Heart pounding

Synonyms

Angina pectoris, heartache, chest tightness

Is that dangerous?

Many patients use the term "palpitations" to describe a sudden, sharp pain in the chest area.
This pain can have many different causes, so there is no universal answer to how dangerous this heartbeat is.
If the heart attack occurs for the first time in the form of a sharp stabbing pain that may radiate into the shoulder, arm or neck, there is a justified suspicion of an acute heart disease, such as a heart attack.
Read more on the subject here Signs of a heart attack.

If the palpitations occur frequently with a low intensity and go away on their own, the situation is probably not an acute life-threatening situation. Fortunately, this is more often the case. However, the underlying cause should definitely be clarified by a heart specialist. Chronic heart diseases such as heart failure, coronary artery disease (CHD) or angina pectoris can trigger serious complications over time.

The most important risk factors in relation to the functionality of the heart (so-called cardiac risk factors) include:

• Diabetes mellitus
• Alcohol consumption
• Consumption of tobacco products
• lack of exercise
• Obesity
• high cholesterol diet

Due to the multitude of possible dysfunctions at the heart level, there can be a number of causes for the development of heart stinging. Starting from temporary overload conditions of the Heart muscles (Technical term: myocardium) trigger the heart pounding over the partial occlusion of small heart vessels (coronary arteries) Up to the complete failure of the organ's self-sufficiency, everything is possible in principle.

Causes and other symptoms

There can be a variety of causes for the occurrence of heart attack. For this reason, it is extremely important for the affected patient to pay attention to more precise details when having a heart stroke.

Patients who frequently suffer from heart attack should pay attention to when exactly these symptoms develop and whether there is a temporal connection to certain activities (e.g. eating or after or during exercise).

Furthermore, it is important to pay attention to whether the perceived pain (heart pounding) is limited to the chest or whether it radiates into other parts of the body. In this case, the radiation of pain to the left shoulder, left arm, neck or jaw is of particular importance. The duration of the heartbeat interval is also of decisive importance for the search for the cause. In addition, the affected patient should, if possible, pay attention to whether there are certain measures that can alleviate the aching heart or even make it disappear completely (for example, elevating the upper body or opening a window).

Read more on the topic: Pain in the region of the heart

The most common causes of heart attack include:

• Muscle tension
• Diaphragmatic tension
• Spine or joint problems
• Disorders of the esophagus (for example: reflux disease)
• Diseases of the stomach (for example: inflammation of the lining of the stomach)
• Diseases of the lungs (for example: pneumonia)
• Coronary heart disease (short: CHD)
• Heart attack
• Inflammation of the lining of the heart (endocarditis)
• Inflammation of the pericardium (pericarditis)
• Valvular heart disease
• Cardiac arrhythmias
• Heart failure (heart failure)
• Major artery aneurysm
  (Synonyms: aortic aneurysm, vascular sac of the main artery)

Stress as a cause of palpitations

The psyche as well as that Stress level can be the cause of the symptom "palpitations". People who are exposed to high demands in everyday life, stress and strain can experience such a symptom. It appears both in stressful situations and in phases of rest and may be a sign of congestion. However, a disease of the heart and blood vessels should be ruled out by a doctor.

Stress can be a too Triggers an attack of angina pectoris As part of the coronary artery disease be at which Heart pounding a Leading symptom represents. In coronary artery disease, constrictions in the coronary arteries limit the oxygen supply to the heart. Due to stress and strain, the heart has to do more work and needs more oxygen. However, as not enough oxygen can get to the heart due to the narrowing of the vessels, it does Undersupply of the heart muscle cells and the typical symptoms such as palpitations. Stress should therefore be avoided in any case.

Coronary artery disease and angina pectoris

The term "angina pectoris" is understood to mean the attack-like occurrence of pain in the area of ​​the chest (heart pounding). The cause of the heart pounding is a temporary circulatory disorder of the heart muscles, which in most cases arises from an existing coronary heart disease (short: CHD). In the course of coronary artery disease, the affected patients develop one or more constrictions in the area of ​​the coronary arteries and a concomitant throttling of the coronary blood supply. The heart muscle itself is not supplied with sufficient oxygen.

Angina pectoris is therefore not an independent disease but rather one of the most important symptoms of coronary artery disease. However, not every patient who suffers from narrowing of one or more coronary arteries develops heart attack.

