Heart palpitations definition
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Understanding Heart Palpitations: Definition and Key Insights
Definition of Heart Palpitations
Heart palpitations are a symptom characterized by an unusual awareness of the heartbeat. This sensation can manifest in various forms, such as a strong, skipping, fluttering, racing, pounding, thudding, or jumping feeling in the chest . Patients may also describe it as a sensation that makes them feel like they need to cough or that their breath is being taken away.
Characteristics and Descriptions
Sensations and Duration
Palpitations can be brief, lasting only a moment, or they can be sustained for several seconds, minutes, or even longer in rare cases. The sensation can be described as the heart beating unusually rapidly or irregularly, and it can also feel like the heart is pounding harder than usual without necessarily being faster .
Normal vs. Abnormal Palpitations
Palpitations can occur under both normal and abnormal circumstances. Normal palpitations are often associated with exercise, emotions, stress, or the intake of substances like coffee and nicotine, which increase adrenergic tone or decrease vagal activity . These are typically recognized as normal because the individual is aware of the cause. Abnormal palpitations, on the other hand, may occur without any apparent reason and can be fast, strong, slow, or feel like a missed or extra beat .
Causes and Underlying Conditions
Cardiac and Non-Cardiac Causes
Palpitations can be caused by a variety of factors, including cardiac arrhythmias, structural heart diseases, psychiatric conditions, systemic non-cardiac diseases, and the use of certain drugs or substances . While many palpitations are benign and related to atrial, nodal, or ventricular extrasystoles, they can sometimes indicate more serious conditions such as tachycardia or other arrhythmias .
Psychological Factors
Anxiety and stress are common causes of palpitations, with up to a third of cases being attributed to psychological factors. In some instances, patients may be misdiagnosed with anxiety or stress when they actually have an underlying cardiac condition.
Clinical Implications and Diagnosis
Importance of Medical Evaluation
Given the wide range of potential causes, it is crucial for healthcare providers to carefully evaluate patients presenting with palpitations. This includes taking a detailed history, performing a physical examination, and using diagnostic tools such as a 12-lead electrocardiogram (ECG) . The goal is to differentiate between benign palpitations and those that may require further investigation or treatment.
Prognosis and Management
Most palpitations are benign and do not require treatment. However, in cases where palpitations are associated with syncope, a rapid pulse, or other concerning symptoms, further evaluation and possibly an electrophysiological study may be warranted. Management strategies will depend on the underlying cause and may range from lifestyle modifications to medical or surgical interventions .
Conclusion
Heart palpitations are a common symptom that can range from benign to indicative of serious underlying conditions. Understanding the various causes and characteristics of palpitations is essential for accurate diagnosis and appropriate management. Healthcare providers play a critical role in distinguishing between benign and potentially harmful palpitations, ensuring that patients receive the necessary care and reassurance.
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