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Chest Pain, Dizziness, Health information, palpitations

Palpitations

Noticeable heart beats

Palpitations are heartbeats that you’re aware of. They may be regular or irregular and often only last a few seconds or minutes. They can feel like your heart is fluttering or pounding and you may notice them in your throat or neck.

Palpitations are usually incidental and not due to any problem with your heart – they are often caused by anxiety but may only be the normal beat of the heart, noticeable because of the position that you’re lying in. However, unless they only happen rarely and for short periods of time without any other symptoms, you should always get palpitations checked out by a doctor.

You may sometimes feel that your heart skips a beat or there’s an extra beat. These are called “ectopic” beats and rarely require any treatment unless they occur very frequently and cause distressing symptoms.

You should seek immediate medical attention if you have palpitations associated with chest pain, dizziness, any period of loss of consciousness (blackouts) or difficulty in breathing.

Causes

Lifestyle factors

Most palpitations are benign and many are caused by factors such as:

  • Smoking
  • Being overweight
  • Caffeine eg: in coffee, tea, cola or energy drinks
  • Alcohol
  • Periods, pregnancy & the menopause
  • Anxiety & panic attacks
  • Illicit drugs such as cocaine, ecstasy and MDMA

It’s worth keeping a note of when palpitations occur and seeing if they are associated with any of these.

Medical issues

Various conditions can cause palpitations, including:

  • Overactive thyroid gland
  • Anaemia
  • Diabetes and low blood sugar
  • Infections & fevers
  • Dehydration

A number of medicines including asthma inhalers, treatments for high blood pressure (hydralazine & minoxidil) and thyroid disease, some antihistamines, antibiotics (clarithromycin & erythromycin) and antifungals, and some medicines used for depression (citalopram and escitalopram) can cause palpitations, especially if you’ve recently started taking them. Seek medical advice if you’re concerned, but don’t stop using them until you’ve done so.

Arrhythmias

The heart has its own pacemaker. This sends electrical pulses down a series of nerve bundles within the heart muscle, controlling the rate at which it beats. This electrical activity is what’s recorded on an ECG or heart trace.

Problems with these nerve bundles can cause palpitations, either due to abnormal extra pathways bypassing the usual circuits or because the bundles are scarred and damaged. The two most common types of arrhythmias are:

  • Atrial fibrillation (AF): affects about one million people in the UK. Feels irregular and often associated with dizziness, shortness of breath and tiredness. Often needs treating to slow the heart down and sometimes to control the rhythm as well.
  • Supraventricular tachycardias (SVTs): similar to AF but the heart rhythm is usually regular.

Structural heart problems:

These problems may be present at birth or develop later in life following infections or heart disease. They include problems with the heart valves , conditions where the heart muscle thickens and heart failure when the heart can’t pump blood as strongly as needed.

Investigation and treatment

If palpitations are short-lived and only occur occasionally, then you may not need to see a doctor. Otherwise, your doctor will probably order some blood tests and an ECG to identify any underlying causes and examine the heart rhythm.

Since the palpitations are often not present all the time, you may need to wear an ECG recorder for 24 or 48 hours to try to pick up an abnormality. An ultrasound of the heart (echocardiogram) may also be done to look at the structure of the heart and to measure how powerfully it’s beating.

Treatment depends on the cause. This may purely be lifestyle changes such as cutting out or reducing coffee, alcohol and nicotine intake or may involve medicines to control the rhythm, surgical procedures to interrupt abnormal electrical activity or treatments to help improve heart function.

Contact Bluezone if …

  • Palpitations last a long time or are occurring more frequently
  • You have a history of heart problems
  • You’ve recently started or changed medicines

You should contact us immediately or call 999 if you have palpitations and any of the following symptoms:

  • chest pain
  • dizziness
  • any period of loss of consciousness (blackouts)
  • difficulty in breathing
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