Palpitation is the term used to describe a palpitation of the heart that is perceived by the affected person as unusual and usually unpleasant. It can have both psychological and physical causes. Palpitations, although often harmless, can in some cases assume life-threatening proportions or be the symptom of a serious, life-threatening illness.
What is palpitation?
The term palpitation includes changes in the strength, speed, and regularity of the heartbeat. Palpitations are strong palpitations, palpitations, so-called heart stumbles, arrhythmias and other abnormalities that are perceived as unpleasant when they are perceived by the affected person himself. Thus, changes in the strength, speed and regularity of the heartbeat fall under this term. Arrhythmias, which also occur in cardiac stuttering, refer to a change in the regularity of the heartbeat. Irregularly, longer pauses or a shortened period between two heartbeats are felt. This can be very stressful for the person affected, as abnormalities in the heart are perceived as an immediate threat to health. In addition, they can be signs of somatic or psychological, potentially very dangerous diseases and should be thoroughly investigated. In the area of psychologically justifiable palpitations, the same may also be “imagined,” i.e., not detectable on an ECG. However, this does not imply a lack of need for treatment, since the patient’s distress nevertheless persists, and even clinically undetectable symptoms can result in panic attacks and impaired psychological well-being. Such stress may, in turn, promote further illness or symptoms.
Causes
Possible causes of palpitations include psychological reasons and substance abuse, but also heart or other diseases. In some cases, the search for the cause remains completely unsuccessful. Psychological reasons can be depression, anxiety disorders or acute or chronic stress. Palpitations are particularly stressful for the affected person in this area, as they cause nervousness and excitement, which has an immediate noticeable effect on the heartbeat, which in turn can lead to increased agitation and even panic attacks. Since heart activity, unlike that of most other organs, can be directly felt and is directly influenced by stress and anxiety that arise of their own accord in these situations, a circular reaction of mutually causing and conditioning symptoms and complaints occurs. Apart from mental illness or a general mental instability, acute states of stress can also result in palpitations. Here, it is important to reduce the stress level. Somatic causes can be heart diseases such as cardiac insufficiency or myocarditis, as well as hyperthyroidism, hypoglycemia or vascular inflammation. The so-called pacemaker syndrome can also cause palpitations. Other causes can be, for example, the use of medications that register palpitations as side effects or caffeine consumption. In sensitive people, even on average harmless amounts of caffeine can lead to increased or irregular palpitations.
Diseases with this symptom
- Anxiety disorder
- Vasculitis
- Heart failure
- Hypoglycemia
- Heart muscle inflammation
- Hyperthyroidism
Diagnosis and course
The diagnosis of palpitations usually proceeds via a medical history, pulse sampling, stethoscope listening and an ECG, and depending on the frequency and duration of the palpitations, also a long-term ECG. This documents the patient’s heartbeat over a longer period, usually 24 hours. As further measures, a so-called “cardiac echo” (an ultrasound examination of the heart) and a cardiac catheterization may be necessary. In the anamnesis, the patient describes his or her complaints to the attending physician as precisely as possible. Clarification of the patient’s circumstances and medical history is of utmost importance, since the possible causes of palpitations are manifold and precise localization can support a rapid and accurate diagnosis. Incorrect treatment can have life-threatening to fatal consequences.
Complications
Palpitation, or the perception of strong palpitations, can be both pathological and physiological.Sports or excitement can cause an increase in heart rate (tachycardia) and blood pressure (hyotonia), but this subsides within a few minutes and does not cause any further complications. In addition, an infection, for example, can cause an increased heart rate. In the worst case, an infection spreads throughout the body, causing sepsis. This is a life-threatening condition that quickly leads to the death of the affected person if left untreated. Decreased blood pressure also causes palpitations, but this does not usually carry complications chronically. Sometimes dizziness and a circulatory collapse can occur, leading to falls that can carry injuries. Especially a traumatic brain injury can lead to life-threatening consequences. Furthermore, other cardiac arrhythmias also lead to feared complications. In the case of atrial fibrillation, the blood can come to a standstill and form a blood clot in the atrium, which then breaks loose and is carried away with the bloodstream. Strokes or shortness of breath are the other consequences. In addition, ventricular fibrillation can end in a heart attack, which eventually leads to heart failure (heart failure) or, in the worst case, cardiac death.
When should you see a doctor?
