Atrial tachyarrhythmia code according to the microbiology 10. What is atrial fibrillation of the heart and how is it dangerous. The nature of the pathology

All cardiologists know in which sections you can find heart rhythm disturbances in ICD-10. This pathology is common among people of different ages. With arrhythmias, the heart rate and coordination are impaired. Some conditions are potentially life threatening and can be fatal.

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Definition of pathology

Arrhythmia is a pathological condition in which the regularity of myocardial contractions and heart rate are disturbed. The conductive function of the organ decreases. Often, this pathology remains unnoticed for a person. There are 3 large groups of arrhythmias:

caused by impaired impulse formation (sick sinus syndrome, extrasystole, atrial and ventricular tachycardia, flutter and flicker);
associated with the difficulty of conducting the impulse (blockade, syndrome of premature excitation of the ventricles of the heart);
combined.

They all have their own distinctive features. Common clinical manifestations include a feeling of heart failure, difficulty breathing, fainting, weakness, and dizziness. Often there is an attack of angina pectoris. Discomfort in the chest is possible.

Development of ventricular premature beats

The group of arrhythmias includes ventricular premature beats. It is characterized by premature excitation of the myocardium. The ICD-10 code for this pathology is I49.3. The elderly are at risk. With age, the incidence rate increases. Single extrasystoles are often detected in young people. They pose no danger and are not pathological.

In the development of ventricular extrasystole, the following factors play a leading role:

angina pectoris;
acute myocardial infarction;
cardiosclerosis;
myocarditis;
inflammation of the pericardium;
vagotonia;
osteochondrosis of the cervical spine;
hypertonic disease;
pulmonary heart;
mitral valve prolapse;
cardiomyopathy;
overdose of medicines.

The classification of extrasystoles is known to all cardiologists. Extrasystoles are early, late and interpolated. By frequency, single, paired, group and multiple are distinguished. This disease is manifested by a feeling of palpitations, weakness, dizziness, a sense of fear and anxiety.

Atrial fibrillation

Atrial fibrillation occupies an important place among diseases characterized by rhythm disturbances. Otherwise, it is called atrial fibrillation. This pathology is characterized by chaotic and frequent (up to 600 per minute) contractions. A prolonged attack can cause a stroke. In many diseases, chaotic waves are formed that make it difficult for the heart to function normally.

This becomes the cause of defective contractions. The heart cannot work at this rate for a long time. It is depleted. Up to 1% of the adult population suffers from atrial fibrillation. There are cardiac and non-cardiac causes of this pathology. The first group includes congenital defects, high blood pressure, heart failure, surgery, rheumatism, myocardial infarction.

Arrhythmia can be caused by thyrotoxicosis, low levels of potassium in the blood, drug overdose, and inflammatory diseases. In the ICD-10, this pathology is under the code I48. Symptoms are determined by the form of atrial fibrillation. With tachysystolic arrhythmias, a person is worried about shortness of breath, frequent heartbeats and chest pain. This pathology is the most difficult.

This condition is characterized by seizures. Their frequency and duration are different. Often, the condition of patients worsens. Specific signs include Morgagni-Adams-Stokes attacks, fainting, polyuria (increased urine output). Often worried about excessive sweating. When examining the pulse, its deficit is revealed. This is due to the fact that not all pulse waves reach the periphery.

Paroxysmal tachycardia

In the international classification of diseases, there is such a pathology as paroxysmal tachycardia. The ICD-10 code for this disease is I47. This is a general concept that unites several pathological conditions. These include recurrent ventricular arrhythmias, supraventricular (sinus), ventricular, and tachycardia of unspecified etiology.

This is a condition in which the heart rate increases against the background of ectopic impulses in the ventricles or atria. The latter is between 140 and 220 beats per minute. The heart of such people works ineffectively. If tachycardia is accompanied by other diseases (cardiomyopathy), then there is a risk of developing circulatory failure.

The following factors play a role in the development of paroxysmal tachycardia:

inflammation;
cardiac muscle necrosis;
sclerosis;
increased activity of the sympathetic nervous system;
heart defects;
heart attack;
hypertension.

More often men are ill. The attack lasts for several seconds or days. With this pathology, neurological symptoms are possible in the form of aphasia, tinnitus and paresis. After an attack, a lot of low-density urine is secreted. Fainting is possible. Paroxysmal tachycardia often has a poor prognosis.

Danger of ventricular fibrillation

The most dangerous forms of cardiac arrhythmias include ventricular fibrillation. This condition can lead to asystole. In this case, emergency assistance in the form of defibrillation is required. Fibrillation (blinking) causes rapid, uncoordinated, and ineffective contractions.

The reason is the formation of numerous chaotic impulses. At fibrillation, blood is not expelled from the heart. This can cause death of a person. With ventricular fibrillation, the following symptoms are possible:

loss of consciousness;
the disappearance of the pulse in the peripheral arteries;
lack of pressure;
convulsions.

After a few minutes, neurons begin to die. Irreversible changes occur in the brain. Ventricular fibrillation is characterized by irregular contractions with a frequency of up to 450 beats per minute. This form of rhythm disturbance develops against the background of shock, hypokalemia, coronary artery disease, heart attack, cardiomyopathy and sarcoidosis.

Examination and treatment tactics

If you have symptoms of arrhythmia, you should consult a cardiologist. The main method for diagnosing this pathology is electrocardiography. In the case of atrial fibrillation, the absence of sinus rhythm (loss of P waves), unequal distance between the complexes, and the presence of small waves are revealed. If a person has atrial flutter, then the waves are larger.

The ventricles contract at the same frequency. Heart rate changes. With ventricular fibrillation, the complexes disappear. Waves of various heights and widths are detected. The heart rate can be as high as 300 beats per minute. With extrasystole, extraordinary ventricular QRS complexes appear on the electrocardiogram. There is also a prolapse of the P wave.

Additional research methods include ultrasound of the heart, sphygmography and rhythmocardiography. Angiography, X-rays, blood tests, and tomography may be needed to determine the cause of the arrhythmia. The results of physical examination (auscultation) are of great importance.

Treatment depends on the underlying pathology. With ventricular extrasystole, it is not always required. In the absence of symptoms, treatment is not carried out. It is recommended to maintain a healthy lifestyle and diet. With severe symptoms, medications are prescribed (sedatives, beta-blockers). With bradycardia, anticholinergics are used.

In severe cases, antiarrhythmic drugs are indicated (Amiodarone, Cordaron). Emergency care for ventricular fibrillation includes resuscitation measures (mechanical ventilation, heart massage). Anti-shock therapy is being carried out. Adrenaline, Atropine and Lycaine are used. Defibrillation is mandatory.

With atrial fibrillation, drugs such as Novocainamide Bufus, Procainamide-Eskom, Cordaron, Amiodarone and Propanorm are prescribed. With a prolonged attack, anticoagulants are indicated. In the event of a complete blockade, the installation of a pacemaker is required. Thus, heart rhythm disturbance is a life-threatening pathology.

