Palpitations, rapid pulse or med. tachycardia is a persistent accelerated pulse to over 90 beats per minute. A pulse of 150 beats per minute or more is called marked tachycardia. Signs of tachycardia, as with rapid atrial fibrillation, include regular or irregular thumping or pounding that may be felt as far up as the neck or carotid artery. The causes of palpitations may be natural or pathological.
What is palpitations?
Palpitations (med.: tachycardia) is the term used to describe an accelerated heartbeat in the chest. Some patients also describe it as a rapid pulse that can appear both racing and thumping. It is not uncommon for those affected to feel this sensation all the way down their throat. Tachycardia is only medically determined when the pulse rate exceeds 100 beats per minute. In the special form of tachycardia, ventricular tachycardia, the cause originates directly in the heart chambers. In this case, a doctor should be consulted quickly. There is also supraventricular tachycardia. This feels very unpleasant for the patient, but is usually harmless. In this case, the cause is located above the ventricles. Nevertheless, it is advisable to consult the family doctor or a cardiologist in case of palpitations, regardless of the genesis. Usually, palpitations are considered a symptom of another, underlying, disease. However, sometimes it can be a disease itself. However, the most common reasons for palpitations are usually mundane bodily processes, such as anxiety, stress, excitement, and joy. However, psychosomatic causes can also condition tachycardia.
Causes
Heart palpitations of more than 100 beats per minute are usually quite natural. This heart rate is reached quickly, especially during physical exertion and sports. Heart rates in young children can exceed 100 even at rest without being pathological. In most cases, palpitations are harmless and occur during anticipation, excitement or stressful situations. However, after calming down, the palpitations quickly disappear. Sometimes, however, palpitations or a rapid heartbeat can also be signs of a more extensive illness, which should be examined by a doctor in any case. Especially diseases of the heart, such as atrial fibrillation (see coronary heart disease), valvular heart disease, myocardial disease or arrhythmia often lead to palpitations and should definitely be clinically diagnosed and treated. In this case, palpitations or palpitations are caused by the heart itself, e.g. by additional conduction pathways, other disorders in the excitation conduction system or by circulatory disorders in the heart muscle. Diseases of the thyroid gland as well as caffeine, nicotine and medications can also trigger palpitations. Palpitations caused by hyperthyroidism affect the excitation conduction system or the heart muscle through the hormones or neurotransmitters. Other possible causes of palpitations are high blood pressure (hypertension), hypotension, hypoglycemia and anemia. A special case of palpitations can also be congenital or inherited tachycardia. In this case, there is a disturbed conduction of excitation at the heart and can be treated by surgery. Heart palpitations are also frequently observed in the course of anxiety disorders. Palpitations can also be accompanied by other symptoms. These include dizziness, heart palpitations, lightheadedness, loss of consciousness, and speech and vision problems.
Diseases with this symptom
- Coronary artery disease
- Heart attack
- Pulmonary embolism
- Ventricular fibrillation
- Heart failure
- Heart muscle inflammation
- Heat stroke
- Sunstroke
- Anxiety disorder
- Fear of heights
- Claustrophobia
- Dental phobia
- Hyperthyroidism
- Anemia
- High blood pressure
- Cardiac neurosis
- Menopause
- Blood poisoning
Diagnosis and course
The cause(s) of palpitations and a possible need for treatment are diagnosed by a medical specialist (e.g. a cardiologist) in various examination steps:
First, the physician usually asks about the time of a first palpitations, possible triggering situations (e.g., stress), concomitant complaints, previous or underlying diseases (such as cardiac arrhythmias), and current medications.Further examination steps then include, for example, blood sampling, pulse and blood pressure measurements and, if necessary, ECGs (electrocardiograms), ultrasound examinations or X-rays. Depending on the cause of the palpitations, the latter often occur suddenly (often accompanied by dizziness/sweating). Physically induced palpitations usually increase steadily or persist steadily as they progress, whereas psychological causes often manifest as episodic palpitations.
Complications
Similar to diseases of the circulatory and respiratory systems, palpitations also worsen as the disease progresses. Since the symptoms only disappear on their own in rare cases, there is a worsening of the general condition. In addition, there are often more serious problems that require the intervention of a physician. If action is not taken in time, dizziness and sweating, a circulatory collapse or a heart attack can occur, for example. Physically caused palpitations are also accompanied by a strong inner restlessness, caused by the chronically accelerated pulse and accompanying symptoms such as the well-known stabbing in the area of the heart and chest. Psychologically caused palpitations occur in episodes, but also continue to increase in severity as they progress. Although the course is rarely fatal, the fast-beating heart and the discomfort that accompanies it sometimes severely limit the quality of life. Particularly stressful for those affected can be anxiety attacks, which in turn promote the development of other diseases. If diagnosed at an early stage, however, an accelerated pulse is easily treatable. The symptoms are usually due to more harmless causes and can be treated with dietary measures and mild medication. The course of palpitations thus depends largely on when the complaints are recognized and what causes underlie them. Complications rarely occur during the treatment itself.
When should you go to the doctor?
