Dr Petcha

Palpitations Made Easy

Palpitations Made Easy

I’m going to talk about four different kinds of heart palpitations today. Is heart palpitations made easy? Everything we know about heart palpitations can be placed into four kinds. If you have palpitations, knowing the different kinds and being able to name them when they happen will help your doctor figure out what’s wrong with your heart more accurately.


Palpitations Made Easy


Pounding, racing, skipping a beat, flip-flopping, or fluttering

First of all, you should know that palpitations are symptoms that you feel yourself. It is a subjective feeling you have in your body, and the doctor who gave you the diagnosis may never experience such symptoms. Palpitations can feel like a distinct heartbeat, an especially stronger heartbeat, a fast heartbeat, a missed beat, or an irregular heartbeat, so it can be hard to describe them by yourself.

Palpitations can be very scary and upsetting, especially when they happen for the first time. When patients experience heart palpitations for the first time, they will not only feel physical discomfort, but they will also feel very scared and worried. When people first feel a palpitating heart or discomfort, they often do not know what it means or whether it might get worse.


Read more about Waking Up With a Headache

More questions than answers

If patients then use Google to find out more about their symptoms, they might begin to see scary terms like non-sustained ventricular tachycardia, supraventricular tachycardia, atrial fibrillation, atrial flutter, and atrial tachycardia. A quick visit to the doctor may lead to even more questions and worries. Most of the time, doctors will ask the patient to self-monitor their heart rate or wear a portable heart rate monitor to keep track of any changes that happen over days or weeks. But the patient may not have palpitations while the monitor is on, and the symptoms may come back when the monitor is taken off. Patients can get very worried when they think they won’t be able to figure out what’s wrong or the uncertainty of if and when it will happen again.


Measure your palpitation

Measure your palpitation, it's made easy.


So, here’s a simple way to figure out what’s going on with your heart palpitations. It simply requires using a tool you already have, your fingers. All it takes is the use of the index and middle fingers, quickly feel your heartbeat with your fingers, count the number of beats by nodding, and then begin to decipher what kind of heart palpitations you are having.


Palpitations Made Easy


Now, when you feel your heart start to the race, you should find your pulse as soon as possible. The best way to do this is to touch the sides of your neck and feel the carotid pulse. If you press lightly with two fingers in these places, you can feel the pulse right away. Once you’ve found your pulse, pay attention to its beat rate, which tells you how fast your heart is beating, and its beat pattern, which tells you how your heart is beating. Normal is between 60 and 80 beats per minute, but most people are fine with a heart rate between 50 and 120 beats per minute. On the other hand, heart rhythm is the way the time in between heartbeats is set up. If the pulses you feel in your fingertips come consistently with regularity,, it means your heartbeat is regular and healthy.


With this understanding, palpitations can be put into one of four kinds, depending on whether the heart rate is normal or not, and whether the heart rhythm is regular or not. Let’s go over each group one at a time.



Normal heart rate and rhythm: not arrhythmia

The first kind of palpitations is when the heart rate and rhythm are normal. Most of the time, these kinds of palpitations are not caused by pathological arrhythmias, but by other things that can cause you to feel palpitations, such as anxiety, fear, or excitement. These things will make the heart beat faster, but this is a normal physical response and not a sign of arrhythmia.



Normal heart rate with irregular rhythm: ectopic beats, atrial fibrillation

The second kind of palpitations is when the heart rate is normal but the heart rhythm is irregular. This could be caused by either an extra heartbeat or atrial fibrillation. Extra beats and called ectopic beats and are random beats in the normal rhythm of the heart. The sensation is akin to you feeling your heart skip a beat and then feeling one or more small throbs. Overall, the rhythm is pretty steady. On the other hand, atrial fibrillation is characterized by heartbeats that don’t beat in a regular pattern. Generally speaking, the heart rate of ectopic heartbeats is usually lower, while the heart rate of atrial fibrillation can be higher than 100 or lower than 60 with the rate varying from one measurement to the next. For these second kinds of palpitations, an ectopic heartbeat is a cause if your heartbeat is mostly regular but has some unusual changes. If your heartbeat is just off or random, it could be atrial fibrillation.


Fast heart rate with regular rhythm: sinus tachycardia, supraventricular or ventricular tachycardia

The third kind of palpitation is when your heart beats too fast but in a regular pattern. This kind of palpitation is marked by a fast heartbeat, but the rhythm of the heartbeat is steady. Palpitations can be caused by a condition called sinus tachycardia, which is mainly a fast heart rate caused by a rise in adrenaline. This third kind of palpitations can also be caused by supraventricular or ventricular tachycardia. To figure out which of these causes is behind a heartbeat that is too fast, like more than 120 beats per minute, you can pay attention to how the heartbeat speeds up and slows down. If the heart beats quickly and then suddenly slows down, it may be an arrhythmia, which is usually caused by supraventricular tachycardia or ventricular tachycardia. Supraventricular tachycardia is more common in young people and the heart rate changes like a switch that suddenly speeds up and then slows back down. In the same way, atrial tachycardia and atrial flutter, both of which are caused by abnormal electrical conduction in the top chambers of the heart, can also cause rapid changes in heart rate. Ventricular tachycardia is a very unusual change in heart rate that can happen less often if you don’t have heart disease. This particular rhythm needs to be investigated and excluded because it could be life-threatening. If the heartbeat speeds up gradually and then takes its time to slow back to normal, this is not an arrhythmia. Instead, it is likely a sign of palpitations caused by sinus tachycardia. For this type of palpitations, we usually think that the heart is working normally, but something other than the heart, like hypoadrenalism, hyperthyroidism, dehydration, fever, or a panic attack, is making the heart beat faster.


Abnormal heart rate with irregular rhythm: atrial fibrillation

The fourth kind of palpitation is when your heart beats too fast or too slow. This can be caused by the same atrial fibrillation that makes the heart beat 150 or even 200 times per minute. So, if your heartbeat is very fast and irregular at the same time, you can pretty much tell that atrial fibrillation is the cause of your palpitations.


What you can do about your palpitation

The next time you have heart palpitations, putting them into one of the above categories will make it easier for you to figure out what’s going on and decide if it could be dangerous. When your heart rate and rhythm are mostly normal, palpitations may be caused by nerves or fear, and you don’t have to worry about your heart at all. When your heart rate is normal but a little bit off, it could be because of ectopic beats. If the irregularity lasts for a long time, it could be caused by atrial fibrillation, which needs more care. When your heartbeat is pretty regular and your heart rate goes up and down slowly, it is less likely to be an irregular heartbeat. But if it speeds up and slows down quickly, it may be caused by supraventricular tachycardia and needs to be further clarified. If you already have a heart problem and your heart rate suddenly speeds up and then just as quickly slows down, this could be ventricular tachycardia, which needs to be closely monitored. For irregular heart rhythm with a very fast heartbeat, atrial fibrillation may be the cause and it means you need to pay more attention. Among the things that can cause palpitations, atrial fibrillation and ventricular tachycardia are the most dangerous for your health. Even if you have a normal heart structure and no history of heart disease or heart failure, heart palpitations are usually not life-threatening, so don’t worry too much.

I hope that figuring out your own heart palpitations will help you learn about the different things that can cause them. With practice, you’ll be able to tell what kind of heart palpitations you have, figure out why you have them and have a better conversation with your cardiologist about how best to treat them.

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