Palpitations: A Sign of Cardiac Diseases?

Meaning of palpitations 

Palpitations are the abnormalities of heartbeats that we sensed, usually perceiving heartbeats as being too fast, irregular or pounding too hard. It can be regarded as a form of arrhythmia, meaning the heart rhythm is irregular. It is observed more frequently as we become older, but is not always indicative of serious heart disease.

Causes of palpitations

The underlying mechanisms and causes of palpitations are wide-ranging. Some causes that have been identified are: 

• Age: It can occur at any age, but is more common in the elderly.
• Psychological reasons: Stress, anxiety, depression, panic attacks, etc. can cause palpitations.
• Medications or substance use: Some medications can be stimulants for the heart, including pseudoephedrine, nimodipine, and adrenaline. Sometimes, some substances or recreational drugs like nicotine, alcohol, caffeine, and amphetamines can also lead to palpitations.
• Strenuous physical activity
• Extreme fatigue
• Inadequate sleep
• Hypotension
• Hypoglycaemia
• High body temperature
• Dehydration
• Changes in hormones: It is particularly prominent in women during pregnancy, menstruation or menopause in which there is a big change in the hormonal environment of the body.

The above causes are seldom fatal, but the ones below can be serious. Palpitations are a sign of early discovery and treatment.

• Disorders in the heart muscle: For instance, when the heart muscle becomes thicker or when the heart chambers enlarge. It is a serious condition. Palpitations will be noticed.
• Disorders in heart valves
• Arrhythmias: For example, atrial fibrillation, supraventricular tachycardia and atrial flutter are types of life-threatening arrhythmias.
• Hyperthyroidism
• Anemia

Signs and symptoms of palpitations

Palpitations are felt occasionally even in healthy individuals. Usually, there is no need to be worried unless you experience the symptoms way too frequently, lasting for way too long or appearing with other symptoms like chest pain or shortness of breath. If so, you are suggested to visit the doctor as soon as possible. The signs and symptoms of palpitations are the sensations of skipping or rapid heartbeat, rapid fluttering, pounding, and flip-flopping perceived in the throat, neck or chest.

Complications of palpitations

Palpitations themselves are not a disease, so there will be no organic complications rising from palpitations. However, since palpitations may come from underlying causes like heart disease, serious aftermath will be presented if the underlying disease is neglected. The consequences include:

• Syncope: It is more commonly known as fainting. Palpitations mean the blood circulation is not stable, hence the supply of blood to the brain is also unstable. This will lead to one fainting.
• Cessation of organised heartbeats (cardiac arrest)
• Stroke
• Heart failure

Diagnosis of palpitations

Palpitations themselves can easily be diagnosed by the report of the symptom by patients. However, for the underlying cause, a thorough examination is required as the palpitations may be caused by many conditions, some are very detrimental to one’s health. The following things may be done to discover the culprit:

• Asking for a complete and detailed history of palpitations: For example, the diet before the palpitations happen may be asked, so that caffeine and other substances, which can precipitate the symptom, can be ruled out. Moreover, the details about the palpitations, like the age of onset, frequency, regularity and other symptoms associated are needed. If the situation starts appearing in childhood, it may be caused by supraventricular tachycardia.
• Stethoscopy: The physician may try to look for signs of heart murmurs or other abnormalities.
• Electrocardiogram (ECG): Heart rate and sinus rhythm are checked in ECG to look for abnormalities. For a more thorough diagnosis, ECG monitoring may last for 24 or even 1 week.
• Examination of orthostatic vital signs: The physician will ask one to lie down, then examine the vital signs. Next, one will be asked to stand up, and vital signs will be taken immediately and compared. It can be used to check for dehydration, atrial fibrillation and atrial flutter.
• Blood test: It can be used to check for abnormalities in the blood, especially to check for malfunctioning of the thyroid gland. It can also discover infections and anemia.
• Echocardiogram: A picture of one’s heart is produced with sound waves to check for circulation and structural details of one’s heart.

Treatment of palpitations

Those without palpitations want to avoid them of course. It can be easily done by avoiding potential triggers like caffeine consumption, alcohol consumption and inadequate sleep. 

However, for those with palpitations, treatments may be provided depending on the underlying cause concluded by the physician. If the physician deems the palpitations to be of harmless causes, medical treatments are not needed and the patients need to avoid the potential triggers.

On the contrary, if the palpitations are caused by medical conditions, for instance, hyperthyroidism, atrial fibrillation and anxiety, corresponding treatments will be provided.