Heart Palpitations: Causes and Concerns Explained

Cardiac issues?

Dear Director, sometimes my heartbeat feels irregular.
I have been checked at a large hospital and they said it is benign and non-cardiac.
However, there are times when it doesn't actually skip a beat, but I feel like it could at any moment with just a slight movement.
I also experience a feeling of tightness in my chest.
Additionally, I would like to ask if eating a small amount of food can also cause these skipped beats.
Could it be related to gastric or abdominal pressure? Thank you, Director.

Wang, 30~39 year old female. Ask Date: 2021/10/27

Dr. He Dongjin reply Cardiology

Hello, experiencing irregular heartbeats raises concerns about arrhythmia, or it could simply be palpitations.
If the tests show no significant issues, the likelihood of palpitations is higher.
Eating a little might also lead to gastroesophageal reflux or increased abdominal pressure affecting the autonomic nervous system.
It would be advisable to monitor the situation or consider a 24-hour Holter monitor for further observation.
Take care from Changhua Hospital.

Reply Date: 2021/10/27

More Info

Heart palpitations are sensations that feel like your heart is pounding, fluttering, or beating irregularly. They can be alarming, especially when accompanied by other symptoms like chest discomfort or shortness of breath. Understanding the causes and concerns related to heart palpitations is crucial for managing your health effectively.

Causes of Heart Palpitations
1. Physiological Factors:
- Stress and Anxiety: Emotional stress or anxiety can trigger palpitations. The body's fight-or-flight response releases adrenaline, which can increase heart rate and cause palpitations.

- Caffeine and Stimulants: Consuming caffeine, nicotine, or other stimulants can lead to palpitations. Even certain medications, including over-the-counter cold medications, can have stimulating effects.

- Hormonal Changes: Hormonal fluctuations, particularly during menstruation, pregnancy, or menopause, can cause palpitations.

2. Medical Conditions:
- Arrhythmias: These are irregular heartbeats that can be benign or indicate a more serious condition. Common types include atrial fibrillation, premature ventricular contractions (PVCs), and supraventricular tachycardia (SVT).

- Thyroid Issues: An overactive thyroid (hyperthyroidism) can increase heart rate and lead to palpitations.

- Heart Disease: Conditions such as coronary artery disease or heart valve disorders can cause palpitations, especially if the heart is under stress.

3. Gastrointestinal Factors:
- Gastric Pressure: As you mentioned, eating can sometimes trigger palpitations. This is often due to increased pressure in the abdomen, which can stimulate the vagus nerve, leading to changes in heart rate. Conditions like gastroesophageal reflux disease (GERD) can also contribute to this sensation.

Concerns Related to Heart Palpitations
While many palpitations are benign, certain symptoms warrant further investigation. If you experience any of the following, it is essential to consult a healthcare provider:
- Persistent or Frequent Palpitations: If palpitations occur regularly or last for an extended period, it may indicate an underlying issue.

- Associated Symptoms: Chest pain, shortness of breath, dizziness, or fainting should never be ignored, as they may signal a more serious condition.

- Change in Pattern: If you notice a change in the frequency or intensity of your palpitations, it is advisable to seek medical advice.

Diagnostic Approach
Given that you have undergone evaluations at a major hospital and were told that your palpitations are benign, it is reassuring. However, if your symptoms persist or worsen, consider the following diagnostic steps:
1. Holter Monitor: This portable device records your heart's activity over 24-48 hours, helping to identify any irregularities during daily activities.

2. Electrocardiogram (EKG): An EKG can provide a snapshot of your heart's rhythm and detect any arrhythmias.

3. Echocardiogram: This ultrasound of the heart can assess its structure and function, ruling out any underlying heart conditions.

Management Strategies
1. Lifestyle Modifications: Reducing caffeine intake, managing stress through relaxation techniques, and avoiding stimulants can help minimize palpitations.

2. Dietary Considerations: Eating smaller meals and avoiding heavy foods can reduce abdominal pressure and potentially alleviate palpitations related to eating.

3. Medication: If palpitations are linked to anxiety or other conditions, your doctor may prescribe medications to help manage these symptoms.

Conclusion
In summary, while heart palpitations can be concerning, they are often benign, especially if thorough evaluations have ruled out serious conditions. However, it is essential to remain vigilant and consult your healthcare provider if your symptoms change or if you have any new concerns. Understanding the interplay between your gastrointestinal health and heart function can also provide insights into managing your symptoms effectively. Always prioritize open communication with your healthcare team to ensure your concerns are addressed appropriately.

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