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Definition

Palpitations are marked by sudden feeling of your heart pounding or racing with varying qualities of fluttering, skipping, or any abnormal sensations.

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They can occur at any time during a person’s normal daily routines. A person can have palpitations in the chest as well as neck and throat. They may or may not be related to the heart and are often not life threatening.

 

Causes

  • Emotions: anxiety, stress, fear, panic
  • Physiological reponses: Exercise, Pregnancy
  • Substance: Caffeine, nicotine, illegal drugs (cocaine, amphetamines)
  • Certain medical conditions: overactive thyroid, anemia, shock, hypoxemia, hypoglycemia
  • Certain medications: asthma inhalers, decongestants, over the counter drugs that can act as stimulants (cough/cold medicine), herbal/nutritional supplement, beta blockers, thyroid and antiarrhythmic medications

 

Heart related palpitations

If a patient has significant risk factors for heart disease, existing heart disease, irregular heart beats (arryhthmia), abnormal heart
valve, then the palpitation may be caused by a problem with the heart.

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Complications of palpitations from heart problems

  • Fainting: If your heart beats rapidly, your blood pressure may drop too much too fast and lead to loss of consciousness.
  • Stroke: If palpitations are due to atrial fibrillation, a condition in which the upper chambers of the heart quiver instead of beating properly, blood can pool and cause clots to form. If a clot breaks loose, it can block a brain artery, causing a stroke.
  • Heart failure: Having an arrhythmia such as atrial fibrillation for a prolonged period can lead to heart failure. Controlling the rate of an arrhythmia is very important to preventing it.
  • Cardiac arrest: Rarely, palpitations can be caused by life-threatening arrhythmias and can cause your heart to completely stop beating effectively.

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When to call your doctor?

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If the palpitation accompanies discomforting symptoms of dizziness, pain, shortness of breath, tightness, unusual sweating then you should set up an appointment.

 

How are palpitations diagnosed?

  • Patient interview: Your doctor will take your past medical history, history of present illness, review your medications, and review your diet
  • Physical examination: Your doctor will listen to your heart and lungs.
  • Screening Tests: electrocardiogram (EKG), stress test, chest X-ray, echocardiogram(heart ultrasound), ambulatory cardiac monitor
  • Confirmatory tests: If an underlying heart problem is suspected patients will be put on electrophysiology study or cardiac catheterization.

 

How are palpitations treated?

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If it’s not related to the heart and you are generally healthy:
No treatments are needed. You should identify any particular
food, medicine, or activity that induce palpitations and either
avoid them or have alternative choices.

 

If it is related to your heart:

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The doctor will prescribe a treatment plan that includes lifestyle modifications such as diet and exercise and medication.

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If the heart has a serious problem the doctor will make a
decision to resolve the underlying heart problem through more invasive methods such as implantations to restore normal rhythm or surgery if necessary.

 

How to prevent palpitations?

Limit or avoid

alcohol, caffeine, tobacco/nicotine, medications that act as stimulants, activities that appear to be associated with palpitations

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Start and do more

exercise (one prescribed by your doctor), maintenance of your blood pressure and cholesterol level through proper diet or medication if necessary, reduce your stress level (through activities such as journaling meditation, yoga, tai chi), and if palpitations do occur try not to pay too much attention to them once any serious causes have been ruled out.

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References

  1. Cleveland Clinic – Arrhythmia: Heart Palpitations (Cleveland Clinic) http://my.clevelandclinic.org/heart/disorders/electric/palpitations.aspx
  2. Heart palpitations http://www.mayoclinic.org/diseases-conditions/heartpalpitations/basics/definition/con-20034780

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