Heart palpitations - how dangerous is it?

definition

As Palpitations becomes a clearly noticeable heartbeat, of the not in time with the normal pulse is designated. This phenomenon is based on so-called extrasystoles, i.e. excitations of the ventriclewith additional contractions of the Heart muscles accompanied.

A palpitations that only occur now and then and last only a few heartbeats are not pathological and do not require treatment. Its appearance increases with age. If heart palpitations occur more often and for a long time (minutes to hours), the patient's heart must be examined carefully as this may be a sign of heart disease that needs to be investigated. If heart stumbling occurs with an existing heart disease, caution is also required and a doctor should be consulted.

The extrasystole

The Palpitations is an additional activity of the ventricle that not in the normal beat rhythm takes place, this is called extrasystole. If you want to understand why some people have extrasystoles, you first have to deal with the Function of the heart employ.

The heart insists two atria, the right and the left, which are upstream of their respective chambers. Not only that blood flows from the atrium towards the chamber, including the electrical conductionthat gives the heart the rhythm, takes place in the Sinus node their way in that direction. The sinus node is that Clock of the heart and lies in right atrium. From here a current flows to the AV node, which lies between atrium and ventricle and transmits the stimulus into the ventricle. The AV node serves as a safety barrier, so it no longer lets the excitations pass if they are too high in frequency. This ensures that the heart stays in a frequency range in which the blood adequately pumped can be. In the chamber, the excitement finally spreads through special Nerve fibers, the His bundle and Tawara thigh, to make the heart muscle cells contract.

Extrasystoles always occur when this conduction is disturbed. If the disorder is in the atrium, it is referred to as supraventricular extrasystoles, if it is in the chamber itself, it is referred to as ventricular extrasystoles.

• The supraventricular extrasystole
  Supraventricular extrasystoles can by excitation cells in the atria or in the AV node arise that have become disconnected from the normal conduction of excitation, they are called ectopic centers. Many people have such extrasystoles, which are often not noticed, but sometimes also cause symptoms of palpitations. They usually are harmless.
• The ventricular extrasystole
  Ventricular extrasystoles usually arise not with healthy heartsbut go with heart disease like that coronary artery disease (KHK). Mostly they start from damaged heart cells, which are more easily excitable due to the damage. These cells can induce ventricular excitations outside of the beat rhythm, which then manifest as ventricular extrasystole.

examination

If a patient presents with cardiac stumbling, the doctor first measures the Pulse and leads one Auscultation of the heart with the help of a stethoscope. The nature of the pulse can already be an indication of possible diseases such as Valve problems or cardiac arrhythmias provide.

When auscultation is particularly on Heart murmurs respected. If two well-defined short tones can be heard in a healthy heart, these can be in the case of diseases a pathological sound skip, this is longer and can be influenced by attributes such as hissing or the louder and quieter (crescendo, decrescendo) are characterized. The place on the chest where the sound is loudest can indicate to the doctor which heart valve falls ill is.

Read our page for more information Heart murmurs.

If a noise could be found in the heart rate, it is advisable to use one of the findings Ultrasound scan of the heart to specify. In addition to imaging the heart, this examination also enables one Statement about the current of the blood.
Another very important research to get to the bottom of heart palpitations is this EKG. The electrical stimulus conduction is measured on the chest wall. With this examination, statements can be made about the heart rhythm, the regular transmission of the electrical system of the heart and inadequate heart actions. In addition, it can be precisely determined how many extrasystoles occur in a certain time interval.
If the ECG on site is not meaningful because the heart palpitations did not occur at the time of measurement, it is advisable to have a 24-hour long-term ECG to record. The data provide better information about possible cardiac arrhythmias. In addition, the Blood pressure measured by the patient.

