Internal Medicine

Causes of palpitations

The cause of a heart palpitations can be rooted in the heart itself, but also through other physical or emotional ailments. In most cases, however, the stumbling of the heart, as a single and rarely occurring event without any disease value, cannot be assigned to a specific cause.

If the cause is heart-related, arrhythmia can lead to a feeling of heart stumbling. Extrasystoles, i.e. additional heartbeats, can be perceived as such, as can ventricular tachycardia, a rapid sequence of extrasystoles originating in the ventricles, which, however, like their special form of "Torsade-de-Pointes“-Tachycardia are potentially life-threatening and must be investigated immediately.

Heart stumbling can also occur in the context of other heart diseases such as heart muscle inflammation (myocarditis).

Please also read: EKG for an inflammation of the heart muscle

In addition, blockages or pathological changes in the conduction system of the heart are a possible cause for the feeling of rhythm pauses. Ultimately, diseases of the heart valves or heart failure can also result in perceptible cardiac arrhythmias due to their disease mechanism.

Causes that cannot be looked for in the heart are, for example, medications, drugs and other poisons. Nicotine, caffeine and alcohol have the potential to provoke additional heartbeats, so-called extrasystoles. Quite a few other substances sometimes have an influence on cardiac activity, in the case of many drugs even without their desired target being the heart itself. Medicines that are used against cardiac arrhythmias also have the potential to induce them themselves.
Patients under or after chemotherapy can suffer from arrhythmias due to the harmful effects of their drugs on the heart. In addition, a number of hormonal disorders are able to influence the heart rhythm, such as the overactive thyroid, which is often associated with a racing heart.
Tumor diseases are rarely the cause of abnormal hormone production, which in addition to changes in the heart rhythm can cause other symptoms.

Ultimately, heart stumbling can occur under physical and psychological stress, which is then either provoked by the physiological workload or caused by the autonomic nervous system modulated by the psyche.

Read more on the topic: Palpitations - is it dangerous?

Heart stumbling through the thyroid gland

In the context of an overactive thyroid (Hyperthyrosis) So-called extrasystoles, i.e. extra intermittent beats of the heart, which are perceived as heart stumbling, can occur.

Since the thyroid hormone accelerates the heartbeat, too much of this hormone can disturb the heart's rhythm to such an extent that extrasystoles occur. These should no longer occur when the overactive thyroid is treated.

If the cause of the heart stumbling is the overactive thyroid, this is one of the so-called extracardiac causes, i.e. one of the causes that are not caused by a malfunction of the heart itself.
In addition to the stumbling of the heart, there can also be a very high pulse in general, also triggered by the thyroid hormones.
In addition to symptoms in the heart, an overactive thyroid can also manifest itself in unwanted weight loss.
In addition, in many cases there is an increase in blood pressure.
The influence of the thyroid hormones leads to an increase in the activity of the cardiovascular system in the event of an overactive condition. This can then also manifest itself in palpitations.

For more information, read on: Heart stumbling through the thyroid gland.

Palpitations from stomach

To understand how the stomach can influence the rhythm of the heart, one must first clarify the position of the heart and stomach in relation to one another.

The heart rests directly on the diaphragm, while the stomach rests directly below the diaphragm. In addition, the esophagus (Esophagus) through the diaphragm.

The organs can influence each other because of this close relationship. In the so-called Roemheld syndrome, increased gas formation in the stomach and intestines leads to an increase in pressure in the area of the abdomen.

This not only inflates the stomach but also pushes the diaphragm upwards. This of course also presses the heart, so that extra beats can occur here as well, which are perceived as stumbling the heart.

The excessive gas formation in the gastrointestinal tract is mainly caused by overeating. Food that is particularly bloating, such as cabbage vegetables, legumes, dried plums, fatty meat, camembert and beans in excess, can lead to excessive gas development.

This is also promoted by metabolic diseases such as lactose and fructose intolerance. Disturbance of the gallbladder function can also lead to overinflation.

In addition to heart stumbling, dizziness and angina pectoris can also occur in Roemheld syndrome. In very severe cases, a brief loss of consciousness can occur, which disappears by itself (syncope).

You can find detailed information on this topic at: Palpitations after eating

Heart stumbling through the spine

Pain in the spine can also indirectly lead to heart stumbling. Due to the close anatomical position of the heart and spine to each other, pain that is primarily localized in the spine can also lead to problems in the heart.

