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Palpitation: Is it the heart or something in your mind!

Palpitations are feelings of having a fast-beating, fluttering or pounding heart. Stress, exercise, medication or, rarely, a medical condition can trigger them.

Although heart palpitations can be worrisome, they’re usually harmless.

In rare cases, they can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.

Heart palpitations can feel like your heart is:

  • Skipping beats
  • Fluttering rapidly
  • Beating too fast
  • Pounding
  • Flip-flopping
 

You might feel heart palpitations in your throat or neck as well as your chest. They can occur when you’re active or at rest.

When to see a doctor ?

Palpitations that are infrequent and last only a few seconds usually don’t need to be evaluated. If you have a history of heart disease and have palpitations that occur frequently or worsen, talk to your doctor. He or she might suggest heart-monitoring tests to see if your palpitations are caused by a more serious heart problem.

Seek emergency medical attention if heart palpitations are accompanied by:

  • Chest discomfort or pain
  • Fainting
  • Severe shortness of breath
  • Severe dizziness

But, much to our surprise, the most common causes of palpitations are not of cardiac or heart-related origin.

Common causes include:

  • Strong emotional responses, such as stress, anxiety or panic attacks
  • Depression
  • Strenuous exercise
  • Stimulants, including caffeine, nicotine, cocaine, amphetamines, and cold and cough medications that contain pseudoephedrine
  • Fever
  • Hormone changes associated with menstruation, pregnancy or menopause
  • Too much or too little thyroid hormone

Occasionally heart palpitations can be a sign of a serious problem, such as an overactive thyroid gland (hyperthyroidism) or an abnormal heart rhythm (arrhythmia).

Heart rhythm changes (arrhythmias) might cause a very fast heart rate (tachycardia), an unusually slow heart rate (bradycardia), a normal heart rate that varies from the usual heart rhythm or combination of the three.

You might be at risk of developing palpitations if you:

  • Are highly stressed
  • Have an anxiety disorder or have regular panic attacks
  • Are pregnant
  • Take medicines that contain stimulants, such as some cold or asthma medications
  • Have an overactive thyroid gland (hyperthyroidism)

Have other heart problems, such as arrhythmia, a heart defect, previous heart attack, or previous heart surgery.

Hence, it is important to rule out the cause of palpitation. A thorough cardiac evaluation can rule out the existence of palpitation of cardiac origin. A good general examination can rule out thyroid and other hormonal causes which may exist to be the cause of palpitations. Once this is ruled out, it is better to see a psychiatrist who may be able to help you get hold of the situation faster. Persistent anxiety leading to palpitation in turn, may become the cause of elevated blood pressure, and raised sugar levels and in the long run, may damage the heart, kidney, and brain to a great extent. Never neglect a signal that the body emits. You can improve your quality of life by keeping a watch on subtle changes that might be affecting you.

Dr Suyash Sinha
MBBS; MD(Gold Medalist)
Consultant Psychiatrist
ETSC-London,UK
NIBS-NIMHANS,Bangalore

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