Heart palpitations meaning
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Understanding Heart Palpitations: Causes, Symptoms, and Diagnosis
Definition and Symptoms of Heart Palpitations
Heart palpitations are characterized by an unusual awareness of the heartbeat, often described as a strong, skipping, fluttering, racing, pounding, thudding, or jumping sensation in the chest . These sensations can be brief or sustained, and may sometimes be accompanied by a feeling of having to cough or experiencing shortness of breath. Palpitations can also manifest as a feeling that the heart is pounding harder than usual, even if the heart rate is not necessarily faster.
Common Causes of Heart Palpitations
Cardiac Arrhythmias
One of the primary causes of palpitations is cardiac arrhythmias, which are abnormal heart rhythms. These can include conditions such as atrial, nodal, or ventricular extrasystoles . Arrhythmias can present with various symptoms, including chest pain, syncope (fainting), or even sudden cardiac death in severe cases .
Psychological Factors
Anxiety and stress are significant contributors to palpitations, with up to a third of cases being linked to psychological causes. Panic attacks and stress-related conditions can often mimic or exacerbate the sensation of palpitations .
Physiological and External Factors
Normal physiological responses such as exercise, fever, dehydration, or excitement can also cause palpitations. These are typically benign and result from the body's natural response to increased demands . Additionally, substances like caffeine, nicotine, and certain medications can increase adrenergic tone, leading to palpitations.
Non-Cardiac Medical Conditions
Palpitations can also be a symptom of non-cardiac medical conditions such as hyperthyroidism, where the thyroid gland is overactive, leading to an increased heart rate. Other systemic diseases and even certain psychiatric disorders can also cause palpitations .
Diagnostic Approach to Palpitations
Clinical Evaluation
The initial approach to diagnosing palpitations involves a thorough clinical evaluation, including a detailed patient history and physical examination. Key aspects to consider include the frequency, duration, and triggers of the palpitations, as well as any associated symptoms like chest pain or syncope .
Diagnostic Tests
Diagnostic tests such as a 12-lead electrocardiogram (ECG) are essential tools for identifying underlying arrhythmias. In some cases, more advanced diagnostic procedures like electrophysiological studies may be necessary, especially if the palpitations are associated with syncope or an inappropriately rapid pulse .
Conclusion
Heart palpitations are a common symptom that can arise from a variety of causes, ranging from benign physiological responses to serious cardiac arrhythmias and psychological conditions. A comprehensive clinical evaluation and appropriate diagnostic testing are crucial for determining the underlying cause and guiding effective management. Understanding the multifaceted nature of palpitations can help in providing reassurance to patients and identifying those who require further medical intervention.
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