Fast heartbeat while sleeping

Introduction The heartbeat is quick when sleeping, the pathological tachycardia is common with sick sinus syndrome, and the compensatory heartbeat after myocardial injury caused by various causes is myocardial ischemia and left ventricular dysfunction. Cardiac insufficiency (heart failure) is an abnormality of the heart's systolic and diastolic function caused by different causes, so that when the circulating blood volume and vasomotor function are normal, the blood pumped by the heart does not meet the needs of the tissue, or can only be filled in the ventricle. When the pressure is increased, the metabolic needs are met. At this time, the neurohumoral factors are activated to participate in the compensation, forming a clinical syndrome with various features of hemodynamic function director and neurohumoral activation.

Cause

Cause: It may be a little high blood pressure, or it may be myocardial ischemia, left ventricular dysfunction. In order to adapt to the increased demand for blood in the whole body after the increase in activity, the heartbeat is increased to supply more blood from a static state to a state of motion, from a low-volume state such as walking to a high-running state such as running, and There are from lying posture to sitting, standing posture, from sitting posture to standing posture. Because the heart needs blood pressure to a higher place, it is also necessary to increase the heart rate.

an examination

Related inspection

Dynamic electrocardiogram (Holter monitoring) ECG

Diagnosis: Myocardial ischemia may also present asymptomatic and physical signs, while clinical examination has evidence of myocardial ischemia, such as ST segment changes, myocardial perfusion defects, and wall motion abnormalities. Usually after coronary artery occlusion, the following changes occur: coronary blood flow decreased, local blood supply and blood demand ratio changed, coronary sinus blood oxygen content decreased; myocardial systolic function and diastolic function decreased; left ventricle Increased diastolic blood pressure; ECG changes, such as ST-segment elevation or depression; chest discomfort. However, these abnormalities often occur in a short period of time, and patients may never have chest discomfort.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Heart palpitations with abnormal heart rate: palpitations is a sense of discomfort or palpitation of a heart beat. When the heart rate is increased, it is felt that the heart beats discomfort, and when the heart rate is slow, it feels powerful. When you have a heart palpitations, your heart rate can be fast, slow, or have arrhythmia. People with normal heart rate and heart rhythm can also have heart.

2. Speed up after a meal: It is normal to cause heart rate to increase after a meal. It is seen in many normal people. If the patient's condition is frequent, it is recommended to check the ECG and so on. Actively find the cause and symptomatic treatment.

3. Heart rate is faster: the normal heart rate should be between 60 and 90 beats per minute, and the athlete's heart rate may be slightly slower. The mechanism for controlling the speed of a person's heartbeat is as follows: there is a sinus node at the root of the aorta, which spontaneously emits electrical stimulation, transmits the current to the myocardium through the conduction beam, causing myocardial contraction; at the same time, the medulla in the central nervous system It is the heartbeat center, which emits a sympathetic nerve that accelerates the heartbeat and a vagus nerve that slows the heartbeat. Usually, the sympathetic and vagus nerves are in equilibrium. In an emergency, the sympathetic nerves are excited, and the heartbeat is accelerated, so that the blood pumped by the heart increases every minute, and more blood is supplied to the whole body to cope with the crisis. At night, the vagus nerve is excited. To slow down the heartbeat, the heart reduces blood supply to the whole body.

4. Heart skipping speed: If the adult heart rate exceeds 100 beats/min, it is called the heart skip speed.

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