Palpitation

As Palpitation is a palpitation of the heart that is noticeable by the person concerned, which is felt as unusual and usually unpleasant. It can have both psychological and physical causes. Palpitations, while often harmless, can in some cases be life-threatening or the symptom of a serious, life-threatening illness.

What is palpitation?

The term palpitation includes changes in the strength, speed and smoothness of the heartbeat.

Palpitations are strong palpitations, heart palpitations, so-called heart stumbling, arrhythmias and other abnormalities that are perceived as unpleasant when they are noticed by the person concerned. Thus, changes in the strength, the speed and the regularity of the heartbeat fall under this term.

Arrhythmias, which also occur with heart palpitations, describe a change in the steady heartbeat. Long pauses or a shortened period between two heartbeats are felt irregularly. This can be very stressful for the person concerned, as abnormalities in the heart are perceived as an immediate health threat. In addition, they can be signs of somatic or psychological diseases, which are potentially very dangerous, and should be examined carefully.

In the area of ​​mentally justifiable palpitations, the same can also be "imagined", i.e. not detectable on an EKG. However, this does not mean that there is no need for treatment, since the patient's suffering still persists and symptoms that cannot be clinically proven can lead to panic attacks and impaired psychological well-being. Such stress can in turn promote further illnesses or symptoms.

causes

Possible causes for palpitations are psychological reasons and drug 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. In this area, palpitations are particularly stressful for the person concerned, as they cause nervousness and excitement, which has an immediate noticeable effect on the heartbeat, which in turn can lead to increased excitement and even panic attacks.

Since the heart's activity, in contrast to that of most other organs, can be felt directly and is directly influenced by the stress and anxiety that arise naturally in these situations, there is a circular reaction of mutually causing and conditioning symptoms and complaints.

Apart from mental illnesses or general mental instability, acute stress states can also result in palpitations. The aim here is to reduce the stress level. Somatic causes can be heart diseases such as heart failure or myocarditis, as well as hyperthyroidism, hypoglycaemia or vascular inflammation. The so-called pacemaker syndrome can also cause palpitations.

Other causes can be, for example, the use of medication with side effects such as palpitations or caffeine consumption. In sensitive people, even on average harmless amounts of caffeine can lead to increased or irregular heart palpitations.

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Diseases with this symptom

• Anxiety disorder
• Vasculitis

• Heart failure
• Hypoglycaemia

• Myocarditis
• Hyperthyroidism

Diagnosis & course

The diagnosis of palpitations usually involves taking an anamnesis, taking a pulse, listening to the stethoscope and an EKG, and depending on the frequency and duration of the palpitations, a long-term EKG. This documents the heartbeat of the patient over a longer period of time, usually 24 hours. A so-called “heart echo” (an ultrasound examination of the heart) and a cardiac catheter examination may be necessary as further measures.

In the anamnesis, the patient describes his symptoms to the attending physician as precisely as possible. A clarification of the living conditions as well as the medical history is of the utmost importance, since the possible causes for palpitations are manifold and a precise definition can support a quick and accurate diagnosis. Incorrect treatment can have life-threatening or fatal consequences.

Complications

Palpitation or the perception of strong palpitations can be both pathological and physiological. Exercise or excitement can lead to an increase in heart rate (tachycardia) and blood pressure (hyotonia), but this will subside within a few minutes and not cause any further complications.

An infection can also cause an increased heart rate, for example. In the worst case, an infection spreads throughout the body and thus causes sepsis. This is a life-threatening condition that, if left untreated, can quickly lead to the death of the person concerned. Lower blood pressure also causes palpitations, but this usually does not cause any chronic complications.

Sometimes dizziness and circulatory collapse can occur, which can lead to falls that can cause injury. A traumatic brain injury in particular can lead to life-threatening consequences. Furthermore, other cardiac arrhythmias also lead to dreaded complications.

Atrial fibrillation can lead to a standstill of the blood, which can form a blood clot in the atrium, which loosens and is carried along with the bloodstream, an embolism can result here. Strokes or shortness of breath are the further consequences. In addition to this, ventricular fibrillation can end in a heart attack, which ultimately leads to cardiac insufficiency or, in the worst case, to cardiac death.

When should you go to the doctor?

