Heart palpitations are sensations that make you aware of your own heartbeat. They may feel like your heart is pounding, fluttering, racing, or skipping beats. Many people experience palpitations at some point. While often harmless, palpitations can sometimes signal an underlying health issue that requires attention.
How the Heart Normally Beats
To understand palpitations, it’s important to know how the heart usually works. The heart beats thanks to electrical signals that trigger its muscles to contract. These signals start in a natural pacemaker called the sinoatrial (SA) node. When the signals are regular, the heartbeat feels steady and calm. When these signals change in timing or strength, you may notice palpitations.
What Exactly Are Heart Palpitations?
Palpitations are your perception of abnormal heartbeats. They can be described as:
- A pounding or racing heartbeat
- A fluttering sensation
- Irregular or skipped beats
- Uneasy or heavy chest feeling
These sensations might last seconds to minutes and may happen once or frequently.
Common Causes of Heart Palpitations
1. Lifestyle Factors
Several everyday factors can cause palpitations without serious problems. These include:
Caffeine: Found in coffee, tea, and energy drinks, caffeine can stimulate the heart.
Alcohol: Drinking alcohol can trigger irregular heartbeats in some people.
Nicotine: Smoking or vaping stimulates the nervous system and heart.
Stress and Anxiety: Emotional stress or panic attacks often cause palpitations.
Exercise: Physical activity naturally increases heart rate and can cause palpitations.
2. Heart-Related Causes
Sometimes palpitations reflect underlying heart conditions. These include:
Arrhythmias: Abnormal heart rhythms like atrial fibrillation, supraventricular tachycardia (SVT), or premature ventricular contractions (PVCs).
Heart Valve Disease: Problems with valves can disrupt normal blood flow and heartbeat sensation.
Cardiomyopathy: Disease of heart muscle affects how the heart pumps and can cause palpitations.
Coronary Artery Disease: Reduced blood flow due to narrowed arteries may cause irregular heartbeats.
Heart Failure: A weakened heart muscle can lead to irregular rhythm and palpitations.
3. Non-Cardiac Medical Causes
Not all palpitations are caused by heart disease. Other conditions that may cause palpitations include:
Thyroid Problems: Hyperthyroidism increases metabolism and heart rate.
Low Blood Sugar: Hypoglycemia can stimulate palpitations.
Electrolyte Imbalance: Abnormal levels of potassium, magnesium, or calcium affect heart rhythm.
Anemia: Low red blood cell count causes the heart to work harder.
Medications and Drugs: Certain medications, including asthma inhalers, decongestants, and stimulants, can cause palpitations.
Symptoms Accompanying Palpitations
Palpitations may come alone or with other symptoms that help determine their cause. Important symptoms to watch for include:
Chest Pain or Pressure: May indicate heart disease or angina.
Shortness of Breath: Can suggest heart failure or lung issues.
Dizziness or Fainting: May be a sign of serious arrhythmias.
Fatigue or Weakness: Could indicate heart or systemic illness.
Swelling in Legs or Abdomen: Possible sign of heart failure.
When Are Heart Palpitations a Sign of Something Serious?
Red Flags That Require Immediate Medical Attention
Not all palpitations require emergency care. However, seek urgent help if you experience:
- Severe chest pain
- Sudden fainting or near-fainting spells
- Palpitations with shortness of breath or severe dizziness
- Rapid or irregular heartbeat lasting more than a few minutes
Possible Serious Conditions
Some palpitations indicate serious heart conditions that need evaluation and treatment. These include:
Atrial Fibrillation (AFib): An irregular and often rapid heartbeat that can increase stroke risk.
Ventricular Tachycardia (VT): A fast, abnormal heartbeat from the ventricles that can be life-threatening.
Supraventricular Tachycardia (SVT): Episodes of very fast heartbeat originating above the ventricles.
Heart Block: Electrical signal delay or blockage causing abnormal heart rhythms.
How Are Heart Palpitations Diagnosed?
To find the cause of palpitations, doctors will perform a detailed assessment including:
Medical History and Physical Exam
Your doctor will ask about your symptoms, medical conditions, medications, and lifestyle habits. A physical exam checks your heart rate, rhythm, blood pressure, and overall health.
Electrocardiogram (ECG or EKG)
This test records the heart’s electrical activity. It helps detect abnormal rhythms or heart damage.
Holter Monitor
A portable device worn for 24 to 48 hours to record heart rhythms continuously during normal activities.
Event Monitor
Used for longer periods, it records heart rhythm when you activate it during symptoms.
Echocardiogram
An ultrasound scan of the heart to assess structure and function, including valve and muscle status.
Blood Tests
To check thyroid function, electrolytes, anemia, and other possible causes.
Stress Test
Records heart rhythm during exercise to detect problems that occur with physical activity.
Treatment of Heart Palpitations
Treatment depends on the cause, frequency, and severity of palpitations.
Lifestyle Changes
For many, avoiding triggers like caffeine, alcohol, and stress helps reduce palpitations. Quitting smoking and managing anxiety are also beneficial.
Medications
If palpitations are due to arrhythmias or other heart conditions, doctors may prescribe:
- Beta-blockers
- Calcium channel blockers
- Antiarrhythmic drugs
Procedures
In certain cases, procedures like catheter ablation can destroy abnormal electrical pathways causing palpitations.
Treatment of Underlying Conditions
Addressing thyroid disorders, anemia, or electrolyte imbalances often resolves palpitations.
When to See a Cardiologist
If you experience frequent, severe, or concerning palpitations, seeing a heart specialist is important. A cardiologist can perform advanced testing and recommend tailored treatment plans.
Conclusion
Heart palpitations are common and usually harmless but can sometimes signal serious heart or medical conditions. Knowing when to seek help and understanding possible causes is essential for your health. If you experience chest pain, dizziness, or fainting along with palpitations, seek medical care immediately.
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