This week in Cardiology

Pulpitations
Interviewed by Gurminder for Doctify

If there’s one symptom that’s likely to give you palpitations, it’s this one. A beating heart is what keeps us alive so feeling like it’s going to jump out of your chest is going to worry anyone. Fortunately most of the time there is nothing wrong with the heart. When there is a problem, a range of effective treatments are available.

What are palpitations? 

Palpitations are a heightened awareness of ones heartbeat. People with palpitations may describe an awareness of ‘’extra heart beats’’ or of irregular or missed beats. This may be accompanied by other symptoms including shortness of breath, light-headedness and occasionally chest pain.

What causes palpitations and should I be worried?

There are many causes of palpitations. The majority of people with them don’t have a serious illness or problem with their heart. Anxiety and stress is very often the cause of palpitations and addressing this is often all that is required.

Palpations can be triggered by alcohol, caffeine (in tea, coffee or high energy drinks), exercise (during or after exercise), drugs (including prescription medications or recreational drugs).

Rarely, palpitations may be due to a low blood count, low blood sugar, hormonal changes in pregnancy and the menopause, heart disorders including leaky valves and heart rhythm disorders (arrhythmias).

Fortunately, the majority of people with palpitations do not have serious underlying medical disorders and will only need to change their lifestyle to deal with the problem. If your palpitations are frequent and bothersome or are associated with chest pain, dizzy spells or fainting, then its worth speaking to your GP.

heart

What tests will my doctor do to investigate my palpitations?

Because most people with palpitations have no serious underlying health problems, your doctor may reassure you and only perform additional investigations if your symptoms persist or are associated with troublesome symptoms like dizziness, shortness of breath or fainting.

An ECG may be required. This gives your doctor an electronic footprint of your heartbeat.

Occasionally a 24-hour or 7-day ECG will be required and rarely a miniature electrical ‘’black-box’’ (loop recorder) will be inserted by a cardiologist for those with infrequent symptoms.

My GP says my palpitations are caused by SVT (supraventricular tachycardia) and has referred me to Cardiologist

Tachycardia is medical speak for fast heart rates (over 100 beats per minute).

The “supra” bit refers to the fact that the origin of the fast heart beat is located in the upper chambers of your heart (the atria) as opposed to the more serious condition, ventricular tachycardia (VT), where the source of the tachycardia is in the lowers chambers of your heart (the ventricles).

Medications such as beta-blockers may be used to treat SVT. Some people will require more specialist tests to investigate the electrical wiring of the heart (electrophysiology studies) and a treatment called ablation (cauterization of very small areas inside the heart responsible for triggering and propagating SVT).

Fortunately, SVT is often only a nuisance with very infrequent attacks. Medications are often not required, let alone invasive tests and treatments.

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