While most heart palpitations are benign, experts advise that they are potentially serious — and the heart is not an organ to ignore. Dr. John C. Evans talks about what heart palpitations are, and what to do if you experience them.
John C. Evans, M.D., Cardiology, Renown Institute for Heart & Vascular Health
It’s a question I’m often asked: What are heart palpitations?
Simply put, heart palpitations are an awareness of the heart beating. Any person at any age can experience heart palpitations, and most people describe them as skipped beats or the sensation of a racing heart.
The question that follows: Are heart palpitations a serious health concern?
Well, yes and no. While most heart palpitations are benign, any heart palpitations are potentially serious, and the heart is not an organ to ignore. Sometimes there is no good explanation for why the palpitations occur. But given that heart palpitations can be both benign and potentially life-threatening, you should watch for the signs that may indicate your palpitations are of concern. One of the biggest red flags is coming close to or actually passing out. You should also be mindful of chest pain and shortness of breath.
Palpitations can be a symptom of underlying heart disease or hormonal imbalance. Sometimes they are the body’s reaction to other illness, even something as simple as the common cold.
And at their most critical, heart palpitations warn of risk of cardiac arrest and sudden death. Palpitations can also stem from atrial fibrillation — the most common type of arrhythmia. This condition causes the heart to beat irregularly, and often very fast, which can cause symptoms such as chest pain and lead to increased risk of stroke and heart failure.
How Do You Assess Heart Palpitations?
Undergoing an electrocardiogram (EKG) while palpitations are occurring is the easiest way to diagnose the condition. And given their intermittent nature, a longer term monitor often needs to be worn — either a Holter monitor that continuously records heart rhythms for 24-48 hours or an event monitor, which is worn for a month and triggered when heart palpitations occur.
Often an EKG is ordered by a general practitioner when palpitations are low risk in a patient with a structurally sound heart. For patients with heart abnormalities or who experience symptoms despite treatments from a general practitioner, I recommend an appointment with a doctor who specializes in heart rhythm disorders, known as a clinical cardiac electrophysiologist.
What Causes Heart Palpitations — and How Can You Avoid Them?
Some risks for heart palpitations are unavoidable, such as heredity. But there are risk factors within your control. Common, avoidable triggers include stress, insufficient sleep and alcohol consumption. Certain foods and even exercise in some cases can also trigger palpitations.
The adverse effects of these triggers increase when undue stress is placed on the heart — especially for older patients — and is exacerbated by other heart conditions such as diabetes and high blood pressure. I find that those patients who keep a diary of their symptoms can more effectively determine potential triggers.
Treatment depends on the particular diagnosis. If triggers can be avoided, no treatment is needed. But if a patient is diagnosed with atrial fibrillation or flutter, usually blood thinners are recommended. Several prescription medications are used to treat atrial fibrillation, and there are potential curative procedures such as an ablation. This treatment helps symptoms but doesn’t increase longevity, so it’s important to make sure the treatment’s side effects are not worse than your original symptoms.
We also recommend a healthy lifestyle — maintaining a healthy body weight and regular exercise — in all patients. Everyone should avoid smoking and excessive alcohol use and recreational drug use. Despite this, some patients will still get palpitations. Because heart palpitations may be the only symptom of a more serious problem, I recommend everyone with palpitations be evaluated by a doctor.
This story was also published in the Reno Gazette-Journal’s Health Source on January 31, 2016.