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Heart Palpitations: Causes, Symptoms, Risk Factors, Diagnosis And Treatment

Palpitation is usually described as an increased awareness of one's heartbeat. It is a sensation in which people feel that their own heart is either beating too fast, too slow, irregular or just flattering in a strange manner. Such discontinuity of the heartbeat is not harmful in many cases but sometimes, it may be the cause of some heart-related problems or hidden disorders in other body parts that require immediate attention [1] .

Normally, the heart beats 60 to 100 times in a minute. When it beats more than 100 times in a minute, the condition is called tachycardia [2] , if it beats less than 60 per minute, the condition is called bradycardia [3] , the extra beat of the heart which occurs occasionally is called extrasystole [4] and abnormal rhythm of the heart is called arrhythmia [5] .

The beating of the heart is actually the pumping in of the oxygenated blood to every part of the body and pumping out the carbon dioxide through lungs. When this process gets obstructed, a person experiences palpitations.

According to medical experts, most of the times when a person feels palpitation, the heart is completely fine and there's nothing to worry about it. The sensation of heart palpitations is often felt in the neck, chest and the throat.

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Causes Of Heart Palpitations

Heart palpitation is a pretty distracting sensation that makes one worry about the health of their heart. There are a plethora of causes for the heart to palpitate and 90% of them are not harmful.

According to the National Heart, Lung, and Blood Institute, the heart is aware of the exact time to contrast and relax due to the electrical impulses or signals sent out by the sinoatrial node which is located in the right atrium (heart's right chamber).

Whenever the adrenaline in the body peaks up due to uncountable reasons mentioned-below, the sinoatrial node starts sending unsteady electrical impulses as a result of which, the person experiences heart palpitations [6] .

In simple terms, the heart has a certain set of receptors that respond to the heightened levels of adrenaline in the body and cause a disturbance in the electrical signal of the heart, leading to palpitation.

The possible causes of heart palpitations are as follows:

  • Stress and anxiety [7]
  • Panic attacks or fear
  • Flu [8]
  • Caffeine
  • Medication [1]
  • Exercise
  • Nicotine [9]
  • Hormonal changes, especially in women during menstruation, pregnancy, or menopause.
  • Low blood sugar [10]
  • Heart-related problems like arrhythmia [5]
  • Overactive thyroid gland [11]
  • Alcohol and drugs
  • Dehydration [12]

Symptoms Of Heart Palpitations

Different people undergo different experiences of heart palpitations. Common signs of heart palpitations are as follows [13] :

  • Heart beating fastly
  • Heart beating slowly
  • Heart pounding
  • Heart throbbing
  • Skipping heartbeat
  • Heartbeat fluttering rapidly
  • Heart murmuring
  • Flip-flopping of heartbeat

Palpitation signs are normal and go away on their own. But if it is continued by the following symptoms, a person may need to seek medical attention. The symptoms are as follows:

  • Dizziness [7]
  • Fatigue
  • Confusion
  • Loss of consciousness
  • Excessive sweating [14]
  • Body pain, especially in arms, jaw and neck
  • Difficulty in breathing
  • More than 100 heartbeats a minute

Complications Of Heart Palpitations

Heart palpitations due to some unharmful causes go away on their own, but when the palpitation is due to some internal heart disorders, they look like the following:

  • Cardiac arrest [15]
  • Fainting
  • Stroke [16]
  • Heart failure [1]

Risk Factors Of Heart Palpitation

  • Pregnancy [17]
  • Medications with stimulations, like for asthma [1]
  • Stress and panic attacks [7]
  • Overactive thyroid glands [11]
  • Certain heart disorders

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Diagnosis Of Heart Palpitations

Firstly, the doctor will listen to the heartbeat with a stethoscope, check for the pulse and ask for the symptoms. They will order a blood test in case they suspect heart palpitations due to anaemia, thyroid imbalance, or low potassium in the body. If the doctor suspects arrhythmia, they may call out for tests like the following:

  • ECG: To detect irregularities in the rhythm of the heart and its cause.
  • Holter monitoring: To detect heart palpitations deeply by recording continuous ECG for 24-72 hours [18] .
  • Echocardiogram: A test carried out by ultrasound of the chest to view a detailed image of the heart structure [19] .
  • Event recording: A device worn by the patient for several weeks to record the heartbeat whenever the symptoms occur.

Treatment Of Heart Palpitations

In the beginning, the doctor will suggest ways to avoid the cause that triggers palpitation. But if the condition is due to some heart disorders like arrhythmia, they may suggest treatments like the following:

  • Medication: Antiarrhythmic drugs like calcium channel blockers and beta-blockers [6] .
  • Catheter ablation: A procedure in which small arrhythmia is triggered to identify the cause and prevent it [20] .
  • Cardioversion: Here, electric shock is given to the patient through the chest wall to make their heartbeat synchronized [21] .

