What are palpitations?

Heart palpitations are heart beats that become suddenly noticeable. This could be due to the heart beat being missed, stronger sensation of heart beat, or fast heart beats that are out of proportion to the activity or emotional state.

 

 

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Palpitations are a common symptom and may occur very infrequently. Anxiety or unaccustomed activity or exercise are common causes. Emotional stress or psychological issues could lead to persistent palpitations. Fever, anemia (low iron levels in the body) or diseases of certain glands (thyroid) could cause palpitations. 

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The heart beats at a regular rhythm at a variety of rates (beats per minute) based on the demands of the body. A regular rhythm makes the pumping action of the heart most efficient. It may beat either too slowly, too quickly or irregularly. Extra heart beats (ectopics) are quite common and if infrequent, are not considered abnormal. Abnormalities of heart rhythm are called arrhythmia and can cause palpitations which can be distressing and on occasions, dangerous.

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Heart muscle abnormalities (cardiomyopathy) can also cause heart palpitations.

 

 

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It is important to rule out arrhythmia and Dr Khambadkone  can help with a good history and investigations such as electrocardiography (ECG) and echocardiography which will be the first tests performed by Dr Khambadkone to look at electrical or structural abnormality of the heart or a heart muscle disease. To catch the episode of palpitations can be difficult if they occur randomly and infrequently. Heart rhythm monitoring for long periods (1 day, or occasionally 1 week) will then be performed. Rarely, an implantable monitor will be placed under the skin for long term monitoring under local or general anaesthetic. Exercise testing is important if palpitations are related to exercise. This will be arranged by Dr Khambadkone in a specialized centre.
 

 

 

 

If there is no serious underlying cause, children will be reassured as most palpitations last for a few seconds and pose no risk to health.

 

Structural abnormalities (e.g. aortic stenosis) can cause excess burden to the heart resulting in cardiac arrhythmias and palpitations, and necessitate treatment.

 

Electrical circuit abnormalities of the heart (ventricular ectopy, supraventricular tachycardia) often occur even with a normal heart structure. They will be treated with special group of medicines called antiarrhythmic medications. These can help control the palpitations. You may need a referral to a specialist who deals with electrical problems of the heart, Electrophysiologists, and Dr Khambadkone will arrange this. Electrophysiological studies is an invasive procedure whereby wires are used to map the abnormal electrical circuits in the heart with a plan to zap them (ablation) and provide a definitive cure.

 

Direct current cardioversion is occasionally used to shock the heart out of any abnormal rhythm. For slow heart beats, pacemakers are used to stimulate the heart and maintain a healthy heart rate. An implantable cardioverter defibrillator device allows for rapid detection and provides treatment by delivering a shock and is a life-saving device for life-threatening arrhythmias.