In addition, blood values ​​have to be determined, since electrolyte disturbances must be taken into account in the case of heart palpitations. The thyroid hormones can then also be measured in the laboratory in order to rule out a possible overactive thyroid (hyperthyroidism).

causes

The causes of a palpitations are diverse and must not straight from the heart originate, so can too hormonal disorders or Shifts in the electrolyte balance be the background of suffering. The heart stumble occurs in some patients after drinking coffee, cigarettes or alcohol on. Another factor that can cause palpitations is high blood pressure. Existing heart diseases such as valve disorders, coronary artery disease or other damage to the heart can also cause heart stumbling.
Some causes are detailed below.

1. Atrial fibrillation
   At the Atrial fibrillation become the heart muscle cells of the atria no longer regularly excited and contracted. A so-called circling excitation occurs and electrical signals are generated as a result Frequencies up to 600 / min sent towards the ventricles. Due to the AV node, these did not reach the chamber, as it only transmits significantly slower frequencies to protect the heart function. As a result will be only a few atrial excitations forwarded into the chambers, this leads to a arrhythmia, an irregular pulse that is also increased. This can cause the patient to experience palpitations, especially if the atrial fibrillation is intermittent and then suddenly the heart rate increases and becomes irregular.
2. Hypokalemia
   If hypokalemia occurs, so one too low concentration of potassium in the blood, heart palpitations may occur. The reason for this is the higher tendency to cardiac arrhythmias due to the shifted ion concentrationsbecause the heart muscle depends on a certain concentration ratio, especially of potassium and sodium, in order to function properly. In addition, the Hypokalemia the risk that drugs, which can potentially trigger heart stumbling, develop this side effect due to the already critical situation for the heart. Exemplary here are the Cardiac glycosides, i.e. digitalis.
   Hypokalemia may be severe Vomit or diarrhea as well as some kidney diseases caused by an increased loss of potassium or when taking diuretics such as furosemide.
3. Hyperthyroidism
   At a Hyperthyroidism there is an increased hormone production, which is why an increased thyroid hormone level can be measured in the blood. This Hormones have a stimulating effect on the body, so in addition to an increased basal metabolic rate, there is also a increased heart rate, because the heart becomes more sensitive to the pulse-increasing adrenaline and noradrenaline. In the course of this it can also lead to a heart palpitations.
   The most common cause of an overactive thyroid is Graves disease, an autoimmune disease, should also have an autonomy of thyroid should be considered as a common cause.
4. Chemotherapy drugs / other drugs
   Chemotherapy drugs used for Cancer treatment can be used in addition to cancer cells also damage the body's healthy cells, including the cells of the heart. This can result after one treatment that in addition to one Heart failure cardiac arrhythmias also occur, which are perceived as stumbling the heart.
   In addition, other drugs that are used far more often can also cause palpitations. This can be exemplary Antidepressants like amitriptyline or Beta blockers be. Paradoxically, drugs used to Treatment of irregular heartbeat can also cause palpitations. Especially in the case of an overdose, there is also a high risk with digitalis that cardiac arrhythmias and cardiac stumbling occur.
5. Psychological causes / panic attacks
   At strong fear or Panic attacks If the pulse increases suddenly, this can also lead to extrasystoles, which some patients can feel. Other psychological stresses can also trigger a palpable heart beat and should be taken into consideration when developing no organic cause and patients suffer from the symptoms.

treatment

Treatment depends on the cause and extent of the heart palpitations.

If heart stumbling has occurred in a person with healthy heart, there is usually no need for treatment as long as it is not accompanied by other symptoms that indicate a more severe heart disease and it does not exceed a certain frequency. If the patient perceives the symptoms as disturbing or even threatening, the stumbling heart can also be treated in this harmless form.
In the case of harmless heart stumbling in the healthy heart without a tangible organic cause, it is often helpful if the patient uses relaxation techniques such as autogenic training, as this can reduce internal tension as a possible trigger. Sufficient sleep and exercise as well as a healthy diet and the economical consumption of stimulants such as coffee, nicotine and alcohol are often an effective remedy for a harmless palpitations.
In the field of naturopathy, there are also some preparations that act on the heart and alleviate heart palpitations. If there is a palpitations due to inner restlessness or nervousness, it can also be helpful to resort to calming plant extracts such as hops, valerian or St. John's wort. For example, homeopathic remedies such as digitalis purpura, potassium carbonicum, aconitum and adonis vernalis are used. Herbal and homeopathic preparations, however, should only be used in people with otherwise healthy hearts.

