Table of contents
Palpitation ?
Palpitation is the feeling and hearing of the heartbeat. Under normal conditions, the heart beats 60-100 times per minute. The person feels little or no heartbeat.
If the heart rate falls below 60 beats per minute, it is bradycardia, if it rises above 100, it is tachycardia.
During palpitations, the heart rate increases, sometimes up to 200 beats/minute. Although this value is life-threatening, low levels are not always harmful. If the feeling of palpitation is prolonged and brings along other complaints, emergency medical attention may be required.
Palpitations are not always a symptom of illness. Palpitations may occur in situations such as excitement, fear, being under stress, excessive exercise, jogging, excessive caffeine intake, and sometimes anxiety. However, in some cases, palpitations may be a symptom of another underlying heart disease.
With the appropriate treatment of the underlying disease in psychological disorders such as anxiety disorder, the feeling of palpitation will also decrease. The calming of emotions such as excitement, stress, fear, and resting after running will relieve palpitation by itself. However, palpitation itself can also act as a trigger for other heart diseases.
The duration of palpitation varies according to the underlying disease or the persistence of the triggering factor. Anxiety-related palpitations may last for a long time, while excitement-related palpitations may last for a few minutes. If there is an underlying heart disease and proper treatment is not started, palpitations may last for months.
EKG is the most important tool in the diagnosis of palpitations. The rhythm level of the heart and the number of heartbeats can be determined by heart radiography. Sometimes the person may feel palpitations, but there may be no changes in the EKG. If the heart rate and rhythm are normal on the EKG despite the feeling of palpitation, psychological or emotional causes may be considered.
In case of palpitation, heartbeats may not be felt only over the chest. Heartbeats can also be felt in the neck and throat of the person.
Palpitation is a common complaint in societies. About one out of every ten applications to the emergency services is due to palpitation, about one out of every five applications to the cardiology outpatient clinics.
In addition to the complaint of palpitation, if there are no symptoms such as chest pain, beating of the heart very very fast, a missing beat, and if there is no evidence of heart disease in the examinations (ECG, holter, etc.), psychiatric diseases such as anxiety disorders are suspected. This is a common situation.
Palpitations causes:
Palpitations can be caused by heart diseases as well as non-cardiac causes. Therefore, a good disease history and examination are important.
Heart diseases that can cause palpitations include:
- High blood pressure,
- Heart rhythm disorders (atrial fibrillation, supraventricular tachycardia, ventricular fibrillation etc.),
- Heart rheumatism,
- Heart muscle diseases (myocarditis),
- Cardiovascular diseases,
- Heart attack (myocardial infarction) (with intense anxiety and chest pain),
- Hereditary diseases of the heart,
- Enlargement of the aorta (aortic aneurysm),
- Inflammation of the lining of the heart (pericarditis).
Causes other than heart disease that can cause palpitations include:
- Sudden excitement,
- Extreme stress, anxiety
- Fear,
- Excessive movement, running,
- Insomnia,
- Fever height,
- Excessive coffee consumption
- Excessive alcohol consumption,
- Substance use,
- Excessive nicotine intake (smoking),
- Some drugs (flu infection, lung disease drugs, etc.),
- Bleeding more than normal, fluid loss,
- Pregnancy,
- Menopause,
- Migraine headaches,
- High altitude, lack of oxygen,
- Anemia,
- Thyroid gland diseases (hyperthyroidism, goiter etc.),
- Low blood glucose,
- Anxiety disorder,
- Panic attack,
- Generalized anxiety disorder,
- Major depression,
- Psychotic attacks.
Diagnosis of palpitation:
The first task in the patient who presents with the complaint of palpitation is to detect the disease causing the palpitations. Palpitation cases that are common in the community may also need to be evaluated by more than one specialty.
First of all, a detailed anamnesis is taken from the patient who applied with the complaint of palpitation. The onset time of the complaints, how often they develop, in which time period they are seen most, duration, severity, and accompanying symptoms are questioned.
A good examination is then carried out. The patient’s blood pressure level is determined. A heart examination is done. The heart rate is measured. It is evaluated in terms of heart diseases, thyroid gland diseases, etc.
Investigations that may be necessary for the diagnosis of palpitations include:
- EKG,
- fasting blood sugar,
- Thyroid function tests,
- Holter,
- EFOR test,
Treatment of palpitations:
Immediate medical attention may be required if there is chest pain, shortness of breath, fainting or feeling of faintness as well as palpitations.
If the underlying cause of palpitation is coffee consumption, excitement, stress, alcohol consumption, and substance abuse, eliminating these may be sufficient to eliminate the complaint.
Supportive treatments can be applied in cases such as pregnancy and menopause. Migraine treatment, controlling blood sugar level, anemia treatment, treatments for thyroid disease can be solutions in some cases of palpitation. In cases such as anxiety disorder, panic attacks, treatment under the control of a psychiatrist is required.
If the underlying disease is of heart origin, treatment is applied for it. Depending on the type of heart disease, drug therapy or interventional treatments are applied. In interventional treatments, radiofrequency ablation (with the help of a catheter in the groin and sending radiofrequency waves to the place where there is a rhythm disorder) or other methods can be tried.