Ashner's test - Causes, symptoms and treatment. MF.

The activity of internal organs in the human body is regulated by the autonomic nervous system. The heart is not an exception and its functions are affected by the sympathetic and parasympathetic departments of the nervous system. The first is represented by fibers from the cervical and thoracic ganglia( knots) and causes an increase in heart rate, increased blood pressure and cardiac output of blood into the aorta. The second section is represented by the fibers of the vagus nerve( vagus) and causes the effects opposite to the effects of the sympathetic nervous system. If there is an imbalance in the body between these two parts, vegetative-vascular dystonia develops. Dystonia is characterized by numerous symptoms, including those from the heart and blood vessels. Sometimes dysfunction of the autonomic nervous system can lead to a violation of the right rhythm of heartbeats, in particular, to tachycardia. Most often, neurogenic disorders cause sinus and supraventricular( atrial, nodular) tachycardia.

To assess the degree of influence of different parts of the vegetative system on the heart, doctors use functional tests. One of them is Ashner's test, also called an eye-heart reflex. Refers to vagal tests, that is, to ways of activating the vagus nerve and its effect on the heart. The essence of the method consists in pressing on the closed eyeballs, which causes a reflex reaction in the heart and vessels. The sample is used for diagnostic purposes, and Aschner's administration can be used with a therapeutic one, for example, helps to eliminate the symptoms of rapid heartbeat.

What is the action of the method based on?

Reflex arc originates from mechanical stimulation( pressure) on fibers of the orbital branch of the trigeminal nerve. Impulses are transmitted to the brain, where they switch to the centers of the vagus nerve. Further pulses along the fibers of the vagus reach the heart muscle, causing a slowdown in heart rate, a decrease in blood pressure and cardiac output. These effects are the basis for the elimination of tachycardia. Cardiac parameters are fixed on the ECG and within a few seconds after the end of the irritation come back to normal. This should be the case with a normal balance of sympathetic and parasympathetic effects on the heart. If there is an imbalance between these structures, the change in the indicators is reflected in the ECG.

Indications for Aschner's

test The test can be used by doctors of neurologists, cardiologists and arrhythmologists with the aim of:
- determination of the type of nerve influences on the heart - sympathicotonic or vagotonic types
- differential diagnosis of the type of tachycardia

The method is used for self-management or under the supervision of a doctor for the suppression of paroxysm of supraventriculartachycardia.

Contraindications for sample

The sample can not be performed with the following diseases:
- heart defects in the decompensation stage
- severe chronic heart failure
- acute infarction, stroke
- acute heart rhythm disorders
- progressive angina
- pulmonary embolism
- aneurysmaorta
- hypertensive crisis
- fever, bleeding, general severe condition of the body
- acute diseases of the internal organs and chronic under the stagerhenium
- acute infectious disease
- acute thrombophlebitis
- pronounced atherosclerosis

reception Aschner patient can not be used if accompanied by an attack of severe symptoms tachycardia - expressed dizziness, syncope, asphyxia, intense pain in the heart, blood pressure lowering. In this case, you need to call an ambulance, so that the doctor can determine the nature of violations of cardiac activity. If an attack of rapid heartbeat arose for the first time in life, it is better to seek medical help to confirm this or that type of tachycardia, since with ventricular tachycardia, extrasystole or atrial fibrillation, the response will not be effective.

Test procedure

The sample is conducted in the functional diagnostic room. The patient is placed on the couch, after several minutes of rest, the ECG is recorded alone. After this, the doctor begins to exert pressure on the patient's closed eyeballs with his thumbs until pain appears. The pressure occurs in the region of the inner upper corners of the orbit and lasts for 10 to 15 seconds( not more than 30 seconds).At this time and for several minutes after the ECG and AD are continuously recorded. Then the doctor interprets the result, and the patient can be free.

Ashner's admission with a tachycardia attack can be used in the case of an established supraventricular tachycardia, if the doctor has already taught the patient this technique. It is carried out in the same way as the test, only the pressure on the orbit is the thumbs of the patient himself.

Evaluation of the

results The results of the test are evaluated as follows:

1. Evaluation of the type of nerve effects on the heart:
- normotonic type - slowing of the rhythm by 4-10 strokes per minute
- vagotonic type - slowing of the heart rate by more than 10 beats per minute
- sympathicotonic type - there is no slowing of the rhythm or there is more frequent
2. Specification of the type of tachycardia according to the ECG:
- with sinus tachycardia, atrial fibrillation, the rhythm slows down slightly
- with ventricular tachycardiam remains unchanged
- at supraventricular tachycardia rhythm or reduced or unchanged
3. Receiving considered effective if subjectively and / or ECG data palpitations removed and recovered correct timing.

Doctor therapist Sazykina O.Yu.