Beta-blockers are medical medicines that function by temporarily blocking or reducing the natural ‘fight-or-flight’ responses of the body.
To addition, certain areas of the body, such as the heart and blood vessels to the brain, are stressed down. They lower blood pressure, protect against heart attacks and can boost outlook for heart disease people.
They are also also called beta antagonists, beta-adrenergic blockers, or beta-adrenergic antagonists.
For his 1964 invention of the first receptor-blocking drug, propranolol, which is still in use today, pharmacologist James Black won the Nobel Prize in Physiology and Medicine.
Fast facts about beta-blockers
- Beta-blockers are prescribed in conditions where the heart rate needs to be slowed.
- Doctors commonly recommend beta-blockers for patients with irregular heartbeats, angina, and high blood pressure.
- Beta-blockers also offer relief for glaucoma, overactive thyroid, and anxiety.
- There are many different brands of beta-blocker.
- Taking beta-blockers can cause dizziness, cold hands and feet, weight gain, and fatigue.
Beta-blockers block the receptors in the sympathetic nervous system: adrenaline and noradrenaline.
One of the autonomic nervous system is the sympathetic nervous system. It activates the ‘fight-or-flight’ response.
Adrenaline and noradrenaline activate the exertion of muscles in the body. It is a vital aspect of handling risk.
Over-exposure to these hormones may be harmful. Too much adrenaline can cause fast heartbeat, high blood pressure, excessive sweating, anxiety and palpitations.
This reduces the force of heart muscle contractions, and the blood vessels in the back, brain, and the rest of the body.
Beta-blockers also prevent angiotensin II, a hormone released by the kidneys, from development.
Reducing the amount of angiotensin relaxes and enlarges the blood vessels, softening blood flow into the arteries.
Beta-blockers are used to treat the following:
- Angina, or chest pain
- Heart failure
- Hypertension, or high blood pressure
- Atrial fibrillation, or irregular heartbeat
- Myocardial infarction, or heart attack
They can be used less frequently for migraines, glaucoma, overactive thyroid, tremors and anxiety.
With beta-blocker eye drops, the high pressure inside the eyeball is reduced. The drug reduces fluid development within the eyeball.
Beta-blockers block the Stress Hormone effects. In such a result, they will also decrease the physical anxiety symptoms such as tremor and sweating.
Nevertheless, a person with chronic anxiety may still require additional care, such as treatment.
Hyperactive thyroid and tremor
Beta-blockers can reduce symptoms such as tremor and slow the heart rate of patients with an overactive thyroid.
Types and brands
Beta-blockers can either be selective or non-selective. Selective beta-blockers affect mainly the nucleus, while non-selective ones affect other body parts.
Here are some common types and brands of beta-blockers:
- acebutolol (Sectral, brand discontinued)
- atenolol (Tenormin)
- betaxolol (Kerlone, brand discontinued)
- bisoprolol (Cardicor, Emcor, Zebeta all brands discontinued)
- metoprolol (Lopressor, Toprol XL)
- nadolol (Corgard)
- propranolol (Inderal LA, Inderal XL, Hemangeol, InnoPran XL)
- timolol ophthalmic solution (Betimol, Istalol, Timoptic)
The most common side effects of beta-blockers are:
- cold feet and hands
- nausea, weakness, and dizziness
- dry mouth, skin, and eyes
- slow heartbeat
- swelling of the hands and feet
- weight gain
The following less common side effects are also possible:
- sleeping difficulties and disturbances
- erectile dysfunction
- abdominal cramps
- depression, memory loss, or confusion
- back or joint pain
Patients who feel dizzy or fatigued should not drive.
People should advise their doctor if they have a history of the following before taking beta-blockers:
- severe peripheral arterial disease, including Raynaud’s syndrome
- slow heart rate
- uncontrolled heart failure
Beta-blockers can be taken by those with stable heart failure.
When a doctor recommends other forms of beta-blockers can be used during pregnancy.
Like all drugs, beta-blockers can interact with a variety of other medications.
