What Causes Palpitations?

Introduction

Palpitations are a sensation of a rapid, fluttering, or pounding heartbeat. They can be alarming but are often benign. Let's analyze the possible causes systematically.

1. Cardiac Causes

Palpitations may originate from the heart itself. Some cardiac-related causes include:
- Arrhythmias : These are abnormal heart rhythms such as atrial fibrillation, supraventricular tachycardia (SVT), or ventricular ectopy.
- Structural Heart Disease : Conditions like dilated cardiomyopathy and valve disorders (like mitral valve prolapse) can also lead to palpitations.
- Coronary Artery Disease (CAD) : Reduced blood supply may irritate the heart's electrical system, causing palpitations.

2. Non-Cardiac Causes

Many cases of palpitations arise from external or systemic factors, such as:
- Stress and Anxiety : Emotional distress can both increase heart rate and make a person more aware of their heartbeat.
- Caffeine and Stimulants : Coffee, tea, energy drinks, nicotine, and recreational drugs (such as cocaine or amphetamines) can trigger palpitations.
- Hormonal Changes : Pregnancy, menopause, and thyroid disorders (especially hyperthyroidism) can cause palpitations.
- Electrolyte Imbalances : Low potassium or magnesium levels can affect the heart's electrical activity.
- Medications : Decongestants, asthma medications, and certain antidepressants may cause palpitations.

3. When to See a Doctor?

Most palpitations are harmless, but medical evaluation is necessary if:
- They are accompanied by chest pain, dizziness, shortness of breath, or fainting .
- They last for an extended period or occur frequently.
- There is a history of heart disease.

A doctor may perform tests like an ECG, Holter monitoring, or echocardiogram to determine the cause.

4. Prevention and Management

• Lifestyle modifications : Reduce caffeine, manage stress, and get adequate hydration.
• Medical intervention : Depending on the cause, treatment may include medications such as beta-blockers or interventions like catheter ablation (for arrhythmias).

Understanding the triggers of palpitations helps in managing and preventing them effectively. If you experience frequent or concerning symptoms, consult a healthcare provider.

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 Palpitations

1. https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-13/Paroxysmal-tachycardias-How-to-address-the-clinical-presentation-of-a-patient-w
2. https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84
3. https://academic.oup.com/eurheartj/article/41/5/655/5556821
4. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
5. https://academic.oup.com/europace/article/13/7/920/447426