Palpitations

What are Palpitations?

Palpitations occur when the heart is not behaving normally; It can appear to, skip a beat, beat rapidly or irregularly or you may even feel a thud in your heart. Although palpitations are very common and often harmless, they can be frightening to the person who is usually unaware of his or her heartbeat.

The word palpitation comes from the Latin word palpitare meaning a gentle tap but in real life to the first-timer or old-timer, it may not be so gentle.

How does the Heart Work?

Palpitations can cause a considerable amount of doctor visits, so let’s first explore the heartbeat. The normal heartbeat works as follows:

The heart is made up of four chambers.    

The two chambers on the top of the heart are called the Atria.                        

The two chambers on the bottom of the heart are called the Ventricles.       

In its optimal state the two sides of the heartbeat in synchronicity, both Atria together and then the Ventricles together to pump the blood around the body.                                 

This is called sinus rhythm  and is the most efficient way for the heart to pump blood. The distinctive sound of the heart, ‘lub dub, lub dub’ is what most people think to be the sound of the heart beating, but it’s not. What you’re hearing is the sound of the valves closing in the chambers of the heart, like doors closing in a room. These valves allow blood to flow in one direction through the heart but prevent blood from flowing backwards, ie, preventing the blood from flowing back down a one-way street.

Imagine going to a concert with a friend and there are two lines of people waiting to get in. One line is for the people who got ground floor tickets and the other line is for the people who are on the balcony. Each line has two sets of turnstiles to pass through just like how the blood passes through the right atria and left atria then through the right and left ventricles at the same time. The turnstile that each pass through rotates at the same time and controls the flow of people into the venue. This is the first sound, ‘lub’. Now the people in the separate line shuffle forward a few steps to the next set of turnstiles to pass through the security, this rotates in sync and makes the noise, ‘dub’. All night long the people pass through turnstiles, ‘lub dub, lub dub’. These are the principles of the heart, really two separate pumps in one. Two separate blood supplies carrying separate and different tickets. Regardless of whether your blood is carrying a ticket for the lungs or a ticket for the rest of the body, it will have to pass through two different chambers and two sets of valves as it is propelled out of the heart and on to its destination.

So to summarise deoxygenated blood passes into the right atria from the vena cava vein then onto the right ventricles to be pumped out into the lungs to collect oxygen meaning to become oxygenated. The blood then passes back into the left-hand atria of the heart to pass through the left ventricles and pumped out of the heart via the aorta, the major artery of the body to supply oxygen to cells around the body.
De-0xygenated blood goes to the heart and is pumped to the lungs to pick up the oxygen. Oxygenated blood comes from the lungs and is pumped out of the heart to the rest of the body. These are the two functions of the arteries and veins.

Irregular Heartbeats.

There are many ways normal rhythm can be altered:

1. The top of the heart fires early known as premature atrial contraction.
2. The bottom of the heart can fire early called, premature ventricular contraction.

These can occur once and cause the heart to thud or beat in multiples and cause atrial or ventricular tachycardia. ‘Tachy’ means swift or rapid, ‘cardia’ means heart so in other words a fast heartbeat.

Another common problem is when the top of the heart loses all organisation of rhythm and quivers like a bag of worms creating atrial fibrillation or AFIB. This is very common today and is of electrical origin. The internal pacemaker keeps the electricity and the pace at which the heart needs to beat.

When to be Cautious of Your Heart Skipping a Beat?

All of us have experienced skipped heartbeats at some time or another. Some people just need a little reassurance that everything is normal but it is often a good idea to search for the root causes especially in:

People with medical issues,

Elderly people,                  

Athletes,

People with additional symptoms of dizziness,

People with near blackouts,

People with shortness of breath,

People with an overactive thyroid,

Those who have lung disease,

Those with electrolyte imbalance,

People with sleeping difficulties,

Patients with silent heart disease.

Some of which may explain the symptoms above.
Other causative factors could be anxiety/stress, excessive alcohol/caffeine intake, medication, or illicit drug use.

How to Treat Your Skipped Heart Beats?

So what can we do?

1. Consider adapting to a diet high in plants and vegetables as additional potassium and magnesium found in whole plant foods can help prevent skipped heartbeats. Magnesium is the most important mineral for heart rhythm and remember, certain medications can lower your magnesium levels. A group of drugs called proton pump inhibitors i.e. Nexium, Zoton, and Losec, used for lowering stomach acids are major culprits.
2. A review of your exercise patterns may be needed if you are a constant marathon runner. This is associated with a fivefold increase in the risk of AFIB. I believe this is connected to dehydration. Routine studies may be needed to keep an eye on your ECG and blood work.

In some cases to control or treat these problems, doctors may need to:

1. Prescribe medication.
2. Facilitate cardioversion, ie stop and restart the heart.
3. Ablation, which normally means destroying the section of heart tissue responsible for the irregular heartbeat. These situations will be carefully monitored by your cardiologist.
   A brief time to heal and restore balance is needed, so, avoid offending medications and stimulants, manage stress levels with yoga and meditation. The ability to use breathing techniques to control the heart rhythm is a powerful one and a great help to a daily routine. Train your cardiac nervous system, it’s easy with deep breathing, in through your nose, out through your mouth.

Edward O’Reilly

Lifestyle Pharmacist 

ed@lifestylepharmacist.ie

087 2051039