What can cause heart palpitations
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These studies suggest heart palpitations can be caused by cardiac arrhythmias, psychological factors, noncardiac issues, medications, and lifestyle factors such as exercise, stress, and diet.
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Causes of Heart Palpitations: An Overview
Heart palpitations, characterized by an abnormal awareness of the heartbeat, can be a distressing symptom for many individuals. They are often described as sensations of rapid, fluttering, or pounding heartbeats. Understanding the underlying causes of palpitations is crucial for effective diagnosis and management. This article synthesizes findings from multiple research studies to provide a comprehensive overview of the potential causes of heart palpitations.
Cardiac Arrhythmias and Heart Palpitations
Common Arrhythmias
Cardiac arrhythmias are one of the most common causes of heart palpitations. These include sinus tachycardia, atrial fibrillation, premature ventricular contractions, and ventricular tachycardia . Arrhythmias can lead to palpitations that are often described as a racing or irregular heartbeat. In some cases, these arrhythmias can be benign, but they can also be indicative of more serious cardiac conditions, especially if accompanied by symptoms like dizziness or syncope .
Non-Arrhythmic Cardiac Causes
Non-arrhythmic cardiac issues such as mitral valve prolapse, pericarditis, and congestive heart failure can also cause palpitations . These conditions may lead to an increased or abnormal awareness of the heartbeat due to structural or functional abnormalities in the heart.
Non-Cardiac Causes of Palpitations
Psychological Factors
Anxiety and stress are significant non-cardiac causes of palpitations. Up to a third of patients experiencing palpitations may have psychological causes such as panic attacks or stress-induced sinus tachycardia . These psychological factors can lead to a heightened awareness of the heartbeat, often described as a fluttering or pounding sensation.
Endocrine and Metabolic Disorders
Endocrine disorders like hyperthyroidism and metabolic issues such as hypoglycemia can also result in palpitations. These conditions affect the body's overall metabolism and can lead to an increased heart rate or irregular heartbeats .
Stimulants and Medications
The use of stimulant drugs, including caffeine, nicotine, and certain over-the-counter and prescription medications, can provoke palpitations. These substances can increase heart rate and lead to sensations of a racing or pounding heart .
Gender-Specific Factors
Women and Palpitations
Palpitations are frequently reported in women, particularly during the luteal phase of the menstrual cycle, pregnancy, and the perimenopausal period. Hormonal fluctuations during these times can lead to increased sympathetic activity, resulting in palpitations . Additionally, conditions like mitral valve prolapse are more commonly diagnosed in women and can be a significant cause of palpitations.
Diagnostic Approaches
Initial Evaluation
A thorough history and physical examination are essential in distinguishing cardiac from non-cardiac causes of palpitations. Ambulatory electrocardiographic (ECG) monitoring, such as Holter monitoring or event recording, is often used to capture and analyze heart rhythms during episodes of palpitations .
Advanced Diagnostic Tools
In cases where initial evaluations are inconclusive, more advanced diagnostic tools like echocardiography can be employed. Echocardiography can reveal underlying structural heart diseases, such as mitral valve prolapse or other valvular diseases, which may be causing the palpitations.
Conclusion
Heart palpitations can arise from a variety of cardiac and non-cardiac causes, including arrhythmias, psychological factors, endocrine disorders, and stimulant use. Understanding these potential causes is crucial for accurate diagnosis and effective management. A combination of thorough clinical evaluation and appropriate diagnostic testing can help identify the underlying cause and guide treatment strategies.
Sources and full results
Most relevant research papers on this topic
1
Diagnostic approach to palpitations.
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Palpitations: what is the mechanism, and when should we treat them?
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