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Using a stethoscope, your doctor will listen to your heartbeat. If healthy, a heart will have a steady rhythm and produce a “lub-dub” sound whenever it beats. The closing of the mitral and tricuspid vales create the first sound in your heartbeat. The second sound comes from the aortic and pulmonary valves closing after blood leaves your heart.
Cardiac arrhythmias, also known as heart arrhythmias, are the abnormal and irregular heart rhythms that occur when the heart beats too slowly, too quickly, or erratically. Anywhere along the heart chambers’ nerve signal pathway, there may be a disturbance, causing a heart arrhythmia. Heart arrhythmias come in many forms and levels of severity; the most serious cases can result in a heart attack or even a sudden death. Treatments include medications, pacemakers, electrophysiologic ablations, and implantable cardioverter-defibrillators.
 
 
Anatomy
 
Your cardiovascular system is made up of the heart and the blood vessels that transport blood all throughout your body. The heart, which is a large fist-sized muscle, is the core of your cardiovascular system. Located leftward in your chest, the heart works as a pump for the blood, which delivers oxygen and nutrients to your body’s cells while carrying away waste products.
 
A thick wall, called the septum, divides your heart into four sections called chambers. The upper two chambers, called atria, receive incoming blood to the heart, while the bottom chambers, called ventricles, send blood outward from the heart.
 
Your heart manages dual pumping systems with one on the left side and one on the right side. The left side’s system comprises the left ventricle and left atrium. When you breathe in, your lungs infuse your blood with new oxygen. Your left atrium receives this newly oxygenated blood and moves it to the left ventricle, which sends it out from your heart to circulate all through the rest of your body.
 
The right side’s pumping system is composed of the right ventricle and right atrium. Deoxygenated blood that has finished circulating throughout the body comes back to the right atrium, which then sends it to the right ventricle. The blood is then sent by the right ventricle to the lungs, where it will receive a fresh supply of oxygen when you inhale.
 
Four valves prevent blood from flowing backward as it travels through the chambers of the heart. The tricuspid and mitral valves control flow from the atria to the ventricles, while the pulmonary and aortic valves regulate blood as it departs the ventricles.
 
Your heart’s four chambers contract in a coordinated and very precise manner. Electrical impulses from the sinus node, which is the heart’s natural pacemaker, control the contractions. The impulses travel down a specific route: the sinus node through the atrium, then down the atrio-ventricular node and through the ventricles.
 
Using a stethoscope, your doctor will listen to your heartbeat. If healthy, a heart will have a steady rhythm and produce a “lub-dub” sound whenever it beats. The closing of the mitral and tricuspid vales create the first sound in your heartbeat. The second sound comes from the aortic and pulmonary valves closing after blood leaves your heart.
 
Causes
 
A heart arrhythmia will occur when there is a disturbance at any point along the nerve signal pathway that goes through the heart. Depending on where the disturbance happens, there is a variety of heart arrhythmia types. Heart arrhythmias may stem from heart attack, heart conditions, endocrine abnormalities, and blood chemistry imbalances. Factors of irregular heart rhythms include caffeine, illegal drugs, and medications. If left untreated, heart arrhythmias can be potentially fatal.
 
Some types of arrhythmia:
 
Atrial fibrillation is a very rapid and uneven heart rate. The heart will improperly pump blood at a rate that can be up to seven times as fast as normal.
Atrial flutter is caused by unusual nerve firing.
Bradycardia, a slow heartbeat, is caused by problems with the sinus node, which is the heart’s internal pacemaker.
Premature atrial contraction, characterized by extra or premature beats, is caused by problems in the atria.
Premature ventricular contraction, characterized by extra or premature beats, is caused by problems in the ventricles.
Sick sinus syndrome is when the heart rate slows down and becomes irregular due to an improperly functioning sinus node.
Supraventricular tachycardia, a rapid heartbeat, is caused by the ventricles.
Tachycardia is a rapid heartbeat that involves either the ventricles or the atria.
Ventricular fibrillation is an irregular and fast heartbeat during which little to no blood is being pumped from the heart. It is an extremely serious condition that requires medical attention immediately and may cause sudden death.
Ventricular tachycardia is a rapid heartbeat that begins in the atria.
 
Symptoms
 
You may or may not experience symptoms from a heart arrhythmia. Symptoms include heart palpitations, the sensation of a fast, irregular, or slow heartbeat, the feeling that your heart is skipping beats, lightheadedness, dizziness, faintness, chest pain, pale and sweaty skin, and shortness of breath. In some severe cases, you may have a heart attack.
 
If a heart attack is suspected, call an ambulance immediately. Heart attack symptoms include nausea, vomiting, shortness of breath, pressure or pain in the middle of the chest, and pain that spreads outward from the chest into the shoulders, arms, teeth, or jaws. Because heart attacks are potentially fatal, immediately medical care is required.
 
Diagnosis
 
After reviewing your medical history and performing a physical exam and tests, your doctor can diagnose you with a heart arrhythmia. Your doctor will first listen to your heartbeat, using a stethoscope, before administering several tests. 
 
These tests can include an echocardiogram, chest X-ray, exercise stress test, and electrocardiogram. You may be asked to wear a Holter monitor for at least 24 hours. Additionally, a loop recorder can detect abnormalities in rhythm over a long period of time. If you are someone with infrequent arrhythmia, you might wear an event recorder, or have it surgically put under your skin for long time periods, to activate when you sense symptoms. An electrophysiologic study is another procedure that can diagnose arrhythmias, and even treat them in some cases. 
 
Your doctor may also use tilt table testing to monitor sudden plunges in heart rate or blood pressure that can result in fainting. In this procedure, you will be secured to an inclined table for various amounts of time while your blood pressure and heart’s electrical activity are recorded.
 
Treatment
 
Treatment depends on the cause, type, location, and severity of your arrhythmia. Treatment may include a surgically implanted pacemaker, ablation, lifelong medication, or implantable defibrillator. Emergency treatment includes intravenous medications or electrical shock therapy.
 
Prevention
 
Keeping a healthy heart helps prevent heart disease and lowers your risk of developing arrhythmias. Maintain a heart healthy diet, exercise regularly, and abstain from smoking, drugs, and alcohol abuse. Receive regular checkups and physicals from your doctor.
 
Am I At Risk?
 
Your risk of heart arrhythmias increases if you have a history of heart attack, heart conditions, endocrine abnormalities, or blood chemistry imbalances. Other risk factors include caffeine, drug use, and certain medications.
 
Complications
 
Arrhythmias are dangerous and potentially fatal, possibly leading to heart attack, stroke, heart failure, and even sudden death in sever cases. Contact your doctor if you experience symptoms, and call an ambulance immediately if you experience a stroke or heart attack.