As long ago as 1995, beta-blockers were found to be able to interfere with a number of different medicines.
- Anti-anginal drugs
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Anti-ulcer medications
- HMG-CoA reductase inhibitors
Different beta-blockers can have different interactions.
A pharmacist or doctor should be able to include a detailed and up-to-date list of interactions with the beta-blockers.
Please tell your treating doctor of any other drug courses you are currently taking.
Stopping a course of beta-blockers
Patients should not immediately quit taking beta-blockers without the guidance and close supervision of their doctor.
Suddenly ceasing treatment with beta-blocker can worsen the condition of the patient, particularly after a heart attack, or during angina treatment.
Ascending aortic aneurysm: What you need to know
Thousands of Americans are affected with ascending aortic aneurysms each year, and if not treated, they can be fatal.
An aneurysm is a blood vessel that has expanded or bulged to more than 1.5 times its usual size. Aneurysms can form in the aorta, the body’s main artery responsible for transporting oxygen-rich blood away from the heart.
An ascending aortic aneurysm is a kind of aneurysm that arises in the ascending aorta, a segment of the artery near the heart that starts at the base of the left ventricle.
Anything that weakens the aortic walls might produce aneurysms. An ascending aortic aneurysm, as well as other types of aneurysms, can be caused by a number of reasons, including:
This condition develops when plaque builds up on the artery walls, making them rigid and inflexible, increasing the risk of the artery walls weakening and bulging.
Medical conditions and infection
Aneurysms in the thoracic area are hypothesized to be caused by genetic abnormalities and inflammatory diseases.
The following genetic disorders may play a role:
- Marfan syndrome: A condition that affects the connective tissue in the body and can lead to aortic wall weakening.
- Ehlers-Danlos: A category of uncommon diseases affecting the connective tissue that supports blood vessels, bones, skin, and other organs and tissues.
- Loeys-Dietz: A condition related to Marfan syndrome that damages the body’s connective tissue as well as causing aorta enlargement.
Giant cell arteritis and Takayasu arteritis are two inflammatory disorders that can enhance the development of thoracic aortic aneurysms.
Untreated infection, such as salmonella poisoning, is a rare cause of a mycotic aneurysm, which is an aneurysm in the aorta.
Aortic valve issues
Ascending aortic aneurysms are more common in people who have difficulties with their aortic valve. For example, persons born with a bicuspid aortic valve, which has just two rather than three cusps, may suffer increased pressure on the artery walls.
Symptoms of ascending aortic aneurysms are not usually present, especially in the early stages and when they are small.
Thoracic aortic aneurysms can create issues as they grow in size, such as:
- shortness of breath
- chest pain
- back pain
- tenderness in the thoracic region
Even when the bulge is significant, not everyone with an ascending aortic aneurysm will develop symptoms.
An aneurysm that has ruptured, on the other hand, is a medical emergency. Among the signs and symptoms are:
- low blood pressure
- rapid heart rate
- sudden and intense pain in the chest or back
- weakness or paralysis on one side of the body
- difficulty breathing
- difficulty swallowing
- loss of consciousness
The following are the different forms of aortic aneurysms:
Thoracic aortic aneurysms
Thoracic aneurysms are aneurysms that form above the diaphragm in the chest and can be ascending or descending. Aortic aneurysms in the rear of the chest cavity are called descending aneurysms.
Abdominal aortic aneurysms
Abdominal aortic aneurysms are aneurysms that form in the lower section of the aorta. Abdominal aortic aneurysms are more prevalent than thoracic aortic aneurysms, accounting for more than 75% of all aortic aneurysms.
Other types of aneurysm
- Peripheral aneurysms occur in the large arteries of the legs and arms.
- Cerebral aneurysms develop in an artery in the brain.
- Thoracoabdominal aneurysms forms between the upper and lower parts of the aorta.
Other variables that raise the chances of an ascending aortic aneurysm include:
- Age: With age, both atherosclerosis and thoracic aortic aneurysms become more likely.
- Sex: An ascending aortic aneurysm affects males 2 to 4 times more frequently than women.
