What causes palpitations?

Many people have experienced symptoms of palpitations. If palpitations often occur after physical activity, it may be a disease. However, if palpitations occur after strenuous exercise or after taking some medications such as atropine, it is generally normal.

1. Youth: mostly physiological

Case 1: Ms. Qian, who is in her early 30s and has a successful career, worked overtime until midnight every day some time ago. Tired Ms. Qian wanted to relax, so she took a 20-minute sauna at home. After walking out of the sauna room, Ms. Qian felt her heart pounding, and she felt very uncomfortable, dizzy, with shaking hands and difficulty breathing. She quickly lay down on the bed and rested for a long time before she recovered.

Analysis: Ms. Qian’s situation should be viewed from two aspects. If Ms. Qian has no underlying heart disease, lacks exercise, and often sits in the office for long periods of time, her heart rate will easily increase with the slightest movement. Then the heat stimulation after taking a sauna will easily cause a sympathetic reaction in the heart, leading to an accelerated heart rate. This is a manifestation of physiological palpitations. There is no need to be too nervous. It will gradually recover after the stimulating factors are removed.

Another possibility is that Ms. Qian herself has paroxysmal tachycardia, and the stuffiness and lack of oxygen while taking a sauna triggered her original arrhythmia. At this time, she needs to go to the hospital for examination and treatment.

2. Middle age: arrhythmia

Case: Mr. Sun is in his 50s. In the past two months, he has often felt chest tightness, palpitations, fast and slow heartbeats, shortness of breath, and cold hands and feet. I feel very irritated when I hear the sound before going to bed at night. Sometimes he would feel his heartbeat suddenly speed up when he was half asleep, waking him up.

Analysis: Because of his older age, Mr. Sun is more likely to develop organic heart disease. Especially if the heartbeat suddenly increases, there is a high possibility of arrhythmia. Mild arrhythmias may be asymptomatic or have mild symptoms and will not cause much harm to the human body. However, some serious arrhythmias, such as ventricular tachycardia and ventricular fibrillation, are the main causes of sudden cardiac death due to their rapid onset and low success rate of treatment.

3. Elderly: Preventing sudden death

Case: Mr. Wang, 68 years old, was diagnosed with coronary heart disease a year ago. In the past year, Mr. Wang has experienced sudden palpitations, sweating, chest tightness, shortness of breath, etc. from time to time. These symptoms will be significantly aggravated after activities. Two days ago, I suddenly felt anxious for no reason, followed by dizziness. Electrocardiogram examination revealed irregular heart rhythm and frequent ventricular premature beats.

Analysis: Clinically, palpitations are common in patients with ventricular premature beats. These patients can feel their hearts skipping moments, which can sometimes severely disrupt their sleep. Premature ventricular beats can occur in people who do not have heart disease. Normal people may experience ventricular premature beats when they are nervous, stressed, drink alcohol, drink coffee, or have poor sleep. These people generally do not require specific treatment if they have no symptoms or have mild symptoms. If there are many premature beats and they cause obvious symptoms, interfering with normal life and work, certain antiarrhythmic drugs can be used for a short period of time under the guidance of a doctor to improve the symptoms. The medical community currently believes that most ventricular premature beats without underlying heart disease are benign, have no impact on life, and generally do not require treatment.