The Treatment of Extrasystoles
Premature beats usually are of no clinical importance and seldom require treatment. Although they occur in many patients with organic heart disease, they are much more common in individuals with perfectly normal hearts and can never be interpreted as evidence of heart disease. Often they cause no symptoms even though they occur at frequent intervals. Certain individuals, however, and particularly those who are hypersensitive may complain of distinctly disagreeable sensations which result either from the premature beat itself or from the forceful systole which follows a long compensatory pause. Among the most common of these symptoms are an awareness of a pause in the heart’s action followed by a sudden, forcible pulsation, a sensation of choking or fulness in the throat, a feeling that “the heart has suddenly risen into the throat,” or momentary light-headedness. Other patients state that the heart seems to turn over in the chest, and an occasional person complains of sharp, sticking pain in the precordium. Symptoms such as these often cause great apprehension.
Frequently, no cause can be found for premature beats. There are, however, a number of factors which at times appear to be directly responsible, and it is advisable to investigate these possibilities in all cases, since their detection and correction may result in prompt disappearance of the irregularity. The most common causative factors are excessive nervous strain, excitement, fatigue, infectious diseases such as pneumonia, influenza, meningitis, and acute tonsillitis, chronic constipation, and individual susceptibility to tobacco, coffee, tea, and alcohol. Organic heart. . .