Palpitation, the strong or rapid beating of the heart that is clearly noticeable to the person concerned, is in many cases physiological. This means that if there is a clearly explainable connection, for example with excitement or physical exertion, a visit to the doctor is not necessary. It is different when the palpitation occurs in inexplicable situations. A visit to the doctor is recommended here as well as in the case of manifestations that are 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 fear-related response of the body. Particularly anxious patients or those who are under great psychological stress, for example, run the risk of developing a heart neurosis.Here the harmless palpitation is assigned a threatening importance and the actually heart-healthy patient lives in constant doctor before a heart failure. This spiral of thought is particularly unfavorable, as this fear causes palpitations again and confirms the person concerned in his fear.

Then at the latest, the next visit to the family doctor should take place. Not to reassure the patient with a new diagnosis, but to break the fateful cycle of fear and palpitation by referring them to a psychotherapist or psychologist.

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Treatment & Therapy

If it has been possible to determine what the cause of the palpitations is, they are treated with medication, a change in lifestyle or psychological measures, depending on the indication. Against inflammation of the myocardium, the symptoms are treated with extensive care and medicinal treatment. The healing of the causal disease leads in such cases to the elimination of the palpitations as a symptom.

If thyroid problems are the cause of the palpitations, hormonal, drug therapy is usually initiated to regulate the overactive thyroid. Here, too, the palpitations can be expected to end as soon as the patient is well adjusted with medication. Usually less acutely hazardous to health, but sometimes more difficult to treat, palpitations are due to psychological causes.

An underlying depression or anxiety disorder needs to be treated just as causally as a physical illness. Although psychological palpitations are usually not as acutely dangerous as, for example, myocarditis, they can weaken the heart and worsen the general condition of the patient due to the additional stress they cause. There is also the risk of panic attacks, which can lead to hyperventilation and actual heart attacks.

Withdrawal treatment is a hybrid of psychological and physical treatment if the cause of the changed heartbeat is a drug addiction. Here the withdrawal symptoms are probably treated with medication, at the same time the psychological well-being of the person concerned and the support during his withdrawal play a major role.

Outlook & forecast

Palpitation should usually be treated by a doctor. The heart is one of the most important organs and must therefore not be treated with self-help means. It is not uncommon for palpitation to be just a subjective assessment. The patient judges their heartbeat to be abnormal or abnormal when suffering 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 treated early. If the palpitation arises due to the abuse of alcohol or other drugs, the symptom will subside after a few days when the drugs are stopped.

Palpitation can lead to panic attacks in many people as they feel like they are about to have a heart attack. This leads to increased anxiety, states of stress and a generally lower quality of life. People who suffer from phobias and depression are very prone to palpitation. In this case, treatment is provided by a psychologist, but it does not always lead to success.

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➔ Medicines to strengthen the heart and circulatory system

prevention

All measures that are good for the heart and the psychological state of the person can be considered preventive for palpitations. These include a healthy diet, drug and alcohol abstinence - alcohol consumption can be the cause of heart muscle inflammation - sufficient relief and recovery from stress and professional treatment of possible mental illnesses such as depression or anxiety disorders.

If you are predisposed to hypoglycaemia or an overactive thyroid, these should be well controlled and treated with an appropriate diet or, if necessary, medication. Since heart muscle inflammation can be the result of viral or bacterial infections that have not been cured, care should be taken to ensure adequate recovery even after apparently minor illnesses.

You can do that yourself

With palpitation there are only a few possibilities for self-help. Problems with the heart should always be treated by a doctor as they can indicate very serious illnesses. However, problems with the heart can be prevented. This primarily includes a healthy diet. The patient should avoid fatty foods. Avoiding alcohol and other drugs is just as important. If the palpitation occurs mainly after the consumption of drugs, these drugs must be stopped immediately.

If palpitation occurs in stressful situations, the stress factor must be reduced. Various sporting exercises or yoga, for example, help to relax. If the palpitation is a bacterial infection, a doctor must be consulted in any case.

Valerian is recommended for general calming of the body and the heart. This can be taken as tea or in the form of tablets and has a positive effect on palpitation. Older people in particular should not expose their bodies to excessive stress in order to protect the heart. If the palpitation occurs due to depression or anxiety disorders, a doctor should be consulted. In this case, no self-help is possible.