Palpitations: Causes, Symptoms, and Treatments

Palpitations are a common yet often concerning symptom characterized by the sensation of a fast, irregular, or forceful heartbeat. Many people experience them at some point, and while they are often harmless, they can sometimes indicate an underlying health issue. This article explores the causes, symptoms, diagnosis, and treatment options for palpitations, helping you understand when to seek medical advice.

What Are Palpitations?

Abnormal awareness of one’s heartbeat. They may feel like:
• A fluttering sensation in the chest
• A pounding or racing heartbeat
• A skipped or extra beat
• A feeling of the heart flipping or “jumping”
These sensations may last only a few seconds or persist for minutes to hours. Some people notice them more when at rest, while others experience them during physical activity or stressful situations.

Causes of Palpitations

Palpitations can arise from a wide range of factors, including lifestyle influences, medical conditions, and heart disorders. Below are some of the most common causes:
1. Lifestyle Factors
Certain lifestyle habits can trigger palpitations, including:

• Caffeine and stimulants: Excessive intake of coffee, energy drinks, or medications containing stimulants can cause the heart to race.

• Alcohol consumption: Alcohol, particularly in large quantities, can irritate the heart and lead to palpitations.

• Stress and anxiety: Emotional stress and anxiety can increase adrenaline levels, causing the heart to beat faster.

• Exercise: While exercise is generally beneficial, it can temporarily elevate heart rate, leading to palpitations, especially if a person is not conditioned or has underlying heart issues.
• Dehydration: Lack of fluids can lead to electrolyte imbalances, affecting heart rhythm.

2. Medical Conditions
Several medical conditions are linked to palpitations, such as:
• Thyroid disorders: An overactive thyroid (hyperthyroidism) increases metabolism, which can cause a rapid or irregular heartbeat.

• Anemia: A low red blood cell count can reduce oxygen supply to the heart, triggering palpitations.

• Low blood sugar (hypoglycemia): Drops in blood sugar can stimulate adrenaline release, causing fast heart beats.

• Fever and infections: Elevated body temperature and infections can increase heart rate.

3. Heart-Related Causes
Although many palpitations are harmless, some may indicate underlying heart conditions such as:
• Atrial fibrillation (AFib): A common irregular heartbeat disorder that can increase the risk of stroke.
• Supraventricular tachycardia (SVT): A condition where the heart suddenly beats abnormally fast.
• Premature ventricular contractions (PVCs): Extra heartbeats that disrupt the regular rhythm.
• Mitral valve prolapse: A condition where the mitral valve does not close properly, potentially causing palpitations.
• Heart failure or coronary artery disease: In rare cases, palpitations may be a symptom of more severe heart conditions.

Symptoms Associated with Palpitations

Palpitations alone are not always a cause for concern, but they can sometimes accompany other symptoms that warrant medical evaluation, such as:
• Chest pain or discomfort
• Shortness of breath
• Dizziness or lightheadedness
• Fainting (syncope)
• Sweating or nausea
If palpitations are persistent, severe, or associated with these symptoms, seek immediate medical attention, as they could indicate a serious heart condition.

Diagnosing Palpitations:

If you experience frequent or concerning palpitations, a doctor may perform several tests to determine the cause:
1. Medical History and Physical Exam
Your doctor will ask about your symptoms, lifestyle habits, medications, and any existing health conditions. They will also check your pulse, blood pressure, and listen to your heart using a stethoscope.

2. Electrocardiogram (ECG or EKG)
An ECG records the electrical activity of the heart and can detect abnormal rhythms, extra beats, or signs of heart disease.

3. Holter Monitor or Event Monitor
If palpitations occur sporadically, a Holter monitor (worn for 24-48 hours) or an event monitor (worn for weeks) may be used to track heart activity over time.

4. Echocardiogram
An ultrasound of the heart can reveal structural issues, valve problems, or weakened heart function.

5. Blood Tests
Blood tests can identify thyroid disorders, anemia, electrolyte imbalances, or other conditions contributing to palpitations.

6. Stress Test
A stress test monitors heart activity while exercising, helping identify heart conditions triggered by physical exertion.

Treatment and Management of Palpitations:

The treatment of palpitations depends on the underlying cause. Here are some general approaches:
1. Lifestyle Modifications
For many people, simple lifestyle changes can significantly reduce palpitations:
• Reduce caffeine and alcohol intake
• Practice stress management techniques (e.g., deep breathing, meditation, or yoga)
• Stay hydrated and maintain a balanced diet
• Get enough sleep
• Exercise regularly but avoid overexertion

2. Medication Adjustments
If medications such as decongestants, asthma inhalers, or stimulants are causing palpitations, a doctor may adjust the dosage or recommend alternatives.

3. Medical Treatments for Heart Conditions
If palpitations are linked to a heart condition, specific treatments may be necessary:
• Beta-blockers or calcium channel blockers: These medications can help control heart rate and rhythm.
• Anti-arrhythmic drugs: These are used to treat irregular heartbeats.
• Ablation therapy: A procedure that targets and eliminates abnormal heart tissue causing palpitations.
• Pacemaker or implantable cardioverter defibrillator (ICD): Devices used in severe cases to regulate heart rhythm.

