caused by certain types of arrhythmias (paroxysmal, atrioventricular block, etc.).
Edema. Swelling with cardiosclerosis is more often observed in the lower extremities. Initially it appears in the ankles, but as the disease progresses it can affect the legs and thighs. Swelling appears in the evening and disappears in the morning.
Muscle weakness and decreased endurance. This symptom is caused by insufficient blood supply to the skeletal muscles and occurs during or after physical activity.
Trophic disorders of the skin. Lack of blood supply skin leads to skin pigmentation, hair loss, and deformation of nail plates.
Pain in the right hypochondrium. This symptom is observed infrequently and is caused by stagnation of blood in the big circle blood circulation, which is caused by hemodynamic disturbances. Pain in the liver area is often accompanied by swelling of the jugular veins, swelling of the legs, hydrothorax and ascites.

The severity of signs of diffuse cardiosclerosis depends on the stage of the disease. If you identify such symptoms, you should urgently visit a cardiologist and undergo all types of examinations that will be prescribed by your doctor.

Diagnostics

Cardiological examination of a patient with cardiosclerosis should include:

collecting anamnesis (complaints, previous diseases, living conditions);
listening to the heart;
biochemical blood tests;
Echo-CG;
MRI of the heart.

After analyzing the data obtained during the examination, the cardiologist can prescribe to the patient complex treatment diffuse cardiosclerosis.

Treatment

Treatment of diffuse cardiosclerosis should begin as early as possible and be comprehensive. Its main points are aimed at the following goals:

elimination of ischemia that caused damage to the myocardium by scar tissue;
improvement of the condition and preservation of the remaining myocardial fibers;
elimination of signs of heart failure;
elimination of arrhythmias.

Treatment of the diffuse form of cardiosclerosis can be carried out in outpatient or inpatient conditions. The patient is advised to limit physical activity, give up bad habits and follow a diet.

Some dishes and foods should be excluded from the patient’s diet:

fried meat dishes;
foods rich in cholesterol (offal, egg yolks, etc.);
strong tea;
natural coffe;
foods that cause bloating;
radish;
turnip;
garlic;

IN daily diet consumption should be limited free liquid And table salt. It is recommended to prepare dishes by steaming, boiling, stewing or baking. Food should be consumed in small portions (5-6 times a day).

For conservative treatment ischemia can be used various drugs, the selection of which can only be carried out by a doctor after a diagnostic examination. To normalize coronary circulation, the following can be used:

Nitrates (Nitroglycerin, Nitrosorbide). These drugs help reduce the load on the heart wall, reduce the myocardial oxygen demand, and improve coronary blood flow. Such antiangial drugs can be taken to eliminate and prevent an attack.
Calcium antagonists (Nifedipine, Diltiazem, Veroshpiron). These drugs help lower blood pressure, reduce the load on the myocardium, and eliminate spasm coronary vessels and help reduce the oxygen demand of the heart muscle.
Beta-blockers (Anaprilin, Inderal, Nebivolol). These drugs, their dosage and frequency of administration must be selected strictly individually. Beta-blockers help reduce myocardial oxygen demand (especially during physical exercise), reduce blood pressure and elimination of certain types of arrhythmias.

If it is necessary to reduce blood cholesterol levels, the patient may be recommended to take statins (Rosuvastatin, Simvastatin, Atorvastatin, Lovastatin). These drugs must be taken according to a special schedule and under constant supervision laboratory parameters blood.

If necessary, the patient may be prescribed:

diuretics (Furosemide, Trifas, Britomar, etc.);
antiplatelet agents (Cardiomagnyl, Aspirin);
ACE inhibitors (Enalapril, Ramipril, Captopril).

The dosage, medications and regimen of their administration are selected individually for each patient, and their self-prescription can cause a number of undesirable consequences.

For ischemia that cannot be treated with medication, the patient may be recommended surgical treatment:

coronary artery bypass grafting;
stenting;
pacemaker implantation.

In some cases, diffuse cardiosclerosis can lead to the formation of a cardiac aneurysm. Such a pathology can threaten the patient’s life, and surgery may also be necessary to eliminate it. The essence of this intervention is aimed at excision of the area of protrusion from the vascular wall and its replacement with a special plastic prosthesis or area blood vessel taken from another part of the patient's body.

Prevention of diffuse cardiosclerosis

Basic goals preventive measures to prevent the development of diffuse cardiosclerosis are aimed at eliminating the causes of myocardial ischemia and timely treatment heart pathologies. Those people who are predisposed to developing coronary heart disease should be especially careful about their health.

