Advanced age and the presence of hypertension are risk factors for the onset of atrial fibrillation, an arrhythmia to be ascertained quickly
I am 83 years old and for a couple of months I have been suffering from nocturnal tachycardia (70/80 beats per minute), which usually wakes me up because, at rest, I have 42/44 beats per minute. One night the tachycardia increased beyond 130 beats/min. I’ve done a lot of sport, I’m a good walker and I follow an almost vegan diet. I don’t think I have any anxiety or stress issues. I had a cardiology visit with a Doppler ultrasound and everything was normal. I take daily cardioaspirin, an anti-cholesterol drug for a TIA (transient ischemic attack) that I had in 2018, an antihypertensive and hormone therapy for prostate recurrence. What could cause nocturnal tachycardia?
He answers Fabrizio TundoDepartment of Arrhythmology, Monzino Cardiology Center, Milan (GO TO THE FORUM).
The sensation of palpitations with the perception of a rapid heartbeat (tachycardia) an event that is common and does not necessarily indicate significant pathology or rhythm disturbances. Sinus tachycardia, which is a simple acceleration of the physiological heart rate beyond 100 beats/minmay be secondary to other factors external to the heart, including anemia, hormonal alterations (such as hyperthyroidism), inflammation, gastrointestinal disorders, anxiety; can be conditioned byabuse of stimulants such as caffeine or due to the use of drugs that activate the sympathetic system (for example bronchodilators for asthma or ephedrine-based nasal decongestants). In your case there may be tachycardia due to an arrhythmia, an abnormal rhythm of the heart. The anamnestic data available, in particular the age over 80 years (even if well carried and with excellent lifestyle habits) and the presence of hypertensionrepresent risk factors for the onset of atrial fibrillationa very common arrhythmia (it is estimated that one in ten patients over the age of 80 is affected).
very important to diagnose a possible atrial fibrillation for the therapeutic implications that derive from it. The main symptom of fibrillation is the perception of an accelerated heartbeat, which tends to be irregular (it is described as the heart jumping continuously or fluttering). Some patients, on the other hand, do not perceive palpitations, but they can feel them general weakness and more easily fatigued, or variable shortness of breath during exertion. The fact that you had a TIA a few years ago is extremely relevant, as the detection of episodes of atrial fibrillation would require the use of an anticoagulant therapy to prevent new similar episodes. Atrial fibrillation, in fact, in addition to generating symptoms such as those described by you in many patients, is associated with an increased risk of cerebral ischemia or cardioembolic strokeThis is due to the migration of a clot (embolus) from the atrium of the heart, where the rapid and weak contraction due to fibrillation can cause a slowdown in blood flow and the formation of small clots (thrombi).
This is just a suspect in his case, but the execution of a recording with a 24h electrocardiographic Holter is highly recommendedor preferably more prolonged if the episodes are not daily (Holter 48h or even up to 7 days), in order to more likely catch a symptomatic event and check how your electrocardiogram behaves in correspondence with the episode. If the presence of an arrhythmia is confirmedyou will need an office visit with a cardiologist or arrhythmologist. In the event of prolonged palpitations for a few hours, it may be advisable to go to the emergency room for a direct check of the heart rhythm and to administer the necessary therapy.
November 22, 2022 (change November 22, 2022 | 10:49 am)
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