In the case of a cause outside the heart, the respective underlying disease must of course be treated. If the palpitations occurred due to medication, these should be discontinued if possible and alternatives sought.

If the stumbling of the heart really takes the form of a cardiac arrhythmia that has its cause in the heart itself, then of course appropriate drugs that act directly on the heart must be given. Drugs from the group of antiarrhythmics are suitable here, which are supposed to ensure that the heart rhythm runs normally again.
Antiarrhythmics are divided into four groups; in principle, the active ingredients in the individual groups either act on ion channels or on the autonomic nervous system, which controls the heart rate and sensitivity to stimuli. Suitable active ingredients that act on ion channels are, for example, verapamil, which blocks calcium channels, or verapamil, which blocks sodium channels. The antiarrhythmics that act on the autonomic nervous system are primarily the beta blockers, which are also known from high blood pressure therapy. Beta blockers are also a possible option if the palpitations are due to high blood pressure or coronary artery disease. In this case, all drugs that are also used for high blood pressure therapy are suitable.

If the heart stumbles due to atrial fibrillation, it may be necessary to perform an electrical cardioversion if the drug antiarrhythmic therapy has not helped. Here, an attempt is made to bring the heart back into a healthy sinus rhythm by means of electric shocks.

In the event of an electrolyte disorder, the responsible cause must be eliminated after clarification and, if necessary, counteracted with infusions or tablets (e.g. potassium-magnesium tablets).

Conclusion

In most cases the palpitations are one harmless symptomwhich does not require treatment, so can more serious illnesses behind it are which ones have to be treated.
If a heart palpitations occurs in a healthy person, it should don't panic however it is advisable that one be Doctor examines the patientso that nothing serious is overlooked. If there is no organic disorder, it can often be helpful Reduce tension and stress and on one healthy eating and lifestyle to pay attention.

If there is an arrhythmia, this is usually the case well adjustable with medication. Often the palpitations can also be a symptom of a disease that does not have its origin in the heart, here it is important to contact the Thyroid and drug side effects to think.

It is important that there is an underlying disease that requires treatment not just herbal or homeopathic remedies is trusted, but this one conventional medicine is treated.

Potassium and palpitations

In our body there is a sensitive one Electrolyte balance.
Electrolytes are the individual, charged particles, such as Sodium, magnesium or potassium.
Deficiency or excess of electrolytes can affect the entire organism.

So you can with one Potassium deficiency (Hypokalemia) not infrequently cardiac Extrasystoles, better known as heart palpitations.

But how does a potassium deficiency come about? The most common causes are severe Gastrointestinal infections With Vomit and diarrhea, as well as the use of certain diuretics (Loop diuretics). But also the abuse of Laxatives, can lead to a loss of potassium.

One speaks of one Potassium deficiency if the concentration in the blood serum is below 3.6 mmol / l. Due to the lack of potassium, individual processes in the area of ​​arousal development and further training in the heart can now be disturbed. As a result, those affected experience heart palpitations!

Palpitations on inhalation

Many patients, especially children and adolescents, have irregularities in their breathing Heart rate.
During inhalation (inspiration) it increases as you exhale (Expiration) it sinks again. This process happens naturally (physiological) and has no disease value.
The doctor then speaks of a "respiratory sinus arrhythmia", short RSA. There are various explanations for the phenomenon, including a link between the nerve centers breathing and heart activity.

In most cases, RSA goes unnoticed and is not infrequently an incidental finding.

Sometimes, however, those affected can feel the changes as heart palpitations! Especially when the break between two heartbeats is prolonged, the symptom appears during inhalation.

Nevertheless, this form of heart palpitations is harmless and does not need therapy. Exercise can help.