The main measures to prevent diffuse cardiosclerosis are:

maintaining an active lifestyle;
compliance with the principles of rational nutrition;
eliminating bad habits;
combating stress;
promptly consult a doctor if symptoms of disease are detected of cardio-vascular system.

The development of diffuse atherosclerosis is preceded by many factors. Timely visit to the doctor for preventive examinations, following all his recommendations after identifying other diseases and maintaining a healthy lifestyle will allow many people to avoid such a serious heart pathology as diffuse scarring of myocardial fibers.

Types of coronary heart disease (CHD), symptoms and treatment IHD occupies a strong leading position among the most common heart pathologies, often leading to partial or complete loss of ability to work...

Myocardial infarction: causes and signs Myocardial infarction is called acute condition with coronary heart disease, which is accompanied by significant insufficiency of coronary blood flow...

IHD, angina pectoris: diagnosis and treatment In this article we will talk about angina pectoris. The focus will be on the principles of diagnosis and treatment of the disease, since it is extremely important to distinguish steno...

Please note that all information posted on the site is for reference only and

not intended for self-diagnosis and treatment of diseases!

Copying of materials is permitted only with an active link to the source.

Other heart rhythm disorders (I49)

Excluded:

bradycardia:
- NOS (R00.1)
- sinoatrial (R00.1)
- sinus (R00.1)
- vagal (R00.1)
conditions complicating:
- abortion, ectopic or molar pregnancy (O00-O07, O08.8)
- obstetric surgical interventions and procedures (O75.4)
cardiac arrhythmia in the newborn (P29.1)

Ectopic systoles
Extrasystoles
Extrasystolic arrhythmia
Premature:
- abbreviations NOS
- compression

Brugada syndrome
Long QT syndrome
Rhythm disturbance:
- coronary sinus
- ectopic
- nodal

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document to record morbidity, reasons for the population’s visits to medical institutions of all departments, causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Coding of atrial fibrillation in the ICD

Atrial fibrillation is a disorder of normal heart rhythm, which is characterized by rapid, erratic excitation and contraction of the myocardium. I 49.0 – according to ICD 10, the code for atrial fibrillation, which belongs to class IX “Diseases of the circulatory system”.

Normally, in a healthy person, with each contraction of the heart, the atria should first contract, and then the ventricles. Only in this way is it possible to adequately ensure hemodynamics. If this rhythm is disturbed, arrhythmic and asynchronous contraction of the atria occurs, and the functioning of the ventricles is disrupted. Such fibrillations lead to exhaustion of the heart muscle, which can no longer work effectively. Restrictive and then dilated cardiomyopathy may develop.

Heart rhythm disturbances in ICD 10 are coded as follows:

I 49.0 – “Ventricular fibrillation and flutter”;
I 49.1 – “ Premature contraction ventricles";
I 49.2 – “ Premature depolarization emanating from the connection";
I 49.3 – “Premature atrial depolarization”;
I 49.4 – “Other, unspecified premature reductions”;
I 49.5 – “Sick sinus syndrome”;
I 49.7 – “Other specified heart rhythm disturbances”;
I 49.8 – “Heart rhythm disturbances, unspecified.”

In accordance with established diagnosis, the required code is indicated on the title page of the medical history. This encryption is the official and uniform standard for all medical institutions; it is used in the future to obtain statistical data on the prevalence of mortality and morbidity from specific nosological units, which has prognostic and practical significance.

Reasons for the development of rhythm pathology

Atrial fibrillation can occur for various reasons, but the most common are:

congenital and acquired heart defects;
infectious myocarditis (bacterial, viral, fungal heart disease);
IHD atrial fibrillation (usually as a serious complication acute heart attack myocardium);
hyperproduction of thyroid hormones - thyroxine and triiodothyronine, which have an inotropic effect;
drinking large amounts of alcohol;
as a consequence of surgical interventions or invasive research methods (for example, fibrogastroduodenoscopy);
arrhythmias after strokes;
when exposed to acute or chronic stress;
in the presence of dysmetabolic syndrome - obesity, arterial hypertension, diabetes mellitus, dyslipidemia.

Attacks of arrhythmia are usually accompanied by a feeling of interruptions in the heart and an arrhythmic pulse. Although often a person may not feel anything, in such cases the diagnosis of pathology will be based on ECG data.

Consequences of arrhythmia

Atrial fibrillation in ICD 10 is quite common and has a poor prognosis, subject to inadequate monitoring and treatment. The disease can be complicated by the formation of blood clots and the development of chronic heart failure.

