Palpitation warning sign for heart disease, says Dr Ogah 

Dr Okechukwu Ogah, a consultant cardiologist at the University College Hospital (UCH), Ibadan, and past president of the Nigerian Cardiac Society, says irregular heartbeats are a way by which the heart is asking for attention and a pointer to a possible heart disease.

What are heart palpitations?

Palpitation is an unusual awareness of the heartbeat. This can last from a few seconds to several hours. They can sometimes be accompanied by pain, dizziness, or shortness of breath. The heart beats a few days after conception, and it’s one of the earliest organs that function in the body. It continues to beat until someone dies. Although we shouldn’t be conscious of our heartbeat, experiencing heart palpitations is a possible sign of heart disease. In the lay public, people who experience heart palpitations typically report feeling an uncommon awareness of their heartbeat. In reality, most people may not even be aware of where their hearts are located until they begin to feel their hearts beating abnormally.

 

Are heart palpitations dangerous?

They are dangerous. First, the heart is telling an individual, “I’m not well.” Second, it may be a sign of an impending danger – maybe a sudden cardiac arrest about to start. The heartbeat may occasionally be felt, and it may not occur for another six months or so. That may not be a reason for concern. However, one should be concerned if it starts to occur more frequently than usual or if one is performing an activity that naturally should not cause discomfort, such as cooking, fetching water, or doing other activities that before didn’t cause any discomfort. Certainly, feeling a lot more exhausted than one usually does is something to be concerned about and reported at the hospital.

 

How come hearts palpitate? What leads to heart palpitation?

Stress, exercise, pain attacks, medication, or, rarely, a medical condition can trigger heart palpitations. Often, the cause of heart palpitations can’t be found. Rarely, heart palpitations can be an indication that something may be wrong with the heart, such as an irregular heartbeat (arrhythmia) that might require treatment. Arrhythmias might cause a very fast heartbeat (tachycardia), an unusually slow heartbeat (bradycardia), a heartbeat that varies from a typical heart rhythm, or a combination of the three. Therefore, palpitation is a symptom of impending or existing heart disease.

 

What other physical symptoms or cardiac problems can palpitations indicate?

It can also be a sign of an issue in another part of the body that is impacting the heart. Let’s say, for example, high blood pressure. The heart has been used to a blood pressure that’s within the normal range, and then the blood pressure rises. The heart is now under strain.

The heart will also protest if there is a buildup of cholesterol in the blood vessels due to inadequate nutrient delivery. Another reason could be an imbalance in the body’s salt levels, which may interfere with the heart’s ability to contract. Palpitation may also arise if there is a problem with the heart’s wiring or conduction system. Similar to a home generator, the heart is an electrical organ. The house’s lightbulbs will appear to be flickering or not lighting up if there is a generator issue.

Additionally, heart palpitations may result from taking certain prescription medications over the recommended dosage. Similarly, hard drugs may cause heart palpitations.

 

Who experiences heart palpitations the most frequently?

This includes those who have an underlying heart disease, whether known or unknown. Those who have a genetic heart problem or a genetic predisposition for heart disease could also experience their hearts beating faster than normal. Heart palpitations can happen to someone who has a cardiac muscle disorder, which typically affects young individuals and is a common problem. It is important to pay attention to a young person who complains of recurrent heart palpitations. It can indicate that the child has a congenital heart condition (a hole in the heart).

 

How can harmless palpitations be differentiated from those suggestive of a possible heart problem?

Very infrequent or short palpitations may be harmless. Frequent palpitations in a young person may connote the presence of heart disease and should be investigated. Heart conditions tied to palpitations include coronary artery disease, heart failure, heart valve problems, and heart muscle problems. Also, in people with previous heart disease, palpitations that are not brought on by an activity are considered harmful. It is still risky. Palpitations indicate that the heart muscle may already be compromised in a person who has had a cardiovascular disease. Also, palpitations that occur about two or three times a day have become more frequent and should be investigated. It is not normal.

 

Are there any additional symptoms that accompany palpitations that individuals should be aware of? 

Yes, usually palpitation comes with other symptoms of heart disease. One is that the individual gets tired easily. Additionally, if someone wakes up in the middle of the night because of trouble breathing or coughing when lying down on a bed,.

Also, palpitations can sometimes be accompanied by other symptoms, like chest pain or discomfort, shortness of breath, lightheadedness, sweating, and fatigue, which might indicate an underlying issue. For instance, some people may feel dizzy or faint during palpitations, possibly due to changes in blood flow or heart rhythm. Similarly, feeling breathless or unable to catch one’s breath can occur alongside palpitations, especially if they are caused by a heart condition.

