A heart stumble is colloquially referred to as an irregular sequence of heartbeats, for example in the form of double beats or skips. In most cases, these are cardiac arrhythmias, so-called arrhythmias, which can indicate a disease, but are often harmless. The exact diagnosis can only be made if the felt heart stutter can also be recorded in the ECG. Therapy depends on the cause of the arrhythmia – in the case of harmless cardiac stumbling, no treatment is usually required at all.
What is heart stuttering?
Heart stumbles usually hide rhythm disturbances of the heart in the form of extra beats, the so-called extrasystoles. Behind heart stumbles are usually rhythm disturbances of the heart in the form of extra beats, the so-called extrasystoles. Depending on the region of the heart in which they occur, these are divided into supraventricular (originating from the atrium) or ventricular extrasystoles (originating from the ventricle). Extrasystoles are extra beats that are felt by the affected person as heart stumbles. If this shifts the natural heartbeat sequence, many people also feel a small interruption – the so-called compensatory pause, which bridges the time until the next normal heartbeat. The extra beats occur in almost everyone, but are often not even noticed. They can be a sign of an underlying disease of the cardiovascular system or even other organs, but often cardiac stuttering has no disease value at all.
Causes
Causes of heart stumbles can be physical or psychological. It is not uncommon to find no trigger at all for a healthy heart to be out of rhythm. Physical causes of arrhythmias include coronary artery disease, myocarditis, congenital heart defects, or hypertension. A typical trigger of heart palpitations is the thyroid gland with over- or underfunction. Disturbances in the electrolyte balance can also trigger extra beats. Especially a deficiency of magnesium or potassium can be responsible for extrasystoles. Often, heart palpitations are caused by the lifestyle of the affected person. Here, stimulants such as coffee and alcohol, drug abuse, but also lack of sleep play a role. In the psychological field, cardiac arrhythmias occur during stress and stressful situations. Here, both acute events such as a quarrel, but also longer periods of stress such as a demanding job can trigger the heart stutter.
Diseases with this symptom
- Coronary artery disease
- Heart attack
- Obesity
- Heart muscle inflammation
- Hypothyroidism
- Ventricular fibrillation
- Heart defect
- Potassium deficiency
- Hyperthyroidism
- Magnesium deficiency
- Hypertension
- Alcoholism
Diagnosis and course
To diagnose cardiac stumbling, an electrocardiogram (ECG) is written. In patients who do not have the stumble regularly, a long-term ECG over one or more days is often needed to detect the arrhythmia. Another option is the event recorder: if sufferers feel the heart stumble, they can record it by pressing the device to their chest. In addition, there are also recorders that capture abnormal ECGs and sometimes even transmit them directly to an emergency call center. If one wants to monitor the heart rhythm over a long period of time, the small recorder can also be implanted under the skin. Once the diagnosis of heart stuttering is confirmed and the specific rhythm disturbance is identified, further diagnostic steps are sometimes taken to search for the cause. In the area of the cardiovascular system, these are primarily ultrasound of the heart and vessels, blood pressure measurements, stress ECG, stress sonography, CT or MRI. With blood tests or a check of other organs such as the thyroid gland, but also discussing the psychological situation of the affected person, it is also possible to look for the reason for the heart stuttering.
Complications
The expression heart stumbling is used by many sufferers for acute arrhythmias (cardiac arrhythmias). Depending on the cause of this symptomatology, serious complications may occur. First and foremost, these include vascular occlusion due to blood clots that have spread. Medically, this is called an embolism.Cerebral infarction (apoplexy), which is still popularly called stroke, is one of the widespread complications of a cardiac arrhythmia, just like myocardial infarction (heart attack). If cardiac stuttering is ignored, heart failure (increasing weakness of the heart) cannot be ruled out as a further complication. This complication results in the heart no longer being able to pump the required amount of blood through the body. Shortness of breath and fatigue are clear indicators of this complication in patients who complain of heart stuttering. In the worst case, ventricular fibrillation occurs. If defibrillation is not performed promptly, ventricular fibrillation can lead to circulatory arrest and sudden cardiac death. Temporary and usually harmless complications include dizziness and shortness of breath as well as brief syncope (fainting). If the heart palpitation is due to the heart beating too early in one of the two ventricles or atria, it is a less dangerous complication. However, these irregular palpations may affect the quality of life to a greater or lesser degree.
When should you see a doctor?