Arrhythmia is especially dangerous in coronary heart disease, arterial hypertension and diabetes mellitus - in these cases, thromboembolism can lead to cardiac arrest, heart attack or stroke.

Heart failure can develop quite quickly and manifest itself as hypertrophy of the myocardial walls, which will aggravate existing ischemia. Arrhythmia in ICD 10 is a common complication of acute myocardial infarction, which can be a direct cause of death.

Add a comment Cancel reply

Scottped on Acute gastroenteritis

Self-medication can be dangerous to your health. At the first sign of disease, consult a doctor.

ICD code 10 paroxysmal arrhythmia

Atrial fibrillation

Atrial fibrillation (ICD-10 code – I48) is atrial fibrillation. This type of heart rhythm disorder is a supraventricular arrhythmia accompanied by tachycardia. The electrical activity of the atria is chaotic, and the pulse frequency is per minute, which does not allow for their coordinated contraction.

Causes and symptoms of atrial fibrillation

The speed with which the ventricles contract directly depends on factors such as the effect of certain pharmacological drugs, the degree of para- and sympathetic activity nervous systems, as well as from the individual properties of the so-called. atrioventricular node. The risk of developing this cardiac pathology increases significantly with age and also depends on the hemodynamic characteristics associated with atrial flutter. Clinical practice shows that atrial fibrillation almost doubles the likelihood of death.

Diagnostics

Diagnosis of atrial fibrillation is based on an electrocardiogram; in this case, P waves are completely absent, but there are many f waves, indicating abnormal atrial flutter. In diagnosis, collecting anamnesis (disease history) is of great importance, since the attending physician needs to find out clinical form atrial flutter. The time of the first attack, as well as the establishment of possible risk factors, also seems necessary. Great importance It also determines which drugs (tablets) help a particular patient stop an attack. A twelve-lead electrocardiogram is required. To establish the presence/absence of organic pathology, echocardiography is performed.

Paroxysmal arrhythmia

Paroxysmal atrial fibrillation is an attack of rapid heartbeat in which absolutely no normal rhythm, but the frequency increases before impacts. As a rule, such an attack begins unexpectedly and ends just as abruptly. During the entire attack of paroxysmal tachycardia, patients complain of chest pain, general weakness, fainting and lack of air even with deep breath. Cyanosis of the lips and general pallor of the skin are objectively determined, which distinguishes the attack from the subjective sensations of the patient. The total duration of the attack can last from several minutes to several days. The end of this period is indicated by abundant diuresis, increased sweating (to the point of “heavy” sweat) and increased, compared to normal, intestinal motility.

Diagnosis of an attack (ICD-10 code – I48) is determined by an electrocardiogram.

Objectively, it is customary to distinguish 3 main forms:

ventricular (characterized by a clearly visible change in the QRST wave);
atrial (characterized by deformation of the R wave on the ECG;
mixed.

After the end of this attack, it may be noted for several days negative T wave. Close monitoring of the patient by a physician is extremely important, since the likelihood of developing a small focus of myocardial ischemia (i.e., infarction) remains.

Classification of atrial fibrillation (ICD-10 code – I48)

first discovered;
paroxysmal;
constant;
persistent;
long-term persistent.

According to the classification of the European Association of Cardiologists, the following forms are distinguished by manifestations:

absence of clinical symptoms;
mild symptoms;
severe symptoms that negatively affect a person’s activity;
symptoms leading to disability.

According to the classification of 201 of the All-Russian Society of Cardiologists, it is customary to distinguish:

tachysystolic form (with tachycardia less than 90 contractions);

bradysystolic (contraction frequency

Heart rhythm disturbances are caused by incorrect creation and conduction of bioelectric impulses, due to which myocardial systole is caused. As a result, the heart may beat very slowly.

A recent US study showed the benefits of cranberry juice in preventing heart disease, stroke and type 2 diabetes. Just 2 glasses of cranberry juice a day have powerful health benefits.

Extrasystole is a disturbance of heart rhythms, also called arrhythmia in medicine. Several types of this pathology lead to the development of complications, if any therapeutic measures will not be undertaken.

Arrhythmia ICD 10

MEDICAL CARE FOR PATIENTS WITH AFIBILIAR ARRHYTHMIA

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION

ON APPROVAL OF THE STANDARD OF MEDICAL CARE FOR PATIENTS WITH AFIBLIAR ARRHYTHMIA

In accordance with Art. 38 Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens of July 22, 1993 N (Vedomosti of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 33, art. 1318; 2004, N 35, art. 3607)

1. Approve the standard of medical care for patients with atrial fibrillation (Appendix).

2. To recommend to the heads of state and municipal medical organizations to use the standard of medical care for patients with atrial fibrillation when providing outpatient care in 2007.

