Palpitations: Symptoms, Causes, Treatment, Cost and Side Effects

Palpitations, also known as heart palpitations, is a sensation that is similar to the pounding or fluttering of the heart. During palpitations, the rhythm of the heartbeat fluctuates. Sometimes, a person may feel palpitations when he or she becomes overly conscious of his or her heartbeat.

The condition is usually harmless and mostly resolves on its own. It may occur as a result of excessive stress, exercise, high caffeine intake, etc. Sometimes, palpitations may also happen to owe to a medical condition such as arrhythmia.

It is generally not a serious or harmful condition and does not require treatment. If you seldom experience heart palpitations that last for a few seconds, there is nothing to be worried about. However, if you have a history of heart disease and are experiencing frequent palpitations, you should consult your doctor.

Palpitations have been classified into the following types:

1. Premature atrial contractions: This is a medical condition that leads to early heartbeats. Premature atrial contractions are generally harmless and don't require any kind of treatment.
2. Atrial fibrillation (AFib): The condition involves contraction of the upper chamber of the heart in an abnormal manner. Atrial fibrillation may make your heartbeat over 400 times in a span of 60 seconds.
3. Atrial flutter: The condition is similar to atrial fibrillation but the contractions are more uniform and regular. Atrial flutter usually affects people with an existing heart condition or those who have had heart surgery recently.
4. Paroxysmal supraventricular tachycardia (PSVT): PSVT is a type of arrhythmia that is similar to a normal but rapid heartbeat. The condition occurs when a short circuit rhythm develops in the heart's upper chamber. This short circuit rhythm leads to a rapid increase in a heartbeat that starts and ends abruptly.
5. Accessory pathway tachycardias: It is a condition in which a person develops a rapid heart rate owing to the presence of an extra pathway between the lower and upper chambers of the heart.
6. AV nodal reentrant tachycardia (AVNRT): AVNRT is a serious condition that results in heart palpitations, fainting, or even heart failure. It is caused by an extra pathway through the atrioventricular node of the heart.

There are certain symptoms that are associated with heart palpitations. Some of those are:

• Rapid heartbeat
• Fluttering
• Skipping heartbeat
• Pounding of the heart
• Flip-flopping

Also, you must see your doctor if your palpitations are becoming more frequent with time and are worsening. Chest discomfort or pain, fainting, severe shortness of breath and severe dizziness are some signs that should never be ignored. Seek immediate medical help.

There can be many. However, some of the most common causes of heart palpitations are:

• Strong emotions like fear, panic, stress or anxiety
• Vigorous physical activity
• Intake of stimulants like caffeine, alcohol and/or nicotine
• Drug abuse
• Medical conditions such as diabetes, hypotension, thyroid disease, fever etc
• Fever
• Hormonal changes
• Pregnancy
• Certain medications
• Herbal supplements

A healthcare practitioner will diagnose heart palpitations after a thorough physical exam. He or she may ask certain questions about your health condition, physical activity, existing prescriptions, caffeine intake, menstrual history etc.

Some of the tests that might be conducted to diagnose the condition include:

• Ultrasound of the heart: It is done to see the detailed images of your heart’s structure and function by doing an ultrasound of your chest
• Electrocardiogram: An ECG (electrocardiogram) will record the electrical impulses that make your heart beat. It will help your doctor in detecting the irregularities in your heart beat.
• Holter monitoring: It is done by wearing a portable device for 24 to 72 hours. It can detect palpitations that are not detected during ECG.
• Event recorder: It is an another that needs to be worn for a few weeks to record your heartbeats.
• Coronary angiography

Other than these test these are the few other tests performed for better diagnosis:

• Blood test
• ECG
• Urine test
• Stress test
• Chest X-ray

Treatment will be provided only if, after going through the test results, your doctor believes that you have a serious heart condition. In other mild cases, there is no need for treatment.

