Heart Palpitations for Months: Causes, Diagnosis, and Treatment

Introduction

Heart palpitations are the sensation of an abnormal heartbeat—fluttering, rapid beating, or irregular beats. While occasional palpitations are usually harmless, experiencing them for months could indicate an underlying health issue. Let's explore the potential causes, diagnosis, and treatment.

Possible Causes

Heart palpitations lasting for months may be caused by various factors, including:

1. Cardiac Causes:

   • Atrial fibrillation (AFib) or other arrhythmias
   • Structural heart disease (e.g., valve diseases, cardiomyopathy)
   • Postural orthostatic tachycardia syndrome (POTS)
   • Congenital heart conditions

2. Non-Cardiac Causes:

   • Anxiety, stress, or panic disorders
   • Hormonal changes (e.g., hyperthyroidism, menopause)
   • Stimulants (caffeine, nicotine, alcohol, illicit drugs)
   • Medications (e.g., asthma inhalers, decongestants, antidepressants)
   • Electrolyte imbalances (low potassium, magnesium, etc.)
   • Anemia or dehydration

Diagnosis

To determine the cause, a doctor will typically perform the following tests:

• Electrocardiogram (ECG/EKG) – Measures heart electrical activity
• Holter Monitor – 24-hour or longer monitoring of heart rhythms
• Echocardiogram – Ultrasound to assess heart structure and function
• Blood Tests – checks for anemia, thyroid dysfunction, and electrolyte imbalances
• Stress Test – Evaluates heart activity under physical exertion

When to Seek Urgent Medical Attention

Seek immediate medical help if you experience:

• Severe chest pain or discomfort
• Shortness of breath
• Dizziness, fainting
• Irregular or very fast heart rate (above 150 bpm at rest)

Treatment Options

The treatment depends on the underlying cause:

• Lifestyle Modifications: Reduce caffeine, alcohol, manage stress, and ensure hydration.
• Medication Management: Beta-blockers, calcium channel blockers, or anti-arrhythmic drugs as prescribed by a doctor.
• Procedures: If necessary, treatments like catheter ablation or pacemaker implantation might be required for arrhythmias.
• Managing Underlying Conditions: Treating thyroid disorders, anemia, or mental health conditions can help manage symptoms.

Conclusion

Persistent heart palpitations should not be ignored. Consulting a healthcare provider is crucial to identify and treat any serious underlying issues. Early diagnosis can prevent complications and improve quality of life.

Source recommendations

1. American Heart Association Guidelines on Arrhythmias

1. https://www.heart.org/en/health-topics/arrhythmia
2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
3. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
5. https://pubmed.ncbi.nlm.nih.gov/29084733/

2. European Society of Cardiology Guidelines on Atrial Fibrillation

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Atrial-Fibrillation
2. https://academic.oup.com/eurheartj/article/42/5/373/5899003
3. https://www.escardio.org/static-file/Escardio/Guidelines/Documents/ehaa612.pdf
4. https://academic.oup.com/eurheartj/article/45/36/3314/7738779
5. https://pubmed.ncbi.nlm.nih.gov/20802247/

3. European Society of Cardiology Guidelines on Ventricular Arrhythmias and Sudden Cardiac Death

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
4. https://pubmed.ncbi.nlm.nih.gov/36017572/
5. https://www.sciencedirect.com/science/article/pii/S2405500X22010945