3. Recognize the Order of the Ministry of Health and Social Development of Russia dated November 22, 2004 as no longer in force. N 246 #171; On approval of the standard of medical care for patients with atrial fibrillation #171;.

Deputy Minister V. I. STARODUBOV

Approved by Order of the Ministry of Health and Social Development of the Russian Federation dated October 5, 2006 N 698

STANDARD OF MEDICAL CARE FOR PATIENTS WITH AFibrillation

1. Patient model

Nosological form: atrial fibrillation (atrial fibrillation)

ICD-10 code: I48

Phase: primary diagnosis

glaucoma

Glaucoma is an insidious disease that creeps up unnoticed. Obvious symptoms of glaucoma do not appear immediately, which makes its effective treatment difficult due to the late presentation of the patient. In this section we will tell you about ways to diagnose glaucoma,

The term glaucoma (translated from Greek as the green color of the sea) is found in the works of Hippocrates dating back to 400 BC. However, modern ideas about glaucoma began to take shape only in the middle of the 9th century. Currently the term

Well-known domestic glaucomatologist Professor A.P. Nesterov in his monograph Glaucoma rightly notes: at present, there are no good methods for treating glaucoma. We can only talk about more or less satisfactory methods. TO

There are eye diseases that develop unnoticed, but ultimately lead to complete loss of vision. A classic example is glaucoma. Glaucoma is a chronic eye disease that causes increased intraocular pressure. If eye pressure

What is called glaucoma today? Glaucoma (from the Greek #8212; the color of sea water, azure) is a serious disease of the organ of vision, named after the greenish color that the dilated and motionless pupil acquires at the stage of the highest development of the painful

Glaucoma (ancient Greek γλαύκωμα - blue clouding of the eye from γλαυκός - light blue, light blue) is a large group of eye diseases characterized by a constant or periodic increase in intraocular pressure with the subsequent development of typical defects

Treatment of glaucoma with folk remedies can always be combined with the prescription of the attending physician. Here you will find the most effective folk methods and methods of treating glaucoma from traditional and alternative medicine. Glaucoma is a broad group of eye diseases that

Paroxysmal atrial fibrillation ICD 10

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION ORDER October 5, 2006 TREATMENT FOR 180 DAYS #8212;#8212;#8212;#8212;#8212;#8212;#8212;#8212;#8212;#8212; #8212 ; * Anatomical-therapeutic-chemical classification. TREATMENT ACCORDING TO 180 DAYS *Anatomical-therapeutic-chemical classification. N 698 ON APPROVAL OF THE STANDARD OF MEDICAL CARE FOR PATIENTS WITH AFibrillation In accordance with Art. 38 Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens dated July 22, 1993 N Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, No. 33, art. 1318; 2004, N 35, art. 3607 I order 1. Approve the standard of medical care for patients with atrial fibrillation. To recommend that heads of state and municipal medical organizations use the standard of care for patients with atrial fibrillation when providing outpatient care in 2007. The order of the Ministry of Health and Social Development of Russia dated November 22, 2004 is declared invalid.

N 246 #171; On approval of the standard of medical care for patients with atrial fibrillation#187;. Deputy Minister V.

Angina pectoris 2–3 FC. Post-infarction cardiosclerosis. It turns out that these are 3 different diagnoses, not one. Correct IBS. Correct IBS. Correct IBS. Correct IBS. Angina pectoris 3 FC; post-infarction cardiosclerosis. Coronary heart disease is a defined nosological form represented by a number of possible syndromes. Thus, angina pectoris can be a manifestation of both atherogenic ischemia and aortic stenosis and, for example, coronaryitis.

Each diagnostic formula is self-sufficient and regulated by certain definitions. Well, at least such a hybrid of domestic and foreign approaches as stable angina causes a smile. Acute transmural infarction of the lateral wall of the left ventricle from. Correctly depending on the period of writing the epicrisis of coronary artery disease.

Transmural infarction or Q-infarction of the lateral wall of the left ventricle, acute/subacute stage.

Sinus arrhythmia is a pathological condition in which a person (both an adult and a child) experiences an irregular heartbeat. Abnormal sinus rhythm consists of periods of slowing (bradycardia) and rapid heartbeats (tachycardia). In general, “arrhythmia” is a group of heart diseases that are united by a violation of the sequence, frequency and rhythm of heart contractions. The diagnosis of the disease is determined depending on the specifics of such disorders.