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION

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

In accordance with Art. 38 of the Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens' Health of July 22, 1993 N 5487-1 (Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Soviet of the Russian Federation, 1993, N 33, Art. 1318; 2004, N 35, Art. 3607)

I ORDER:

1. To approve the standard of medical care for patients atrial fibrillation(Application).

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

3. To recognize as invalid the Order of the Ministry of Health and Social Development of Russia dated November 22, 2004. N 246 "On approval of the standard of medical care for patients atrial fibrillation «.

Deputy Minister V. I. STARODUBOV

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

STANDARD OF MEDICAL CARE FOR PATIENTS WITH ATIBLE ARRHYTHMIA

1. Patient model

Nosological form: atrial fibrillation(atrial fibrillation)

ICD-10 code: I48

Phase: primary diagnosis

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Treatment of glaucoma with folk remedies can always be combined with the appointment of a doctor. Here you will find the most effective traditional methods and treatments for glaucoma from traditional and alternative medicine. Glaucoma is an extensive group of eye diseases, with

Paroxysmal atrial fibrillation mkb 10

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION ORDER October 5, 2006 TREATMENT FROM CALCULATION OF 180 DAYS ——————————— * Anatomical-therapeutic-chemical classification. TREATMENT FROM THE CALCULATION OF 180 DAYS ———————— ——— * Anatomical-therapeutic-chemical classification. N 698 ON THE APPROVAL OF THE STANDARD OF MEDICAL CARE FOR PATIENTS WITH ATIBLE 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 Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Soviet of the Russian Federation, 1993, N 33, art. 1318; 2004, N 35, Art. 3607 I order 1. To approve the standard of medical care for patients with atrial fibrillation application. Recommend the heads of state and municipal medical organizations to use the standard of medical care for patients with atrial fibrillation in the provision of outpatient care in 2007. To recognize as invalid the order of the Ministry of Health and Social Development of Russia dated November 22, 2004 No.

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 of October 5, 2006 N 698 STANDARD OF MEDICAL CARE FOR PATIENTS WITH ATIBLE ARRHYTHMIA 1. Patient model Category age adults Nosological form atrial fibrillation atrial fibrillation ICD-10 code I48 Phase all primary stages Complications any complications Conditions for providing outpatient care 1.1. Patient model Category age adults Nosological form atrial fibrillation atrial fibrillation ICD-10 code I48 Phase stable permanent form Any stage Complications without complications Conditions for providing outpatient care 2.1. DIAGNOSTICS 2.

** Estimated daily dose. ** Estimated daily dose. *** Equivalent course dose. *** Equivalent course dose. Patient model Category age adults Nosological form atrial fibrillation atrial fibrillation ICD-10 code I48 Phase stable paroxysmal form Any stage Complications without complications Conditions for providing outpatient care 3.1. Example Incorrect ischemic heart disease. Example Incorrect ischemic heart disease. Example Incorrect ischemic heart disease. Example Incorrect ischemic heart disease.

Exertional angina pectoris 2–3 FC. Postinfarction cardiosclerosis. It turns out that these are 3 different diagnoses, and not one. Correctly ischemic heart disease. Correctly ischemic heart disease. Correctly ischemic heart disease. Correctly ischemic heart disease. Exertional angina pectoris 3 FC; postinfarction cardiosclerosis. Ischemic heart disease is a delineated nosological form, represented by a number of possible syndromes. So, angina pectoris can be a manifestation of both atherogenic ischemia and aortic stenosis and, for example, coronaritis.

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

Each diagnostic formula is self-sufficient and regulated by certain definitions. Well, at least such a hybrid of domestic and foreign approaches as "stable exertional angina" evokes a smile. Acute transmural infarction of the lateral wall of the left ventricle from G. 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.

The diagnosis of paroxysmal atrial fibrillation (PMA) is a type of arrhythmia, a violation of atrial contraction. Another name for atrial fibrillation is atrial fibrillation. The paroxysmal form of the disease is characterized by the alternation of normal heart function with the onset of attacks (paroxysms) of tachycardia. With paroxysm, the atria contract irregularly and often (up to 120-240 beats per minute). This condition occurs suddenly and can end spontaneously. Such attacks require immediate medical attention and treatment.

A paroxysmal form of atrial fibrillation is understood as a form of atrial fibrillation, in which an attack of a pathological heart rhythm lasts no more than 7 days, with a longer attack duration, a permanent form of atrial fibrillation is diagnosed

Paroxysm in atrial fibrillation is one of the most common manifestations of atrial contraction disorders. This is a tachycardic attack, which is characterized by an irregular heart rhythm and an increase in heart rate to 120-240 beats per minute.

The ICD 10 classification of diseases assigns the international code I48 to paroxysmal atrial fibrillation.

Attacks of this type of arrhythmia usually begin suddenly. After a while, they stop in the same way. The duration of this state, on average, takes from a few minutes to two days.

The disease is more susceptible to elderly people over 60 years of age. Only in 1% of cases it occurs in young people.

The paroxysmal form of the disease is difficult for humans to tolerate, since with atrial fibrillation, the heart rate becomes high. During an attack, the heart works under increased load, it contracts frequently, but weakly. There is a high likelihood of blood clots in the atria due to blood congestion. Thrombus embolism can lead to ischemic stroke.

A frequent complication of pathology is the development of heart failure.

Clinical picture

Dizziness is one of the symptoms of paroxysmal atrial fibrillation

Paroxysm that occurs during atrial fibrillation manifests itself in certain clinical signs. The symptoms of the disease may differ from case to case. In some patients, at the time of an attack, only pain in the region of the heart is felt. Others may complain of the following symptoms of the disease:

severe weakness throughout the body;
feeling of lack of air;
strong heartbeat;
sweating;
trembling in the body;
feeling of coldness in the upper or lower extremities.

In some patients, during an attack, blanching of the skin and cyanosis, that is, cyanosis of the lips, is observed.

If the attack is severe, then the standard symptoms are supplemented by concomitant symptoms:

dizziness;
semi-faint state;
loss of consciousness;
panic attacks.

The latter symptom often manifests itself, since at the moment of a strong deterioration in well-being, a person begins to seriously worry about his own life.

Important! Symptoms associated with paroxysmal atrial fibrillation may indicate other conditions. To accurately determine the cause of their appearance, it is required to undergo a set of diagnostic measures.

At the end of the attack of paroxysmal atrial fibrillation, the patient has a clear increase in intestinal motility. Also, by this time, there is abundant urination. With an excessive decrease in heart rate, the patient's cerebral blood supply deteriorates. It is this change that explains the development of semi-fainting and fainting states. Cessation of breathing, requiring urgent resuscitation measures, is not excluded.

Possible complications

The paroxysmal form of atrial fibrillation requires compulsory treatment. Otherwise, the disease will lead to serious complications. As a result of untreated pathology, patients develop heart failure, blood clots appear. These conditions lead to cardiac arrest and ischemic stroke. Alzheimer's disease may develop.

The most dangerous complication is death.

Diagnostics

The primary stage in the diagnosis of arrhythmia can be carried out by a therapist or cardiologist using an electrocardiogram

Atrial fibrillation is a sign of a serious illness. A person with atrial fibrillation may need urgent help. However, the correct diagnosis must be made in order to carry out the necessary therapy.