In most cases, other factors cause the affected patient to have an acute attack. In most cases a series of heart attacks is preceded by a physical and / or psychological stressful situation. For patients suffering from coronary artery disease, in many cases even a low level of stress is sufficient to no longer be able to meet the oxygen demand of the heart muscle. The consequence is acute heart attack. The duration of a rather "harmless" heart attack (angina pectoris) is between a few seconds and a few minutes. Many of the affected patients also report the occurrence of heartburn, cramp-like pressure in the heart region and toothache-like symptoms.

In everyday clinical practice, a general distinction is made between stable angina pectoris (heart stinging) that occurs over a longer period of time with the same intensity and disappears completely within a few minutes without medical intervention, and unstable angina pectoris (heart stinging) that is different in type and Shows duration very variable.

Read more on this topic at: Heart pain, symptoms of a heart attack

Palpitations on inhalation

For "Heart pounding“, Which occurs mainly when inhaling, a number of different causes come into question.
First of all: Heart disease such as a heart attack or its precursor Coronary heart disease (CHD) are usually not included. Problems with the musculoskeletal Area. Here is especially the so-called Thoracic wall syndrome (partly also as Intercostal neuralgia It is worth mentioning that nerves or blood vessels are pinched between the ribs and the intercostal muscles.
Simple blockages in the ribs can also cause breathing problems.

Diseases of the respiratory organs are also possible causes. Inflammation of the lungs (pneumonia) and especially of the pleura and pleura (pleurisy) can cause very severe pain, which intensifies when you inhale. In the case of pleurisy, they arise when the pleura and pleura rub against each other.
Does it come to one in the course of the illness Pleural effusion, the symptoms can lessen or go away completely.

Read more detailed information on the topic: Palpitations on inhalation

After all, the cause of "heart pounding" when inhaled can still be in the gastrointestinal tract. On the one hand, harmless complaints after eating or due to an unfavorable position or pain as a result of heartburn are conceivable.
The pain caused by heartburn usually has a burning character, but it can also be stinging.

Palpitations and shortness of breath

Sharp pains in the chest area can be very uncomfortable. If symptoms such as shortness of breath or even shortness of breath are added to these, the fear of a heart attack quickly arises. The cause of the "Heart pounding“And shortness of breath are usually not to be found in the heart.

More likely, the cause of shortness of breath and sharp pain is in the area of ​​the Lungs. Both through inflammation of the lung tissue itself (pneumonia) or the pleura and pleura can cause such complaints. Both diseases would also urgently need treatment, so a medical clarification is always recommended.

However, psychosomatic reactions can also play a role in chest pain and dyspnoea. "Heart pounding" is quickly associated with the universally feared heart disease, such as a heart attack, and can thus trigger severe anxiety in those affected. As a result, other physical symptoms such as shortness of breath can occur. Chest pain itself can also be of a psychogenic nature and is then referred to as a heart neurosis.

However, if you are concerned about chest pain and shortness of breath, you should not be afraid to see your doctor for further clarification. Above all, this should also be done if the symptoms mentioned occur regularly, for a long time or with great intensity.

Heart attack and heart attack

Synonyms: Myocardial infarction, heart attack

Another clinical picture that leads to severe heart attack is the so-called myocardial infarction (colloquially: heart attack). This condition is an acute, life-threatening event that can be triggered by various underlying diseases of the heart. As a rule, during a myocardial infarction with severe heart pounding, there is a circulatory disorder (ischemia) of the heart muscle cells. As a result, those heart muscle cells that cannot be adequately supplied with oxygen die. In most cases, the direct cause of acute ischemia is the blockage of individual arteriosclerotically changed coronary vessels by blood clots.

The sudden onset of severe heart pounding is considered to be the leading symptom of myocardial infarction. This specific heart attack is usually a severe pain that lasts more than 20 minutes (so-called "Annihilation pain“) In the chest area. Typically, this heart pounding radiates to the left shoulder, left arm, neck and lower jaw. Many of the affected patients also report that the heart attack spreads to the upper abdomen. In addition, strong sweats appear during the heart attack, which are accompanied by nausea and vomiting. The affected patients experience a state of fear of death during myocardial infarction with heart pounding.