 

What is the connection, therefore, between heart palpitation and diseases like diabetes and hypertension?

If the high blood pressure is not managed, the heart will eventually be under a lot of strain, and the heart muscle will suffer damage. This can provoke palpitations. The same thing is true with diabetes because it could lead to injury to the heart or myocardium, which can cause palpitations.

Diabetes, especially when poorly controlled, can lead to fluctuations in electrolytes such as potassium and magnesium. These imbalances can disrupt the normal electrical activity of the heart, potentially causing palpitations. Similarly, medications commonly used to treat diabetes and hypertension can sometimes cause side effects like palpitations. For example, certain antihypertensive medications or medications that affect insulin sensitivity may influence heart rhythm.

Equally, living with chronic diseases like diabetes and hypertension can lead to increased stress and anxiety, which are themselves triggers for palpitations. Diabetes and hypertension are often associated with obesity; as such, excess weight can put a strain on the heart, leading to palpitations as a result of increased workload on the cardiovascular system.

 

Can heart palpitation be the first sign an individual will have before a heart attack?

Yes, it can be. In such situations, the body is telling you that the blood supply to the heart is not adequate.

 

People who are anxious or under severe fear can feel their hearts beating very fast. So, is heart palpitation, therefore, the same as anxiety?

They are not the same, but they can be closely related and sometimes occur together. We expect that in a frightened or fright situation, the heartbeat will increase for a normal person. In such a situation, if someone becomes anxious, their heart will race. It’s possible to feel the heart beating and be aware of it because the heart rate has increased. It’s just anxiety. Anxiety is a function of the brain, and the brain can also work on the heart by raising the heart rate, especially in individuals prone to stress or anxiety disorders.

 

Is it normal for women to experience palpitation during pregnancy? Is it a dangerous symptom of pregnancy?

One, It is a normal occurrence in pregnancy, but if it becomes excessive, one should not look at it as a normal symptom of pregnancy. If it becomes excessive or there is difficulty breathing, the pregnant woman should seek medical attention. Excessive palpitation during pregnancy may be a symptom of ongoing heart disease during pregnancy. During pregnancy, there is a redistribution of blood within the system. The blood volume also increases, putting a lot of pressure on the heart and leading to palpitations. Palpitations during pregnancy can be caused by even mild anaemia (low red blood cell count) as the heart tries to compensate for decreased oxygen-carrying capacity. The growing baby in the womb can also put pressure on the diaphragm and affect the positioning of the heart, leading to occasional palpitations.

Anaemia during pregnancy can also cause palpitations. Pregnancy itself can be a stressful time, and anxiety or emotional stress can trigger palpitations in some women.

Although palpitations during pregnancy in most cases do not pose a threat to the mother or the baby, it is essential for pregnant women to consult a doctor for evaluation, especially if palpitations are severe, prolonged, or accompanied by other symptoms such as chest pain, dizziness, fainting, or shortness of breath. These could be signs of a more serious underlying condition that requires a medical evaluation.

 

What are the risk factors for heart palpitation?

Heart palpitations can occur in individuals with various risk factors, which can contribute to their frequency or severity. Some common risk factors, including heart disease, stress, anxiety, caffeine, excessive alcohol consumption, cigarette smoking, use of recreational drugs or substance abuse, pregnancy-related changes, and physical factors such as dehydration and anaemia, can contribute to palpitations. Moreover, a family history of heart conditions or arrhythmias may increase the likelihood of experiencing palpitations. Also, obesity, a lack of regular physical activity, and a poor diet can contribute to cardiovascular health issues that may manifest as palpitations.

 

Studies say that some sweeteners and supplements can cause heart palpitations. Why is this so?

This may be due to its components; some components of certain sweeteners may be provocative to the heart. Anything that can provoke the heart can also lead to palpitation. Some herbal supplements, once used for weight loss and athletic performance, have been banned in many countries due to safety concerns. They contain ephedrine, a stimulant that can significantly increase heart rate and blood pressure, leading to palpitations and other cardiovascular issues.

 

Why does coffee give some people palpitations while not doing the same for others?

We have different genetic makeup. Some people may not have issues when they take coffee. But for some people, their adrenergic system may be hyperactive, or the coffee tends to excite their hearts more than others. So in such cases, people may not tolerate coffee.

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