Heart Palpitations
By Alan Peterson, MD
What Are Heart Palpitations?
Heartbeats that are fast or irregular are called palpitations. Your heart is like a pump. Each time it beats, it pumps blood through your body. When you exercise, it is normal to hear or feel your heart “pounding” as it beats faster. But if you have palpitations, you might feel your heart beating fast while you are sitting still or moving slowly. Frequently you notice them more when trying to rest or sleep.
What Causes Heart Palpitations?
Many things can cause palpitations. Some of these things have to do with your heart and some of them do not. However, doctors sometimes cannot find the cause of palpitations. This happens in about one of every seven people with palpitations. The palpitations in these people where no obvious cause is found usually are not harmful.
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Heart related causes. People with an irregular heartbeat (or arrhythmia) also may have palpitations. Most of the time, palpitations and irregular heartbeats are harmless. Sometimes, the break in your heart’s rhythm can be a serious problem. You also may have palpitations if you have problems with the valves in your heart. Valves are what help move blood through the heart.
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Non-heart-related causes. Certain medicines, herbal supplements, and illegal street drugs can make your heart beat faster. Medicines that can cause palpitations include asthma inhalers and decongestants. Caffeine (found in coffee, tea, soda and chocolate) and alcohol can cause palpitations. People with panic disorder feel their heart pounding from adrenaline when they are fearful of something, or having a panic attack. Some medical conditions such as overactive (hyperthyroid) thyroid disease and anemia can also cause palpitations. Smoking can also cause irregular heart beats.
How Will My Doctor Find Out What Is Causing My Palpitations?
Your doctor will examine you and ask you about any medicines you are taking, your diet, and if you have panic attacks, or are under significant stress. Your doctor may want you to have a resting electrocardiogram test (EKG). This test keeps track of your heartbeat over a certain amount of time. Your doctor may also want to test your blood.
If these tests do not show what is causing your palpitations, your doctor may have you wear a heart monitor for one to 30 days. This monitor will show any breaks in your heart’s rhythm that may cause palpitations. Your doctor might refer you to a cardiologist (a heart doctor) for more tests or treatment. However, he may decide after a simple electrocardiogram that no further tests are warranted, especially if you are not having any light- headedness, dizziness, or passing out, and as long as the other studies are normal. Sometimes even an EKG is not necessary or indicated.
What Can I Do to Help Prevent Palpitations?
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Do not use illegal street drugs.
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Avoid caffeine, chocolate, smoking and alcohol.
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Do not take prescription or over the counter decongestants.
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Tell your doctor what medicines and herbal supplements that you take, how much alcohol you drink, and if you use anything else that might cause palpitations. Some non-smokers that are breathing in the smoke of others can develop palpitations (and even chest pain).
Keep track of your palpitations. Write down the time that they happen and what you were doing when they began. Give this information to your doctor.
Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.
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