Heart palpitations

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 13, 2015
StartDiseasesHeart palpitations

Heart palpitations are an uncomfortable awareness of one's own heartbeat. Many people experience heart palpitations every now and then due to stress and other factors. While palpitations are usually no cause for alarm, they can sometimes be indicative of greater cardiac issues, so patients should see their doctors to identify the source of their palpitations and find ways to reduce them.

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Definition & Facts

Palpitations may be felt in a patient's chest, neck or throat. They can occur when the heart rhythm is normal or abnormal. When a patient feels a palpitation, they are simply noticing their heart's normal, constant function of pumping blood. Most healthy human hearts beat between 60 and 100 times each minute, but some athletes and patients who take cardiac medications may have lower resting heart rates.

A heart rate greater than 100 beats per minute is a condition called tachycardia, and a heart rate lower than 60 beats per minute is termed bradycardia. An occasional extra heartbeat is called an extrasystole. Heart palpitations are usually not serious; however, an abnormal heartbeat, also called an cardiac arrhythmia, could indicate a major health problem.

Symptoms & Complaints

The classic signs of a heart palpitation include:

  • an acute awareness of one's own heartbeat
  • the feeling that the heart is racing, pounding, fluttering or skipping beats

Patients experiencing heart palpitations for the first time should not be alarmed, but they should talk about it with their doctor during their next check-up. Patients should immediately call emergency services if palpitations are accompanied by any of the following symptoms:

Patients experiencing heart palpitations should contact their doctor as soon as possible if:

Causes

Palpitations can stem directly from underlying cardiac problems, or they may be indirectly related to the heart. For example, some indirect causes of heart palpitations include:

Palpitations after eating could be indicative of sensitivity to a certain food. Recording meals in a diary can help patients pinpoint problem foods.

Palpitations that are a result of underlying cardiovascular problems usually manifest as arrhythmia, or an abnormal heart rate. Some heart issues that can cause palpitations include:

Diagnosis & Tests

To identify the source of a patient's heart palpitations and to make sure they aren't a sign of greater problems, doctor can start by performing a physical exam and asking patients about their diet and lifestyle habits. Doctors should ask about the frequency of palpitations and at what times they are most likely to occur.

A blood analysis may be necessary to check for anemia, electrolyte imbalances and thyroid problems. Some other tools that doctors may use to get to the root of heart palpitations include:

  • a electrocardiogram, or ECG, interprets the heart's electrical signals to identify rhythm abnormalities. An ECG may be conducted while the patient is exercising or at rest.
  • a Holter monitor is a device that patients wear on their chest, which tracks the heart's electrical signals over the course of a day or two. Holter monitors may pick up abnormalities that an ECG missed.
  • an event recorder is another device that patients carry around with them, but it is manually operated and designed to only record electrical signals when symptoms arise.

In some circumstances, doctors may need to refer patients to a cardiologist for more exams or treatment.

Treatment & Therapy

Heart palpitations are usually not dangerous, and they often stop without treatment. If no underlying medical problems are found during testing, patients should try to identify and avoid things that stimulate palpitations. Some medications can trigger palpitations; doctors can prescribe alternative medications if this is the case.

Some effective tactics for managing heart palpitations include:

Behavioral and lifestyle changes should be enough to reduce palpitations, but if symptoms do not improve, doctors may prescribe medications such as beta blockers or calcium channel blockers.

Palpitations that are the result of a medical problem necessitate treatment of the underlying condition. If an arrhythmia is detected, the patient may require medication or surgery. A referral to an electrophysiologist, or heart rhythm specialist, may also be necessary.

Prevention & Prophylaxis

The best way to prevent heart palpitations is to maintain a healthy diet and lifestyle. Foods that promote heart health include many fish, nuts and berries. Routine exercise, especially cardio aerobic exercise, can greatly improve heart health.

Quitting smoking can help reduce palpitations and potentially extend a patient's life for several years. Even very healthy people can still experience heart palpitations under stress or due to the influence of stimulants such as caffeine, but symptoms quickly abate. Patients who regularly have palpitations should avoid triggers and learn ways to cope with stress.

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