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Heart Palpitations 101

Have you been suffering chest pain and need to learn more about heart palpitations? Contrary to the songs, your heart skipping a beat is not always a good thing. Dr. Cynthia Thaik is an LA-based cardiologist who offers a holistic perspective on heart disease, the leading cause of death among US residents. If your feel like your heart is sputtering or racing strangely, 

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Heart Palpitations— Causes, Diagnoses, and Treatments

Palpitation is a broad medical term, which can apply to many occurrences. The general public broadly understands that a skipped or irregular heartbeat is a palpitation. What is less commonly known is that the same term can be applied to any abnormal heart activity. One example could be a heartbeat that thumps in your chest, or a heart that beats too quickly for your level of exertion. Anything that brings your heart rate to your attention is a type of palpitation. In some circumstances, you may even feel a strong pulse beyond your chest, in your neck or throat. These also qualify as palpitations.

The good news is that most palpitations are not caused by heart issues. Palpitations can be triggered by things like:

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As bodies age, muscles lose the strength they had in their youth. The strain exercise can put on your heart, while typically a net benefit for your body, can cause heart palpitations.

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It has been observed that there is a link between regular alcohol consumption and greater risk of heart palpitations.

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Nicotine withdrawal

Unfortunately, while nicotine is harmful to the heart and general health, one of the symptoms of nicotine withdrawal is also palpitations.

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Not commonly considered, but no less a contributor, are inflammatory illnesses such as arthritis, gingivitis, autoimmune conditions, and even metabolic conditions associated with inflammation, such as diabetes. An unhealthy gut may cause gut dysbiosis or a condition called ‘leaky gut’. When bacteria remnants invade the blood system, heart palpitations can ensue.

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Low Blood Sugar

Insufficient blood sugar can cause heart palpitations, even in those without diabetes.

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Stress or Anxiety

Both excess stress and anxiety episodes can trigger palpitations. Anxiety is actually the most common cause of palpitations. Both of these circumstances activate the body’s autonomic nervous system (ANS). This means your body goes into ‘fight, flight, freeze, or fawn’ mode, a heightened state of physical awareness where muscles and senses go into overdrive. This obviously includes the heart, and it is common for hearts to race out of proportion with the threat or stressor the individual faces. 

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Hormonal Changes

Women undergoing substantial hormonal changes (such as pregnancy, menopause, or menstruation) may experience palpitations. In particular, hot flashes are especially known to cause heart palpitations.

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Caffeine (and other stimulants)

While this isn’t universal, caffeine is known to cause palpitations in people sensitive to it. It is recommended that those with caffeine sensitivities (or sensitivities to other stimulants) limit their consumption to prevent cardiovascular complications.

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Thyroid Condition

While palpitations are commonly associated with hyperthyroidism, it can also crop up in cases of hypothyroidism, either through anxiety or because of thyroid hormone replacement treatment.

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Both the COVID infection and vaccine side effects can increase heart rate. Exposure to the virus itself sometimes leads to the development of autonomic dysfunction. This in turn can cause orthostatic hypotension, and postural tachycardia. Any inappropriate regulation of the autonomic nervous system (sympathetic or parasympathetic) can be referred to as dysautonomia.

Primary care physicians will do their best to correctly diagnose the cause of heart palpitations when they are informed about them. However, because there are so many potential causes, it’s important to get a full picture of the patient’s condition. A thorough physical exam is required, as well as extensive questioning about other medical conditions, sleep patterns, stress levels, use of caffeine, other stimulants, alcohol, prescription medication, supplements, and OTC medication. We may also ask about a patient’s menstrual history, if applicable.

When to See a Cardiologist for Heart Palpitations

In the event of there being serious cause for concern of a heart condition (for example, if your palpitations are making you light-headed or even pass out), your doctor can refer you to a cardiologist to undergo tests. Apart from blood and urine tests, it may also be necessary to undergo an ECG, chest X-ray or heart ultrasound. Another possibility is using a machine called a Holter monitor, which records the heart’s rhythm for 24-48 hours, or a 7 day prolonged monitor. In rare instances, we may use an implanted longer term monitoring device. 

If the palpitations are the extent of the problem, there is usually not much that a typical doctor will be able to do for you besides indicate lifestyle changes that can make a difference. Reducing stress, hydrating regularly, cutting down on caffeine, nicotine, or alcohol, getting regular exercise and eating a healthy diet can all help, but may be difficult to implement without making significant lifestyle changes. There is a possibility that one of your medications is causing heart palpitations. In that case, you and your doctor should work together on finding an alternative to your current medication.

Frequently Asked Questions about Palpitations

Understandably there are many questions that people ask when experiencing heart problems such as palpitations. We want to assuage people’s concerns where possible.

Regular palpitations can be a sign of atrial fibrillation. While this condition can continue for years without harm, a consistent increase in heart rate can cause heart enlargement. This is a hazard which can result in heart failure. Atrial fibrillation also comes with an increased risk of stroke from blood clots that can form as a result.

Without a solid understanding of the causes, it can be hard to definitively put a stop to heart palpitations. However, the treatments mentioned above: reducing stress and intake of stimulants, alcohol, and nicotine, exercising more, and eating a balanced diet, are all good steps forward. If your cardiologist determines that you have a more serious heart condition that may be life-threatening, it will require treatment. There are heart medications which can prevent more serious heart rhythm disorders. However, because of their significant side effects, they are not prescribed lightly. Consequences of misuse can lead to heart attacks, or even sudden death.

Some people experience heart palpitations after eating. While those palpitations may be attributable to an underlying medical condition, it is also possible that the food or beverage that was just consumed is responsible. Sugar can have this effect, particularly on hypoglycemic people. Alcohol is another common influence, particularly among those who have paroxysmal atrial fibrillation (PAF). Foods rich in tyramine or theobromine, such as cheese, red wine, bananas, and especially chocolate (which has both), can increase heart rate and may cause atrial fibrillation.

Actually, no. A more likely cause of heart palpitations is in fact low blood pressure. It is true that medication for high blood pressure can have a side effect of causing palpitations, which may be what is happening when someone with high blood pressure experiences palpitations.

When to Worry About Heart Palpitations

Palpitations are common. However, if you experience them for more than a few seconds at a time, or at regular intervals (such as mealtimes or several times a day) it is likely that something is wrong. You should call your doctor to come in for a talk about your health. In the meantime, you can monitor your palpitations: how long do they last for? When are they happening? Data of this kind will be useful for your doctor to evaluate in diagnosing your condition or making a referral.

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Why Choose the Holistic Healing Heart Center If You Suffer From Heart Palpitations?

The Holistic Healing Heart Center offers wellness services, for a structured path towards a healthier lifestyle that will provide patients with a lifestyle more resilient to cardiovascular concerns such as palpitations. Our award-winning cardiac care with a concierge touch is highly-regarded throughout the Los Angeles area and beyond. To find out more about how Dr. Cynthia Thaik and her team of healthcare professionals can improve your cardiovascular health, please contact us via our website.

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