Palpitations - definition and causes
What is Palpitations and Definition
Palpitations is perception that the HEART is racing, pounding, or skipping beats. Palpitations are may represent signs of underlying cardiovascular conditions such as ARRHYTHMIA though frequently signal high stress, anxiety, or excessive consumption of STIMULANTS such as CAFFEINE or NICOTINE (via cigarette smoking). When palpitations do suggest arrhythmia, they tend to occur along with other symptoms such as weakness and SYNCOPE (fainting). Awareness of the heartbeat is common during or immediately following strenuous exercise, when the heart feels as if it were pounding, and right before falling asleep at night.
Causes of Palpitations
| SUBSTANCES THAT CAN CAUSE PALPITATIONS | |
|---|---|
| albuterol | ALCOHOL |
| CAFFEINE | COCAINE |
| levothyroxine | ma huang |
| NICOTINE (tobacco) | pseudoephedrine |
| theophylline | |
The most common presentation of palpitations is the premature beat, which can be atrial or ventricular and feels like a skipped beat though it is not. Because the premature beat is early, there is a slight pause before the regular beat which makes the regular beat feel enhanced. Such palpitations are nearly always the result of stimulants (including cold and flu preparations) or anxiety, and go away either when the stopping the stimulant or removing the cause of stress.
Palpitations require a doctor’s evaluation when they occur
- frequently or for sustained periods of time
- with syncope or lightheadedness
- with chest discomfort
- with shortness of breath (DYSPNEA)
- in people who have diagnosed forms of CARDIOVASCULAR DISEASE (CVD) such as HYPERTENSION, CORONARY ARTERY DISEASE (CAD), and arrhythmia disorders
The arrhythmia disorders most likely to include palpitations among their symptoms are ATRIAL FIBRILLATION and PAROXYSMAL ATRIAL TACHYCARDIA (PAT), also called paroxysmal supraventricular tachycardia (PSVT). These disorders typically cause periods of rapid heartbeat. Though disconcerting, these arrhythmias are rarely dangerous. HYPERTHYROIDISM may also cause palpitations, which go away with treatment for the hyperthyroidism.
An ELECTROCARDIOGRAM (ECG) provides the necessary information to determine whether palpitations indicate an arrhythmia or other heart problem. A Holter monitor (24-hour recording of the heart’s electrical activity) and an exercise STRESS TEST help identify arrhythmias and conduction disorders that are intermittent or brought on by physical exertion. Unless there is a significant underlying arrhythmia disorder, there is no need to treat palpitations. MEDITATION, relaxation techniques, and eliminating substances that can have a stimulant effect on the heart often reduce or end the palpitations.
See also PREMATURE VENTRICULAR CONTRACTION (PVC); LONG QT SYNDROME (LQTS); WOLFF-PARKINSONWHITE SYNDROME.
