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Paroxysmal Tachycardia

Categories: Uncategorized
Sources: Disturbances Of The Heart

This condition is generally termed by the patient a "palpitation,"

and palpitation of the heart is recognized by most physicians as

meaning a too rapidly acting heart, the term "tachycardia" being

reserved for an excessive rapidity of the heart. Many of the so-

called tachycardias are really instances of auricular fibrillation

or flutter. Some persons normally have a pulse and heart too rapid;

children more or less con
tantly have a heart beat of from 90 to

100. Women have more rapid heart action than men, and it becomes

more rapid with their varying functions, specifically increasing its

rapidity before, and perhaps during, menstruation. Many patients

have a rapid heart action with the slightest increase in temperature

and in any fever process. Some have a rapid heart action after the

least exertion without any cardiac lesion or assignable excuse for

such rapidity. Others have a rapid heart with mental activity and

excessive excitement. Therefore in deciding that a heart is

abnormally rapid one must individualize the patient.

During or after illness many patients are said to have palpitation

when the real cause is an unhealed myocarditis. Tuberculosis almost

invariably causes increased heart action, even when there is no

fever. All high fever increases the heart's action, but not so

markedly in typhoid fever as in other fevers; in fact, the heart in

typhoid fever, during the early stages, is apt to be slower than the

temperature would seem to call for. In anemia when the patient is

active the heart is generally rapid. The rapid heart from cardiac

disease has already been considered. For the palpitation or rapid

heart Just described there is little necessity for other treatment

than what the acute or chronic condition would call for. With proper

management the condition will improve unless the patient has an

idiosyncrasy for intermittent attacks of slightly rapid heart, as

from 100 to 120 beats per minute.

A permanently rapid heart, when the patient has no heart lesion and

is at rest, is generally due to hypersecretion of the thyroid, which

will be discussed later. Paroxysmal tachycardia is a name applied to

very rapid heart attacks in persons who are more or less subject to

their recurrence. They may occur without any tangible excuse, and

are liable to occur during serious illness, after a large meal,

after a cup of tea or coffee, or after taking alcohol. The heart may

beat as rapidly as from 150 to 200 times a minute, or even more,

with no other symptoms than a feeling of constriction or tightness

in the chest, an inability to respire properly and a feeling of "air

hunger." The patient almost invariably must sit up, or at least have

his head raised. Attacks of cardiac delirium (often auricular

fibrillation) may occur with serious lesions of the heart, as

valvular disease or sclerosis, but paroxysmal tachvcardia occurs in

certain persons without any tangible cardiac excuse. The auricles of

the heart may act more energetically than normal, and precede as

usual the ventricular contraction; or the auricles and ventricles

may contract almost together--a so-called "nodal" type of

contraction. Rarely does a patient die of paroxysmal tachycardia.

The length of time the attack may last varies from a few minutes to

an hour, or even for a day or more.