The most important diagnostic method for paroxysmal atrial fibrillation is electrocardiography. The ECG shows the main signs that indicate the disease.

Advice! It is necessary to trust the decoding of the ECG result to a competent specialist. Self-assessment of the result can lead to an incorrect diagnosis.

Holter monitoring, exercise testing, listening to heart sounds with a phonendoscope, ultrasound and ECHO KG are used as auxiliary diagnostic methods.

Treatment

Only a competent specialist can prescribe the correct treatment. With paroxysmal atrial fibrillation, you may need to use different techniques. They are selected individually for each patient.

The choice of the method of therapy directly depends on the duration of the paroxysms and the frequency of their occurrence.

If atrial fibrillation bothers a person for no more than 2 days, then doctors take measures to restore sinus rhythm. At a later date, treatment is required to help prevent the development of life-threatening complications.

In difficult situations, the patient is prescribed therapy, the main goal of which is to restore the correct rhythm of atrial contractions. Additionally, you need to take medications that can thin the blood.

Drug treatment

Class III antiarrhythmic drug, has antiarrhythmic and antianginal effects

With paroxysmal heart rhythm disturbances, due to which the entire cardiovascular system suffers, you can fight using drugs. To reduce heart rate and restore disturbed rhythm. the drug Cordaron is used. It has a minimal number of adverse reactions, therefore it is suitable for the treatment of most patients.

When diagnosed with atrial fibrillation, Novocainamide is often prescribed. The drug is slowly introduced into the human body. During the procedure, it is forbidden to rush, since the injection can dramatically reduce blood pressure, thereby aggravating the situation. In some cases, Digoxin is prescribed, which is able to control the contraction of the ventricles.

Note! The drugs listed above are injected. Therefore, patients should not use them on their own at home. Such drugs are administered to a person during an attack by ambulance doctors or specialists who work in the inpatient department.

If for the first time the prescribed drug showed a good result, then during its use with a new attack, one should not expect the same effect. Each time, the effect of the medication will weaken.

Electro-impulse therapy

Electric pulse therapy is used to treat atrial fibrillation, the procedure is carried out in the clinic in one day, the patient should not eat anything for 6 hours before the start of the session

To eliminate attacks of arrhythmia, a method of electro-impulse treatment was developed. It is prescribed if the medication course does not give the expected result. An electric discharge is indicated for patients who have developed complications due to the next paroxysm.

Electro-impulse treatment is performed according to the standard scheme:

Initially, the patient is put into a state of drug-induced sleep, anesthesia (the procedure is characterized by high painfulness).
2 electrodes are placed on the chest area.
Next, you need to set the required mode, which corresponds to the discharge of atrial contractions;
It remains to set the current indicator and conduct a discharge.

After the discharge, the heart starts its work again. From now on, its functions are performed slightly differently. The electric current "recharges" the conductive system, which is why it is forced to start giving rhythmic impulses of excitation of the sinus node.

Practice shows that this treatment option in most cases guarantees a positive result.

Surgical intervention

If the attacks of the disease occur too often, then the patient will need surgery. It is used to relieve the symptoms of pathology and eliminate its cause. Thanks to this method, arrhythmia attacks are stopped, since the surgeon destroys the focus of pathological excitation in the heart.

The relief of paroxysm and the prevention of new seizures is the main goal of the operation.

Surgery (catheter ablation) is performed using a catheter that is inserted through an artery. If necessary, the operation is repeated after a certain period of time.

What to do in case of an attack?

The patient and his relatives should know what to do in the event of a paroxysm. The following procedures help to completely remove or reduce the degree of intensity of the painful condition:

squeezing the abdominal press;
holding your breath;
pressure on the eyeballs.

At the same time it is necessary to call an ambulance team. The doctor injects the patient intravenously with Korglikon, Strofantin, Ritmilen, Aimalin or Novocainamide. Sometimes the attack is relieved by intravenous administration of potassium chloride.

Forecast

In the prognostic plan, arrhythmias are extremely ambiguous, it is recommended to limit the intake of stimulants (caffeine), exclude smoking and alcohol, self-selection of antiarrhythmic and other drugs

The prognosis for the treatment of paroxysmal atrial fibrillation depends on the disease, against the background of which there was a violation of the rhythm of atrial contraction.

Provided proper treatment with such a disease, you can live for another 10-20 years.

Lack of therapy and failure to provide timely assistance to the patient during an attack of paroxysmal atrial fibrillation can result in the development of dangerous conditions that lead to death.

ICD-10 was introduced into health care practice throughout the Russian Federation in 1999 by order of the Ministry of Health of Russia dated 05/27/97. No. 170

A new revision (ICD-11) is planned by WHO in 2017 2018.

As amended and supplemented by WHO

Processing and translation of changes © mkb-10.com

Treatment and prognosis for persistent atrial fibrillation

Permanent atrial fibrillation is a form of atrial fibrillation. With this rhythm disturbance, a chaotic contraction of the muscle fibers of the atria occurs. This is one of the most common heart disorders.

A permanent form of atrial fibrillation, which has the ICB 10 international classification code, can develop both at a young age and in adulthood. However, it is most often diagnosed in humans after the flight. This is due to the fact that a number of cardiological diseases contribute to its appearance.

The risk of developing the disease increases with age. If at the age of 60 years this type of arrhythmia occurs in 1% out of 100, then at 80 years old - already in 6%.

What is permanent atrial fibrillation

Decoding the elements of the cardiogram

The contraction of the heart is determined by the work of the so-called sinus node. It generates impulses that cause the atria and ventricles to contract in the correct sequence and rhythm. Normally, the heart rate varies within the range of contractions per minute. The atrioventricular node, in turn, is responsible for preventing impulses exceeding 180 per minute from missing during contractions.

If the work of the sinus node for any reason fails, then the atria begin to generate impulses with a frequency of up to 300 and higher. In this case, not all of the impulses enter the ventricles. As a result, they cannot fully work: the atria are not completely filled with blood, and its supply to the ventricles is uneven and in small quantities. A decrease in atrial pumping function entails a gradual decrease in the pumping function of the whole heart.

Atrial fibrillation can be paroxysmal or persistent. Additionally, you can read about the causes of atrial fibrillation in a separate article on our website.

The increase in symptoms can develop over a number of years.

The American Heart Association classifies as permanent all attacks that last more than one week. If the episode of disruption of the sinus node lasts up to 2 days, we are talking about a paroxysmal form. The duration of an attack from 2 to 7 days indicates the development of a persistent form of the disease.

In the paroxysmal form, the normal activity of the sinus node is restored by itself.

However, it has already been proven that with frequent attacks for a long time, changes occur in the atria, as a result of which the paroxysmal form can eventually transform into persistent, and then into permanent. Therefore, the appearance of the first attacks of fibrillation requires an appeal to a cardiologist.

An important sign of persistent atrial fibrillation is the inability to maintain sinus rhythm without medical attention. Also, this type of arrhythmia is extremely rare in healthy people. As a rule, it is accompanied by a number of diseases of the cardiovascular system.

Heart attack with strokes is the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blockages in the arteries of the heart or brain. In almost all cases, the reason for such a terrible end is the same - pressure surges due to hypertension.

