The heart beats, on average, 70 times per minute, but a frequency between 60 and 100 beats per minute (bpm) is still considered “normal.” In some trained athletes or in individuals who are treated with some particular medications, the rate may drop as low as 50 bpm or below, without causing any discomfort to the individual.
In reality, each “beat” consists of a “systole “-the phase when the heart contracts to expel blood and send it to all organs-and a “diastole,” when the heart relaxes to receive venous blood from the organs and lungs. This continuous alternation between the two phases is not perceived by the individual except under special conditions.
Palpitations consist, precisely, of theconscious and unpleasant self-perception of heartbeats, which are felt to be more violent, regular or irregular; they are often accompanied by the feeling of “heart in the throat,” brought about by the sudden change in heart rhythm. This often represents a cause for considerable apprehension…
In fact, all individuals may experience palpitations at some time in their lives: in connection with strenuous physical exercise, especially in untrained individuals, strong emotions, or in particular anxiety situations. And this happens without any underlying heart disease.
Then there are also other non-cardiac causes, which can be: fever,hyperthyroidism (i.e., increased production of hormones by the thyroid gland),anemia (from iron deficiency, very heavy or very frequent menstruation, poor absorption, or hematologic diseases), nerve reflexes of gastrointestinal, hepatic, or uro-gynecologic origin (think menopause, for example!).
Disturbances may consist of “tachycardia “-increased heart rate even well above 100 bpm-or so-called “extrasystoles,” those out-of-rhythm beats, often very annoying, but almost always isolated. And most of the time these sensations catch the patient at times when, instead, he or she is trying to relaxor get to sleep, and thus frighten him or her greatly.
However, when the individual already has heart disease, noticing these rhythm disturbances should prompt him or her to seek a consultation with his or her family physician or, alternatively, with a cardiology specialist. Only professionals, in fact, will be able to determine, with an accurate history and a well-conducted objective examination, whether the disturbance occurs at rest or under stress, the duration and frequency of the episodes, whether the onset or cessation is abrupt or gradual, and finally whether the position (decubitus) influences the characteristics of the disturbance itself. This may either reassure the patient or decide to investigate further with other specific tests, such as a dynamic ECG according to Holter (24-hour ECG), an echocardiogram, or a stress test.
If, finally, it becomes necessary, appropriate drug and non-drug therapies can be prescribed to reduce or eliminate the troublesome symptom.
C.I.D. s.r.l. Società a Socio Unico – Casa editrice del settimanale Gente Veneta – CF e PI 02341300271 – REA: VE – 211669 – Capitale Sociale 31.000 euro i.v. – Dorsoduro,1 – 30123 Venezia
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