Palpitations is an unpleasant, subjective sensation of a palpable, altered heartbeat, most often described by patients as a feeling of accelerated, increased or irregular heartbeat. It is a symptom that is one of the most common ailments and reasons for visiting a family doctor.
Palpitations: causes
The main causes of heart palpitations are:
A) heart diseases, more precisely disturbances of its rhythm or conduction of electrical impulses, as well as organic diseases of the heart muscle:
- atrial fibrillation
- atrial flutter
- frequent additional stimulations of supraventricular or ventricular origin
- ventricular tachycardia
- supraventricular tachycardia
- ischemic heart disease
- heart failure
- pericarditis
- cardiomyopathies
- congenital heart disease
B) mental disorders, which mainly include panic attacks and panic attacks, but palpitations are also reported by patients suffering from neurosis, depression and hypochondriac disorders
C) stimulants and medications often cause a feeling of palpitations. Psychoactive substances such as alcohol, nicotine or caffeine are responsible to a large extent for its occurrence, but we cannot forget about psychostimulants such as cocaine or amphetamine, and popular drugs, including adrenaline, theophylline, beta-blockers, or beta2- mimetics
D) metabolic and hormonal disorders of the course of which the feeling of palpitations is often reported are hyperthyroidism, phaeochromocytoma, menopause, hypoglycaemia and electrolyte disturbances
E) anemia
F) fever
G) pregnancy
H) migraine
Palpitationscan occur both in he althy people and be the first symptom of organic heart disease. It is worth noting, however, that this subjective symptom, unfortunately, does not correlate well with the actual arrhythmias and heart rate disturbances.
Physiologically, he althy people do not feel their heart rhythm when they are resting. They may experience a transient feeling of irregular, accelerated action or a strong beating of the heart duringexercise, under the influence of strong emotions or stressful situations, and also be a side effect of medications.
There are no cardiac arrhythmias in most reported palpitations.
Mechanism of palpitations
Palpitations most often occur due to a disturbance in the formation of a stimulus in the sinoatrial node of the heart, i.e. an electrical impulse causing contraction of the heart muscle or its abnormal conduction in the heart's stimulus-conducting system.
Palpitations: Clinical Division
The feeling of palpitations is divided according to the timing of its onset into paroxysmal palpitations, which are characterized by a sudden onset and abrupt end, and non-paroxysmal palpitations, which increase slowly, gradually and gradually disappear. There is also a division of palpitations due to the rhythm of the heartbeat - regular and irregular palpitations.
Symptoms of heart palpitations
The symptoms associated with palpitations that are frequently reported by patients to their GPs include fatigue, rapid breathing, dizziness and increased sweating. Patients may feel short of breath and have problems with balancing, and even feel faint or faint. Some people report chest discomfort.
Palpitations: diagnosis
Palpitations is a subjective sensation reported by the patient. It can be felt both when the heart rate is really faster, more intense and irregular, and when there is no objective change in the heart rhythm.
That is why it is so important to take a careful interview and perform laboratory tests to determine the causative agent of palpitations.
Pay attention to the results of specialized blood tests, such as ionogram (assessment of sodium, potassium, calcium and magnesium levels in the peripheral blood) and the levels of thyroid stimulating hormone (TSH) and thyroid hormones (thyroxine, triiodothyronine).
For further diagnostics, resting electrocardiography (EKG), Holter monitoring (consisting of many hours of ECG recording in patients with normal daily activity) and echocardiography (i.e. ultrasound examination of the heart) are used.
It is worth noting, however, that very often the feeling of heart palpitations is psychological and it is impossible to establish the cause of the reported ailments.
Palpitations: diagnosis
The decision to start the treatment is made by the doctor on the basis of an interview, physical examination of the patient, andalso the results of laboratory and echocardiographic tests.
Often, in order to establish the diagnosis and use the therapy, it is necessary to consult a specialist psychiatrist or cardiologist who will assess possible indications for pharmacotherapy.
When palpitations is the only disease symptom presented by the patient, and the examinations did not show any deviations from the norm, doctors often give up the use of specialized medications and recommend a sparing lifestyle, avoiding excessive stress, drinking strong coffee, tea or alcohol , performing relaxation exercises and therapy with a psychologist.