Causes of atrial fibrillation

External and internal reasons can provoke the development of the disease. External include:

taking arrhythmogenic drugs;
long-term alcohol consumption;
long-term smoking;
some types of surgery;
exposure to vibrations in the workplace;
intoxication with toxic substances;
intense physical activity;
hyper- and hypothermia.

It is important to note that these factors can provoke the development of atrial fibrillation, in particular constant atrial fibrillation, in persons predisposed to cardiac diseases and already having changes in the work of the heart, since in this case there is already a violation of the automatic regulation of the cardiovascular system.

Risk factors include:

cardiac ischemia;
arterial hypertension (high blood pressure);
dysfunction of valves and their pathological changes;
cardiomyopathies of various types;
tumors of the heart;
thyrotoxicosis (hyperfunction of the thyroid gland);
chronic lung disease;
calculous cholecystitis;
kidney disease;
hernia of the diaphragm;
diabetes mellitus, predominantly type II.

Various inflammatory diseases of the heart muscle can cause the development of atrial fibrillation:

It is believed that pathological changes in the nervous system can also trigger the development of arrhythmias. Thus, individuals with cardio-neurosis and cardiophobia should be carefully examined and receive adequate treatment for arrhythmias to prevent the development of the disease.

The disease develops in 5-10% of patients with arterial hypertension and in 25% of people with coronary artery disease and heart failure. At the same time, further coronary artery disease and a permanent form of atrial fibrillation mutually aggravate each other's course.

There is a connection between the development of the disease and the presence of severe hypertrophy (enlargement) of the left ventricle, diastolic dysfunction of the left ventricle. Mitral valve defects dramatically increase the likelihood of developing the disease.

Symptoms of a persistent form

25% of patients may not feel any symptoms of rhythm disturbance. However, most often this is a consequence of the fact that a person does not pay attention to a number of changes in well-being, considering them a sign of age, vitamin deficiency or fatigue.

The presence of persistent atrial fibrillation can be indicated by:

weakness and fatigue;
frequent dizziness and fainting;
a feeling of interruptions in the work of the heart;
palpitations;
dyspnea;
chest pain;
cough.

Typically, these symptoms occur after exercise. Its degree does not matter - even small physical efforts can cause similar symptoms.

At the time of attacks, a feeling of panic may appear. Atrial fibrillation differs from vegetative disorders with panic attacks and hypertensive crisis of the vegetative type in that at the time of the attack there is not a rise, but a drop in blood pressure.

A hallmark of constant fibrillation is an irregular pulse with different filling. At the same time, there is a pulse deficit when its frequency is less than the heart rate.

Hypertension, ischemic heart disease, angina pectoris, valvular defects aggravate the symptoms of the disease.

Diagnostic methods

Basic research methods:

It is important to differentiate the disease from diseases that are similar in symptomatology, such as:

sinus tachycardia;
various forms of tachycardia;
atrial extrasystoles;
vegetative-vascular dystonia with panic attacks.

From this point of view, the most informative method is ECG, which is specific for each type of arrhythmia.

The constant form on the ECG is manifested by an irregular rhythm and irregular R-R intervals, the absence of P waves, the presence of irregular F waves with a frequency of up to. The ventricular rhythm can be regular or not.

Holter monitoring is a valuable research method, because it allows you to identify all rhythm fluctuations during the day, while a conventional ECG study may not give a complete picture.

During a personal examination, the doctor reveals an irregularity of the pulse and interruptions in its filling. An irregular heartbeat is also heard.

Treatment methods

With this type of arrhythmia, the doctor rarely has the goal of normalizing the sinus rhythm. Although, with an uncomplicated form of the disease, you can try to return the normal sinus rhythm with the help of drug treatment or electrocardioversion. If it is impossible to achieve this, the task is to normalize the heart rate (HR) in the corridor of beats per minute at rest and up to 120 beats during physical activity. It is also important to reduce the risk of blood clots and thromboembolism.

Contraindications to the restoration of sinus rhythm are:

the presence of intracardiac blood clots,
weakness of the sinus node and bradycardic form of atrial fibrillation, when the heart rate is reduced;
heart defects requiring surgery;
active rheumatic diseases;
severe arterial hypertension of the 3rd degree;
thyrotoxicosis;
chronic heart failure of the 3rd degree;
age over 65 years in patients with heart disease and 75 years in patients with coronary heart disease;
dilated cardiomyopathy;
left ventricular aneurysm;
frequent attacks of atrial fibrillation requiring intravenous antiarrhythmic drugs.

The restoration of the rhythm is carried out with the help of antiarrhythmic drugs such as Dofetilide, Quinidine, Amiodarone, as well as with the help of electrical impulse therapy.

In the case of persistent atrial fibrillation, the effectiveness of drugs in restoring the rhythm is 40-50%. The chances of success with the use of electrical impulse therapy increase to 90% if the disease lasts no more than 2 years and is still the same 50% if it lasts more than 5 years.

Recent studies have shown that antiarrhythmic drugs in people with diseases of the cardiovascular system can have the opposite effect and worsen the course of arrhythmias and even cause life-threatening side effects.

Therefore, the first choice is drugs that lower the heart rate.

B-blockers (drugs in the treatment of permanent atrial fibrillation - metoprolol, propranolol) and calcium antagonists (verapamil) in combination form allow to reduce the heart rate to the required limits. These drugs are often combined with cardiac glycosides (digoxin). Periodically, the patient should be monitored for the effectiveness of treatment. For this purpose, Holter ECG monitoring and veloergometry are used. If it is not possible to achieve normalization of the heart rate with medication, then the question arises of surgical treatment, in which the atria and ventricles are isolated.

Since the formation of blood clots is one of the most formidable and frequent complications of persistent atrial fibrillation, treatment involves the administration of anticoagulants and aspirin in parallel. As a rule, such treatment is prescribed to patients over 65 years of age who have a history of stroke, high blood pressure, heart failure, diabetes mellitus, malfunctioning of the thyroid gland, and ischemic heart disease.

For people over 75 years old, anticoagulant therapy is prescribed for life. Also, on an ongoing basis, such drugs are prescribed on an ongoing basis for those who have a high risk of stroke and thromboembolism. The only absolute contraindication to the appointment of anticoagulants is an increased tendency to bleeding.

With the brady form (rare pulse) of the disease, electrocardiostimulation has shown high efficiency. Stimulation of the ventricles with electrical impulses can reduce the irregularity of the rhythm in patients with a tendency to bradycardia at rest when taking medications to lower the heart rate.

The simultaneous ablation of the atrioventricular node and the installation of a pacemaker can improve the quality of life of patients who do not respond to antiarrhythmic drugs, as well as those who have a combination of left ventricular systolic dysfunction in combination with a high heart rate.

Treatment with folk remedies

Alternative methods should be used in parallel with medications prescribed by a doctor. This greatly facilitates the patient's condition and reduces the risk of side effects. Herbal medicine will also help to reduce the dose of medications taken or to gradually abandon them.

First of all, decoctions and tinctures of plants are used that normalize the heart rate. These include hawthorn, calendula, motherwort. The action of mixtures is most effective.

