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titleWhat do my heart palpitations mean?

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caption58 goodhealth. Does your heart ever pound or skip a beat? Sometimes a heart arrhythmia – an irregular heartbeat or abnormal heart rhythm – is quite normal, but it can also be a sign of a more serious issue. Cardiologist and arrhythmia management specialist Dr Peter Kistler answers our questions on heart palpitations. Many people can experience an irregular heartbeat on occasion – so when is it normal and when is it a sign that something is amiss? Pip Harry asked an expert What do mean? What is a normal heartbeat? It’s a regular beat – generally between 60 and 100 beats per minute (bpm) at rest. However, in younger and very fit people, it might be a bit lower – around 50bpm. Our heart rate does vary throughout the day though – going up to 120 to 140bpm with exertion and down to 40bpm overnight. When is our heartbeat abnormal? It’s abnormal if it’s irregular or the rate becomes very rapid unexpectedly. We expect our heart rate to increase with exercise, anxiety and stress, but not for it to become suddenly very rapid. It’s also abnormal if it’s associated with being light-headed, breathless or feeling unwell. They would all be concerning symptoms. What’s a heart palpitation? A heart palpitation or arrhythmia is the sensation of an abnormal heartbeat. So it might be beating too rapidly, skipping a beat or doing an extra beat – all of those would be considered palpitations. Why do heart palpitations occur? There are lots of reasons. It can be due to an extra electrical pathway within the heart which upsets the rate and rhythm of the heartbeat. It can also be a sign of a mechanical problem with the heart such as a leaky valve or an enlarged muscle (cardiomyopathy). Or there might have been a previous heart attack which left some damage to the structure. Anxiety, stress or shock can also increase heart rate. Can palpitations occur because of what we eat or drink? Yes. Some energy drinks have a lot o

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caption59 photography corbis When should people seek treatment? Number one, if they’re worried. Number two, if the palpitation is recurring and it’s associated with light-headedness, chest discomfort, breathlessness or blackouts – these indicate a more serious condition. If the heart rate is continuous, fast and sudden in the way it comes on or goes away, it should be looked into. If you’re worried, what should you do? Go to your GP for a check-up and ask for a referral to a heart specialist. Generally, the mainstay of investigation is an ECG (electrocardiogram), where 12 dots are connected to the outside of the chest, wires are connected up and it produces an electrical recording of the heartbeat. With an exercise ECG you’re wired up and put on a treadmill and we see what happens to the heart with exercise. You might also be asked to wear a portable heart monitor for 24 hours and your cardiologist will then likely do an echocardiogram – an ultrasound which looks at the size of the heart chambers and the valves. How do you treat heart palpitations? Some people can learn little tricks like coughing or rubbing the artery on their neck, which changes the pressure in the chest and can stop the episode. There are lifestyle measures you can adopt, too, such as avoiding alcohol, smoking and caffeine. If it becomes too much, anti-arrhythmic medications such as beta-blockers can slow the abnormal heartbeat. There are also surgical options. I do a procedure called catheter ablation, which involves putting little wires up through the leg into the heart and then looking for the parts of the heart muscle that are misfiring and cauterising those spots. The operation takes a few hours but recovery is fast.  gm0213palp59.pdf Page 59 10/12/2012, 11:39:10 AM