Palpitations

Symptoms Of Palpitations

It is important to understand that heart palpitations are a symptom of a condition or a state of the body and not a medical disease in itself. Palpitations are sensations that make a person feel like their heart is pounding or racing. One can feel heart palpitations in the throat or neck too. The symptoms of heart palpitations include the following:

• Being unpleasantly aware of your own heartbeat

• Feeling like your heart has skipped a beat or stopped beats 

• Heart is fluttering rapidly 

• Pounding heartbeat 

• Flip-flopping of heat beat 

Aditionally, symptoms that can be associated with palpitations are:

• Shortness of breath 

• Chest pain 

• Fainting 

• Dizziness 

• Headache

• Sweating

Palpitation associated with chest pain suggests coronary artery disease, or if the chest pain is relieved by leaning forward, pericardial disease is suspected. Palpitation associated with light-headedness, fainting or near fainting suggest low blood pressure and may signify a life-threatening abnormal heart rhythm. If a benign cause for these concerning symptoms cannot be found at the initial visit, then ambulatory monitoring or prolonged heart monitoring in the hospital might be warranted. 

Noncardiac symptoms should also be elicited since the palpitations may be caused by a normal heart responding to a metabolic or inflammatory condition. Weight loss suggests hyperthyroidism. Palpitation can be precipitated by vomiting or diarrhea that leads to electrolyte disorders and hypovolemia. Hyperventilation, hand tingling, and nervousness are common when anxiety or panic disorder is the cause of the palpitations.

Causes Of Palpitations

Some common causes of palpitations include the following:

• Experiencing powerful emotional reactions such as stress, anxiety or panic attacks.

• A difficult workout 

• Undergoing mental health conditions such as depression or anxiety disorder

• Drinking excessive amounts of food products containing stimulants such as coffee or tea. 

• Medications that contain nicotine, amphetamines, cold and cough medications containing pseudoephedrine, asthma inhalers and withdrawal from beta blockers.

• Experiencing hormonal changes during menstruation or pregnancy

• Too much or too little thyroid hormones. 

• Taking diet pills 

• Fever 

• Low level of oxygen in the blood 

• Blood loss

• Low blood sugar 

Sometimes, palpitations can be caused because of an abnormal heartbeat that can be caused due to the following medical conditions:

Abnormal heart valve 

Conditions such as a mitral valve prolapse affects the flaps or leaflets of the heart that play important roles in the pumping of blood through the heart. The mitral valve is present between the left heart chambers and normally bulges into the hearts upper left chamber when the heart contracts. A defect or a disease that affects the mitral valve can result in an abnormal heartbeat. 

Heart arrhythmia

Palpitations can be caused by certain conditions that can cause arrhythmia (problem with the rhythm of the heart). Some common heart arrhythmias include atrial fibrillation, a condition in which the heart beats irregularly and at a faster pace than normal. Atrial flutter causes a fast and irregular heartbeat and Supraventricular tachycardia results in an abnormally fast heart rate. 

Abnormal level of potassium 

Potassium is a key nutrient that plays an important role in influencing the heart rate. If a person has low levels of potassium they can experience an irregular heartbeat that is known as heart arrhythmia. Excessive levels of potassium can also lead to irregular heartbeat and a person may experience a fluttering sensation in the chest. This results in palpitations and can indicate a serious heart condition that would need professional medical advice. 

Heart diseases 

Heart conditions such as congenital heart defects (heart problems that develop when a foetus is growing), coronary heart disease (a condition that causes plaque buildup in the arteries responsible for moving oxygenated blood through the body) and cardiomyopathy (a condition that causes the muscle of the heart to grow thick or weak) can cause palpitations. 

Congestive heart failure 

Congestive heart failure or CHF affects the pumping ability of the heart and is often referred to as heart failure. This condition results in a stage where the fluids within the heart build up and results in inefficient pumping of blood. This condition can result in palpitations and irregular heartbeat. 

Other medical conditions

Sleep apnea: A condition that is caused by the continuous repetitive collapse of the upper airway during sleep. It is one of the most common breathing-related disorders. 

