Heart palpitations shortness of breath
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Heart Palpitations and Shortness of Breath: Causes and Diagnostic Approaches
Heart palpitations and shortness of breath are common symptoms that can be distressing and indicative of various underlying conditions. This article synthesizes research findings to explore potential causes and diagnostic approaches for these symptoms.
Common Causes of Heart Palpitations and Shortness of Breath
Cardiac Arrhythmias and Structural Abnormalities
One of the primary causes of heart palpitations and shortness of breath is cardiac arrhythmias. These irregular heartbeats can range from benign to life-threatening. For instance, supraventricular tachycardia (SVT) is a common arrhythmia that can cause rapid heart rates, leading to palpitations and dyspnea 8. Additionally, structural heart abnormalities, such as a univentricular heart, can also present with these symptoms. An 18-year-old male with a univentricular heart experienced palpitations and shortness of breath over several years 6.
Intracardiac Masses and Tumors
Intracardiac masses, such as hemangiomas, can also be a cause. A patient with a left atrial hemangioma experienced shortness of breath and irregular heartbeats, which were resolved after surgical excision of the tumor 2. Similarly, thrombi in transit through a patent foramen ovale can present with rapid atrial fibrillation and associated symptoms 4.
Metabolic and Drug-Induced Causes
Metabolic conditions like thyrotoxicosis and the use of stimulants such as caffeine, cocaine, and amphetamines can lead to palpitations and shortness of breath 1. These substances can overstimulate the heart, causing arrhythmias and other cardiovascular symptoms.
Diagnostic Approaches
Electrocardiogram (ECG) and Holter Monitoring
An electrocardiogram (ECG) is a fundamental tool in diagnosing arrhythmias. For instance, a 41-year-old woman with recurrent palpitations and shortness of breath had an ECG that led to the initiation of oral anticoagulation and further electrophysiology consultation 3. Holter monitoring and loop recorders are also valuable for capturing intermittent arrhythmias that may not be present during a standard ECG 5.
Echocardiography
Echocardiography is crucial for visualizing structural heart abnormalities. In one case, a 33-year-old woman with recurrent episodes of breathlessness and palpitations underwent an echocardiogram that helped in further evaluation 1. This imaging modality can reveal issues such as intracardiac masses, valvular heart disease, and cardiomyopathies.
Advanced Imaging and Electrophysiology Studies
Advanced imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), can be used to evaluate structural abnormalities and masses within the heart. Electrophysiology studies are essential for diagnosing complex arrhythmias that are not responsive to standard medical treatments 3.
Conclusion
Heart palpitations and shortness of breath can result from a variety of cardiac and non-cardiac causes, including arrhythmias, structural heart abnormalities, metabolic conditions, and drug use. Accurate diagnosis often requires a combination of ECG, Holter monitoring, echocardiography, and advanced imaging techniques. Understanding the underlying cause is crucial for effective management and treatment of these distressing symptoms.
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