What does premature ejaculation mean?

Everyone knows that a normal person's heart needs to beat every day, and the frequency of this beating is within a certain normal range. If the frequency is abnormal, there is a problem with the heart. The phenomenon of premature beats is a common condition in heart disease, but many people still don’t quite understand what premature beats mean. Next, I will introduce to you what premature beats mean.

Causes

Premature beats can occur in normal people. But it is more likely to occur in patients with cardiac neurosis and organic heart disease. Emotional excitement, nervous tension, fatigue, indigestion, excessive smoking, drinking or drinking strong tea can all cause attacks. There may also be no obvious triggers. The toxic effects of digitalis, barium, quinidine, sympathomimetic drugs, chloroform, cyclopropane anesthetics, potassium deficiency, and heart surgery or cardiac catheterization can all cause attacks. Coronary heart disease, advanced mitral valve disease, heart disease, myocarditis, hyperthyroidism heart disease, mitral valve prolapse, etc. are prone to premature beats.

Clinical manifestations

Premature beats may be asymptomatic or may cause palpitations or a feeling of cardiac arrest. Frequent premature beats can cause symptoms such as fatigue and dizziness (due to reduced cardiac output). For people with existing heart disease, this can induce or aggravate angina pectoris or heart failure. Auscultation may reveal irregular heart rhythm and a long compensatory interval after premature beats. The first heart sound of premature beats is often enhanced, while the second heart sound is often weakened or disappeared. When premature beats are in a binomial or tripeminic rhythm, a long pause can be heard after every two or three heartbeats. Premature beats are inserted between two regular heartbeats and may appear as three consecutive heartbeats. Palpation of the pulse may reveal an intermittent pulse.

Classification

The common electrocardiographic feature of premature beats is one or more P-QRS complexes that are earlier than the basic heart rhythm.

1. Atrial premature beats

The P wave appears early, its morphology is different from the P wave of the basic heart rhythm, and the PR interval is >0.12s. QRS waves are mostly the same as those of sinus rhythm, sometimes slightly widened or deformed, accompanied by corresponding changes in ST and T waves, which is called intraventricular differential conduction and needs to be distinguished from ventricular premature beats. When atrial premature beats are accompanied by intraventricular aberrations, an early and abnormal P wave can be seen before the abnormal QRS complex. A premature distorted P wave may not be followed by a corresponding QRS wave, which is called a blocked atrial premature beat. It needs to be differentiated from sinus arrhythmia or sinus arrest. If an abnormal premature P wave is found on the ST segment or T wave of the previous heart beat, it can be diagnosed as atrial premature beat due to block. Atrial premature beats often invade the sinoatrial node, causing it to depolarize prematurely. The sinoatrial node then spontaneously depolarizes and restarts the original cycle, forming an incomplete compensatory interval. Occasionally, a complete compensatory interval is seen after atrial premature beats.

Frequent atrial premature beats (marker A) have an early abnormal P on the T wave of the previous heartbeat. If the transmitted QRS wave is different from the sinus wave, it is intraventricular differential conduction. If there is no QRS wave after the first and eighth marks A, it is a blocked atrial premature beat.

2. Premature beats at the atrioventricular junction

Except for the earlier onset, its electrocardiographic features are similar to those of atrioventricular junctional escape. When premature beats invade the sinoatrial node, an incomplete compensatory interval is formed. When premature beats do not interfere with the spontaneous depolarization of the sinoatrial node, a complete compensatory interval is formed.