You can find more information under our topic: Heart attack
Alternatively, you might also be interested in this article: Troponin test

Heart failure / heart failure

Another disease that can lead to the occasional heart attack is the so-called Heart failure. With heart failure (synonym: Heart failure) is a disease in which the muscular hollow organ is no longer able to pump sufficient amounts of oxygen-enriched blood into the body's circulation. As a result, there is a significant lack of oxygen. To this day, the heart failure, which can occasionally lead to heart attack, is one of the most common causes of death in Germany. In medicine, a distinction is made between different forms of heart failure based on the affected heart sections (global heart failure, left heart failure, right heart failure).

The symptoms of this disease largely depend on the parts of the heart affected. Patients suffering from a weakness of the left heart suffer develop symptoms such as Palpitations, coughing and shortness of breath (dyspnoea). These symptoms are usually less pronounced at rest and only become clear below physical exertion. Particularly severe cases of left ventricular failure are not only expressed by the occurrence of heart stinging. Usually affected patients develop over time Water retention in the Alveoli (Pulmonary edema) and a resulting severe shortness of breath.

Right heart failure, on the other hand, is illustrated in most cases by Water retention around the ankles. The reason for this is the fact that, due to the restricted function of the right heart, not enough blood can be transported back to the organ. Other symptoms of right heart failure are Heart pounding, dry skin, inflammation and impaired wound healing.

You can find more information on this topic at: Heart failure / heart failure

Heart pounding at night

It can various causes for the occurrence of palpitations at night. Diseases of the heart how various cardiac arrhythmias can lead to palpitations, which can also show up at night. Means Long-term ECG, which also records the heart rhythm at night, and various other diagnostic tools, arrhythmias are detected and then treated.

Often stuck, however no damage or disease to the heart behind such symptoms. Stress and mental stress or mental suffering like Panic attacks or Anxiety disorders can also lead to palpitations, which can also show up at night. The exclusion of a heart disease corroborates this suspicion.

Some people also report from Tension or blockages in the spinethat caused the palpitations. Heart attack is often a very subjective symptomthat, for example, can also indicate muscular tension or irritation of nerves. After treatment with Massages and physical therapy the symptoms usually improve.

Palpitations while lying down

Heart pounding can also occur when lying down. Diseases of the heart like one coronary heart disease or Cardiac arrhythmias are possible causes for this. Also Muscular tension in the back muscles, vertebral blockages in the thoracic spine or tension in this area can also lead to heart pounding while lying down.

Sharp pain behind the breastbonethat occur specifically when lying down can also be an indication of a Reflux disease in which stomach acid enters the esophagus. Since heart pains are a very subjective feeling, those affected often cannot pinpoint where the pain or the stinging is coming from. It should therefore first Keep calm become. If a disease of the heart is ruled out, other causes such as those already mentioned are obvious. Also the Accompanying circumstances can provide clues to the cause.

Heartache during pregnancy

In the very rarest of cases, complaints such as palpitations or palpitations during pregnancy really come from the heart. Usually they are a sign of increased stress, stress or nervousnesst and put no cause for alarm An examination by the doctor can bring certainty and relief here. Also the Administration of magnesium can alleviate the symptoms. Mostly, however Sufficient rest and relaxationto get the heart pounding under control.

Of course, this can also be done with pregnant women Tension and blockages in the spine lead to a stitch of the heart. Especially in the late pregnancyWhen women do not move enough and the additional load on the spine increases, such complaints are preferred. Careful exercise, which is best done with guidance in a pregnancy class or physical therapy, and massages can alleviate the discomfort.

Heartache after sport

The fear of one Heart attack or its preliminary stage the Coronary artery disease (a narrowing of the heart vessels and a resulting inadequate supply of the heart muscle) is rightly very common in our society.
Fortunately, worries in this regard are usually unfounded in the case of cardiac stinging, as diseases of the heart usually express themselves in the form of a constricting pain with a dull, oppressive character.
It is not for nothing that the symptoms of coronary heart disease (CHD) as "Chest tightness“ (Angina pectoris) described.

The actual cause of heart attack after exercise can be complex and not immediately apparent. First of all, the presence of a so-called Thoracic wall syndromewhich involves pinching nerves or blood vessels between the ribs and the muscles that run between them. Breath-dependent pain in particular suggests this. Another possible cause can be Gastrointestinal complaints be. Also conceivable, albeit much less often, are lung diseases, especially in the form of inflammation (please refer: lung infection).

If the stinging in the chest area occurs repeatedly or with great intensity, if it lasts for a long time, or if it simply causes you concern, you should definitely have it checked out by your family doctor.

