Common causes of palpitations

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Posted by Master, Doctor Nguyen Van Phong - Internal Medicine and Cardiovascular Interventionist - Cardiovascular Center - Vinmec Times City International General Hospital

Many people often think that palpitations are just normal signs when the body is tired or overworked. However, this can be a manifestation of some typical diseases with many different causes. Therefore, if the palpitations appear frequently, the patient should soon go to the medical center to examine and find the cause for appropriate treatment.

1. What does palpitations feel like?

Sometimes you feel your heart pounding, fluttering, or feel like it's skipping a beat, this could be palpitations. This feeling can cause anxiety and fear, but most are not serious and rarely require treatment. Accordingly, knowing the cause of your palpitations helps you not to panic when it happens and you know when to see a doctor. Some common causes of palpitations are as follows:

1.1. Stress and anxiety

Intense emotions can trigger the release of hormones that increase heart rate. When you feel afraid, when you are in danger, the feeling of being threatened can cause a rapid heartbeat, sweating or chills, sometimes a feeling of shortness of breath, shortness of breath, even chest pain.
Sometimes a panic attack has symptoms like angina . If you are not sure about your condition, you should see a doctor right away

1.2. Practice

Exercise is very beneficial for health. When you exercise like cycling, jogging or playing sports, it will make your heart beat faster, helping to pump more blood to supply energy to muscles during exercise. If you feel your heart pounding, it could be because you haven't exercised for a long time and your body is not completely healthy. Irregular heartbeats or arrhythmias can also cause palpitations when you exercise.

1.3. Caffeine

Do you feel your heart beat faster after drinking a cup of coffee in the morning? Caffeine is a stimulant that increases your heart rate whether you get it from coffee, tea, chocolate, energy drinks, or from another source. One study found that caffeine from tea, coffee or chocolate was unlikely to cause palpitations in healthy people. However, researchers are not sure if it can trigger arrhythmias in people with a history of arrhythmias.

1.4. Nicotine

Nicotine and the addictive substances in cigarettes, as well as other tobacco products raise your blood pressure and increase your heart rate. Quitting smoking is one of the best things you can do for your heart, although quitting doesn't lower your heart rate right away, but it will over time.
Palpitations can also be a symptom of nicotine withdrawal, however after 3-4 weeks of quitting your heart rate should return to normal.

1.5. Hormonal changes

Women during menstruation, during pregnancy, during perimenopause may feel a faster heartbeat. It is caused by changes in female sex hormones. The increase in heart rate in this case is usually temporary and not cause for concern.
If you are pregnant, palpitations can also occur in case you have anemia , when you do not have enough red blood cells to carry oxygen around the body so they compensate by increasing heart rate up.

1.6. Fever

When you have a fever the body will use more energy at a faster rate, so the heart rate will increase. Normally, body temperature > 380C can affect heart rate, the increase is usually 10 beats/1 degree C increase.

1.7. Some drugs

Certain medications you are taking (including prescription and over-the-counter medicines) can cause rapid heart rate as a side effect of the medicine such as:
Certain antibiotics Antifungal drugs Antipsychotic medications Asthma medications Cough and cold medications Some blood pressure medications Thyroid medications If you're on one or more of these medications check with your doctor to see if any of them can affect your heart rate. yours does not. However, do not skip any dose before consulting your doctor.

1.8. Low blood sugar

Have you ever noticed when you're hungry you feel palpitations? In fact, when your blood sugar drops, your body releases hormones like adrenaline just in case of an emergency. It is the adrenaline that causes the increased heart rate.

1.9 Overactive thyroid

Thyroid is an endocrine gland located in the neck, it produces hormones involved in metabolism and many other problems. When the thyroid gland is overactive (called hyperthyroidism) it secretes more thyroid hormones (T3,T4, FT3,FT4) that act on the heart to make them beat so fast that you feel palpitations. In addition, if you have hypothyroidism, additional thyroid hormone therapy can also increase your heart rate.

1.10. Heart arrhythmia problems

Sometimes an irregular heartbeat or arrhythmia can cause palpitations. Specifically:
Atrial fibrillation: This condition occurs when groups of muscles in the upper chambers of the heart (also called the atria) vibrate instead of contracting normally. Supraventricular tachycardia: An abnormally fast heart rhythm that originates in the atria. Ventricular tachycardia: A rapid heart rhythm disorder caused by abnormal signals from the lower chambers of the heart called the ventricles. Premature ventricular contractions (PVCs) are extra heartbeats. They occur when the heart's ventricles contract too early. This beat will beat the normal heart rate, if the frequency is high, you will feel your heart pounding or pounding wildly in your chest. If you have a healthy heart, abnormal ventricular extrasystoles are nothing to worry about, however treatment may be needed if you have a heart condition such as: heart failure, coronary artery disease, valvular heart disease, or frequent sensations heart pounding, erratic.

1.11. Alcohol

If you drink a lot or even just drink more alcohol than usual, you may feel your heart beat faster or feel palpitations or palpitations. This symptom usually occurs on holidays or weekends when most people drink more causing it also known as “holiday heart syndrome”. For some people, symptoms can occur even if you drink very little alcohol

1.12. Cocaine and other addictive drugs

Illegal drugs such as amphetamines, cocaine, ecstasy... are very dangerous for the heart. Specifically:
Cocaine increases blood pressure, increases heart rate and damages the heart muscle. Amphetamine stimulates the sympathetic nervous system to increase heart rate. Ecstasy triggers the body to release a chemical called Nor adrenaline, which makes your heart beat faster.

2. When to see a doctor?

If you are healthy, you may not need to worry about palpitations that occur occasionally and last only a few seconds. But you should see a doctor if palpitations are more frequent and are accompanied by the following symptoms:
Angina or a feeling of pressure in the chest. Shortness of breath, shortness of breath. Dizzy. Faint.

3. What does the doctor need to do to find the cause of the palpitations?

The following tests help your doctor find the cause of your palpitations:
Electrocardiogram (ECG): This test looks for abnormal electrical signals that are causing your arrhythmia. Holter ECG 24 hours: you wear a portable ECG recorder for 24 hours even up to 72 hours at a time. This device helps detect arrhythmias at any time while you are wearing the device even when you do not feel any symptoms or while you are sleeping. Echocardiogram: An echocardiogram helps to detect structural abnormalities of the heart or heart valves that may be the cause of your arrhythmia. In addition, the doctor may do some more blood tests such as electrolytes, thyroid hormone ... to find the cause of the arrhythmia.

There are many causes of palpitations, if the feeling of palpitations only appears transient, you do not need to worry too much, but on the contrary, if it occurs with a continuous frequency, making the patient difficult to breathe, chest pain then This could be a sign of heart disease, a dangerous arrhythmia. At this time, finding the cause of palpitations and performing screening for cardiovascular disease is essential.
Cardiovascular disease is often silent but causes severe consequences. Cardiovascular screening helps to detect and treat promptly before it is too late. Vinmec International General Hospital now has a Cardiovascular Screening Package - Cardiovascular Basic Examination, which helps customers to detect cardiovascular diseases even when there are no symptoms, thereby having early treatment to bring optimal results.

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