With sinus arrhythmia, there are no equal intervals between heartbeats. For healthy people such a process is completely normal, but sometimes it can indicate the development of diseases of the cardiovascular system, such as ischemia, rheumatism and even heart attack. Abnormal sinus rhythm occurs when excessive consumption medications and neuroses. To accurately determine the causes of this condition, you need to consult a cardiologist who will prescribe an examination, including an ECG, and after diagnosis, choose the optimal treatment regimen.

ICD 10 code

Sinus arrhythmia is included in the group of diseases of the 10th revision, i.e. has a code according to ICD 10. What does this abbreviation mean? ICD is the International Classification of Diseases, which was specially developed by WHO and since 2007 has been a generally accepted classification designed to code various medical diagnoses.

ICD-10 consists of 21 sections, each of which contains subsections with disease codes and pathological conditions of different etiologies. Cardiac dysfunctions are most often associated with disruptions in the conduction of the myocardial conduction system. Based on the results of electrocardiography, the classification of cardiac arrhythmias consists of the following nosologies:

sinus arrhythmias,
paroxysmal tachycardia,
extrasystole,
atrial fibrillation and flutter,
blockades

To accurately diagnose diseases associated with disorders of the heart muscle, it is imperative to undergo a medical examination by a cardiologist. Only by the results of an ECG can one accurately determine the type of disease, as well as identify the degree of its neglect. After the examination, the doctor will prescribe effective treatment using medications and other methods.

Sports and sinus arrhythmia

Sinus arrhythmia requires a review of lifestyle, in particular, giving up bad habits. Daily moderate-intensity physical activity will be useful, as well as swimming, walking, and simple morning exercises.

Sports and non-respiratory sinus arrhythmia are incompatible concepts, especially if a person is involved in running, skiing, cycling, rowing, etc. Active workouts with increased loads may lead to complications of the disease and undesirable consequences. The only exception is respiratory arrhythmia, which does not pose a serious danger or threat to human health. In this case, sports can take place as usual, but constant monitoring by a cardiologist and an ECG every three months are recommended for timely detection and prevention of the development of more severe diseases.

In any case, only a consultation with a doctor will help you decide on limiting physical activity. The results of the medical examination will show whether there is a disease that threatens the person’s health and whether training should be stopped.

Forecast

Sinus arrhythmia, when diagnosed in a timely manner, can be treated quickly and safely, unless it is caused by organic disorders in the functioning of the heart muscle, which require immediate surgical intervention.

The prognosis for sinus arrhythmia is generally favorable, especially for the respiratory type, which often occurs in children during puberty. If this condition is a sign of a serious heart pathology, then the outcome will directly depend on the course and severity of the disease.

The prognosis for coronary heart disease, which is accompanied by myocardial rhythm disturbances, is determined by the type of arrhythmia. Tachycardia or bradycardia does not have a significant effect on the development of coronary artery disease if there are no clinical manifestations.

The outcome of a heart attack can depend on many factors. The age of the patient is of no small importance. According to statistics, in elderly patients (over 60 years of age), mortality as a result of myocardial infarction reaches 39% or higher, and in patients under 40 years of age - only 4%. This indicator is influenced by factors such as lung disease, stroke, widespread atherosclerosis, diabetes mellitus, hypertonic disease, obesity, vein pathology, etc.

Sinus arrhythmia and the army

Sinus arrhythmia often occurs in young men of pre-conscription age. This raises the question of their suitability for military service.

Sinus arrhythmia and army - are these concepts compatible? Partly it all depends on the decision of the medical commission, as well as general well-being person. If the heart rhythm disturbance is not caused by a serious heart pathology, then the young man, naturally, is drafted into the army.

Hazardous to health are:

attacks of atrial flutter and fibrillation, paroxysmal tachycardia;
sick sinus syndrome;
Adams-Stokes-Morgagni attacks;
some forms of ventricular extrasystole.

If the ECG results show the presence of such types of arrhythmia, the man requires treatment, because complications may arise with these pathologies. Their development is associated with myocarditis, cardiosclerosis, and pre-infarction conditions. A symptom of paroxysmal tachycardia is a sharp increase in heart rate, which causes fear and a panic attack. Due to poor blood supply to the brain, dizziness, weakness, severe shortness of breath occur, and cyanosis appears on the face (in the area of the nasolabial triangle). The presence of these diseases significantly reduces the quality of life. The person may have difficulty moving.

After the course of treatment, the medical commission resolves the issue with the army - if the results of therapy are positive and the patient can cope with military duties, he can be taken into the army and examined under point “B”.