Palpitations: what they are and how to tell if they’re serious

Heart palpitations are more common than we think, and often occur without warning. You may feel your heart pounding or your heart rhythm change suddenly, causing discomfort or anxiety. But what do these sensations really mean? In this article, we’ll explore the causes, symptoms and when to get help, for you to better understand what your body is trying to tell you and the best way to take care of it. 

What are palpitations? 

Heart palpitations are uncomfortable sensations like your heart is beating too fast or irregularly, and these can be felt in the chest, neck or throat. Most of the time, they’re not serious and may be caused by factors such as stress, anxiety, too much caffeine intake or intense physical activity.
However, in some cases, palpitations can be related to arrythmias  or other heart conditions. Therefore, if the palpitations are frequent or accompanied by symptoms like chest pain, shortness of breath or dizziness, it’s crucial to seek urgent medical help. 

What do palpitations feel like? 

Palpitations feel different from person to person, but the most common sensations include:

Racing heartbeat

Your heart may feel like it’s beating faster than usual, which can be uncomfortable or even alarming when this happens unexpectedly.

Irregular  heartbeat

Your heart rhythm may change unpredictably, making your heart seem to occasionally "flutter" or "skip" a beat.

Pounding pulse

Some people feel their heartbeat so strongly that it is felt in their chest, neck or even throat. This sensation can be alarming, but is usually temporary.

Dizziness or vertigo 

When palpitations are stronger, you may feel a slight loss of balance or like your body can’t keep up with your heart’s rhythm, making you feel dizzy or faint.

Shortness of breath

In more intense cases, palpitations may be accompanied by difficulty breathing, which can make the experience even more uncomfortable and alarming. Although palpitations are often harmless, especially when they occur sporadically, it’s important to be vigilant. If the symptoms are recurrent or accompanied by chest pain, excessive sweating or lightheadedness, it’s crucial to seek urgent medical help. The body is sending signals and it’s essential to listen to them to guarantee good health and wellbeing

How are palpitations diagnosed? 

Diagnosing palpitations begins with a thoughtful conversation between the patient and cardiologist. The aim is to understand the frequency, intensity and moments when the palpitations occur, as well as possible factors that trigger them.
Next, the physician will perform a physical examination, listening to the heart to identify irregular heartbeats or other warning signs.
After this, complementary tests may be prescribed, such as an electrocardiogram (ECG), which registers the heart’s electrical activity, a Holter electrocardiogram, a device that records heartbeats over a longer period (24 or 48h), or an event monitor to identify patterns and possible irregularities. If necessary, an echocardiogram (cardiac ultrasound) provides a more detailed view of the heart’s structure and function.
Blood tests may also be prescribed to assess hormone or electrolyte levels that can interfere with the heart’s rhythm. And if the palpitations are associated with physical exertion, an exercise stress test may be recommended to observe the heart’s behaviour while the patient exercises.
Using all of this data, the physician can ascertain if the palpitations are temporary and innocent, or if they are related to something that requires further attention.

How are palpitations treated? 

The treatment for palpitations depends on the cause identified during the diagnosis. When they are not associated with serious heart conditions, treatment can be simple and focused on relieving the symptoms.

Lifestyle changes

If the palpitations are caused by stress, anxiety or lifestyle habits like excessive caffeine or alcohol consumption, the physician may recommend adjusting those factors. Relaxation techniques, such as meditation, yoga or deep breathing, can also help control palpitations.

Medication

When palpitations are associated with heart arrythmias or hormonal problems, the physician may prescribe specific medication. For example:
• Betablockers can be used to control the heart rhythm.
• Other anti-arrythmic drugs can also help normalise the heart rhythm.
• Sedatives or anti-anxiety drugs may be indicated to reduce anxiety, if this is a contributing factor.

Treatment of underlying conditions

If the palpitations are caused by conditions like hyperthyroidism or electrolyte disorders, treatment will focus on controlling these conditions with medication or dietary adjustments.

Medical  procedures

In serious cases, when there are arrythmias or other heart problems, other procedures may be necessary, such as:
• Electric cardioversion: A controlled shock to restore a normal heart rhythm.
• Cardiac ablation: A procedure to eliminate small areas of the heart that are causing irregular heartbeats.
• Pacemaker implantation: If the problem is a very slow rhythm, a pacemaker may be recommended to regulate the heartbeats.

How to prevent palpitations? 

Preventing palpitations often starts with taking better care of your body and mind. This means maintaining a balance between healthy habits and paying attention to your body’s signals. Here are some tips to help prevent palpitations from becoming a recurring problem:

Stress and anxiety  management

Stress is one of the most common causes of palpitations. Find ways to relax, such as meditation, yoga or even deep breathing techniques. Taking care of your mind also takes care of your heart.

Healthy diet

Avoid excessive intake of caffeine, alcohol or heavily processed foods, to help maintain a balanced heart rhythm. A healthy diet rich in fruit, vegetables and wholefoods also helps maintain the body and heart’s overall wellbeing. Avoiding carbonated drinks may also be advisable.

Regular exercise

Moderate exercise, like walking, swimming or cycling, strengthens the heart and improves circulation, which may help prevent palpitations. 

Sleep well

A good night’s sleep is essential for the body to regenerate. Proper rest helps balance the central nervous system and reduce the likelihood of symptoms of palpitations caused by fatigue or stress.

Avoid stimulating substances

In addition to caffeine, substances like some medication or recreational drugs can also trigger heart palpitations. Pay attention to your intake and talk to a physician about any substances that may interfere with your heart rhythm.

Regular check-ups

Regular check-ups can aid the early detection of any changes that may be affecting heart rhythm, such as thyroid or electrolyte disorders.

Joaquim Chaves Saúde, protecting your heart 

If you have been feeling palpitations or any other related symptom, don’t wait to get help. At Joaquim Chaves Saúde, you can count on personalised assistance, an accurate diagnosis and effective treatment, to guarantee your wellbeing and a healthy heart. Schedule your consultation today and give your heart the care it deserves.

Sources

• https://www.afibmatters.org/pt-pt/o-que-preciso-saber/o-que-posso-sentir-se-estiver-com-fibrilhacao-auricular/palpitacoes/  
• https://www.euromedice.pt/pageflips/conselhos_maijun19.pdf  
• https://www.cardio365.pt/saber/palpitacoes-quando-sao-sinal-de-problema/  
• https://www.heartfailurematters.org/pt-pt/sinais-de-aviso/palpitacoes/  
• https://www.nhs.uk/conditions/heart-palpitations/  
• https://www.bhf.org.uk/informationsupport/conditions/palpitations  
• https://www.webmd.com/heart-disease/what-causes-heart-palpitations