Yes, heart palpitations that are not caused by an underlying medical condition can be prevented. You can start with some of the following measures to reduce the risk of heart palpitations:

• Quitting smoke
• Following a balanced diet
• Keeping yourself hydrated
• Getting adequate rest and sleep
• Lowering stress
• Exercising regularly
• Reducing the intake of stimulants such as caffeine
• Limiting intake of alcohol

Palpitations are often caused by regular consumption of alcohol. Limiting alcohol can reduce heart palpitations caused by the beverage. Similarly, palpitations caused by anxiety can be stopped by practising mindfulness and meditation.

Heart palpitations should not last for more than a few seconds. But if they persist, accompany other symptoms such as dizziness, chest pain, fainting, shortness of breath, and a health condition, it is vital to get the treatment.

• Heart attack
• Heart disease
• Heart failure
• Cardiomyopathy
• Abnormal heart valve

There may be various causes for palpitations. The food-related cause is also a possibility in certain cases which can’t be ignored. Hence it is important to take care of what we eat and what time we eat. Some of the foods to be preferred to avoid palpitations are such as :-

• Low-sugar diet
• Low-carbohydrate diet
• Low-caffeine diet
• Less consumption of tyramine-rich foods which include cheese, soy sauce, red wine, and meats.
• Fresh fruits and vegetables
• Healthy fats such as olive oil, avocados, nuts, and fish.
• Proteins such as lean proteins, legumes, seeds etc.
• Consumption of low-salt containing foods

Diagnostic tests may cause temporary redness or itching in your skin due to the instruments that are attached. Do not worry; the effects wear off soon.

Heart palpitations are completely normal. It is usually caused by excitement or an adrenaline rush. These heart palpitations feel like your heart skipping a beat or beating faster than normal which makes you overly aware of your heartbeats, however, it should not last for more than a few seconds.

You should avoid consuming illegal drugs. Limit the amount of tobacco and alcohol intake. Make sure that your meals are filled with healthy foods like fruits, vegetables, pulses, meat, fish etc. Avoid heavy work out sessions. Exercise according to your age and as per the instructions of your doctor.

Palpitations need not be treated usually unless there is an involvement of any systemic medical abnormality or any occurrence of serious symptoms related to it. Some of the conditions which evoke the need for the treatment are such as :-

• The duration of palpitations go on increasing without any improvement
• The individual is presenting a history related to heart disorders.
• Shortness of breath which is getting severe
• tightness as well as pain in the chest
• Dizziness, nausea, or light-headedness
• Unconsciousness or fainting
• Heat conditions such as arrhythmia.
• Intake of certain medications such as antidepressants, antihistamines, antibiotics, antifungal medicines etc.

The time period of recovery depends on the kind and severity of the condition you are diagnosed with. Normal palpitations go away with time.

One session of consultation with your doctor may cost around ₹400 - ₹800. The cost of ECG is between ₹300 and₹1100. Echocardiogram may cost ₹1200 - ₹1900. Holter testing costs ₹3500 - ₹6000.

You can get rid of heart palpitation by following simple home remedies. These remedies include:

• Simple relaxation techniques like Yoga and Meditation
• Drinking plenty of water
• Maintaining balance of electrolytes in the body
• Avoiding or reducing the intake of stimulants like caffeine, alcohol, nicotine etc.

The validity of results depend on the kind and severity of condition you are diagnosed with.

You can try to control the palpitations by reducing stress or anxiety. Meditation, yoga and deep breathing help in doing so. Illegal drugs like cocaine and amphetamines are known to bring on heart palpitations. Stay away from them. Excess caffeine, nicotine and energy drinks also contribute in bring on palpitations. Limit your consumption.

Summary: Palpitations are nothing but sudden, unusual, and irregular beating of the heart that can be felt and are noticeable. The condition may resolve itself in most cases without undergoing treatment. In case palpitations stay longer or become problematic, or the person presents a history related to heart disorders, they should be taken as a serious concern and need to consult with a doctor. Some modifications to diet and lifestyle can play a key role in its management.