Palpitation, the strong or rapid beating of the heart that is clearly perceptible to the affected person, is physiologically caused in many cases. This means that if there is a clearly explainable connection, for example with excitement or physical exertion, a trip to the doctor is not necessary. It is different if the palpitation occurs in inexplicable situations. In this case, a visit to the doctor is just as advisable as in the case of manifestations associated with other physical symptoms such as sweating, dizziness or even fainting. If pathological causes such as chronic high blood pressure can then be ruled out, a visit to the doctor is usually no longer necessary. An exception are patients for whom palpitation is a reaction of the body associated with anxiety. For example, particularly anxious patients or those who are under a great deal of psychological stress are at risk of developing cardiac neurosis. Here, the harmless palpitation is given a threatening meaning and the actually heart-healthy patient lives in constant doctor before a heart failure. This thought spiral is particularly unfavorable, since this fear again causes Palpitationen and confirms the concerning in its fear still. At the latest, the next visit to the family doctor should be made. Not to provide the patient with further reassurance with a new diagnosis, but to break the fateful cycle of anxiety and palpitation by referring the patient to a psychotherapist or psychologist.
Treatment and therapy
If it has been possible to determine what is causing the palpitations, they are treated with medication, lifestyle changes, or psychological measures, depending on the indication. Inflammation of the heart muscle is treated with comprehensive rest and medication of the symptoms. In such cases, curing the causative disease leads to the elimination of palpitations as a symptom. In the case of thyroid problems as the cause of the palpitations, hormonal drug therapy is usually initiated to regulate the hyperthyroidism. Here, too, palpitations can be expected to cease as soon as the patient is well controlled with medication. Palpitations due to psychological causes are normally less acutely dangerous to health, but are sometimes more difficult to treat. An underlying depression or anxiety disorder must be treated as causally as a physical illness. Although psychological palpitations are not normally as acutely dangerous as, for example, myocarditis, they can weaken the heart and worsen the patient’s general condition due to the additional stress they cause. In addition, there is a risk of panic attacks, which can lead to hyperventilation and actual heart attacks. A mixed form of psychological and physical treatment is represented by withdrawal cures if the cause of the altered heartbeat is rooted in drug addiction.Here, withdrawal symptoms are presumably treated with medication, and at the same time, the psychological well-being of the affected person and support during his withdrawal play a major role.
Outlook and prognosis
Palpitation should usually be treated by a physician. The heart is one of the most important organs and therefore should not be treated with self-help remedies. It is not uncommon for palpitation to be merely a subjective assessment. The patient estimates his heartbeat as unusual or pathological if he suffers from anxiety or stress. However, even in this case, a doctor should be consulted to check the heart. Heart problems can be treated relatively well and rarely lead to complications if treatment occurs early. If palpitation occurs due to abuse of alcohol or other drugs, the symptom will go away after a few days when the drugs are stopped. Palpitation can lead to panic attacks in many people, as sufferers feel they are about to have a heart attack. This leads to increased anxiety, stress levels and a generally lower quality of life. People who suffer from phobias and depression are very susceptible to palpitation. Treatment in this case is done by a psychologist, but does not always lead to success.
Prevention
Prevention for palpitations can be considered all measures that are good for the heart and the mental state of the person. These include a healthy diet, abstinence from drugs and alcohol – alcohol consumption can be causative for heart muscle inflammation – sufficient relief and recovery from stress, and professional treatment of any mental illnesses such as depression or anxiety disorders. If there is a predisposition to hypoglycemia or hyperthyroidism, these should be well controlled and treated by appropriate diet or, if necessary, medication. Because myocarditis can be consequences of uncured viral or bacterial infections, care should be taken to ensure adequate recovery even after apparently mild illnesses.
Here’s what you can do yourself
There are few self-help options for palpitation. Problems with the heart should always be treated by a doctor, as they can indicate very serious diseases. However, problems with the heart can be prevented. First and foremost, this includes a healthy diet. The patient should avoid fatty foods. It is equally important to abstain from alcohol and other drugs. If the palpitation occurs mainly after the consumption of drugs, these drugs must be discontinued immediately. If palpitation occurs in stressful situations, the stress factor must be reduced. Various sports exercises or yoga, for example, help to relax. If the palpitation is a bacterial infection, a doctor must be consulted in any case. For general calming of the body and the heart, valerian is recommended. This can be taken as tea or in the form of tablets and has a positive effect on palpitation. Especially older people should not expose their bodies to too much stress, in order to protect the heart. If palpitation occurs due to depression or anxiety disorders, a doctor should be consulted. In this case, self-help is not possible.