- Family background: Aortic aneurysm is frequently connected to a family history of the condition.
- General health: Hardening of the arteries, a risk factor for ascending aortic aneurysm, is more likely in people who have high blood pressure and high cholesterol.
- Smoking: The use of tobacco products, such as cigarettes, is a major risk factor for the development of an aortic aneurysm.
If a clinician suspects an aortic aneurysm, one or more of the tests listed below may be used to confirm the diagnosis:
- magnetic resonance angiography (MRA)
- CT scan
Because most ascending aortic aneurysms don’t cause symptoms, they go unnoticed until they’re identified during a doctor’s visit or medical check-up.
Small aneurysms are commonly treated with beta-blockers, a kind of blood pressure medicine. Regular testing will be needed to track the aneurysm’s development.
Large or fast developing aneurysms will necessitate surgery. Surgical procedures include:
During this operation, doctors create a chest incision. They remove the injured aorta and replace it with a graft, which is a synthetic tube. Following surgery, you can expect to be out of commission for at least four weeks.
Endovascular surgery is a less intrusive type of surgery that includes passing a tiny catheter through an artery in the leg to the aorta. The catheter is then used to place a stent in the aneurysm, lowering blood pressure in the artery. This technique keeps the aneurysm from becoming larger, lowering wall tension and lowering the chance of rupture.
An ascending aortic aneurysm will necessitate emergency surgery if it ruptures. While the aorta can be repaired, the risks are high, and the patient is more prone to develop problems.
An ascending aortic aneurysm is a potentially fatal condition. It may burst, resulting in life-threatening internal hemorrhage. The greater the size of the aneurysm, the higher the danger of rupture.
Aortic dissection, a life-threatening medical emergency characterized by ripping of the aortic layers, can also be caused by bigger aneurysms.
Smaller aneurysms can lead to:
- a build up of atherosclerotic plaque at the site
- the formation of clots around the aneurysm, which increases the risk of stroke
A change in lifestyle can enhance general health and reduce the chance of an ascending aortic aneurysm or another form of aortic aneurysm.
The following are some preventative measures to take:
- engaging in regular cardiovascular activity
- managing stress levels
- reducing intake of foods high in fat, sugar, and sodium
- treating medical conditions that can raise the risk of an aortic aneurysm
- stopping smoking
- keeping blood pressure within the healthy range
- maintaining a healthy weight
- keeping cholesterol levels within the healthy range
People who have a higher risk of having an aortic aneurysm, such as those who have a family history of the condition, should see their doctor for routine screening tests to check for aneurysm formation.
The outlook for people who have an ascending aortic aneurysm is determined by a number of circumstances, including the prevalence of co-existing illnesses including heart disease, high blood pressure, and high cholesterol.
Treatment for these conditions, as well as monitoring existing aneurysms, are critical for rehabilitation and avoiding complications.
What to know about arrhythmia
An arrhythmia accounts for an irregular heartbeat. With this condition the heart of a person may beat too fast, too slowly, too early, or with an irregular rhythm.
Arrhythmias occur when there is no proper processing of the electrical signals regulating heartbeats. An irregular heartbeat may sound like a heart beating or a flutter.
Many arrhythmias are harmless to the heart. However, arrhythmias can cause serious and potentially fatal symptoms and complications if they are extremely irregular or result from a weak or damaged heart.
We describe Arrhythmia in this article, as well as its causes and symptoms. We also describe the medications and various forms that might be available.
What is arrhythmia?
Cardiac arrhythmia is a group of conditions which cause the heart to beat irregularly, too slowly, or too fast.
There are several categories of arrhythmia, including:
- bradycardia, or a slow heartbeat
- tachycardia, or a fast heartbeat
- irregular heartbeat, also known as a flutter or fibrillation
- early heartbeat, or a premature contraction
Most arrhythmias are not serious, and are not complicated. But some can increase the risk of stroke or heart arrest.
Some people may hear the term “dysrhythmia” used by doctors when referring to their irregular heartbeat. The terms arrhythmia and dysrhythmia mean the same thing, but more is the word arrhythmia.
