Palpitations: Causes, Symptoms, and Treatment Options

Palpitations

Hello, when I was around seven years old during a physical education class, I suddenly felt my heart beating very strongly, which was quite uncomfortable.
I could feel each heartbeat distinctly.
Then my breathing became more rapid than usual, and I felt restless.
Is this palpitations? This has happened occasionally even until now, but very rarely.
It usually occurs when I am feeling emotionally tense.
During these episodes, I experience some panic and have thoughts that my heart might stop beating and I could die.
Typically, I would lie down or sit, and after about thirty minutes, I would return to normal.
There have been times when my heart kept racing throughout the day because I couldn't rest while out on the street.
Is this condition a type of heart disease? Does consuming caffeinated beverages increase the likelihood of these episodes? Is there treatment available for this condition? Is this situation common globally? Could it lead to heart failure and death? Thanks, Shun.

Shun, 30~39 year old female. Ask Date: 2009/07/19

Dr. He Dongjin reply Cardiology

Hello, the difference between palpitations and arrhythmias is that palpitations refer to the sensation of feeling one's own heartbeat, which does not necessarily indicate an arrhythmia.
Sometimes, anxiety can cause the heart to beat more forcefully, leading to this sensation, but it does not mean there is an arrhythmia.
Palpitations are not a disease; they are simply a term used to describe the awareness of one's heartbeat.

Arrhythmia, on the other hand, refers to an irregular heartbeat.
Ideally, the heart should beat in a regular rhythm, and any irregularity is classified as an arrhythmia.
In reality, a person's heart beats over 100,000 times a day, and it is normal for a few beats to be less than smooth.
Everyone experiences this; it’s just a matter of whether one feels it or not.
For instance, when walking, it is common to have a few unsteady steps, which is normal.
Generally, having fewer than 1,000 irregular heartbeats in a day is considered acceptable.
Of course, arrhythmias can be categorized into hundreds of types, but over 80% are benign.
Based on your described symptoms, it seems to be palpitations, likely caused by autonomic nervous system dysregulation, but there is a possibility of an underlying arrhythmia.
It is advisable to seek medical attention promptly during an episode and have an electrocardiogram (ECG) done.
If abnormalities are detected, it would indicate an arrhythmia, and further evaluation by a specialist would be necessary to determine the type and management.

If the ECG is normal, it may simply be palpitations.
However, if these symptoms cause significant disruption in daily life, medication can be used to alleviate them.
This situation does not necessarily indicate heart disease.
Consuming caffeinated beverages can increase the frequency of these episodes.
Such symptoms are quite common worldwide and do not lead to cardiac arrest or death.
Changhua Hospital cares about you.

Reply Date: 2009/07/19

More Info

Hello Shun,
It sounds like you are experiencing episodes of palpitations, which can be quite distressing, especially when accompanied by feelings of anxiety or fear. Palpitations are sensations that your heart is beating too hard or too fast, and they can occur for a variety of reasons. Let's delve into the causes, symptoms, and treatment options for palpitations.

Causes of Palpitations
Palpitations can be triggered by numerous factors, including:
1. Emotional Stress: Anxiety, panic attacks, or stress can lead to increased heart rate and the sensation of palpitations. It seems that your episodes are often linked to emotional tension, which is a common trigger.

2. Stimulants: Caffeine, nicotine, and certain medications can stimulate the heart and lead to palpitations. If you consume caffeinated beverages, it might be worth monitoring how they affect your symptoms.

3. Physical Activity: Intense exercise can also cause palpitations, especially if you are not accustomed to it.

4. Hormonal Changes: Fluctuations in hormones, such as during menstruation or pregnancy, can lead to palpitations.

5. Medical Conditions: Conditions such as hyperthyroidism, anemia, or heart-related issues can also cause palpitations. It’s essential to rule out any underlying medical conditions, especially since you mentioned experiencing these sensations since childhood.

Symptoms
The symptoms you described—feeling your heart beating strongly, rapid breathing, and anxiety—are typical of palpitations. They can be accompanied by:
- Dizziness or lightheadedness
- Chest discomfort
- Shortness of breath
- A feeling of impending doom or fear of dying

Treatment Options
1. Lifestyle Modifications: Reducing caffeine intake, managing stress through relaxation techniques (like deep breathing, yoga, or meditation), and ensuring adequate sleep can help reduce the frequency of palpitations.

2. Medical Evaluation: It’s crucial to consult a healthcare provider for a thorough evaluation. They may recommend tests such as an electrocardiogram (ECG), Holter monitor, or echocardiogram to assess your heart's health and rule out any serious conditions.

3. Medication: If palpitations are frequent and distressing, your doctor may prescribe medications to help manage them. This could include beta-blockers or anti-anxiety medications, depending on the underlying cause.

4. Cognitive Behavioral Therapy (CBT): If anxiety is a significant factor in your palpitations, therapy can be beneficial in addressing the thoughts and behaviors that contribute to your anxiety.

Prevalence and Risks
Palpitations are relatively common and can affect people of all ages. While they are often benign, it is essential to take them seriously, especially if they are accompanied by other concerning symptoms like chest pain or fainting. The fear of your heart stopping is understandable, but most palpitations are not life-threatening. However, it’s crucial to have a healthcare professional evaluate your symptoms to ensure there are no underlying heart conditions.

Conclusion
In summary, while your experiences with palpitations can be alarming, they are often manageable with lifestyle changes and appropriate medical care. It’s essential to consult with a healthcare provider to discuss your symptoms in detail and to rule out any serious conditions. Remember, you are not alone in this, and many people experience similar sensations. With the right support and treatment, you can find relief and improve your quality of life.

Take care, and I wish you the best on your journey to better health!

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