What happens if you feel your heart fluttering?

Feb 24, 2019 Dr Zulfikar Bux, Features / Columnists

Assistant Professor of Emergency Medicine
We all would have experienced our heart fluttering for different reasons. In Guyana, we often say our heart is “flattering”. Its correctly called fluttering instead of flattering. The medical term for it is palpitations. So for the purpose of clarity, we will use palpitations in the rest of this article instead of “flattering” or fluttering.
It is normal to hear or feel your heart “pounding” as it beats faster when you exercise. You may feel it when you do any physical activity. But if you have palpitations, you might feel your heart pounding while you are just sitting still or moving slowly. Feeling your heartbeat while you are at rest constantly may be an indicator of palpitation due to a more serious underlying condition.
Today we will try to decipher what can be causing palpitation in some and what can be done to help.

WHAT ARE SYMPTOMS OF PALPITATIONS?
Heart palpitations may feel different to different people. They may feel like your heart is skipping a beat. They may feel like a flutter in your chest. Or they may feel like the pounding that I described earlier. You may have heart palpitations while you are sitting or while you are lying down.

WHAT CAUSES HEART PALPITATIONS?
Many things can cause palpitations. Some causes of heart palpitations include:
• Strong emotional responses, such as stress, anxiety or panic attacks
• Depression
• Strenuous exercise
• Stimulants, including caffeine, nicotine, cocaine, amphetamines, and cold and cough medications that contain pseudoephedrine
• Fever
• Hormone changes associated with menstruation, pregnancy or menopause
• Disorders of the heart such as valve problems, artery blockages
• Low blood count
• Too much or too little thyroid hormone
Sometimes the cause of palpitations cannot be found. This happens in about 1 of every 7 people who have palpitations. Palpitations in these people usually are not harmful.

WHEN SHOULD YOU SEEK EMERGENCY HELP?
You should visit your doctor or an emergency department if you have any of the following symptoms with your palpitations:
• Chest discomfort or pain
• Fainting
• Severe shortness of breath
• Severe dizziness
• Profuse sweating (without exercise)

HOW ARE HEART PALPITATIONS DIAGNOSED?
If your heart races when you aren’t exercising, you should see your doctor. Your doctor will examine you and ask you about any medicines you are taking. He or she will also ask about your diet and ask if you have panic attacks. Your doctor may want you to have a resting electrocardiogram test. This test keeps track of your heartbeat over a certain amount of time. Your doctor also may test your blood.
If these tests do not show what is causing your palpitations, your doctor may have you wear a heart monitor. If so, you will wear it for 1 to 14 days. This monitor will show any breaks in your heart’s rhythm. Your doctor might refer you to a cardiologist (a heart specialist) for more tests or treatment.

CAN HEART PALPITATIONS BE PREVENTED OR AVOIDED?
Heart palpitations cannot always be prevented or avoided. Here are some things you can do that may help prevent or avoid heart palpitations:
• Do not use illegal street drugs, such as cocaine.
• Avoid caffeine, alcohol, and tobacco.
• Tell your doctor what medicines and herbal supplements you take.
• Tell your doctor how much alcohol you drink and if you use anything else that might cause palpitations.

WHAT ARE THE TREATMENT OPTIONS FOR HEART PALPITATION?
Most of the time, heart palpitations are harmless and will go away on their own. In these cases, they do not require treatment.
If your heart palpitations are related to a heart condition or other medical problem, your doctor will treat you for that. In these cases, your heart palpitations will likely go away as a result of treatment.
If your heart palpitations are a result of certain foods, beverages (alcohol and caffeine), or medications, try cutting back. Doing so could stop your heart palpitations.
If you can understand what is causing your palpitations, you will likely be able to manage them. You will be able to avoid known triggers, like diet pills, caffeine, and cold/cough medicines.
Palpitations that are caused by anxiety or stress are sometimes harder to control. The anxiety can cause the palpitations, and the palpitations can create anxiety. These often make up a seemingly endless cycle. In these cases, your doctor may prescribe a medication to help ease anxiety. But do not ignore your “flattering” heart. It may be warning you of something serious.

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