Palpitations: Causes and Management for New Mothers

Palpitations?

Hello Doctor, I am the postpartum woman with peripartum cardiomyopathy.
I wanted to ask you about my EF of 58 from the check-up in August.
The doctor said I didn't need to return for follow-up.
However, due to long-term psychological issues, I now experience palpitations almost once a month, waking up in the middle of the night with palpitations one or two times.
The sensation lasts from 5 to 30 minutes, and it feels like my heart is racing and about to jump out of my throat when I lie down.
I take one tablet of Jing An Ning and 0.25 mg of Kankun.
I would like to know if having palpitations once or twice a month is concerning, especially since I have severe anxiety and panic disorder.
I also don't understand why this happens at that specific time in the middle of the night.

Si, 20~29 year old female. Ask Date: 2023/09/27

Dr. He Dongjin reply Cardiology

Hello EF58, there's no need for a follow-up appointment.
First of all, congratulations on your graduation! Experiencing palpitations once or twice a month is not concerning; this is likely caused by anxiety or panic.
Don't worry, just take your medication consistently before bed for now.
Let's stabilize your condition first; taking more won't lead to addiction or dependence.
Rest assured, Changhua Hospital cares about you.

Reply Date: 2023/09/27

More Info

Palpitations, or the sensation of feeling your heart beating rapidly or irregularly, can be particularly concerning for new mothers, especially those with a history of peripartum cardiomyopathy or other heart conditions. In your case, it seems that your palpitations are occurring during periods of heightened anxiety, which is not uncommon. Understanding the causes and management of these symptoms is crucial for your well-being.

Causes of Palpitations
1. Anxiety and Stress: Given your history of severe anxiety and panic disorder, it is likely that your palpitations are closely linked to these psychological factors. Anxiety can trigger the body's "fight or flight" response, leading to an increased heart rate and the sensation of palpitations.

2. Hormonal Changes: After childbirth, women experience significant hormonal fluctuations that can affect mood and physical health. These changes can contribute to anxiety and palpitations.

3. Sleep Disturbances: New mothers often face sleep deprivation, which can exacerbate anxiety and lead to episodes of palpitations. Waking up in the middle of the night can trigger feelings of panic, which may further increase your heart rate.

4. Caffeine and Stimulants: Consumption of caffeine or other stimulants can lead to palpitations. If you are consuming coffee, tea, or energy drinks, consider reducing your intake.

5. Medications: You mentioned taking medications like Jing An Ning and Kang Ken. While these can help manage anxiety, they may also have side effects that include palpitations. It's essential to discuss any concerns about your medications with your healthcare provider.

Management Strategies
1. Consult a Healthcare Provider: Since you have a history of peripartum cardiomyopathy, it is essential to keep your healthcare provider informed about your symptoms. Even if your ejection fraction (EF) is stable, any new symptoms warrant a discussion with a cardiologist or a primary care physician.

2. Cognitive Behavioral Therapy (CBT): Engaging in therapy, particularly CBT, can help you manage anxiety and develop coping strategies for dealing with panic attacks and palpitations.

3. Mindfulness and Relaxation Techniques: Practices such as deep breathing, meditation, and yoga can help reduce anxiety and improve your overall sense of well-being. These techniques can also help you manage your heart rate when you feel palpitations coming on.

4. Sleep Hygiene: Improving your sleep environment and establishing a bedtime routine can help you achieve better sleep quality. This may reduce the frequency of nighttime awakenings and associated palpitations.

5. Lifestyle Modifications: Regular physical activity, a balanced diet, and adequate hydration can improve your overall health and may help reduce anxiety and palpitations.

6. Medication Review: If your palpitations persist, it may be worth discussing your current medications with your doctor. They may consider adjusting your dosage or switching to a different medication that has fewer side effects.

Conclusion
While experiencing palpitations can be alarming, especially in the context of anxiety and a history of heart issues, it is essential to approach the situation with a comprehensive management plan. Regular follow-ups with your healthcare provider, combined with lifestyle changes and therapeutic interventions, can significantly improve your quality of life. Remember, you are not alone in this journey, and seeking help is a vital step toward recovery.

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