As a rule, so-called extrasystoles are responsible for the fact that a heart palpation is perceived. Affected persons are therefore often concerned that cardiac arrhythmias or another serious illness could be the cause. If there is a one-off heart stumble that does not cause any other side effects, medical advice is not absolutely necessary. However, a doctor should be consulted if the heart stuttering lasts for a longer period of time, minutes or even hours. In particular, medical advice is also required if other secondary signs are also present: Headache, dizziness, disturbances of consciousness or shortness of breath. The physician (usually the cardiologist) will order an ECG and check blood pressure. High blood pressure may be the cause of frequently recurring extrasystoles. A low-dose beta blocker or daily administration of potassium may be helpful as therapy. However, under no circumstances should heart palpitations occur without consulting a physician. Since extrasystoles often occur due to stress, a change in lifestyle or diet should be considered. The physician will also advise the affected person to exercise more and eat a wholesome, healthy diet.
Treatment and therapy
Treatment of heart stumbling is based on the trigger and disease value of the disorder. Harmless heart stumbling does not require treatment. If an underlying disease of the cardiovascular system is present, it must be treated. This ranges from the insertion of a stent in the case of constricted vessels, to the adjustment of an unhealthy blood pressure, to the use of medications to bring the heart back into rhythm. Beta-blockers have a simultaneous blood pressure-lowering and stabilizing effect, but in some cases special antiarrhythmic drugs are also used. If the detected arrhythmia poses a risk of sudden cardiac death due to ventricular fibrillation, the patient is usually implanted with a small defibrillator. This is a device that detects life-threatening cardiac arrhythmias and terminates them independently with an electric shock. If the cause of the cardiac stuttering is a malfunction of the thyroid gland, this is adjusted with medication. If the patient lacks electrolytes for a physiologically functioning metabolism, the empty stores are replenished by administering potassium or magnesium. It is important for the patient to adjust his or her diet and the amount of fluids consumed in such a way that no new deficiencies occur. In the case of psychologically-induced extra strokes, sport, relaxation methods and possibly psychological support help to work. It is not uncommon for patients to get into a panic that is sometimes difficult to control, even in the case of harmless cardiac arrhythmias. Here, behavioral therapy helps to learn to cope with heart stuttering.
Outlook and prognosis
Cardiac arrhythmia, which occurs spontaneously and usually lasts only a short time, is accompanied by a positive prognosis because the heart rhythm usually stabilizes itself again. If the cardiac stuttering accumulates and occurs several times a day, it can also be considered a harbinger of a manifest cardiac arrhythmia. For example, it can develop into atrial fibrillation, which is not immediately life-threatening, but which in the longer term leads to irreversible damage to the myocardium (heart muscle) if the atrial fibrillation is not treated.If physiological causes, such as potassium deficiency, are identified in a frequent heart palpitation, the palpitation will heal on its own as soon as the cause is eliminated. If the cardiac stuttering is associated with other symptoms such as dizziness, impaired consciousness, high blood pressure, angina pectoris, or similar, it is advisable to check for organic problems or external disorders that could be the cause of the extrasystoles. There is a risk that, in the presence of unnoticed external factors, a persistent cardiac dysrhythmia may develop from the heartbeat and require treatment. The outlook and prognosis for the frequently occurring extrasystoles are then correspondingly different. If the perceived extrasystoles lead to permanent anxiety and increased tone of the sympathetic nervous system (sympathetic tone), a type of vegetative dystonia may develop. If left untreated, the prognosis for cardiac stuttering can then be considered rather unfavorable.
Prevention
Heart stumbles can have numerous triggers, most of which can be prevented with healthy lifestyle choices. These include regular exercise, eating a healthy diet and drinking enough fluids, and getting enough sleep. A sensible approach to coffee and alcohol is just as important as abstaining from drugs. Stress at work and at home should be kept to a minimum. Important: Medications for the heart, blood pressure or thyroid must be taken consistently so that they can properly exert their effect against heart stuttering.
What you can do yourself
If the symptom occurs frequently and leads to pain, an emergency physician or cardiologist must be consulted urgently. In any case, a healthy lifestyle will help against heart palpitations. This includes regular exercise and a healthy diet. Fatty and sweet foods in high moderation should be avoided. The patient should also avoid and reduce excess weight. Likewise, the use of drugs can promote cardiac stuttering. Therefore, alcohol and other drugs should be completely discontinued. Smoking is also harmful to the human heart, and the patient should refrain from it to combat the heart stumble. If the heart stumble is triggered in stressful or panic situations, these should be avoided. Although this is not always easy, it can be practiced relatively well through self-control. Valerian or nettles are recommended to calm the heart and the entire circulatory system. Both can be taken either in the form of tablets or as a tea. If there is pain or a strong pressure in the chest when the heart stumbles, a doctor must be consulted urgently. In this case, it may be a heart attack, which cannot be treated by oneself.