Lifestyle Changes To Prevent Heart Palpitations

  • Quit smoking [9]
  • Stay hydrated [12]
  • Cut down on alcohol
  • Get a sound sleep
  • Eat on a regular basis to avoid low sugar [10]
  • Consult a doctor to check whether your medications are causing heart palpitations or not.
  • Stay calm and do yoga
  • Consume high potassium foods.
  • Limit the caffeine intake
View Article References
  1. [1] Goyal A, Robinson KJ, Sanchack KE. Palpitations. [Updated 2019 Jul 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  2. [2] Gopinathannair, R., & Olshansky, B. (2015). Management of tachycardia. F1000prime reports, 7, 60. doi:10.12703/P7-60
  3. [3] Hafeez Y, Grossman SA. Sinus Bradycardia. [Updated 2019 May 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  4. [4] Touboul, P. (1993). What is a practical approach to atrial extrasystole?. La Revue du praticien, 43(12), 1498-1503.
  5. [5] Antzelevitch, C., & Burashnikov, A. (2011). Overview of Basic Mechanisms of Cardiac Arrhythmia. Cardiac electrophysiology clinics, 3(1), 23–45. doi:10.1016/j.ccep.2010.10.012
  6. [6] Ershadifar, T., Minaiee, B., Gharooni, M., Isfahani, M. M., Nikbakht Nasrabadi, A., Nazem, E., … Kazemi Saleh, D. (2014). Heart palpitation from traditional and modern medicine perspectives. Iranian Red Crescent medical journal, 16(2), e14301. doi:10.5812/ircmj.14301
  7. [7] Alijaniha, F., Noorbala, A., Afsharypuor, S., Naseri, M., Fallahi, F., Mosaddegh, M., … Sadrai, S. (2016). Relationship Between Palpitation and Mental Health. Iranian Red Crescent medical journal, 18(3), e22615. doi:10.5812/ircmj.22615
  8. [8] Mwirigi, N. W., & Rodriguez-Porcel, M. (2010). 31-year-old man with fever, palpitations, and generalized rash. Mayo Clinic proceedings, 85(4), e13–e16. doi:10.4065/mcp.2008.0728
  9. [9] D'Alessandro, A., Boeckelmann, I., Hammwhoener, M., & Goette, A. (2012). Nicotine, cigarette smoking and cardiac arrhythmia: an overview. European journal of preventive cardiology, 19(3), 297-305.
  10. [10] Chopra, S., & Kewal, A. (2012). Does hypoglycemia cause cardiovascular events?. Indian journal of endocrinology and metabolism, 16(1), 102–104. doi:10.4103/2230-8210.91203
  11. [11] Binu, A. J., Cherian, K. E., Kapoor, N., Chacko, S. T., George, O., & Paul, T. V. (2017). The Heart of the Matter: Cardiac Manifestations of Endocrine Disease. Indian journal of endocrinology and metabolism, 21(6), 919–925. doi:10.4103/ijem.IJEM_212_17
  12. [12] Olivero J. J., Sr (2016). Cardiac Consequences Of Electrolyte Imbalance. Methodist DeBakey cardiovascular journal, 12(2), 125–126. doi:10.14797/mdcj-12-2-125
  13. [13] Mirvis DM. Palpitations. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 10.
  14. [14] Chatterjee, B., Hirzel, C., & Sahli, R. G. (2013). Hypertension, sweating and palpitation in a psychotic patient - don't miss the somatic cause. JRSM short reports, 4(11), 2042533313496087. doi:10.1177/2042533313496087
  15. [15] Park, J. K. (2015). Palpitations and Arrhythmias and Sudden Cardiac Arrest/Sudden Cardiac Death in Children and Adolescents. Pediatric annals, 44(12), e279-e286.
  16. [16] Clementy, N., Fourquet, A., Andre, C., Bisson, A., Pierre, B., Fauchier, L., … Angoulvant, D. (2018). Benefits of an early management of palpitations. Medicine, 97(28), e11466. doi:10.1097/MD.0000000000011466
  17. [17] Adamson, D. L., & Nelson-Piercy, C. (2007). Managing palpitations and arrhythmias during pregnancy. Heart (British Cardiac Society), 93(12), 1630–1636. doi:10.1136/hrt.2006.098822
  18. [18] Mubarik A, Iqbal AM. Holter Monitor. [Updated 2019 Mar 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  19. [19] [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What is an echocardiogram? 2016 Oct 6 [Updated 2019 Jan 31].
  20. [20] Skelly A, Hashimoto R, Al-Khatib S, et al. Catheter Ablation for Treatment of Atrial Fibrillation [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Apr 20. Introduction.
  21. [21] Sucu, M., Davutoglu, V., & Ozer, O. (2009). Electrical cardioversion. Annals of Saudi medicine, 29(3), 201–206. doi:10.4103/0256-4947.51775
Story first published: Sunday, September 29, 2019, 8:00 [IST]
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