Anemia: A condition that occurs due to decreased number of healthy red blood cells in the body resulting in an insufficient supply of oxygen to the body. This can result in palpitations, fatigue and shortness of breath. 

Metabolic conditions: There are many metabolic conditions that can result in palpitations including, hyperthyroidism, hypoglycemia, hypocalcemia, hypermagnesemia, hypomagnesemia, and pheochromocytoma

Other etiologies also include excess caffeine, or marijuana. Cocaine, amphetamines, 3-4 methylenedioxymethamphetamine (ecstasy or MDMA) can also cause palpitations.

Risk Factors For Palpitations

Some common risk factors of palpitations include the following:

• Pregnancy 

• Stress

• An overactive thyroid 

• Taking medications for cold or asthma 

• Anxiety or panic disorder

• Irregular heartbeats 

• Previous heart surgery or structural heart changes 

Diagnosis Of Palpitations

To diagnose the cause behind palpitations your doctor will firstly conduct a physical exam and listen to your heartbeat using a stethoscope. If your healthcare provider suspects a medical condition behind your palpitations they will recommend further tests to determine the cause behind the same. 

Electrocardiogram or EKG

This diagnostic procedure is a test that is quick and painless in nature. It measures the electrical activity of the heart by using sticky patches also known as electrodes. The electrodes are placed on the patient's chest, arms and legs while the wires connect the electrodes to a monitor that displays the results. An electrocardiogram helps in determining whether a person has a rapid or slow heartbeat. 

Holter monitoring 

This is a portable and easy to use ECG device that can be worn by the patient for a day or more. The device records the heart rhythm and rate while carrying out their daily activities. It helps in determining heart palpitations that aren't found during an EKG exam. Smartwatches often contain remote EKG monitoring and can be advised by a doctor. 

Event recording 

There might be cases when an irregular heartbeat isn't recorded while wearing a Holter monitor and the event may occur fewer times than in a week. In such cases, your doctor may recommend you to follow event recording. This requires a patient to press a button when they experience the symptoms and is usually recommended to be worn for 30 days or more until you experience heart palpitations. 

Implantable loop recorder

An implantable loop recorder is a device that is placed subcutaneously and continuously monitors for cardiac arrhythmias. These are most often used in those with unexplained syncope and can be used for longer periods of time than the continuous loop event recorders. An implantable loop recorder is a device that is placed subcutaneously and continuously monitors for the detection of cardiac arrhythmias. These are most often used in those with unexplained syncope and are used for longer periods of time than the continuous loop event recorders. Electrophysiology testing enables a detailed analysis of the underlying mechanism of the cardiac arrhythmia as well as the site of origin.

Echocardiogram 

This noninvasive modality uses sound waves to create pictures of the heart in motion. The test helps in showcasing the blood flow and structural problems on the heart and helps a provider in pinpointing the cause behind a heart symptom. 

Blood tests 

Your healthcare provider may recommend blood tests to check your hormone levels because palpitations can be caused due to an increase in the levels of hormone seen in cases of pregnancy or menstruation. The blood tests will also help in determining the levels of certain electrolytes in the blood that influence heartbeat such as potassium & calcium. 

• Complete blood count can assess anemia and infection.

• Serum urea, creatinine to assess for renal dysfunction.

• Other blood tests, particularly tests of thyroid gland function, are also important baseline investigations (an overactive thyroid gland is a potential cause for palpitations; the treatment, in that case, is to treat the thyroid gland over-activity)

Urine test 

A urine test will help in determining the levels of electrolytes, hormones, blood cells and blood sugar levels in the body.

Urine metanephrines testing is used to help detect or rule out the presence of a rare tumor called a pheochromocytoma or a paraganglioma that releases excess metanephrines.

Stress test 

A stress test may be recommended by your doctor to determine the cause of your palpitations. This test allows a doctor to study your heart while the heart rate is elevated. This can be done by making the patient walk briskly on a treadmill or while taking a medication that causes an increase in the heart rate. 

Coronary angiography 

This modality helps in checking how blood flows through the heart. It helps in determining whether you have a blockage in the coronary artery that can result in symptoms such as heart palpitations. In this test, a contrast dye is injected into the arteries while the doctor observes the blood flow through the heart on an X-ray screen. 

