DEAR DOCTOR K:
I often experience heart palpitations — almost every time I’m excited, angry or scared. Is this dangerous to my health?
The word “palpitations” is used differently by different people. To me, palpitations are simply an awareness of your heart beating. People aren’t usually aware of their heart beating. But when it beats unusually forcefully, irregularly or rapidly, you notice the heartbeat.
Most people feel their heart beating forcefully and rapidly during intensive exercise. But people who have never experienced heart palpitations at rest may not realize how frightening they can be. Certain conditions can make a person’s heart feel as if it is pounding, skipping or racing so fast that it will explode from their chest.
Palpitations during exercise occur because of a rush of adrenaline that courses through your body. This causes your heart to beat more forcefully and rapidly than usual. Adrenaline surges can also be generated by a strong emotion such as excitement, fear or anger. They can also come on after consuming a stimulant such as caffeine.
Another common source of palpitations is premature contraction of the atria, the heart’s upper chambers. Sometimes these chambers pump a fraction of a second earlier than they should. Then they rest an instant longer afterward to get back to their usual rhythm. This feels like a skipped beat. It is often followed by a forceful contraction as the ventricles clear out the extra blood they accumulated during the pause. These premature beats are almost always harmless.
The sensation of abnormal heartbeat can be a warning sign of a heart rhythm problem. Some of these heart rhythm problems are of no consequence. But others, unfortunately, can be very serious: They may lead to stroke, and even sudden death.
So, you should ask your doctor to check out your palpitations, particularly if they have become more frequent or severe in recent months. And if you’ve been having other symptoms, such as shortness of breath or chest pain, it’s even more important to get checked out.
Assuming the doctor does not find anything serious behind your palpitations, you should feel reassured. But if you’re still bothered by unexplained palpitations, some simple changes may reduce both their frequency and intensity.
Low blood sugar can trigger palpitations, so make a point of eating regularly. Drinking plenty of fluids and getting enough sleep may also help. Stress and anxiety are a source of palpitations in many people. If that is the case for you, breathing exercises, meditation or other relaxation techniques may do the trick. Nicotine can cause palpitations. So can alcohol and certain over-the-counter decongestant medications.
When self-care measures aren’t enough, certain drugs may help prevent palpitations. Beta blockers that quell the effects of adrenaline on the heart can successfully combat many types of fast heart rhythms. Some people may get relief with anti-anxiety medicines.
Heart palpitations will usually turn out to be nothing serious and easy to fix. But sometimes the cause of the palpitations can be a serious condition. Don’t try to guess whether it’s serious; let your doctor make that decision.