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Heart palpitations

Heart palpitations

Views: 4 | Updated On: | By Dr. Rachana Jangir

The feeling that the heart is racing, hammering, fluttering, or missing beats is frequently uncomfortable but rarely an indication of cardiac disease.

Causes of palpitations-

The brain networks that are currently understood to be involved in the perception of the heartbeat are not fully understood. These channels may contain a variety of extracardiac and intracardiac structures, according to some theories. Palpitations are a common problem, especially in people with structural heart disease. The list of causes of palpitations is extensive, and sometimes it is impossible to pinpoint the cause. In one study that looked at the causes of palpitations, it was discovered that 43% had a cardiac cause, 31% had a mental cause, and about 10% had other causes, such as medication-induced, thyrotoxicosis, coffee, cocaine, anemia, amphetamine, and mastocytosis.

The cardiac etiologies of palpitations are the most life-threatening and include ventricular sources (premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation), atrial sources (atrial fibrillation, atrial flutter) high output states (anemia, AV fistula, Paget's disease or pregnancy), structural abnormalities (congenital heart disease cardiomegaly, aortic aneurysm, or acute left ventricular failure), and miscellaneous sources (postural orthostatic tachycardia syndrome POTS, Brugada syndrome, and sinus tachycardia).

Palpitations can occur during times of catecholamine excess, such as during exercise or at times of stress. The cause of the palpitations during these conditions is often sustained supraventricular tachycardia or ventricular tachyarrhythmia. Supraventricular tachycardias can also be induced at the termination of exercise when the withdrawal of catecholamines is coupled with a surge in the vagal tone. Palpitations secondary to catecholamine excess may also occur during emotionally startling experiences, especially in patients with a long QT syndrome.

Many psychiatric conditions can result in palpitations including depression, generalized anxiety disorder, panic attacks, and somatization. However, one study noted that up to 67% of patients diagnosed with a mental health condition had an underlying arrhythmia.

There are many metabolic conditions that can result in palpitations including, hyperthyroidism, hypoglycemia, hypocalcemia, hyperkalemia, hypokalemia, hypermagnesemia, hypomagnesemia, and pheochromocytoma.

The medications most likely to result in palpitations include; sympathomimetic agents, anticholinergic drugs, vasodilators, and withdrawal from beta blockers. Common etiologies also include excess caffeine or marijuana. Illicit drug use such as cocaine, amphetamines, 3-4 methylenedioxymethamphetamine (Ecstasy or MDMA) and can also cause palpitations.


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