Palpitations

Examination of palpitations by the use of a stethoscope Palpitations are excessively rapid and strong heartbeats that may be irregular in rhythm. They occur in everyone with exercise, anxiety, stress, pain or a fright, but usually settle quite quickly.

Heavy smoking, caffeine in cola drinks tea or coffee, excess alcohol, food sensitivities and some food preservatives and colourings may trigger palpitations.

Pregnant women generally have a faster heart rate and hormonal surges may trigger brief episodes of palpitations.

Bacterial and viral infections, or any other disease that causes a fever will cause an increased heart rate while the fever is present.

Paroxysmal atrial tachycardia (PAT) is a very common condition, particularly in women. For no apparent reason, but sometimes because of hormonal changes during the menstrual cycle and menopause, the heart will start beating rapidly, usually at double its normal rate. This harmless but distressing condition may last for a few seconds or several hours before settling spontaneously.

Other causes may include a heart attack (myocardial infarct), atrial fibrillation (due to heart damage) and ectopic beats.

Less common causes for palpitations include:

  • anaemia,
  • infections (endocarditis, myocarditis) or inflammation of the heart muscle,
  • an overactive thyroid gland (hyperthyroidism),
  • reflux oesophagitis,
  • phaeochromocytoma (black-celled tumour of the adrenal glands)
  • da Costa syndrome (a psychiatric disturbance).

Medications such as salbutamol (Ventolin – for asthma), glyceryl trinitrate (Anginine – for heart pain), terbutaline (Bricanyl – for asthma), aminophylline (for lung conditions) and imipramine (for depression) may have palpitations as a side effect.

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(Last modified: 17th Oct 2014)

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