For the treatment of arrhythmia, you can prepare infusions from the above plants, taken in equal proportions. Drink the infusion three times a day for a quarter of a glass. The treatment is long lasting, for several years.

You can mix ready-made tinctures of hawthorn, calendula and motherwort. Drink the mixture three times a day, 30 drops.

Decoctions and infusions of yarrow and mint have proven themselves well. Yarrow, mint, calendula are boiled and mixed with honey. The mixture is taken at 150 mg 3-4 times a day. Tea made from viburnum, cranberry and lemon mixed with honey has a beneficial effect on well-being.

Hypertension and pressure surges caused by it - in 89% of cases kill the patient with a heart attack or stroke! How to cope with pressure and save your life - an interview with the head of the Institute of Cardiology of the Russian Red Cross.

Lifestyle with persistent atrial fibrillation

With arrhythmias, it is extremely important to start leading a healthy lifestyle. You should stop eating fatty, spicy, smoked foods and increase the amount of cereals, vegetables and fruits in the diet. Preference should be given to those that are good for the heart: figs, dried apricots, persimmons, apples, bananas.

Exercise, daily walks, walking, swimming will help exercise the heart muscle and lower blood pressure. However, patients will have to give up sports with heavy loads, as they can provoke a deterioration.

You need to constantly monitor your condition and regularly visit your doctor. With drug treatment with anticoagulants, if bruising occurs, you should immediately discontinue the drug and consult a doctor to eliminate the risk of internal bleeding.

It is important to inform your doctors about the medications you are taking, especially if you are about to have a dental procedure.

Possible complications

Atrial fibrillation is not considered a life-threatening disease, although it can significantly reduce its quality. However, it aggravates the course of existing concomitant diseases of the cardiovascular system. This is the main danger of the disease.

Constant atrial fibrillation causes persistent circulatory disorders and chronic oxygen deprivation of tissues, which can negatively affect the tissues of the myocardium and brain.

In the overwhelming majority of patients, there is a gradual decrease in exercise tolerance (tolerance). In some cases, a detailed picture of heart failure may appear.

The presence of this form of arrhythmia increases the risk of developing heart failure up to 20% in men and 26% in women, with population mean values of 3.2% and 2.9%, respectively.

Coronary and cerebral reserves are reduced, which means the risk of developing myocardial infarction and stroke. Today, persistent atrial fibrillation is considered one of the main causes of ischemic strokes in the elderly. According to statistics, the incidence of strokes in patients with permanent atrial fibrillation is 2-7 times higher than in the rest. Every sixth case of stroke occurs in a patient with atrial fibrillation.

Life forecast

When receiving constant adequate treatment, the prognosis of life with atrial fibrillation is quite favorable. The patient's standard of living at the required quality can be maintained medically for a long time. The most favorable prognosis in patients who do not have severe cardiac and pulmonary diseases. In this case, the risk of thromboembolism is minimized.

With age, with an increase in the symptoms of heart disease, an increase in the size of the left atrium may occur. This increases the risk of thromboembolism and death. Among people of the same age, mortality in the group with atrial fibrillation is twice as high as in those with sinus rhythm.

Useful video

What is atrial febrillation is very clearly and in detail shown in the following video:

Persistent atrial fibrillation is a disease that requires regular monitoring by a cardiologist and receiving ongoing treatment. In this case, in each case, the treatment is selected by the doctor, based on the individual characteristics of the patient. Only in this case it is possible to prevent the development of complications that pose a threat to life.

Do you have a question or experience on a topic? Ask a question or tell us about it in the comments.

I48 Atrial fibrillation and flutter

Atrial fibrillation is a rapid, chaotic contraction of the atria. It occurs more often in men over 60 years of age. Risk factors include smoking, fatty foods, alcohol abuse, lack of exercise, and being overweight. Genetics doesn't matter.

During an attack of atrial fibrillation, the atria contract weakly at a rate of about once a minute. Only a fraction of the impulses that cause this rapid heartbeat travel through the heart to the ventricles, which also contract faster than normal, about 160 times per minute. Because the atria and ventricles contract at different rates, the heart becomes uneven, which reduces the amount of blood pumped.

Atrial fibrillation can begin for no apparent reason, especially in the elderly, but it usually occurs when the atria are enlarged due to heart valve disease, coronary artery disease, and high blood pressure. Risk factors for most of these diseases are smoking, lack of exercise, fatty foods, and being overweight. Atrial fibrillation is often seen in people with an overactive thyroid gland or low potassium levels in their blood. In addition, alcoholics and people suffering from respiratory arrest during sleep are at risk.

Atrial fibrillation is not always accompanied by symptoms, but if they appear, then suddenly. The following sensations can be periodic or permanent:

rapid and uneven heartbeat;
dizziness;
dyspnea;
chest pain.

The most severe complications of atrial fibrillation are stroke and heart failure, and the risk increases with age. Since atrial fibrillation does not completely empty the atria, blood stagnates in them, and this can lead to its clotting. If part of the clot breaks down and enters a blood vessel, it can block an artery anywhere in the body. A stroke occurs when a blood clot clogs a cerebral artery.

If atrial fibrillation develops, see your doctor. A doctor can diagnose atrial fibrillation from an uneven and rapid heart rate. An EKG is done to confirm the diagnosis, as well as blood tests to identify an underlying cause, such as hyperthyroidism. Once the underlying cause (such as hyperthyroidism or hypertension) is diagnosed and treated, the symptoms of arrhythmia also resolve. When atrial fibrillation is diagnosed early, it is successfully terminated with defibrillation. Atrial fibrillation is usually treated with antiarrhythmic drugs such as beta-blockers or digitalis drugs. These drugs slow the passage of impulses from the atria to the ventricles, giving them enough time to fill with blood before contracting. Antiarrhythmic drugs are then prescribed to restore a normal heart rhythm. The patient will also be prescribed the anticoagulant warfarin, which reduces the risk of blood clots and therefore the likelihood of a stroke.

Complete medical reference book / Per. from English E. Makhiyanova and I. Dreval. - M .: AST, Astrel, 2006.

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Atrial fibrillation mcb 10

Atrial fibrillation or atrial fibrillation mcb 10 is the most common type of arrhythmia. For example, in the United States, it affects approximately 2.2 million people. They often experience ailments in the form of fatigue, lack of energy, dizziness, shortness of breath and heart palpitations.

How dangerous is their future and can such a disease be cured?

What is the danger of atrial fibrillation mcb 10?

In addition, the clot can get into other parts of the body (kidneys, lungs, intestines) and provoke various kinds of deviations.

Atrial fibrillation, microbial code 10 (I48) reduces the heart's ability to pump blood by 25%. In addition, it can lead to heart failure and pulse spikes.

How to identify atrial fibrillation?

For diagnostics, specialists use 4 main methods:

Electrocardiogram.
Holter monitor.
A portable monitor that transmits essential and vital data about the patient's condition.
Echocardiography

These devices help doctors know if you have heart problems, how long they last, and what the cause is.

There is also the so-called persistent form of atrial fibrillation, you need to know what it means.

