Heart palpitations

Posted on 7 August 2012

Meet our expert Dr Razeen Gopal, a cardiologist and electrophysiologist at Panorama Mediclinic. 

I sometimes feel like my heart is pounding. Should I worry?
A palpitation is the unsettling feeling that your heart is pounding or racing, or that it is irregular and has skipped a beat or stopped for a moment. While palpitations are not necessarily serious and can happen to us as a result of things like stress, it can also signal arrhythmias, or abnormal heart rhythms, and should be checked by a doctor.

How would I know if I have arrhythmia? What are the symptoms?
Aside from the palpitations – the unpleasant skipping or fluttering of an irregular beat or a racing, forceful heartbeat – you may also experience shortness of breath, weakness, fatigue, dizziness or light-headedness, fainting bouts and chest pain.

Why does this happen to me, and what causes it?
Every heartbeat, or heart muscle contraction, is the result of a seamless, regular flow of electricity through the heart.  However, if the electrical flow is blocked or gets stuck in a ‘short circuit’ – going over and over the same pathways – it can lead to disturbances in heart rhythms, or cardiac arrhythmias. Causes include:

• disease of the heart muscle, valves or coronary arteries
• disease of the electrical system of an otherwise healthy heart
• medications
• excessive alcohol intake
• excessive levels of thyroid hormone
• low blood-oxygen levels
• stress
• smoking

How do I know whether my palpitations are arrhythmic or not?
If you have any doubts, see a doctor, who may first set out to determine whether your symptoms are actually due to arrhythmias, and if so, what type – because treatments differ according to type. You might have rapid arrhythmias, called tachycardias, when your heart beats faster than 100 beats a minute; bradycardias, which are when it’s slower than 60 beats a minute; or irregular heart rhythms or fibrillations. To test this, your doctor might use a resting electrocardiogram (ECG), 24-hour rhythm monitoring, an echocardiogram or a treadmill exercise test. Blood tests will also measure blood sodium, potassium, calcium, magnesium, thyroid hormone levels and medication levels.

How easy is an arrhythmia to diagnose?
Because arrhythmias are by their nature fleeting and irregular, it is difficult to actually capture palpitations during any single test. Sometimes it’s necessary to monitor the heart over time. Alternatively, a cardiac electrophysiologist, who has specialised in diagnosing and treating heart rhythm, provokes abnormal rhythms in a safe environment to evaluate and diagnose the problem.

If I have arrhythmia, what treatment can I expect?
• Medications often help.
• Cardiac ablation can be the most effective treatment by destroying the tissue housing the short circuit and restoring normal rhythm, or by blocking damaged electrical pathways from sending faulty signals to the rest of the heart. This is also known as radiofrequency catheter ablation, and it’s the treatment of choice for a host of heart-rhythm disturbances, as it is safe and curative in most cases.
• An implantable device such as a pacemaker or defibrillator might be necessary in some cases.

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.