What is a normal heartbeat?
Doctors define a healthy heartbeat by counting the number of times each minute (bpm) the heart beats at rest. This is known as heart rate control.
The range for a healthy resting heart rate varies from individual to individual, but the American Heart Association ( AHA) suggests it usually is between 60 and 100 bpm.
The fitter a person is, the lower it becomes their resting heart rate. For example, olympic athletes would normally have a heart rate of less than 60 bpm, since their hearts are highly effective.
With a normal rhythm, the heart should beat consisting of double “ba-bum” beats with even spaces in between.
One of these beats is the heart contract to supply oxygen to the already flowing blood and the other includes the heart pumping oxygenated blood throughout the body.
A person can measure their heart rate using their pulse. This is a point where they can sense the beat of their heart through the skin. The best positions for that on the body are:
- the wrists
- the insides of the elbows
- the side of the neck
- the top of the foot
There are several types of arrhythmia, as described here:
That is the atrial chambers’ repetitive pounding, and it almost always causes tachycardia. Atrial fibrillation (A-fib) is normal, and occurs primarily in adults over the age of 65.
The chamber fibrillates, or quivers, rather than creating a single, powerful contraction, frequently resulting in a rapid heartbeat.
While fibrillation in the atrium produces several random and distinct quivers, atrial flutter usually originates from one region in the atrium that does not conduct properly. This creates consistent pattern in irregular conduction of the heart.
Some people may experience flutter, as well as fibrillation.
Atrial flutter can be a dangerous problem, which typically leads to untreated fibrillation.
The disorder known as supraventricular tachycardia (SVT) refers to a fast yet steady rhythmic heartbeat. An person can experience a burst of heartbeats that can last from a couple of seconds to a couple of hours.
Atrial fibrillation and flutter are graded by doctors under SVT.
This condition refers to irregular electrical impulses that begin in the ventricles, triggering an abnormally rapid heartbeat. This often occurs if a wound from a previous heart attack is in the heart.
This is an abnormal heart rhythm composed of the ventricles’ quick, uncoordinated, and fluttering contractions. Instead, the ventricles do not pump blood, but rather quiver.
Ventricular fibrillation can endanger life, and is typically associated with heart disease. Its sometimes caused by a heart attack.
Long QT syndrome
This condition refers to a disturbance of the heart rhythm that often triggers short, uncoordinated heartbeats. This can lead to fainting, which may be life-threatening.
It can also be caused by genetic deficiency or by taking certain medicines.
Any disruption of the electrical impulses that causes contractions in the heart can lead to arrhythmia.
Many factors may cause the heart to operate incorrectly, including:
- alcohol abuse
- substance use disorder
- drinking too much coffee
- heart disease, such as congestive heart failure
- high blood pressure
- hyperthyroidism, or an overactive thyroid gland
- scarring of the heart, often due to a heart attack
- certain dietary and herbal supplements
- some medications
- structural changes in the heart
An individual with good heart health will hardly ever experience long-term arrhythmia unless they have an external cause, such as a problem of drug use or an electrical shock.
An underlying heart condition, however, may mean that electrical impulses do not pass right through the heart. This raises the chance of becoming arrhythmic.
Arrhythmia can not cause symptoms which are evident. A doctor can however detect an arrhythmia during a routine examination or after applying for an electrocardiogram (EKG).
And if a person shows signs, they don’t actually have a serious arrhythmia.
Some people with life-threatening arrhythmias may not have symptoms, and those with symptoms do not have significant arrhythmias.
Symptoms depend on the form of arrhythmia according to the following:
Symptoms of tachycardia
Symptoms of a rapid heartbeat include:
- fainting or nearly fainting
- fluttering in the chest
- chest pain
- sudden weakness
Symptoms of bradycardia
Bradycardia can cause the following symptoms:
- angina, or chest pain
- trouble concentrating
- finding exercise more difficult than usual
- shortness of breath
- fainting or nearly fainting
- profuse sweating
Symptoms of A-fib
When A-fib symptoms occur, they often have a rapid onset and may involve:
- fainting or nearly fainting
Because of arrhythmia some people do not experience active symptoms. Treatment is, however, also necessary to avoid further complications, which may include stroke and heart failure.