Atrial fibrillation treatment

Specialists select a treatment option based on the results of the examination, but most often the patient should go through 4 important stages:

Restore normal heart rate.
Stabilize and control your heart rate.
Prevent blood clots.
Reduce the risk of stroke.

In addition to taking medication, you should change some of your habits:

If you notice that your heart problems are related to a certain activity, you should give it up.
Quit smoking!
Limit alcohol consumption. Moderation is key. Ask your doctor to compose or find a safe dose of alcohol for you.
According to the specification - atrial fibrillation mcb 10 - beverages such as coffee, tea, cola and over-the-counter caffeinated drugs are responsible for many heart-related symptoms. If possible, eliminate them from the diet or reduce the usual dose.
Beware of medicines for coughs and colds. They contain a component that causes spontaneous heart rhythms. Read the labels and ask your pharmacist to find the right and safe medicine for you.

Believe me, if you go to get well, you will definitely succeed.

Copying site materials is possible only if there is an indexed hyperlink to the resource!

What is permanent atrial fibrillation

How is persistent atrial fibrillation manifested? This question will be answered by a qualified cardiologist, who should be contacted in case of characteristic symptoms.

Atrial fibrillation (or flutter) is the most common form of heart rhythm abnormalities after extrasystolic disturbances that doctors often encounter in daily practice.

Now atrial fibrillation is the reason for hospitalization of 1/3 of patients with cardiovascular disorders.

There is a paroxysmal form of atrial fibrillation. Consider the question of what it means, and, of course, the key aspects of this topic.

Why does the disease develop?

The International Classification of Diseases (ICD) has assigned a specific international code to each ailment.

Constant atrial fibrillation has an ICD 10 code number 148.

The frequency of occurrence of AF in residents of our country is 0.5%. There is a significant quantitative correlation between different classifications of this violation.

But almost all of them, due to the presence of a varied prognosis, including depending on the type of therapy chosen, imply their obligatory differentiation, this is how chronic and paroxysmal forms of atrial fibrillation differ.

The chronic form is permanent and persistent.

The permanent form of AF should include a variety that lasts about 10 days. If the case of fibrillation is 5 days, we are talking about a persistent type of AF.

And in a situation of duration of the fact of AF up to 2 days, a paroxysmal form of the disease is revealed.

Today, permanent AF combines a complementary element to its own definition, according to which it is characterized by a condition during the period when the sinus rhythm cannot be maintained at the end of the cardioversion process or in a situation where the attending specialist and the patient due to the presence of certain circumstances decided not to subject the sinus rhythm to the recovery process.

When and under what circumstances is atrial fibrillation possible? The possibility of progression of atrial fibrillation is determined by the factors of the age group to which the patient belongs, and the presence of an organic disease in the region of the heart and blood vessels, which include ischemic and other types of heart disease, arterial hypertension and a violation of the valvular structures of the heart muscle.

Today, type 2 diabetes mellitus should be considered as an isolated factor provoking the development of AF.

With regard to the age factor, it is believed that the possibility of AF progression increases rapidly when the patient reaches 55 years of age and continues to increase as he ages, in the presence of acquired heart diseases.

How is persistent atrial fibrillation manifested?

So, as the age of 60 years approaches, AF appears in 1% of residents, and in patients after 80 years - in 6% of cases. In coronary artery disease, not only the detection of coronary atherosclerosis, but also the presence of complications of this ailment is of primary importance. –0.8%.

In a situation where people with coronary artery disease have a clinical picture of this disease, as well as other heart diseases similar in severity and nature, the likelihood of AF manifestation increases to 25%.

In people with arterial hypertension, AF is common - in 10% of patients, and in the case of combining arterial hypertension with IHD, the probability of AF progression increases to 20%.

It should be said that the level of its frequency is characterized by a strong degree of correlation with a pronounced degree of hypertrophic failure in the left ventricular region, the presence of diastolic disorder of the left ventricle, in the event of detection of systemic failures and transmitral blood flow that changes the hemodynamic load on the heart.

The determining role in this process is inherent in the activation of the myocardial renin-angiotensin-aldosterone system in hypertension of the arteries, which helps to stimulate myocardial fibrosis.

AF in the presence of rheumatic myocarditis, occurring without valve damage, is an extremely rare occurrence - 5% of patients. But in the case of detection of a defect in the valve structures, and it does not matter, mitral stenosis or another type, the likelihood of AF progression increases rapidly.

About 50% of patients with aortic valve calcification and developing stenosis have paroxysmal or permanent AF. In addition, there is an isolated type of AF observed in people who have reached 60 years of age, in whom precursors of heart and pulmonary diseases are not diagnosed by physiological and laboratory-instrumental methods. ...

These patients have a good prognosis for recovery due to the presence of an extremely low probability of vascular thrombosis and death. However, by the nature of the disease progression over the years, as well as structural cardiac pathology and an increase in the parameters of the left atrium, the risk of thromboembolism and death increases.

In medical research, the frequency of AF by itself ranges from 12% of all AF cases to 30%.

Pathophysiological formations associated with atrial fibrillation.

Despite extensive research, AF disease remains associated with a significant number of scientifically significant problems.

In a large number of patients, the disease is reduced to a decrease in the susceptibility to physical activity to the active manifestations of the disease, cardiac and cerebral vascular blood flow decreases. Today, AF should be considered as one of the underlying causes of strokes, particularly in the elderly.

In addition, the disease causes an increase in the degree of anxiety and a significant deterioration in the quality of life.

Due to its prevalence, this disease is a tangible problem for medicine. What to do if a permanent form of fibrillation is detected?

Upon completion of the process of diagnosing a permanent form of AF, a specialist is faced with a certain range of questions:

Is there a possibility of carrying out heart rate restorative procedures in a particular patient?
If the heart rate is not subject to restorative measures, then how can the frequency of contractions of the heart muscle be normalized?
Preventive measures for the disposal of thromboembolic complications.

How is the disease treated?

Treatment is an important point in this disease.

Distinguish between drug treatment and therapy with folk remedies. Drug treatment includes the use of antiarrhythmic drugs, as well as the use of physiotherapy aimed at preventing this disease.

The main role of the doctor in this case is to normalize the heart rate and prevent thrombophlebitis. For this, a range of blocker drugs, antiarrhythmic drugs, calcium channel blocking drugs, including blood thinners, are prescribed.

You should not take these drugs on your own for the treatment and prevention of the disease - their appointment is the responsibility of a specialist who observes the patient.

As for the folk methods of treating this ailment, there is a wide range of herbs and infusions.

The following herbal remedies will help cure the disease and maintain the body in a normal state:

Treatment with folk remedies is not a substitute for the main one, but only acts as its addition.

The electrical activity of the atria is chaotic, and the frequency of impulses is per minute, which makes it impossible for their coordinated contraction.

Diagnostics

Paroxysmal arrhythmia

mixed.

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

mild symptoms;

Paroxysmal atrial fibrillation code 10

Diffuse cardiosclerosis: causes, symptoms, treatment

Any pathology of the heart 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 of connective tissue on the heart muscle appear in the place of death of muscle cells (for example, in the heart attack zone).

