Irregular Heart Beats (arrhythmia)

Your heart contains a natural pacemaker called the sinoatrial or sinus node that triggers electrical impulses to spread over the heart, causing it to contract (beat).

Any abnormal rhythm of the heartbeat is known as an arrhythmia.

Common causes include:

• electrical impulses coming from other areas of the heart instead of the sinus node that regulates heartbeat
  
  
• electrical impulses coming from the sinus node but that take a different pathway through the heart
  
  
• a very fast heart rate (with either a regular or irregular rhythm)
  
  
• a combination of a regular and irregular heart rhythm.

Types of Heart Diseases

Following are the some types of Heart Diseases

• Irregular heart beats (arrhythmia)
• Cardiomyopathy
• Heart failure
• Congenital heart disease
• Heart attack
• Heart valve problems
• Infection

All will be described one by one in further posts...

What is Heart Disease?

When talking about heart conditions, doctors use the terms coronary heart disease (CHD) and the broader cardiovascular disease (CVD).

• CHD is used for any condition that affects heart function.
  
  
• CVD refers to both coronary heart disease and diseases of the circulation such as stroke, when a clot blocks blood supply to the brain. Stroke is the country's third biggest killer, claiming 70,000 lives each year.
  
  

Most doctors now prefer to use the term CVD because it is the major cause of premature death in the UK, causing around 32 per cent of premature deaths in men and 28 per cent in women.

One person in Britain dies from heart disease every three minutes - making us one of the world’s worst countries for this problem.

When should a child be taken to the doctor?

• If the child still wets the bed after the age of six.
  
• If the child suddenly starts wetting the bed without having done so earlier.
  
  
• If the child's urine has a strong smell, or if the child says that it hurts during or after urination.
  
  
• If the child starts to wet him or herself during the day.
  
  
• If the child urinates more than usual, day or night.
  
  
• If the child has constipation or defecates in their pants.

What can I do to help my child?

Try using a bedwetting alarm, which makes a ringing or buzzing sound or vibrates if the child wets the bed. These are successful in curing the condition in 70 per cent of cases.

The alarm is very effective because it makes your child wake up as soon as the first drop of urine hits the underwear or the sheet. Your child is thus made aware that they are urinating and what it feels like when their bladder is full.

There are different kinds of alarms. Some have a copper net which is placed under the sheet. The net is connected to a bell, which will go off as soon as the first drop of urine hits the sheet. Others have a small sensor, which is placed in the pants, and is also connected to a bell.

Both your GP and the local children’s continence nurse will be able to advise you on obtaining an alarm. The alarm is often required for up to five months to achieve success, being used for a minimum of three weeks following the child’s last wet night.

It is possible to use drugs and an alarm at the same time and this has been shown to be beneficial in some cases.

Do not make the bedwetting a big issue in the family. Most children are embarrassed about wetting the bed, so it will help if the family support the child and show a positive attitude. Don't get angry with the child or punish them if they wet their bed. This could only make matters worse.

Let the child know that many other children do it too. If someone in the family has had the same problem, tell the child about it. Knowing that others have been affected in the same way will help a child deal with the problem.

Make sure the child doesn't drink very much during the two hours prior to bedtime. There is still no guarantee that the child will not wet the bed, but it may help.

Ensure the child goes to the toilet before getting into bed. Protect the bed by using a waterproof mattress, or a fitted waterproof mattress cover under the bottom sheet. This must be fastened securely to prevent any danger of suffocation. Place clean nightclothes and sheets next to the bed so the child can change if they wake up.

Let the child change the sheets; not as a punishment, but in order to learn to deal with the problem. It will also make the child more aware of the situation. If the child is in agreement, keep a calendar or diary and mark dry nights with a star. Praise the child when he or she wakes up in the morning without having wet the bed. Encouragement is often the most helpful way of dealing with the problem.

Some children take longer than others to achieve night-time dryness - initially having maybe one or two dry nights a week and gradually building up the number of dry nights over the following months.

However, if your child is persistently wet every night for a week or two he or she may not be ready to become dry. In this case, as a temporary measure, you may wish to use absorbent night-time pants rather than going back to using nappies. You could then try again in about three to four months.

Many parents have been told to wake the child in the middle of the night and make them go to the bathroom. Studies show that the positive effect of this is almost non-existent, since the child does not wake up by him or herself because of the need to urinate.

It may take weeks or months before there is any change. Training a child will take time, so patience is required from all involved. Most children naturally stop wetting the bed eventually. Do not be embarrassed to discuss further options with your doctor or health visitor if none of the above suggestions appear to be effective.

Why do children wet the bed?

In a significant minority of children who wet the bed no reason can be found.

Often it is passed on through the family. About 70 per cent of children who wet their beds either have a brother, sister or a parent who has experienced the same problem. Studies have localised a genetic predisposition to this condition.

It may have a medical, social or psychological cause such as constipation, kidney disease, cystitis, diabetes, sensitivity to certain food or food additives; and problems at school, at home, or the divorce of parents.

One explanation could be that these children are heavy sleepers who do not wake up when their bladder is full. Also, some children develop bladder control later than others.

At night, some children produce too little of the antidiuretic hormone (ADH), which controls the production of urine. Tablets containing desmopressin (eg Desmotabs) may help. The child needs to be examined by a doctor who will then decide whether treatment is necessary.

Is bedwetting common?

Frequent bed wetting is common in children up to the age of six. The child should not be put under pressure if younger than six - children do not wet the bed on purpose.

Approximately 15 to 20 per cent of all five- and six-year-olds wet the bed and it is more common among boys. With teenagers, the figure is 2 to 3 per cent up to 14 years and 1 per cent at 15 years and over.