Ритм и аритмия сердца у человека

У здорового человека сердце сокращается ритмично, интервалы между отдельными пульсовыми волнами одинаковы.

При заболеваниях сердечно-сосудистой системы часто возникают нарушения ритма сердечных сокращений, которые называются аритмиями. Последние наблюдаются чаще всего при заболеваниях сердечной мышцы или проводящей системы сердца; аритмия возникает иногда вследствие расстройства деятельности блуждающего или симпатического нерва.

Важнейшими для оценки состояния здоровья человека есть такие виды аритмий:

1. Экстрасистолическая. При этом виде аритмии между двумя очередными сокращениями сердца возникает дополнительная систола — экстрасистола;
пауза, следующая за экстрасистолой, называется компенсаторной паузой, она длиннее обычной. Экстрасистолы могут быть одиночными (появляются через определенное число пульсовых волн) или беспорядочными и групповыми.

При некоторых заболеваниях возникают приступы экстрасистолической тахикардии, которые длятся от нескольких секунд до нескольких дней и даже месяцев. Они называются пароксизмальной тахикардией.

2. Мерцательная аритмия характеризуется отсутствием какой-либо закономерности ритма и наполнение пульса. В этом случае малые и большие пульсовые волны возникают беспорядочно.

Мерцательная аритмия всегда является следствием тяжелого поражения миокарда, она появляется при пороках сердца, кардиосклерозе, базедовой болезни. Очень часто при мерцательной аритмии развивается так называемый дефицит пульса. В этом случае не все сердечные сокращения выбрасывают в артерии достаточное количество крови, некоторые сокращения бывают такие слабые, что пульсовая волна не достигает периферических артерий и поэтому при ощупывании не определяется. Появление дефицита пульса указывает на ухудшение работы сердца. Поэтому при мерцательной аритмии недостаточно бывает только подсчитать пульс на лучевой артерии, обязательно нужно подсчитать число сердечных сокращений.

Признаком тяжелого поражения сердечно-сосудистой системы является так называемый поочередный пульс, при котором попеременно чередуются слабые и  сильные пульсовые волны.

При дикротическом пульсе образуется двугорбая пуль  сова волна.

Появление аритмий, особенно при одновременном ослаблении и ускорении пульса, указывает на ухудшение сердечной деятельности, о чем нужно немедленно сообщить врачу.

Исследования сосудистой стенки. При нормальном состоянии стенка артерии мягкая, гладкая, ровная, эластичная. Твердая или жесткая сосудистая стенка свидетельствует о ее поражении, часто наблюдается у лиц пожилого возраста.

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