Myocardial death in diffuse cardiosclerosis occurs gradually. With its spread, the patient's condition also worsens: the attacks of angina pectoris become more pronounced, the ability to work worsens, arrhythmia, heart defect or aneurysm, etc. may develop. Lack of adequate treatment with the spread of myocardial sclerosis 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 the places of death of myocardial fibers, which occurs due to various pathologies of the heart. The main reasons for the development of diffuse cardiosclerosis in most cases is ischemic heart disease or atherosclerosis of the coronary arteries. Also, other conditions and diseases can lead to damage to muscle fibers:

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

Often, the initial stages of diffuse cardiosclerosis proceed completely imperceptibly and can only be detected during a specialized cardiological examination (for example, during an Echo-KG or ECG). Also, this disease is characterized by periods of relapse and prolonged remission (sometimes it can last for several years). That is why it is extremely important that people with heart disease know about the signs of this pathology and can suspect the onset of the development of cardiosclerosis in time.

Symptoms

The diffuse form of cardiosclerosis manifests itself as 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 with the progression of the proliferation of scar tissue, 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 heart cough is usually dry and occurs after exercise or when lying down. Subsequently, the patient may experience attacks of cardiac asthma.
Heart pain, increased or weakened heartbeat, arrhythmias (atrial fibrillation, paroxysmal, blockade, etc.). These symptoms are caused by the inability of the myocardium to function normally. At first, they are poorly expressed and manifest themselves after physical exertion, but subsequently progress and may appear at rest.
Loss of consciousness. This symptom is caused by some types of arrhythmias (paroxysmal, atrioventricular blockade, etc.).
Swelling. Puffiness with cardiosclerosis is more often observed on the lower extremities. Initially, it appears in the ankle area, but as the disease progresses, it can affect the shins and thighs. Swelling appears in the evening, and disappears in the morning.
Weakness in muscles and decreased endurance. This symptom is caused by insufficient blood supply to the skeletal muscles and occurs during or after exercise.
Trophic disorders of the skin. Insufficient blood supply to the skin leads to the appearance of skin pigmentation, hair loss, deformation of the nail plates.
Pain in the right hypochondrium. This symptom is observed infrequently and is caused by stagnation of blood in the systemic circulation, which is caused by a violation of hemodynamics. Liver pain is often accompanied by swelling of the jugular veins, leg edema, hydrothorax, and ascites.

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

Diagnostics

Cardiological examination of a patient with cardiosclerosis should include:

collection of anamnesis (complaints, previous illnesses, living conditions);
listening to the heart;
biochemical blood tests;
Echo-KG;
MRI of the heart.

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

Treatment

Treatment of diffuse cardiosclerosis should begin as early as possible and be comprehensive. Its main points are aimed at such 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 on an outpatient or inpatient basis. The patient is advised to limit physical activity, give up bad habits and follow a diet.

Some dishes and products should be excluded from the patient's diet:

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

In the daily diet, the intake of free liquid and table salt should be limited. We recommend steaming, boiling, stewing or baking. Food should be consumed in small portions (5-6 times a day).

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

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

If it is necessary to lower the level of cholesterol in the blood, the patient may be advised to take statins (Rosuvastatin, Simvastatin, Atorvastatin, Lovastatin). These drugs should be taken according to a special scheme and under constant monitoring of laboratory blood parameters.

If necessary, the patient can be assigned:

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

Dosage, drugs and their regimen are selected individually for each patient, and their self-administration can cause a number of undesirable consequences.

In case of ischemia that cannot be eliminated with medication, the patient may be advised to perform surgical treatment:

coronary artery bypass grafting;
stenting;
implantation of a pacemaker.

In some cases, diffuse cardiosclerosis can lead to the formation of a heart 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 excising the protrusion area from the vascular wall and replacing it with a special plastic prosthesis or a section of a blood vessel taken from another part of the patient's body.

Prevention of diffuse cardiosclerosis

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

The main measures for the prevention of diffuse cardiosclerosis are:

leading an active lifestyle;
observance of the principles of rational nutrition;
exclusion of bad habits;
fight stress;
timely access to a doctor if symptoms of diseases of the cardiovascular system are detected.

The development of diffuse atherosclerosis is preceded by many factors. A timely visit to a doctor for preventive examinations, adherence to 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 (IHD), symptoms and treatment of IHD occupies a strong leading position among the most common heart pathologies, often leads to partial or complete disability ...

Myocardial infarction: causes and symptoms Myocardial infarction is an acute condition in ischemic heart disease, which is accompanied by a significant insufficiency of coronary blood flow ...

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

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

not intended for self-diagnosis and treatment of diseases!

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Other cardiac arrhythmias (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 procedures and procedures (O75.4)
neonatal arrhythmia (P29.1)

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

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

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

ICD-10 was introduced into health care practice throughout the Russian Federation in 1999 by order of the Ministry of Health of Russia dated 05/27/97. No. 170

A new revision (ICD-11) is planned by WHO in 2017 2018.

As amended and supplemented by WHO

Atrial fibrillation encoding in ICD

Atrial fibrillation is a violation of the normal heart rhythm, which is characterized by rapid, erratic excitement and contraction of the myocardium. I 49.0 - according to ICD 10 code of atrial fibrillation, belonging to class IX "Diseases of the circulatory system."

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

Violation of the heart rhythm in ICD 10 is coded as follows:

I 49.0 - "Fibrillation and flutter of the ventricles";
I 49.1 - "Premature contraction of the ventricles";
I 49.2 - "Premature depolarization emanating from the compound";
I 49.3 - "Premature depolarization of the atria";
I 49.4 - "Other, unspecified premature contractions";
I 49.5 - "Syndrome of weakness of the sinus node";
I 49.7 - "Other specified cardiac arrhythmias";
I 49.8 - "Unspecified cardiac arrhythmias."

In accordance with the established diagnosis, the required code is put 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 a variety of 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 of acute myocardial infarction);
hyperproduction of thyroid hormones - thyroxine and triiodothyronine, which have an inotropic effect;
drinking a lot of alcohol;
as a consequence of surgical interventions or invasive research methods (for example, with fibrogastroduodenoscopy);
arrhythmias after strokes;
when exposed to acute or chronic stress;
in the presence of dysmetabolic syndrome - obesity, arterial hypertension, diabetes mellitus, dyslipidemia.

Arrhythmia attacks are usually accompanied by a feeling of interruption in the work of 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 fairly common and has a poor prognosis if inadequately monitored and treated. The disease can be complicated by the formation of blood clots and the development of chronic heart failure.

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

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

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Self-medication can be hazardous 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 frequency of impulses is per minute, which makes it impossible for their coordinated contraction.

Causes and symptoms of atrial fibrillation

The rate at which the ventricles contract directly depends on factors such as the action of certain pharmacological drugs, the degree of activity of the para- and sympathetic nervous systems, as well as on 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 features associated with atrial flutter. Clinical practice shows that atrial fibrillation almost doubles the probability of death.

Diagnostics

Atrial fibrillation is diagnosed based on an electrocardiogram; there are no P waves at all, but there are many f waves indicating abnormal atrial tremor. In diagnosis, it is of great importance to collect anamnesis (history of the disease), since the attending physician needs to find out the clinical form of atrial flutter. The timing of the first attack is also necessary, as well as the establishment of possible risk factors. It is also of great importance which drugs (tablets) help a particular patient to stop an attack. An electrocardiogram is required to be performed in twelve leads. To establish the presence / absence of organic pathology, echocardiography is performed.

