Heart palpitations causes
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Common Causes of Heart Palpitations
Heart palpitations are a frequent symptom, often described as a fluttering, pounding, racing, or skipping sensation in the chest. The most common causes include cardiac arrhythmias, anxiety, and various physiological or lifestyle factors. Less than half of patients with palpitations actually have a true heart rhythm abnormality, and many cases are benign or related to non-cardiac issues such as stress, exercise, fever, certain foods, nicotine, and alcohol use Thompson2006Abbott2005Gale2016+1 MORE.
Cardiac Arrhythmias and Structural Heart Disease
Arrhythmias are a leading cause of palpitations. These include sinus tachycardia, atrial fibrillation, premature ventricular or atrial contractions, and ventricular tachycardia. Some arrhythmias are benign, while others can be more serious, especially if accompanied by symptoms like dizziness or fainting Thompson2006Abbott2005Bethencourt2022+3 MORE. Structural heart diseases, such as mitral valve prolapse, hypertrophic cardiomyopathy, and rare cardiac tumors like myxomas, can also cause palpitations, though structural causes are relatively rare Bethencourt2022James2021.
Non-Cardiac and Psychological Causes
A significant proportion of palpitations are due to non-cardiac causes. Anxiety, panic attacks, and psychological stress are common contributors, accounting for up to a third of cases. Other non-cardiac causes include hyperthyroidism, hypoglycemia, and side effects from stimulant drugs or medications Thompson2006Abbott2005Gale2016+2 MORE.
Triggers and Risk Factors
Palpitations can be triggered by physical activity, emotional stress, fever, dehydration, or stimulant intake. They may also occur as a normal response to increased heart workload, such as before or after exercise. Older adults and those with a history of heart disease are at higher risk for cardiac causes of palpitations Thompson2006Bethencourt2022Wexler2017.
Diagnostic Approach
A thorough history and physical examination are essential to distinguish between cardiac and non-cardiac causes. Initial tests often include an electrocardiogram (ECG) and basic laboratory work to rule out systemic causes like hyperthyroidism or anemia. If structural heart disease is suspected, echocardiography is recommended. For frequent or unexplained palpitations, ambulatory ECG monitoring (such as Holter or event monitors) is used to capture abnormal rhythms Abbott2005Bethencourt2022Wexler2017+2 MORE.
Conclusion
Heart palpitations have a wide range of causes, from benign lifestyle factors and psychological stress to potentially serious cardiac arrhythmias and rare structural heart diseases. Careful evaluation is needed to identify the underlying cause and guide appropriate management, with most cases being non-life-threatening and manageable with reassurance or targeted treatment Thompson2006Abbott2005Bethencourt2022+3 MORE.
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