Heart Palpitations

What is heart palpitations?

Heart palpitations means feeling the heart beating. It is not just a high pulse. It is usually not serious or worrying. However, in some cases it can be associated with an abnormal heart rhythm (arrhythmia). Patients may feel heart palpitations as fluttering in the chest or neck, the heart beating in the throat, pounding, thumping, misfiring, the heartbeat shaking the body, short bursts of pulsing, falling into a void or pauses in the heart. A strong or irregular heartbeat is also perceived as palpitations.

Causes of Heart Palpitations?

As well as being a symptom of heart rhythm disorders, it may also develop due to the following conditions.

  • Thyroid function disorders
  • Fever
  • Pregnancy
  • Stress, anxiety
  • Panic attack
  • Smoking, alcohol, substance abuse
  • Exercise
  • High blood sugar
  • Some medicines (such as asthma medicines)

In hypertension and low pulse rate, strong heartbeats can feel like palpitations. In which cases is the cause of palpitations thought to be a arrhythmia? If your palpitations start suddenly out of nowhere, if you have structural heart disease, if you have an irregular pulse, if you feel a misfire, it is more likely to be due to a arrhythmia. Paroxysmal tachycardia, which is an occasional heart palpitations that start for no apparent reason, is also an indication of a arrhythmia.

Do psychological heart palpitations occur?

Heart palpitations can be caused by psychological reasons. Heart palpitations due to anxiety, anxiety disorders, panic attacks and stress are common.

How to recognize the cause of palpitations?

Your doctor listens to you and makes a preliminary diagnosis of the cause of palpitations from your statements. Using physical examination, laboratory tests, electrocardiography, rhythm holter, event recorder or wearable ECG devices, he/she will try to pinpoint the cause of your palpitations.

Is Every Heart Palpitations Tachycardia?

Tachycardia refers to a condition in which the heart rate is higher than normal, usually above 100 beats per minute. Palpitations are a symptom felt by the patient and are not necessarily tachycardia. Bradycardia, a low heart rate, is also a cause of palpitations. Premature beats, extrasystoles and irregularities in the pulse rate are also felt as palpitations.

Arrhythmias Cause Palpitations?

Arrhythmias that cause palpitations are as follows;

  • Supraventricular Tachycardias (AVNRT, AVRT, AT, nodal tachycardia)
  • Atrial extrasystole or atrial premature beat
  • Atrial fibrillation
  • Atrial Flutter
  • VES or ventricular extrasystole, premature beat
  • Ventricular tachycardia
  • Low pulse rate (slow but strong heartbeat causing a feeling of palpitations)

Which palpitations are dangerous?

If you have structural heart disease, i.e. if you have had a heart attack or an enlarged heart, significant valvular disease or a pacemaker, you should take every palpitation seriously. Otherwise, palpitations may be accompanied by

  • Feeling faint, fainting
  • Very fast, irregular pulse
  • Dizziness, blackouts
  • Chest pain
  • Shortness of breath
  • Cold sweating
  • History of sudden death in family members

If you have such conditions, your palpitations may be due to dangerous rhythm disturbances, you should definitely have a cardiology examination.

Can heart palpitations occur at a young age?

There are many causes. Some palpitations, those due to arrhythmia, increase with age, while others can develop in childhood or even in the womb. Electrical abnormalities in the heart can cause palpitations at any time of life. Palpitations due to arrhythmia tend to start and end more suddenly. Physiological conditions such as fear, excitement, sadness and stress, which can also occur normally, can also cause palpitations. You can distinguish these. They start more slowly and go away on their own when the condition causing palpitations improves.

Why does heart palpitations start when lying down?

Some heart palpitations are more pronounced at rest. The most typical example is premature beats or extrasystoles. When you lie down, these extrasystoles become more frequent when your heart rate drops. During the day, when you are busy at work and your normal heart rate increases, the extrasystoles are suppressed and your symptoms decrease.

How to relieve heart palpitations?

The relief of heart palpitations depends on the cause of the palpitations. If it is a heart rhythm disorder, it can be treated with medication or interventional treatments such as ablation. Thyroid problems, fever, panic attacks or stress, in short, whatever the cause, should be treated accordingly. Whether the cause of palpitations is arrhythmia or other causes, a healthy lifestyle can help reduce your symptoms.

What to do in case of palpitations?

If you have supraventricular tachycardia (SVT), some maneuvers can help you stop palpitations. These are maneuvers such as pushing and coughing. A method called “cold immersion” can also help to stop palpitations. This means putting ice water in a bowl and washing your face with it. These techniques can only stop SVT.

What is good for palpitations?

It depends on the cause of palpitations. If it is a rhythm disorder, the rhythm disorder should be treated. Apart from this, various lifestyle changes can also help your palpitations.

If you have ventricular premature beats, if they are caused by the outflow tract, regular sports activity can reduce your premature beats. Avoiding stimulants such as tea, coffee and cigarettes may help your palpitations.

If you have atrial fibrillation, you should keep your rhythm problem and hypertension under control, reach your ideal weight, stop drinking alcohol and treat sleep apnea.

Stress, low fitness and obesity can cause palpitations. Therefore, a healthy lifestyle can help reduce symptoms and improve your palpitations.

Causes of Heart Palpitations
Causes of Heart Palpitations

Reference: Palpitation

Update: Feb 14, 2024

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Picture of Prof. Dr. Taylan Akgün
Prof. Dr. Taylan Akgün

He is a cardiologist specialised in the diagnosis and treatment of heart rhythm problems (ablation), pacemaker procedures.
He works in Istanbul province.

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