Paroxysmal arrhythmia

Paroxysmal atrial fibrillation is an attack of rapid heartbeat, in which an absolutely normal rhythm is maintained, but the frequency of strokes increases. As a rule, such an attack begins unexpectedly, and just as abruptly ends. During the entire attack of paroxysmal tachycardia, patients complain of chest pain, general weakness, fainting and lack of air even with a deep breath. The cyanosis of the lips and the general pallor of the skin are objectively determined, which distinguishes the attack from the subjective sensations of the patient. The total duration of an attack can last from several minutes to several days. The end of this period is indicated by abundant diuresis, increased sweating (up to "pouring" sweat) and increased, in comparison with the usual, intestinal peristalsis.

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 traceable change in the QRST wave);
atrial (characterized by deformation on the ECG of the R wave;
mixed.

At the end of this attack, a negative T-wave may be noted for several days. It is extremely important to closely monitor the patient by the doctor, since the likelihood of developing a small focus of myocardial ischemia (i.e., heart attack) 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 Cardiology, the following forms are distinguished by manifestations:

lack of clinical symptoms;
mild symptoms;
bright symptoms that negatively affect human activity;
symptoms leading to disability.

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

tachysystolic form (with tachycardia less than 90 contractions);

bradystolic (frequency of contractions

Violation of the heart rhythm is due to the incorrect creation and conduct of bioelectric impulses, due to which myocardial systole is caused. As a consequence, the heart is capable of beating or very slow.

A recent US study found that cranberry juice can help prevent heart disease, stroke, and type 2 diabetes. Just 2 cups of cranberry juice a day has a powerful healing effect.

Extrasystole is a violation of heart rhythms, also called arrhythmia in medicine. Several types of this pathology lead to the development of complications if no therapeutic measures are taken.

Arrhythmia mkb 10

MEDICAL CARE FOR PATIENTS WITH AFILIC ARRHYTHMIA

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION

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

In accordance with Art. 38 of the Fundamentals of the Legislation of the Russian Federation on the Protection of the Health of Citizens of July 22, 1993 N (Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Soviet of the Russian Federation, 1993, N 33, Art. 1318; 2004, N 35, Art. 3607)

1. To 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 in the provision of outpatient care in 2007.

3. To recognize as invalid the Order of the Ministry of Health and Social Development of Russia dated November 22, 2004. 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 of October 5, 2006 N 698

STANDARD OF MEDICAL CARE FOR PATIENTS WITH ATIBLE ARRHYTHMIA

1. Patient model

Nosological form: atrial fibrillation (atrial fibrillation)

ICD-10 code: I48

Phase: primary diagnosis

glaucoma

The famous Russian glaucomatologist professor A.P. Nesterov, in his monograph Glaucoma, rightly notes: there are currently no good methods of treating glaucoma. We can only talk about more or less satisfactory methods. TO

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

Glaucoma (ancient Greek γλαύκωμα - blue cloudiness of the eye from γλαυκός - light blue, 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

Paroxysmal atrial fibrillation mkb 10

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION ORDER 5 October 2006 TREATMENT FROM THE CALCULATION OF 180 DAYS # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212 ; * Anatomical-therapeutic-chemical classification. TREATMENT BASED ON 180 DAYS # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; # 8212; * Anatomical-therapeutic-chemical classification. N 698 ON THE APPROVAL OF THE STANDARD OF MEDICAL CARE FOR PATIENTS WITH ATIBLE ARRHYTHMIA In accordance with Art. 38 of the Fundamentals of the Legislation of the Russian Federation on the Protection of the Health of Citizens of July 22, 1993 N Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Soviet of the Russian Federation, 1993, N 33, art. 1318; 2004, N 35, Art. 3607 I order 1. To approve the standard of medical care for patients with atrial fibrillation application. Recommend the heads of state and municipal medical organizations to use the standard of medical care for patients with atrial fibrillation in the provision of outpatient care in 2007. To recognize as invalid the order of the Ministry of Health and Social Development of Russia dated November 22, 2004 No.

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

Each diagnostic formula is self-sufficient and regulated by certain definitions. Well, at least a smile is caused by such a hybrid of domestic and foreign approaches as stable exertional angina. Acute transmural infarction of the lateral wall of the left ventricle from G. 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) has an irregular heartbeat. An abnormal sinus rhythm consists of periods of slowing (bradycardia) and increased frequency (tachycardia) of heart beats. In general, "arrhythmia" is a group of heart diseases, which 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 quite normal, but sometimes it can indicate the development of diseases of the cardiovascular system, such as ischemia, rheumatism and even a heart attack. Abnormal sinus rhythm occurs with excessive medication and neuroses. To accurately determine the causes of this condition, it is necessary to consult a cardiologist, who will prescribe an examination, including an ECG, and, after diagnosis, will choose the optimal treatment regimen.

Icb code 10

Sinus arrhythmia is included in the grouping of diseases of the 10th revision, i.e. has a code for mkb 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 for various medical diagnoses.

ICD-10 consists of 21 sections, each of which contains subsections with codes of diseases and pathological conditions of different etiology. Cardiac disorders are most often associated with failures in the conduction of the myocardial conduction system. According to the results of electrocardiography, the classification of cardiac arrhythmias consists of the following nosologies:

sinus arrhythmias,
paroxysmal tachycardia,
extrasystole,
atrial fibrillation and flutter,
blockade.

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

Sports and sinus arrhythmia

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

Sports and non-respiratory sinus arrhythmia are incompatible concepts, especially if a person is engaged in jogging, skiing, cycling, rowing, etc. Active training with increased loads can lead to a complication of the course 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, however, it is recommended that constant observation by a cardiologist and an ECG be taken every three months for the timely detection and prevention of the development of more serious diseases.

In any case, only a doctor's consultation will help determine the limitation of physical activity. The results of the medical examination will show whether there is a medical condition that threatens human health and whether training should be abandoned.

Forecast

Sinus arrhythmia, with timely diagnosis, is quickly and safely treated, unless it is caused by organic disorders in the work of the heart muscle, which require immediate surgical intervention.

The prognosis of sinus arrhythmia is generally favorable, especially for the respiratory type, which is common 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 ischemic heart disease, which is accompanied by myocardial rhythm disturbances, is determined by the type of arrhythmia. Tachycardia or bradycardia does not significantly affect the development of coronary artery disease if there are no clinical manifestations.

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

Sinus arrhythmia and the army

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

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

Dangerous to health are:

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

If the results of the ECG showed the presence of such types of arrhythmias, the man needs treatment, because with these pathologies complications may arise. Their development is associated with myocarditis, cardiosclerosis, preinfarction state. A symptom of paroxysmal tachycardia is a sharp increase in heart rate, which causes fear, an attack of a panic attack. Due to poor blood supply to the brain, dizziness, weakness, severe shortness of breath occur, 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 walking.

After the course of treatment, the medical board decides 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 item "B".