♦ Avoid stimulants like caffeine (found in tea, coffee, cola, energy drinks)
♦ Some cold or asthma medications can cause palpitations. Ask your doctor for alternatives
♦ Some herbal medications with ephedrine or thyroid hormones in the impure plant form cause palpitations
♦ There has to be lifelong control of diabetes, hypertension and thyroid disease
♦ It is essential to stop smoking. Even second hand smoke can be detrimental
♦ To reduce stress, walk an hour a day, meditate, do yoga and Tai Chi, and listen to music
We are usually not aware of the functioning of our heart, as it silently and efficiently pumps blood twenty-four hours a day seven days a week. The rate at which it beats can be measured at either wrist or automatically read off one of the popular wearable fitness devices. The rate is normally around 80-100 per minute. It can be around 40-60 per minute in athletes and other conditioned and fit individuals.
The right atrium of the heart has a self-firing node called the SA (sino atrial) node, which automatically releases electrical impulses. These reach another node in the ventricles of the heart, causing them to contract. These electrical impulses can be recorded from the surface of the skin as an ECG (electrocardiogram). The SA node is richly supplied with nerves. It responds to stimuli like anger, fear, frustration, fever, or exercise by increasing the rate of firing. An increase in the heart rate can be felt as an uncomfortable pounding in the chest. Sometimes, the heart suddenly misses a beat and then we can feel the compensatory beat as an extra thump.
Most of the time, rapid or skipped beats are harmless occasional occurrences. They need to be evaluated:
♦ If they are frequent and are associated with sensations of choking or fainting
♦ If the pulse is more than 100 beats per min (without fever or exercise)
♦ If the beats are irregular and appear to be "coupled"
♦ If you already have diabetes, high blood pressure and deranged lipids.
Physicians evaluate palpitations using an ECG, a wearable Holter device, or an event recorder to monitor the heart for 15 to 30 days.
Palpitations may occur in situations of high stress or anxiety, during pregnancy, hypertension, with an overactive thyroid, anaemia or electrolyte imbalances. Caffeine in coffee, tea and cola drinks can cause the heart to beat rapidly. Stimulants in sports drinks can have the same effect. A combination of dehydration, exercise and sports drinks can be fatal. Tobacco (chewed or smoked) can cause palpitations. Some people are sensitive to medications such as pseudoephedrine, salbutamol, diet pills or MSG (monosodium glutamate). Even small amounts can precipitate palpitations.
Some stimulant drugs meant for other illnesses are taken by students to enhance mental capability. Their use is counterproductive and can cause palpitations and cardiac arrest instead.
The palpitations may be due to a prior heart attack which has damaged the muscles of the heart, blocks in blood vessels of the heart, heart failure, valve (prolapse damage) or muscle problems (cardiomyopathy).
If there is a specific problem causing the palpitations then its treatment will control the disease. If there is no specific cause, lifestyle modifications can help.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be sent to her at yourhealthgm@yahoo.co.in