Prevention Of Palpitations

If your doctor doesn't suspect a medical condition behind the occurrence of palpitations you can be asked to follow certain guidelines that can help in the prevention of palpitations. This includes the following 

• Trying to identify and avoid triggers that cause palpitations. You can maintain a log of your activities that result in palpitations and try to avoid them. This can include the intake of caffeine or certain medications and foods. You will also be required to keep a note of your emotional state and events that trigger you to feel anxious which results in palpitations. 

• Adding relaxation exercises in your daily routine that can help you in managing stress and anxiety.

• Avoid stimulants such as nicotine and stimulant recreational drugs. 

• Incorporating regular exercising in your life 

• If you have low blood sugar, take your medications regularly and ensure that your blood sugar level does not fall below the recommended level. 

• Managing blood pressure and cholesterol levels.

• Following a healthy lifestyle and eating a nutrient-rich diet. 

• Avoiding smoking and using tobacco products. 

Smoking has severe side effects and can result in many health complications. Worldwide, tobacco use causes more than 7 million deaths per year. Learn how you can stop smoking. 
Tap To Read!

Specialist To Visit

You should visit a doctor if you are experiencing symptoms such as loss of consciousness, chest pain, unusual sweating, dizziness, lightheadedness, experiencing more heartbeats frequently, pulse more than 100 per minute, shortness of breath and history of cardiac problems or if the palpitations lasts a longer time or gets worsen . These symptoms might indicate the possibility of a medical condition behind the palpitations. You can consult the following doctors for diagnosis:

• General physician

• Cardiologist

Do not ignore any signs and symptoms. It is best to consult a doctor for the right diagnosis and treatment. Consult India’s best doctors here.
Consult Now!

Treatment Of Palpitations

Generally palpitations that aren't caused by an underlying medical condition tend to resolve on their own. If your doctor doesn't suspect a medical condition behind your palpitations they might recommend the following steps to avoid the triggers that cause palpitations. 

Management of stress and anxiety 

This will include incorporating relaxation techniques in your daily life that can help you in managing stress and anxiety. You can opt for daily physical activities, breathing exercises, yoga or meditation in your daily life. 

Avoiding stimulants 

Palpitations are often caused after consuming products that stimulate the heart and cause a rapid heart beat. You can be asked to record the triggers that cause palpitations and try to avoid them. Consuming excessive amounts of caffeine is often the reason behind palpitations. You can limit your caffeine intake or choose a decaffeinated beverage. Drugs such as cocaine and ecstasy are also stimulants that cause palpitations. Talk to your doctor if you are taking any medications since some medicines may contain stimulants that cause heart palpitations. 

Eat a healthy diet 

Low blood sugar is a leading risk factor for heart palpitations. Eating nutrient-rich food and replacing simple carbs with complex carbohydrates is a great way of maintaining stable blood sugar levels. You will be asked to swap fruit juices, white bread, and sugary drinks with whole grains and vegetables. 

If the cause behind your palpitations is a medical condition such as atrial fibrillation, your treatment will be focused on treating the condition. 

Medications to treat arrhythmia 

Antiarrhythmic medications are used to convert an abnormal heartbeat into a normal rhythm. These medications are also used to prevent the occurrence of arrhythmia. 

Some of the common antiarrhythmic drugs are amiodarone, adenosine, beta blockers, ibutilide, flecainide and calcium channel blockers .

Anticoagulant medications such as warfarin or aspirin are used to reduce the risk of blood clot formation. 

Electrical cardioversion 

People with persistent arrhythmias such as atrial fibrillation may require an invasive procedure such as electrical cardioversion. This procedure is performed after administering short-acting anaesthesia. An electrical impulse is delivered through the chest wall that helps in synchronising the heart and stabilising a normal heart rhythm. 