4. Managing Anxiety and Stress
For palpitations caused by anxiety, cognitive behavioral therapy (CBT), relaxation techniques, and, in some cases, medication may help.

When to See a Doctor about palpitations:

You should seek medical attention if:
• Palpitations are frequent and persistent
• They are accompanied by chest pain, shortness of breath, or fainting
• They worsen over time
• You have a history of heart disease or risk factors such as high blood pressure, diabetes, or high cholesterol

Conclusion:

Palpitations are often harmless but can sometimes signal an underlying health issue. Identifying triggers, making lifestyle adjustments, and seeking medical evaluation when necessary can help manage and prevent them. If you experience persistent or concerning palpitations, consult a healthcare professional to ensure proper diagnosis and treatme

Salam Salloum

Consultant Cardiologist, Specialist In Cardiac Imaging, Heart Failure, And Valve Disease. Dr. Salloum has been working in the field of cardiovascular medicine for over 20 years between cardiac surgery, cardiac intensive care, and cardiology. In 2016 he was appointed as a consultant cardiologist with a special interest Heart Failure, Valve Disease, Cardiac Imaging (Cardiac CT, Cardiac MRI, Echocardiogram, and Stress Echocardiogram), along with General cardiology (angina, hypertension, and palpitations). Dr. Salloum received his training to be a Cardiology Doctor in prestigious UK University Hospitals. He did over 2 years at Southampton University Hospital training in cardiac intensive care and post-cardiac surgery care. He did 18 months at Papworth Hospital – Cambridge spending 1 year in cardiac surgery and 6 months in advanced heart failure training including pre and post-heart transplant care. The general cardiology, echo, stress echo and cardiac CT trainings all were gained through training programme at Oxford University Hospital (John Radcliffe Hospital) where he spent over 3 years. Dr. Salloum then took over 2 years of fellowship training at The Royal Brompton Hospital – London to obtain a level 3 EACVI Accreditation in cardiac MRI. He also has the British, European, and American Board Certifications in Echocardiography. Dr. Salloum has performed over 5000 Dobutamine Stress Echo (DSE) to assess ischaemia and valve disease. He reported over 3000 cardiac MRI studies assessing ischaemia, heart structure, valve diseases, aortopathies, and different types of cardiac cardiomyopathy conditions. He also reported over 2000 cardiac CTs assessing cornary calcifications, and coronary artery diseases non-invasively. All expertise aside, Dr. Salloum’s real goal is to help those who need it. He decided becoming a virtual doctor and offering both general and cardiology services online would be the best way to do so. He committed himself to be able to offer the best advice to anyone who asks as well as provide more in-depth consultative services through the phone, internet and face to face. So rest assured, no matter what kind of issues you have faced, whether it is pre-operative, post-operative or you have been experiencing some sort of cardiovascular symptoms you feel you need to ask a doctor or cardiologist about, The UK-Cardiologist will do the absolute best to help you through this troubling time through the virtual clinic and online services. Dr. Salloum will pass this experience on to everyone who needs to ask a cardiologist anything online. Qualifications: M.D. MRCP UK. CMR Level 3 EACVI: Cardaic MRI. CTCA SCCT II: Cardiac CT. NBE: Natioanl Board of Echocardiogram (USA). Member of: RCP: Royal College of Physicians. ESC: European Society of Cardiology. ASE: American Society of Echocardiography. EACVI: European Asscoiation of CardioVascular Imaging. MDDUS and AoN: Meidcal Indemnity Insurances. Subspecialties: Cardiac Imging. Herart Failure. Valve Disease. Stress tests. Special interests in the following cardiac conditions: Acute Coronary Syndrome (ACS) Angina Aortic Valve Degeneration Aortic Valve Disease Aortic Valve Regurgitation Aortic Valve Stenosis Atrial fibrillation Atrial flutter Beathlessness Crdiomyopathy Crdiovascular Disease Chest Pain Cngestive Heart Failure Cronary Artery Disease Heart Failure Heart Murmurs Heart Valve Problems High Blood Pressure Hypertension (High Blood Pressure) Conditions Non-Invasive Heart Imaging Oedema Palpitations Pericarditis Postural Orthostatic Tachycardia Syndrome (POTS) Supraventricular Tachycardia (SVT) Takotsubo Syndrome Valvular Heart Disease Investigations: 24 Hour Blood Pressure Monitor Bubble Contrast Echocardiography CT Coronary Angiogram Calcium Coronary Score Cardiac CT Cardiac Imaging Cardiac MRI Cardiac Screening Dobutamine Stress Echocardiogram ECG (Electrocardiogram) ECG Holter Monitor Ehocardiogram (Cardiac Ultrasound) Exercise Stress Test Heart Health Check Heart Scan Sress Echocardiogram Transthoracic Echocardiogram (TTE) Languages: English Arabic

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