Stroke: Atrial fibrillation means the heart is not actively pumping. This condition can cause blood to gather in pools, form clots.
If a clot dislodges, it can travel to a brain artery causing, or stroke, a potentially fatal blockage. Stroke may cause damage to the brain and can need emergency treatment.
Heart failure: Long-term tachycardia or bradycardia may cause heart failure. When the heart is failing, it can not pump enough blood to the body and its organs. Typically treatment will help to improve that.
Arrhythmic treatment is only required if the disorder raises the likelihood of more severe arrhythmia or a complication, or if the symptoms are severe.
Different arrhythmias require different treatments.
Treatments for bradycardia
If bradycardia is caused by an underlying disorder, a physician may first need to treat the condition. The doctor can suggest implanting a pacemaker if they find no underlying issue.
A pacemaker is a small device placed under the skin of the chest or abdomen by a doctor to help regulate irregular heart rhythms. Pacemakers use electrical pulses to cause the heart to beat at a minimum daily rate.
Treatments for tachycardia
Various treatments for tachycardia exist:
Vagal maneuvers: Unique moves and exercises that a person can perform at home can stop some types of arrhythmia starting above the lower half of the heart.
Medications: These may not cure an arrhythmia but are mostly effective in minimizing the number of episodes of tachycardia. Even some medicines facilitate electrical conduction through the heart.
Cardioversion: The doctor can reset the heart to its normal rhythm using an electric shock or medication.
Ablation therapy: One or more catheters are implanted into the inner heart by a surgeon The catheters are mounted in areas of the heart that they believe may be the cause of the arrhythmia. They are then used by the surgeon to remove small parts of damaged tissue, which also corrects the arrhythmia.
Implantable cardioverter-defibrillator (ICD): This is inserted above the left collarbone by a surgeon. The unit then tracks the rhythm of your heart. If an unexpectedly fast rate is detected, the heart is stimulated to return to its normal velocity.
Maze procedure: The surgeon makes a number of surgical incisions in the heart during the maze technique. These then heal into scars and form blocks that direct the electrical impulses, helping to effectively beat the heart.
Ventricular aneurysm surgery: An aneurysm, or bulge, often may cause arrhythmia in a blood vessel that leads to the heart. If the other therapies are not successful, the aneurysm can need to be removed by a surgeon.
Coronary bypass surgery: A surgeon grafts arteries or veins on to the coronary arteries from elsewhere in the body. This helps the circulation bypass any narrow regions and increase blood flow to the heart muscle.
A doctor must recognise the irregular heartbeat to diagnose an arrhythmia, and try to locate its source or cause. This will require a detailed interview that may influence the history of medicine, family history, nutrition, and lifestyle.
A doctor can order the following tests to help in the diagnosis of arrhythmia:
- blood and urine
- A Holter monitor, a wearable device to record the heart for 1–2 days
- chest X-ray
- a tilt-table test to help identify if sudden decreases in blood pressure or heart rate are the cause
- electrophysiologic testing
- heart catheterization
Risk factors and prevention
The following may increase a person’s risk of arrhythmia:
- being 65 years of age or older
- inherited genetic anomalies
- underlying heart problems
- hypothyroidism or hyperthyroidism
- some prescription medications and over-the-counter drugs
- uncontrolled diabetes
- obstructive sleep apnea
- electrolyte imbalances
- heavy and regular alcohol consumption
- too much caffeine
- illegal drugs
While some of these are inevitable, a person can take a couple of measures to reduce their risk of arrhythmia.
These activities include being healthy, avoiding the daily use of alcohol or illicit drugs and restricting the consumption of caffeine.
The AHA suggest at least 150 minutes of moderately intense exercise each week.
What is the pulse and how do I check it?
‘Pulse’ is one of medical terminology that is best known. It is commonly recognised as heartbeat scale.
