The heart beats about 70 to 80 times per minute in the average adult and the rhythm is usually regular. The rate, however, may rise during activity and lowers during rest. Usually a person is not aware of their beating heart unless they feel their pulse. During periods of exercise, the heart beat may become more prominent and can be perceived but it quickly settles and remains “silent” once again.
What is a palpitation?
A palpitation is the awareness of the beating heart. It may be perceived as a pounding sensation in the chest, pulsating in the throat or neck, or even a faint beating in the ears. This sensation may occur in a person with a healthy heart and normal beat, rate and rhythm, which is just more prominent in certain situations or conditions. Palpitations are more like to arise with certain abnormalities in the heart rate, usually above 100 beats per minute ( tachycardia), or in the rhythm, known as an arrhythmia. A person may also experience palpitations with an abnormally slow heart rate known as bradycardia.
How do palpitations occur?
Palpitations are described in many ways – thumping, pounding, racing, skipping, jumping or even a fluttering heart. These terms, although not medically accurate, are a crude indication of the underlying process. While the exact mechanism of a palpitation is not known, it appears that changes in the rate (speed), rhythm and force of the heart contraction may all contribute to the sensation. Therefore a fluttering heart may be described by a person experiencing extra beats or irregular rapid contractions, pounding or thumping indicates more forceful contraction or jumping and racing may be indicative of a fast heart beat.
Palpitations seem to be more prominent when the electrical activity of the heart is disrupted leading to irregular heart beat (arrhythmia) and especially with certain types of irregularities like “fluttering” (fibrillation – particularly atria) and “extra beats” (extrasystoles – atrial or ventricular). Tachycardia (rapid heart rate) or bradycardia (slow heart rate) is where the electrical activity is faster or slower than normal but there is no problem with the electrical activity or conduction system of the heart.
Causes of Palpitations
Certain situations and substances may cause palpitations because the heart rate or the force of the heart contraction (contractility) increases. The rhythm is usually normal and there is no structural change in the heart indicative of any disease process. This is seen with :
- Stress and anxiety
- Excessive intake of caffeine
- Excessive alcohol consumption
- Medication like slimming pills, thyroid medication and certain ‘flu’ medication.
- Narcotic drugs
- Any substance used as a stimulant, including herbal and nutritional supplements.
In many of the cases where palpitations occur with disease processes, there is usually some abnormality of the heart rhythm known as an arrhythmia. Other serious heart diseases without the presence of an arrhythmia and even non-cardiac diseases may also contribute to palpitations.