Asperger's syndrome

Do you know Asperger's syndrome? It is a very serious heart disease. People may not know much about this disease and rarely hear about it. In fact, there are many such diseases in clinical practice. It is a syndrome of cerebral ischemia caused by heart disease. It is a sudden disease, very serious, and can cause fainting.

The life safety of patients with Asperger's syndrome will be threatened to a certain extent. The cardiac output will be reduced in a very short period of time, leading to severe cerebral ischemia, syncope, and loss of consciousness. Once this disease occurs, it must be treated as soon as possible to avoid more serious hazards.

Causes

1. Rapid arrhythmia

Cardiogenic syncope caused by rapid arrhythmia is more common in patients with organic heart disease, and rarely in normal people.

(1) Ventricular tachyarrhythmias ① Ventricular tachycardia (VT) Not all types of ventricular tachycardia cause syncope. Syncope caused by ventricular tachycardia mainly occurs in patients with fast ventricular rate and organic heart disease, which causes a sharp drop in cardiac output. ② Ventricular flutter and ventricular fibrillation are seen in various organic heart diseases, adverse reactions to antiarrhythmic drugs, preexcitation syndrome combined with atrial fibrillation, severe electrolyte disorders, electric shock, lightning strikes, etc., and are extremely serious arrhythmias. The hemodynamic effects of both are equivalent to ventricular arrest. Once present, patients rapidly develop Adams-Stokes syndrome. ③ Frequent multi-source premature ventricular contractions may occasionally cause cardiogenic syncope.

(2) Supraventricular tachyarrhythmia ① Paroxysmal supraventricular tachycardia usually does not cause cardiac syncope. Syncope may occur when the ventricular rate exceeds 200 beats/minute and is accompanied by organic heart disease. ② Syncope may also occur in patients with atrial flutter and atrial fibrillation who have extremely fast ventricular rates and underlying heart disease. ③ Rapid supraventricular arrhythmias involving preexcitation syndrome include reverse atrioventricular reentrant tachycardia, atrioventricular reentrant tachycardia caused by multiple accessory pathways, atrioventricular nodal reentrant tachycardia via accessory pathway, atrial tachycardia with 1:1 accessory pathway, atrial flutter with 1:1 or 2:1 accessory pathway, and atrial fibrillation via accessory pathway. These types of rapid supraventricular arrhythmias are often accompanied by rapid ventricular rate and lead to cardiogenic syncope.

2. Bradyarrhythmia

Cardiogenic syncope caused by this type of arrhythmia can be seen in various organic heart diseases, such as acute myocarditis, acute myocardial infarction, various types of cardiomyopathy, congenital heart disease, etc.

(1) Sick sinus syndrome includes severe sinoatrial block, persistent sinus arrest, slow-fast syndrome, double node disease, etc., all of which are prone to cardiogenic syncope.

(2) High-degree or complete atrioventricular block may cause cardiogenic syncope when the ventricular rate is extremely slow.

3. Acute cardiac blood discharge obstruction

(1) Cardiac muscle disease is mainly seen in primary hypertrophic obstructive heart disease, in which the ventricular septum under the aortic valve is significantly thickened, exceeding 15 mm, and the ratio of the ventricular septum to the left ventricular posterior wall thickness is >1.3:1. When exercising vigorously or changing body position, the heart contraction strengthens, the hypertrophic ventricular septum approaches the anterior leaflet of the mitral valve, aggravates the left ventricular outflow tract obstruction, and causes syncope or even sudden death. Syncope and sudden death in some patients are related to arrhythmias.

(2) Heart valve disease is mainly caused by valvular stenosis. ① Rheumatic heart valvular disease A. Patients with severe mitral stenosis (valve diameter <0.8 cm) may experience syncope after changing body position or exercising. Some patients may suffer syncope or sudden death due to huge left atrial mural thrombus or vegetation being entrapped, or falling off and getting stuck in the valve orifice. B. When the aortic valve area is <1 square centimeter, syncope may occur after changing body position or exercising. Syncope and sudden death in some patients are related to arrhythmias. ② Congenital or degenerative valvular diseases: congenital mitral stenosis, congenital or degenerative aortic valve (membrane) orifice, supravalvular stenosis, and subvalvular stenosis. ③Cardiac tumors are mainly seen in left atrial myxomas, which are benign tumors. When the tumor is lodged in the atrioventricular valve orifice, the cardiac output will be sharply reduced or even interrupted, leading to syncope or sudden death. It often occurs when changing body position. ④ Intracardiac mural thrombus A large mural thrombus on the left side of the heart can also block the mitral valve orifice and cause syncope. ⑤ When cardiogenic shock occurs in coronary heart disease and myocardial infarction, the left ventricular output drops sharply, leading to syncope and sudden death. Some patients with acute myocardial infarction seek medical treatment with syncope or sudden death as the first symptom. Syncope in some patients is caused by combined severe arrhythmia. ⑥ In case of acute pulmonary embolism with large area of ​​pulmonary embolism, the amount of blood returning to the left heart may drop suddenly, leading to the onset of cardiogenic syncope. ⑦ Aortic dissection: Syncope may occur when aortic arch dissection involves one common carotid artery. ⑧ Cardiac tamponade, trauma, surgery, heart rupture caused by acute myocardial infarction, etc., cause a sudden increase in fluid accumulation in the pericardial cavity and a sharp decrease in venous return, leading to syncope.

4. Congenital heart disease

(1) Syncope often occurs during exercise or physical activity in patients with tetralogy of Fallot, because exercise causes a decrease in peripheral vascular resistance and reflex spasm of the right ventricular outflow tract, which increases the right-to-left shunt volume, further decreases the partial pressure of oxygen in the arterial blood, aggravates cerebral hypoxia, and causes syncope. It can also be caused by cardiac arrhythmia.

(2) Primary pulmonary hypertension often causes syncope during exercise or exertion because the vagus nerve reflex causes pulmonary artery spasm, which leads to a sharp restriction of right ventricular blood output and a sharp decrease in left heart output, causing syncope.

(3) Eisenmenger syndrome may occasionally cause syncope due to pulmonary hypertension.

Adams-Stokes syndrome is often seen in patients with high-degree atrioventricular block, long pause after premature contraction, too frequent premature contraction, sinus arrest, torsades de pointes ventricular tachycardia and supraventricular tachycardia with very fast ventricular rate. Usually, the ventricular rate of supraventricular tachycardia is not too fast, so it will not cause Adams-Stokes syndrome, but if the original cerebral artery insufficiency exists, it will often cause this syndrome. In addition, cardiac catheterization, pleural puncture, and endoscopic examination can all reflexively induce Adams-Stokes syndrome.

The most prominent symptom of Adams-Stokes syndrome is sudden syncope. In mild cases, there is only dizziness and impaired consciousness, while in severe cases, there is complete loss of consciousness, often accompanied by convulsions and incontinence, pale face, and then cyanosis, snoring and wheezing breathing, and sometimes Cheyne-Stokes respiration (also known as Cheyne-Stokes respiration, which is a cyclical breathing that changes from shallow and slow to deep and fast, and then from deep and fast to shallow and slow, followed by a period of apnea, and then begins the above changes again).

Everyone should understand the cause of Asperger's syndrome. People with this disease have heart problems, especially those with congenital heart disease. Patients will have symptoms of arrhythmia. Acute myocardial infarction, acute myocarditis, etc. can all lead to Asperger's syndrome. This disease poses a threat to our physical health and even life safety.