Pounding in the chest,
rapid heartbeat, palpitations, or racing
- This is not a disease but a congregate of symptoms in which the patient suddenly becomes extremely aware of his heartbeat, often describing fast, slow, regular, or irregular heartbeat. Pounding in the Chest and fluttering are terms often used by patients to describe their palpitations.
- Palpitations may have a sudden or gradual onset, and may be triggered by certain factors.
- Under normal conditions, electrical signals travel to the heart and stimulate it to pump blood to other body parts. Redistribution of the normal electrical impulses gives rise to abnormal patterns experienced as palpitations. Consequently, it may feel as though the heart is missing or skipping a beat, but in reality there are extra or premature beats, or an early beat followed by a pause (rest), then a heavy beat.
- Benign (not dangerous) palpitations
are common, lasting for a few seconds with no other
symptoms. Frequent palpitations associated with symptoms can
be dangerous and may require immediate
- Often asymptomatic, lasting a few seconds to a few minutes
- Feeling that the heart is racing, Pounding in the Chest, or fluttering
- Skipped beat or extra heartbeat may be felt over the chest or the neck
- Dangerous symptoms include:
- Light headedness
- Shortness of breath
- Chest pain
- Chest pressure or heaviness
- Pain in the arms, jaws, or neck
- Occurring often
- Lasting longer than a few minutes and with symptoms.
- 6 or more extra beats per minute.
- Beats come in runs of 3 or more.
- Heart rate (pulse in the
wrist) more than 100 beats per minute without any activity,
fever, or drugs (normal heart beat is 60-100 beats per
- Arrythmias -- any variation from the normal rhythm of the heart
- Any structural abnormality, such as mitral valve prolapse
- Diseased blood vessels -- coronary heart disease
- Congenital heart defects --
defects present at birth, such as a hole in the heart
- High Blood Pressure
- Thyroid disease
- Hypoxemia or conditions that lower blood oxygen levels, such as lung disease
- Acidemia -- an increase in the acid content of the blood as seen in some lung problems.
- Low Blood Sugar
- Anemia (low blood)
- Cocaine use
- Amphetamine use
- Caffeine -- coffee, tea, sodas
- Vigorous exercise
- Panic attacks
- Lack of sleep
- Over eating
- Medications including over- the-counter cold remedies, diet pills
- Overdose of thyroid medicine,
theophylline, or some
- A general physician may need to consult a cardiologist if he suspects heart disease as the cause of palpitations.
- Medical history:
- Symptoms -- how long, how often, sudden, other symptoms, or triggers?
- Past and recent illnesses,
surgeries, medications, habits, allergies, and family
- General exam -- entire body, blood pressure, pulse, and temperature.
- The doctor may listen to the
lungs and the heart using a stethoscope.
(EKG) -- records the electrical activity of the heart and provides information about the rate and rhythm of the heart (painless and fast).
- The doctor may order a Holter monitor (Walkman-size device that you take home and record the heart's activities over 24 hours. This is also painless test but can help to identify the time, triggers, causes, and types of arrythmia.
- Echocardiogram --
uses sound to provide a picture of the heart's structures. It can show enlarged heart, defects present at birth, or abnormal valves.
- X-Ray of the chest may show an enlarged heart or lung disease.
- If other conditions are
suspected, blood and urine analysis may be
- Heart surgeries or procedures
- See other
- Treating the underlying cause is the first step.
- Most palpitations need no treatment.
- Avoid stimulants such as alcohol, caffeine, tobacco, diet pills, emotional stress, or fear.
- Learn to meditate and relax
- Multiple medications including beta blockers such as atenolol can normalize the heart rate and offer relief.
- In some cases cardiac surgery or
other procedures may be
diet, sleep, rest, relax, and avoid stress. Contact your
doctor for a checkup. If you have any of the danger signs
and symptoms, call 911.
- Rapid heart rate with fever, Anxiety, activity
- See causes
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