Palpitations as a symptom can have a harmless, but also very serious background. Sports, physical work, stress and excitement cause palpitations. After some time it settles here again by itself. A reason for a visit to the doctor would only be given here if the heart palpitations in such situations occur significantly earlier or last longer than usual. Palpitations can also be caused by an organic disease. An increased heart rate or palpitations are referred to as tachycardia. In medical terms, tachycardia is defined as a heart rate of 150 heartbeats per minute or more. Some people naturally have a faster heartbeat. Often, however, tachycardia is based on a medical condition. Heart diseases such as coronary heart disease and diseases of the heart muscle or heart valves can also cause palpitations, as can a cardiac arrhythmia. Since the heart is the engine of life, tachycardia should always be diagnosed by a doctor if there is no trigger for it as mentioned above. Apart from the heart itself, the cause of palpitations can be due to another disease. In particular, high or low blood pressure, anemia, hypoglycemia and hyperthyroidism are often accompanied by palpitations. Palpitations can also be an effect of caffeine and nicotine use, as well as medication use. Visual disturbances, dizziness, lightheadedness, and loss of consciousness can be symptoms of palpitations and cause for a visit to the doctor.
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Please answer the following questions as fully as possible. Also note any additional questions and then ask your doctor.
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Treatment and therapy
First of all, the doctor should find out whether it is harmless palpitations or whether the causes are disease-related. The physician will try to inquire for this the background of the heart palpitations. In doing so, he will explicitly address family stress and professional strain and also ask about potential previous illnesses and other complaints. Furthermore, he will ask which medications are being taken and whether cardiac arrhythmias or heart stumbles occur. After that, blood is usually drawn, and blood pressure and pulse are measured. An electrocardiogram (ECG) is also performed. If the causes of the palpitations can already be identified here, or if no exact diagnosis can be established, further examinations are performed. These include long-term ECG, stress ECG, ultrasound examination and possible long-term blood pressure measurement and X-rays. If the cause of the palpitations is identified, it is treated. If the cause is psychological stress, relaxation measures and stress avoidance are recommended. Autogenic training is particularly promising in this regard. Natural sedatives, such as valerian, can also have a supporting effect. However, they should always be taken only in conjunction with combating stress and should be approved by a doctor. Smoking and drinking a lot of coffee should be stopped. Atrial fibrillation and cardiac arrhythmias should be treated with medication. A pacemaker may also be advised. If there is hyperthyroidism, it should be treated to eliminate the palpitations.
Outlook and prognosis
Benign palpitations can usually be positively influenced by the patient himself, otherwise drug treatment can provide relief. In the treatment of certain forms of tachycardia, the administration of beta-blockers has proven effective. The same applies to obliteration by means of catheter ablation. If the tachycardia is due to fibrillation of the atrium, the heart rate can be reduced with the aid of beta blockers or antiarrhythmic drugs. The increased risk of thrombosis is controlled with anticoagulants. If ventricular fibrillation is responsible for the racing heart, there is an acute danger to life. A defibrillator, which emits a strong electrical impulse, or a fist blow to the chest can interrupt the hyperactive conduction and thus generate a slower heartbeat again. In these cases, the patient usually has to undergo surgical intervention in a timely manner. If the psyche is the trigger for the palpitations, tranquilizers such as benzodiazepines can help, although they then usually have to be taken for a long time. With the help of relaxation techniques such as yoga or autogenic training, the patient can learn to remain calm in exceptional emotional situations. He will then no longer react immediately with palpitations in stressful situations.
Prevention
Heart palpitations that are not pathological can be well prevented by leading a healthy, stress-free life with plenty of exercise, fresh air, a healthy diet and abstaining from smoking and alcohol. Autogenic training is also preventive, as it not only helps to calm down, but can also bring more relaxation into everyday life. In some patients suffering from psychosomatic symptoms, such as palpitations, the permanent intake of valerian tincture has helped sustainably.
This is what you can do yourself
In the case of sudden palpitations, a light massage on the neck can lead to an improvement in symptoms. Using the index and middle fingers, gently massage those points on both sides of the neck where the pulse of the carotid artery can be felt.During this procedure, the patient should sit or lie down, because the massage can not only make the palpitations disappear, but also lower blood pressure. The procedure stimulates the carotid sinus nerve on the internal carotid artery, whose pressure receptors are responsible for measuring blood pressure in the artery. The increase in pressure sends electrical impulses to the brain, to which the circulatory system responds by throttling the heart rate and lowering blood pressure. Holding the nose and mouth while exhaling can also be helpful. Doctors call this method the Valsalva maneuver, researched by the Italian physician of the same name. There is a strong tension in the respiratory and abdominal muscles and increased air pressure in the airways. The result is a lower blood volume in the right ventricle, which leads to a lower stroke volume. The procedure may only be performed for ten seconds, otherwise there is a risk of circulatory collapse. However, a doctor should be consulted beforehand. If the patient frequently complains of palpitations, it is advisable to avoid coffee and nicotine. In addition, stress should be avoided; instead, long walks in the great outdoors are worthwhile, as well as lots of sport and exercise after consultation with the attending physician.
| Tips:
Don’t stress: the most common cause of palpitations is stress. Try to relax, take a walk in the fresh air or do moderate sports such as jogging or strength exercises. Autogenic training, yoga and progressive muscle relaxation round out the anti-stress methods. No stimulants: Avoid coffee, caffeinated drinks and smoking. Avoid alcohol. Drink cold: Drink a cold sparkling water and then toast. This method is similar to doing the Valsalva maneuver and can curb palpitations. Valsalva maneuver: hold your nose while closing your mouth. Then try to exhale slowly through your mouth. The pressure this creates in your chest will slow your heartbeat, lowering the feeling of a racing heart. Massage the neck: Feel your pulse at the carotid artery with two fingers. By gently massaging the carotid nerve there, the pulse can slow down. Since this can also drop blood pressure, this exercise should be done lying down after consulting a physician. Deep breathing: Breathe deeply in and out slowly. It is known that this can gain calmness and reduce palpitations. |