The pulse is a critical heart rate indicator. Combined with dizziness, an unusually slow pulse may signify shock and help to detect internal bleeding.
In contrast, a pulse that is too fast points to high blood pressure and cardiovascular problems.
With practice, taking your own pulse and other people’s ones is fast.
But what is the pulse, why is it important and how can the pulse be detected and measured best? This article provides clear guidance.
Important facts about checking your pulse
Here are a few key points to test your pulse. The main article includes more descriptions and supporting material.
- As the heart pumps, the arteries expand and contract. This is the pulse.
- The pulse is easiest to find on the wrist or neck.
- A healthy pulse is between 60 and 100 beats per minute (bpm).
What is the pulse?
The pulse is the expansion of the arteries. This expansion is caused by an rise in blood pressure each time the heart beats, pressing against the elastic walls of the arteries.
With the heart these expansions rise and fall in time as it pumps the blood and then rests as it refills. At other points on the body, the pulsations are felt, where wider arteries run closer to the skin.
Finding the pulse
Arteries converge at the wrist and neck close to the surface of the skin making the pulse especially easy to detect at these stages.
Here are the basic steps needed to get a pulse on the wrist. The radial pulse is defined as:
- Turn one hand over, so it is palm-side up.
- Use the other hand to place two fingertips gently in the groove on the forearm, down from the fold of the wrist and about an inch along from the base of the thumb.
- When the position is right, you should feel the pulsation of your heart beat.
The pulse can also be detected on the neck in a similar way, using two fingers. Gently press each side of the windpipe into the soft groove.
This is the pulse running through one of the carotid arteries. These are the principal arteries which run from the heart to the head.
Less easy places to find a pulse are:
- behind the knees
- on the inside of an elbow when the arm is outstretched
- in the groin
- at the temple on the side of the head
- on the top or the inner side of the foot
The video below, presented by a nurse, explains how a pulse should be taken:
Recording the pulse
If you’ve found the pulse by following the above steps, keep it still and take the following steps:
- Use a timepiece or watch with a second hand, or look at a clock with a second hand.
- Over the course of a minute or 30 seconds, count the number of beats felt.
- The number of pulses over a minute is the standard heart rate measurement. This can also be calculated by doubling the number of pulses felt over 30 seconds.
- The pulse should be between 60 and 100 bpm.
In a normal interval between each contraction, the heart should beat continuously, so that the pulse will always be steady.
As a general rule, a resting heart rate for adults is 60 to 100 beats per minute ( bpm). Individuals with greater physical health should usually have higher heart rates than pepole who exercise less. For example, athletes may have a resting heart rate of just 40 to 60 bpm.
It is normal, however, that the heart rate varies in response to movement, activity, exercise, anxiety, excitement and fear.
If you feel your heart is beating out of rhythm or at an unhealthy speed of less than 40 bpm or more than 120 bpm, and this can be felt when taking a pulse, talk to a doctor about this.
You may also feel like your heart missed or “skipped” a beat, or there was an extra beat. An extra beat is known as ectopic rhythm. Ectopic beats are very normal, generally harmless and require no treatment whatsoever.
However, if there are concerns regarding palpitations or ectopic beats, please visit a doctor.
Heart rate monitors
Hospitals use monitors that can check the heart rate and the pulse.
If you use a home monitor, you should:
- check with your doctor that is has been validated
- take your blood pressure at the same time every day
- take several readings and record the results
A clinical development of recent years is the wide range of products for personal health monitoring now available on the consumer market.
Numerous devices can be connected to mobile phone software apps, and a number of wearables for health monitoring are available which combine hardware and software in one device.
The Food and Drug Administration of the United States (FDA) has a page listing some of the applications approved by the regulator for health products. This may be a good starting-point.
Devices which attach to mobile phone software apps are now available. These home-use tools provide both hardware and software. Some give readings equivalent to those of a machine with an electrocardiogram ( ECG).
Measuring a pulse is easy, and can give a useful indication of your health status.
When you have questions about the heart rate, talk to your doctor.