Palpitations are a really common symptom that I see in my clinic and the majority of palpitations are not serious, the big worry, when people experienced palpitation, is whether they may have a heart rhythm disturbance even if they have a heart rhythm disturbance most heart rhythm disturbances are not serious.
So that’s a little bit of reassurance the first thing I’d like to talk about is what is a palpitation I suppose the palpitation is an awareness of one’s heartbeat to the extent that it feels abnormal.
So the heart could be beating normally but is sensed abnormally now there are many normal causes of palpitations so for example if you were walking down a dark alley in someone jumps out that would cause palpitation that would cause the heart to beat very fast and that would be spelt as a palpitation the bet doesn’t signify a problem with the heart itself.
The heart is just doing what it’s meant to do it’s beating closed in response to the adrenaline that circulates around the body similarly anxiety stress can cause publication people who drink a lot of caffeine alcohol can cause palpitation exercise can obviously so these are the kind of sort of normal things that can cause palpitations.
We don’t see anything to be worried about then there are various heart rhythms that can various abnormal heart rhythms and one of the first thing to try and work out whether the publication is just because of something else or whether it’s an intrinsic part of the problem and there are a few things that very few clues that you can get if your publication of mainly occurring.
When you also lying in bed you know her lying down after a busy day in the early morning when you’re still in bed than that signifies that it’s unlikely to be a heart rhythm disturbances don’t look at the time of day they can occur at any time when you’re getting the maddest certain time every day then you know this could be reflective of stress that you may or may not be aware of a lot of people who are going through a breakup or something like that will experience the opposition and they’re locked and come to me and say well.
You know I don’t notice it at all during the daytime but when I come back home and I lie in bed then I notice issues sometimes I wake up in the early hours and I tell them that you know I think this is less likely to be a hundred that disturbs the second thing to watch out for is the onset you know if your heart rhythm of publications are gradual onset and that’s less likely to be a heart rhythm disturbance heart rhythm disturbances just like that and they’ve been very sudden onset and they’re generally very sudden offsets that.
When they go away just within a few seconds a second whereas people who have another cause such as stress or anxiety than the offset is much slower there are other things to be aware of the rich that the heart is beating out is important because usually you know if the heart is beating a hundred and sixty beats per minute then that’s more likely to be a heart rhythm disturbance but not always and irregularities really important so worried about your publications always work working out whether the heart rhythm is regularly it’s a regular rhythm.
It’s generally less likely to be a hard rhythm disturbance although there is there are a few episodes that can be regular they tend to be very fast onset and sudden lots that what else I think it’s important things now it does in association with chest discomfort or if there’s an association with blackouts or something else then that’s obviously serious and it’s important to get that checked out I want to just check out a few beats of different competition just so you know.
So let’s check them out became the first one is the normal heartbeat again you will notice that it’s nice and slow and nice and regular ok now the second one is something called atrial fibrillation.
Which is when the top two chambers of the heart the atria stopped working that’s an abnormal heart rhythm it’s not a dangerous heart rhythm it’s an intermediate that does carry with it a small risk of causing strokes but it is always worth getting checked out if you’re experiencing something like this and then you can see that that that was normal and then suddenly became phones and became irregular and then went off that’s typically relation ok.
Here’s another one and this is called Escherichia supraventricular tachycardia and this is a more common heart rhythm disturbance and younger people’s all those can occur in older people as well but generally some people can habit from a very young age again it’s not a serious problem it’s an inconvenient problem it’s worth checking out because it can now be cured very few things in medicine that we actually but this is one of them say it’s well worth checking out who will work getting checked out.
If you experience the day so normal hundred themselves and then suddenly out says here again now on this occasion you can notice that it was sudden it was very fast and then the office it was a lot of people will actually find that’s you know pressing on your eyeballs are holding your nose and then blowing out pressing on your neck back and get rid of these symptoms.
There are typical vagal manoeuvres that people use them they don’t even realize they’re actually doing something so often I see people in a way so that the whole market an sdt the most common type of altercation I experienced my neck.
When I see patients is this so people will say they get this see what happens here is that will people are experiencing is normal and then something missus and then a big thought and that again that’s typically extra beats and then usually not dangerous and most people will find the most noticeable at rest and not when they’re doing things that actually.
If you’re getting this in the middle of the night and you’re worried about it if you go for a brick wall you’ll find that gets rid of it all together these everyone gets extra beat some people just noticed them a little bit more than others so those are the main types of heart rhythm.
Just now if you getting harsher them disturbance what should you do well if you’re getting something that is making you feel very very uncomfortable then it’s always worth just calling an ambulance going to the hospital otherwise most of the times you could wait till the next day and go and see your GPU GPS should take a history and then ideally organized because the answer is to capture the heart rhythm disturbance.
When you’re getting your symptoms on an ECG if the heart rhythm is normal of the CG then that’s that answers that question disturbance and there are various bonuses that are available 24 hours under seven days there are others that you can keep on for four to six weeks ended really depends on how frequent symptoms are and where they used to do the frequent enough of the monitor’s marks sometimes the easiest thing is just to come to casualty happen ECG there and then answer your questions.
If your GP’s concerned he’ll probably want to send you to a cardiologist like me what should I do well I always start off St just trying to work out from the history as to what the symptoms they represent could represent I don’t listen to the horses and then I organized the baseline ECG is normal then that’s encouraging there’s always again really good to try and trap those publications on an ECG monitor.
So I normally give my patients an ECG monitor to wear for one day or sometimes a week I also think it’s really useful to scan the heart because if you scan the card and you find that the heart just dropped room or Linux comp well and it’s not disease did anyway then that’s generally a very good sign and no matter what the publications of the prognosis are very good most publications are eminently treatable now and should be really no cause for concern or you know last night’s.
Some of them easily controlled with tap dance until Jen need any medication whatsoever and some of them are actually a meaningful legacy cheese that’s about it really.