HEART PALPITATIONS CAN be alarming, a nuisance and can feel very unpleasant. But when should you start to worry?

Palpitations are often described as a fluttering feeling in the chest or a sensation of the heart racing or pounding. Sometimes you may feel skips and jumps, like missed or extra beats. This can last for anything from seconds to hours or even days.

Palpitations describe the feeling of your heartbeat or an awareness of a change in your heart rhythm. Most of the time we are completely unaware of our heart beating.

Palpitations are very common, and most people can experience them from time to time. In most cases they are harmless and not a sign of heart problems.

But accompanied by other symptoms, such as dizziness, fainting or tightness in your chest, they can sometimes be a sign of a heart problem and may need further investigation.

What causes palpitations?

Palpitations are a common occurrence and usually nothing to worry about, yet the cause is often unknown. Certain situations and lifestyle factors can trigger palpitations or cause them to occur more frequently.

Common triggers include:

• Strenuous exercise
• Surges of adrenaline, a hormone released in response to strong emotions like anxiety, excitement and stress
• Cigarette smoking due to the stimulating effect of nicotine
• Excessive consumption of tea or coffee due to the stimulating effect of caffeine
• Drinking excessive amounts of alcohol or eating rich, spicy foods
• Using recreational drugs
• Illness such as colds or flu and fever

Less common triggers:

• Hormone changes associated with menstruation, pregnancy or menopause
• Side effects from some types of medication e.g. some asthma inhaler medications that contain stimulants; some cold and cough remedies
• Palpitations can sometimes be associated with some medical conditions which can make the heart beat faster, stronger or irregularly. These include an overactive thyroid, a low blood sugar level, anaemia (a low blood count), and an abnormal heart rhythm (arrhythmia).

What do I need to do?
Palpitations that occur just occasionally and last a few seconds usually don’t need any investigation or treatment.

If you are concerned about your palpitations, it is sensible to go and see your GP, particularly if they happen on a frequent basis.

Unless your doctor finds that you have a heart condition, they rarely need treatment. Instead, your doctor may recommend ways for you to avoid the triggers that cause your palpitations.

If you have a history of heart disease, your palpitations become more frequent or they worsen, or they are accompanied by other symptoms, see your doctor. You may have a heart rhythm problem (arrhythmia), such as atrial fibrillation (a fib) or supraventricular tachycardia (SVT). Further tests may be needed to assess your heart rate and rhythm.

If your palpitations are caused by an arrhythmia, your treatment will focus on correcting the underlying condition.

A fib is one of the most common heart rhythm problems causing a fast, irregular pulse. It is generally not life threatening, but is a major cause of stroke and will usually require treatment.

SVT is an abnormally fast heart rate which is usually steady and regular. Episodes are usually harmless and often settle down on their own without treatment.

Tips to reduce common triggers

• Stay well hydrated when exercising
• Reduce stress and anxiety. Try relaxation techniques such as meditation, yoga, mindfulness
• Avoid stimulants like excess alcohol, nicotine and some cold and flu remedies
• Reduce caffeine drinks like tea, coffee and energy drinks
• Avoid recreational drugs

For more information on heart health, visit the Irish Heart Foundation’s website.

Patricia Hall is the Irish Heart Foundation’s Helpline Nurse Manager.

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