In rather rare cases, this is directly due to organic causes, but rather to the fact that many patients are very worried when symptoms occur near their heart. The psyche therefore plays a particularly important role in this area.

Since many people are aware of the symptoms of a heart attack, they are more likely to get nervous when they experience similar pain due to changes in the spine. It is therefore very understandable that those affected also experience a heart stumble, as the body reacts to a stressful situation by increasing the heart rate.

Read more on the topic: Palpitations and back (pain)

Palpitations from stress

For many people, stress has a wide variety of effects on health and an individual's sense of health.

In addition to the physiological adjustment mechanisms such as an increase in the Cortisone mirror and activation of the Sympathetic, psychogenic factors can also play an important role.

The increased activity of the sympathetic system in the cardiovascular system not only leads to increased blood pressure but also to an increase in the heart rate, which initially usually leads to a racing heart and later to a heart stumbling. As the stress subsides, the palpitations tend to subside too.

More information can be found here: Racing heart caused by stress

However, if those affected are exposed to very stressful situations for a long time, it can be helpful to see a cardiologist to rule out an organic cause.

Stumbling the heart is usually not dangerous, but if the heart rate is increased for a long period of time, this increases the risk for a Heart failure.

Heart stumbling through psyche

Many people who have an increased feeling of illness from stress project this stress onto their heart.
Since the heart attack is classified as a very life-threatening disease, many other diseases are also "postponed“.
For example, people who have a Bowel disease have, which is usually perceived as less threatening by the population, to heart stumbling due to a psychogenic displacement of the disease.

Even organically healthy people can experience heart stumbling under severe psychological stress. This psychological stress can have various causes.
For one, patients who are under a burnout suffer from palpitations.

But not only professional reasons can lead to this, but also private ones.
For example, relatives of patients with a heart attack often perceive their health differently after this event than before.
Heart palpitations can also occur here without an organic cause. Overall, patients suffering from psychogenic heart stumbling should contact their doctor, because heart stumbling without organic causes can also be treated, for example through behavioral therapy.

Palpitations during menopause

Many women also experience changes in heart rhythm during menopause. These are often noticeable as stumbling or racing heart and can be traced back to so-called extrasystoles. It is an additional heart action that occurs outside of the normal rhythm. Usually this is not dangerous and is based on a change in hormonal balance.

Read detailed information on the subject: Palpitations during menopause

Nevertheless, an internist or a cardiologist should clarify whether there is another, organic cause behind the heart palpitations. For this purpose, an electrocardiogram (EKG) is usually recorded and possibly an ultrasound of the heart, an echocardiography, is carried out

Palpitations during pregnancy

It is not uncommon for women to stumble during pregnancy. Additional cardiac contractions occur outside of the normal heart rhythm. During pregnancy, due to hormonal changes, heart rate and blood pressure change to ensure that the baby is adequately supplied. An increase in the heart rate promotes the development of so-called extrasystoles, i.e. additional heartbeats. This is usually harmless and should go away on its own after the pregnancy is ended.

Read more on the topic: Palpitations during pregnancy

Another cause of cardiac stumbling in pregnant women is a change in the electrolyte balance. This can be caused by vomiting, which is common in pregnant women. This leads to a relative lack of potassium, which can cause cardiac arrhythmias.

Read more on the topic: You can recognize a magnesium deficiency by these symptoms

In addition, the general emotional situation and the tiredness that often accompanies pregnancy contribute to the fact that the heart rhythm can be disrupted

Read more on the topic: Palpitations during pregnancy

Palpitations due to potassium

Potassium plays an important role in maintaining a regular heart rhythm. Together with magnesium, it is responsible for keeping the heart muscle cells at a certain level of excitation. If there is not enough potassium in the body, the heart muscle cells are more easily excitable and an additional heartbeat (extrasystole) can be triggered more quickly. A potassium deficiency can result from excessive vomiting or diarrhea, because the body then excretes more potassium. Kidney disease can also be associated with a potassium deficiency. Likewise, the use of urination medication (diuretics) can lead to an increased excretion of potassium and a resulting potassium deficiency.

Read more on the subject: Recognize potassium deficiency and These symptoms indicate a magnesium deficiency