Palpitations in children

Whether through the media, acquaintances or relatives - everyone is confronted with the subject of heart attacks on a regular basis. The fear of heart attacks is accordingly widespread.
Many parents are therefore quickly concerned when their own child has "Heart pounding“Complains. As a rule, these worries can usually be dispelled quickly. For one thing, heart disease in children, unlike adults, is very unlikely.
On the other hand, diseases of the heart usually do not manifest themselves in the form of sharp pain. Rather, they present themselves as a dull, very tight feeling or pain.

Instead, what is more likely to be a stinging in the chest in children?
Physical complaints, especially in small children, are often very unspecific. Another problem is that children are not yet able to articulate their complaints as well as adults.
However, one likely cause of "heart attack" is Gastrointestinal complaints (see also: Abdominal pain in children), mostly harmless in nature.
Also heartburn can cause pain in the area behind the breastbone, which is then usually described as burning. Diseases of the respiratory tract can also be stinging. A note for a Inflammation of the lungs in the baby, Bronchi or windpipe is that the pain occurs depending on the breath.
Breath-dependent pain can also be caused by problems in the musculoskeletal system. Often are here Entrapment of nerves or blood vessels between the ribs and the intercostal muscles, which is then referred to as chest wall syndrome.

However, if you are concerned about the child's symptoms or if the palpitations occur regularly, with intense intensity or for a long time, you should not hesitate to seek medical advice in any case.

Diagnosis of heart attack

The most important point in diagnosing heart attack is one extensive doctor-patient discussion (short: anamnese). During this conversation the temporal course and possible triggers of the heart pounding. In addition, the attending physician should possible previous illnesses, medicines taken regularly or other abnormalities be disclosed. The doctor-patient interview is usually followed by an extensive one physical examination where not only that heartbut also the lung, of the Abdomen, the Neck veins and the legs are examined for any visible abnormalities. In addition, a patient who suffers from heart attack must be promptly EKG to be written.

If there is any indication of a certain illness that may be responsible for the occurrence of the heart attack, an targeted blood test. The first choice of imaging technique is to carry out one, even if there is a heart attack Ultrasound examination. Only then should further procedures such as Cardiac catheterization or Myocardial scintigraphy be initiated.

therapy

The therapy for a heart attack depends on the underlying disease. In the case of acute heart attack without a confirmed diagnosis, a Emergency treatment be initiated. For patients suffering from “harmless” angina pectoris due to a pre-existing coronary artery disease, physical rest is sufficient in many cases Give a nitro spray to make the heart pounding disappear completely.

In addition, the Elevation of the upper body of patients suffering from acute heart attack as a particularly suitable treatment measure. in case of an real myocardial infarction With heart pounding, sweating and fear of death, the therapy is completely different. The administration of the nitro spray does not usually provide any relief for the affected patients. For these patients, the first few minutes of the heart attack are of crucial importance, because within the first hour there is still a chance of clearing the blocked vessels with the help of a so-called Lysis therapy to open again.

For this reason, quick action is of the utmost importance for medical laypeople who observe a heart attack. First and foremost, one should promptly Emergency call be dropped off; be discontinued; be deducted; be dismissed (Emergency number: 112). The emergency medical therapy takes place via the administration of a Nitro sprayswho have favourited relief from palpitations Morphine preparations, the gift of anticoagulant ASA and Clopidogrel and the Submission of oxygen.

In the clinic it then applies to reopen closed coronary arteries and thus the To ensure oxygen supply to the heart muscle cells again. Possible methods are Balloon dilatation or the introduction of a so-called Stents. Patients who have suffered a myocardial infarction with a stinging of the heart are usually monitored by intensive care during the first few days. Following clinical monitoring and treatment, the majority of patients do lifelong drug therapy necessary. In this way, the renewed occlusion of a coronary artery and thus another myocardial infarction with heart pounding should be prevented. Among the most commonly prescribed drugs in this context are Beta blockers, ASS, Statins, ACE inhibitors and Clopidogrel. In addition, a rehab lasting several weeks and the conversion of certain habits must usually be connected.

forecast

The prognosis for a heart attack depends on the underlying disease. In the meantime, medical care has matured to such an extent that the prognosis for those patients who have suffered a myocardial infarction with a heart attack is quite good. However, this is a prerequisite for a relatively normal lifestyle after an illness that leads to heart attack strict adherence to medical instructions.