Radiofrequency ablation (RFA)

Radiofrequency energy is used in heart tissue or normal parts to destroy abnormal electrical pathways that are contributing to a cardiac arrhythmia. It is used in recurrent atrial flutter (Afl), atrial fibrillation (AF), supraventricular tachycardia (SVT), atrial tachycardia, multifocal atrial tachycardia (MAT) and some types of ventricular arrhythmia. The energy-emitting probe (electrode) is at the tip of a catheter which is placed into the heart, usually through a vein. This catheter is called the ablator. The practitioner first "maps" an area of the heart to locate the abnormal electrical activity (electrophysiology study) before the responsible tissue is eliminated. Ablation is now the standard treatment for SVT and typical atrial flutter and the technique can also be used in AF, either to block the atrioventricular node after implantation of a pacemaker or to block conduction within the left atrium, especially around the pulmonary veins.

Home-care For Palpitations

Here are a few things that you can follow at home to limit the occurrence or prevent palpitations:

• Reduce your caffeine intake and note down the stimulants that result in palpitations. 

• Practice relaxation techniques such as yoga and meditation that can help you manage stress and stabilise your mood. 

• Try breathing exercises and deep relaxation techniques such as aromatherapy

• Incorporate regular exercise in your life 

• Cease or limit smoking and avoid using any products that contain nicotine. 

• Avoid herbal and nutritional supplements that contain stimulants 

• Consult a mental health specialist if you experience mood disorders such as panic attacks, anxiety disorder or depression

• Avoid eating spicy or rich foods that may cause heart palpitations. 

• Label your drugs and set the alarm to make sure you have the medicines every day at the same time. 

• Stick to the right treatment plan, as decided by your doctor, and incorporating the necessary lifestyle changes can help you take care of your condition and recover faster.

Complications Of Palpitations

Palpitations that do not resolve on their own and are caused by medical conditions can cause certain complications if left untreated. This includes the following:

Fainting 

One can experience loss of consciousness if the heart beats too rapidly leading to a drop in the blood pressure. The risk of the same increases in people who are suffering from congenital heart conditions or specific heart valve problems. 

Cardiac arrest 

Sometimes palpitations can be caused due to life-threatening heartbeat problems that can result in the heart stopping beating effectively. 

Stroke 

If the palpitations are caused by a condition that affects the upper chambers of the heart resulting in the heart beating to quiver instead of beating regularly, stroke can occur. This is caused due to pooling of blood that causes clots to form, if a clot breaks it can occlude a brain artery and result in a stroke that can be life-threatening. 

Heart failure

Specific arrhythmias can effectively reduce a heart's capacity to pump blood through the body. Heart function can be improved by controlling the rate of an arrhythmia that's causing heart failure. 

Alternative Therapies For Palpitations

If you have palpitations, these therapies can help you control the condition. They are:

Exercising 

Leading a healthy lifestyle and doing light exercises daily such as walking can help in managing your medical condition. Talk to your doctor about what kind of exercises would suit your condition.

Diet changes 

Choose a diet that is low on unhealthy carbs and follow protein guidelines given by your doctor. The guidelines of what you are supposed to eat will depend on the severity of the condition and the treatment regimen that you are on. It is important to follow the advice of your doctor since your diet influences your health.

Yoga 

Opting for simple exercises such as yoga can help you avoid stress and anxiety that can further help your health.

Living With Palpitations

Experiencing palpitations can be scary and can cause difficulty in carrying out day to day tasks. However, modern science has opened the doors to several possibilities that can allow you to live a healthy life and prevent the occurrence of irregular heart rhythms. Along with your medical treatments, it is important to incorporate lifestyle changes that will help you cope with your condition. Here are a few tips that you can follow:

Follow up with your doctor

Make sure that you stay in touch with your doctor and report any changes in your palpitations or if you keep regularly experiencing heart palpitations. Call your doctor if you experience any sudden change in the nature of your palpitations or feel that you are losing consciousness. 

Follow a healthy lifestyle 

Incorporate the changes recommended to you by your doctor. You may be advised to exercise regularly and eat a balanced diet that incorporates fruits, vegetables and whole grains. 

Take your medications regularly 

If you have been given medications to regulate arrhythmia, take the medicines regularly and follow up with your doctor about any change in your condition 

Manage stress and anxiety 

If you are experiencing stress due to a work situation or a personal relationship, practice relaxation techniques that can help you in managing stress and anxiety.