Have you ever felt the area around your chest fluttering/ thumping/ beating/pounding or even seems to skip beats. At times you may have felt it radiating to your neck, head, or perhaps even experiencing lightheadedness, difficulty to breath- forcing you to sit and rest for a moment. It’s an unpleasant awareness of the forceful, rapid, or irregular beating of the heart.
This is called the palpitation.
In the quest of finding for an answer from Mr. Google, you may choose to take it easy/lightly- since it’s only happening occasionally for a brief period of time- drawing to conclusion ‘’Ahh, maybe it’s anxiety or the coffee I had this morning.’’
Having to approach this issue; these are the few things that need to be considered in determining the cause of your palpitations.
First and foremost,
Firstly, identify- other accompanying symptoms along with palpitation, such as dizziness, sweating, loss of consciousness- blackouts, room spinning sensation, chest pain or difficulty breathing;
Also, duration-how long does it take-it may happen from just a few seconds to minutes.
Also, frequency- how many times does it occur in a few hours/day(s).
Red Flags May Lead to a “White Tag’’
If you’ve experienced a loss of consciousness/blackouts;
Known as red flags, you need to be rushed to the nearest Emergency Department. The likely causes could be deadly, due to electrical conduction “misfiring’’ in the heart- reversible if treated in time.
List May Go On
The causes of palpitation are as follows:
1. Emergency- electrical disturbance of the heart
Varies from ventricular/ atrial arrhythmias (irregular heartbeat)
2. Non-emergency
Chronic (long due) or intermittent electrical disturbance of the heart
3. Hyperthyroidism
Increased secretion from your thyroid glands often leaves you experiencing palpitations if left untreated medically or surgically. Other symptoms you may experience in this condition are hand tremors, loss of weight, neck swelling, anxiety, difficulty tolerating warm/ hot / heat. A thyroid function test is warranted.
4. Other conditions/ situations
Stress, anxiety, caffeine intake, panic attack, exercise, energy drink, nicotine, anemia, hormone changes such as in pregnancy, fever, medications, low blood sugar, holiday heart syndrome due to alcohol, cocaine/street drugs, medical drugs
Conditions like gastritis, diarrhea, muscle pain not uncommon to cause palpitation.
Dreadful Implications if Ignored-(Point 4)
Point number 4 shall not be taken lightly, especially in a condition like anxiety – ranging from mild-to-severe often, may lead to a panic attack- which may occur at an unpredictable time- example like when you’re driving. The probability of a crash is high.
Palpitation in pregnancy is extremely important; as it involves 2 lives. Issues like anemia (dilutional- due to natural physiological changes in pregnancy) and hyperthyroidism must be treated effectively and maintained at the optimum range for both mother and child’s well being.
You see, the above list can be exhaustive and difficult to determine the exact cause, having said that-subtle matters could be easily missed. This is why a doctor’s training takes years long before allowed to practice. Always leave matters as above to your attending doctor to evaluate. Do not take it with a pinch of salt. This is not the time to apply that-especially in regards to your health and well being.
Identifying the cause is important because treatments are available. Treating the cause does not only remove the palpitation but also prevents complications arising from those diseases-which may cost your life. Conditions like atrial fibrillation occurring in chronic periods of time may lead to stroke if not treated effectively.
Next Step of Action and Things to Expect
Some of the things that you can expect from your doctor; interviewing you with an array of questions followed by a thorough physical examination. Investigations are vital to figuring- ‘what is going’ on, to reach a diagnosis. To begin with, the first step which is available in any clinic/ hospital is a 12-lead electrocardiogram (ECG). Other tests may include Holter monitoring, ambulatory cardiac rhythm monitoring, echocardiogram, full blood count (FBC), and thyroid function test (TFT).
Get your FBC and TFT as the first basic step.
Scoring System to Aid Management
Doctors may commonly use scoring systems, apart from their clinical acumen to help determine management plan.
Such scoring systems; are the Canadian Syncope Risk Score, which predicts 30-day serious adverse events in patients presenting with syncope.
Another one is, EGSYS (Evaluation of Guidelines in SYncope Study) Score for Syncope– predicting the likelihood that if syncope is from a cardiac cause.
Let’s leave the above scoring for doctors’ use as it requires certain technical parameters.
Begin Now- Expose the Cause of Your Palpitation
You may start off with self-reflection, things which only you know- know better of yourself. Knowing yourself is important, as it allows you to recognise the issue within- making it easier to share with your attending Doctor. Approximately 75% of patients do not know or may deny the fact of an emotional strain.
Speak to us to further clarify-via a teleconsultation session (FREE) and we’ll help determine the next step of action. Start off with these;
Hamilton Anxiety Scale– Rates level of anxiety based on clinical questions.
GAD-7 (General Anxiety Disorder-7)– Measures the severity of anxiety.
Scoring system list and credits to their creators.
Canadian Syncope Risk Score by Dr. Venkatesh Thiruganasambandamoorthy
EGSYS by Dr. Attilio Del Rosso
Hamilton Anxiety Scale by Dr. Max Hamilton
GAD-7 by Dr. Robert L. Spitzer
