Harmless or a Sign of Something Serious? Decoding Heart Palpitations

The sensation of missed heartbeats, called heart palpitations, can be unsettling and scary. If you’re like most people, heart palpitations may leave you wondering if you’re about to have a heart attack or doubting your health. These skipped heartbeats can cause different sensations, such as the feeling that your heart is beating too quickly, fluttering, stopping and starting, pounding and skipping beats. Interestingly, palpitations can be felt whether you’re being physically active or resting.

As frightening as palpitations are, there’s good news in that they’re usually harmless. However, in rare instances palpitations can be a signal of something more serious going on with your heart, such as an irregular heartbeat, called an arrhythmia. When palpitations are accompanied by chest tightness or pain, fainting, feeling out of breath, or dizziness, medical treatment may be necessary.

There are a number of factors that can cause palpitations, including:

• Stress, emotional upsets, anxiety and panic attacks
• Depression
• Strenuous exercise
• Caffeine, nicotine and other stimulants
• Running a high fever
• Hormonal changes associated with your menstrual cycle, pregnancy, perimenopause or menopause
• An imbalance of thyroid hormones
• In people who are sensitive, alcohol can be a trigger
• Certain medications, such as decongestants, asthma inhalers, some antidepressants, and ironically, some medications used to treat irregular heartbeats
• Blood loss, such as from a recent surgery, trauma that involved bleeding, heavy periods or recent labor and delivery

While in most cases palpitations are harmless, if they’re associated with a heart condition, they can cause some complications. This includes fainting due to a drop in blood pressure, cardiac arrest in which your heart stops beating effectively, formation of blood clots causing a stroke, and heart failure. That said, in many cases, controlling the rate of an irregular heart pattern also helps to improve heart function.

If you have your palpitations assessed by your doctor, they will do a physical exam and listen to your heart. Their main focus is to look for signs of a medical condition or factors that may be causing your palpitations. Some tests that they might want to order include:

An Electrocardiogram (also called ECG or EKG). This is a quick test that measures the electrical activity of your heart. Electrodes are placed on your chest, with wires that connect to a computer that shows the results. This kind of test can determine if your heart is beating too slow, fast or skipping beats.

A Holter Monitor. This is a device that’s worn for a day or more (usually for 24 hours). It records your heart’s rate and rhythms throughout the day. This is a useful test, because it can uncover palpitations or arrythmias that aren’t detected during a regular exam or ECG. In addition, some smart personal devices, such as your watch or phone have remote monitoring available. It’s worth asking your doctor whether this is an option.

Event Recording. Sometimes arrythmias can be so infrequent that they’re not picked up on a Holter monitor or ECG. An event recorder is a device that may be worn for up to a month. When you have any symptoms, you push a button on the recorder. This kind of test can help pick up on symptoms that may occur only occasionally.

Echocardiogram. This is a noninvasive test that creates images of your moving heart through the use of sound waves. An echocardiogram is useful because it can show the flow of blood and any problems with the structures within your heart.

Treating Your Palpitations

If your palpitations warrant treatment, your doctor may prescribe a medication to regulate your heart rhythm, such as a beta blocker or calcium channel blocker. When palpitations are a symptom of an underlying heart condition, then treatment would be directed at addressing the specific condition. In most cases, however, heart palpitations can be managed through lifestyle adjustments and avoiding triggers. This includes:

• Managing your stress through Yoga, deep breathing, meditation or any other activity that you find calming.
• Addressing anxiety and panic disorders by talking it out with a therapist, acupuncture treatment, Chinese medicine or, in severe cases, medication.
• Avoiding stimulants, such as coffee, sugar, nicotine and energy drinks, which can increase your heart rate and trigger palpitations.
• Reviewing the drug prescription and over-the-counter medications you’re taking for any that may trigger palpitations, which can include thyroid medications. If you are taking any medications, it is important to talk to your health care provider about potential side effects. Also, be aware that street drugs, such as cocaine and amphetamines can cause heart palpitations.
• Determining if you have a sensitivity to alcohol, by limiting your intake for several weeks or more to see if your palpitations subside.
• Becoming a label reader. This is especially important if you’re taking any over-the-counter weight loss supplements. Many have ingredients that give you a temporary boost in energy or speed up your metabolism, such as ephedra, coffee extract, caffeine, amphetamines and herbal extracts. They typically are included in doses that are high enough to trigger palpitations.
• Quitting smoking. If you’re a smoker, having episodes of heart palpitations is another reason to quit. Smoking damages your cardiovascular system and can cause palpitations and other heart arrhythmias. I know, quitting is hard, but acupuncture and Chinese medicine can help you through the process.
• Making sure you’re getting enough sleep—seven or eight hours a night is a good place to start.
• Looking at portion sizes when you’re eating, as overeating can trigger palpitations. Eating and digesting very large meals can place stress on your body that can be enough to cause palpitations.

Many people turn to acupuncture for their heart palpitations, and scientists have found that this is a good idea. A scientific review of several studies on this topic determined that 87-100% of patients involved in the studies reverted to normal heart rhythm after having acupuncture. Other research concluded that acupressure for arrhythmias lowered patients’ heart rates and blood pressure, which alleviated their heart arrhythmias.

Acupuncture works for heart palpitations and arrhythmias in a number of ways. It helps to activate your parasympathetic nervous system, which offsets the fight or flight response of the sympathetic nervous system. Some call it the rest and digest response, as it helps your body sleep, recover from stress and rejuvenate itself. Acupuncture is well known as a treatment for conditions such as stress, anxiety, depression and emotional upsets, as well as a treatment for insomnia and poor sleep quality. It has been documented that acupuncture has been used to treat a number of conditions associated with cardiovascular function for thousands of years.

Chinese herbal medicine is a good addition to acupuncture for treating palpitations, too. Herbs are combined into a formula specific to each patient’s needs, and can be focused on easing the side-effects of stress, calming emotional upsets, promoting good sleep, supporting digestion and nourishing your heart. Your practitioner can also help you decipher the labels on any supplements you’re taking to look for ingredients that may be triggering or aggravating your palpitations. They can also direct you to foods and food ingredients to include or avoid and any lifestyle tweaks that may help.

While heart palpitations aren’t usually a sign that your heart is failing, they can be upsetting. Your acupuncturist can help uncover the cause of your palpitations, as well as come up with a plan for treating them by combining acupuncture, herbal medicine, nutrition and lifestyle changes. If you’re experiencing palpitations and want to know more about how to relieve them, give our clinic in Vancouver a call.

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