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Encyclopedia > Palpitation
Symptom/Sign: Palpitation
Classifications and external resources
ICD-10 R00.2
ICD-9 785.1
DiseasesDB 29231
MedlinePlus 003081
eMedicine aaem/337 

A palpitation is an abnormal awareness of the beating of the heart, whether it is too slow, too fast, irregular, or at its normal frequency. The difference between an abnormal awareness and a normal awareness is that the latter is almost always caused by a concentration on the beating of one's heart and the former interrupts other thoughts. Palpitations may be brought on by overexertion, adrenaline, alcohol, caffeine, disease (such as hyperthyroidism) or drugs, or as a symptom of panic disorder. More colloquially, it can also refer to a shaking motion. It can also happen in mitral stenosis. Image File history File links Question_book-3. ... A symptom is a manifestation of a disease, indicating the nature of the disease, which is noticed by the patient. ... In medicine, a sign is a feature of disease as detected by the doctor during physical examination of a patient. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // R00-R99 - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R09) Symptoms and signs involving the circulatory and respiratory systems (R00) Abnormalities of heart beat (R000) Tachycardia, unspecified (R001) Bradycardia, unspecified (R002) Palpitations (R008) Other and unspecified abnormalities of heart beat (R01) Cardiac murmurs and other... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Heart rate is the frequency of the cardiac cycle. ... The heart and lungs, from an older edition of Grays Anatomy. ... Epinephrine (INN) or adrenaline (BAN) is a hormone and a neurotransmitter. ... Alcoholic beverages An alcoholic beverage is a drink containing ethanol, commonly known as alcohol, although in chemistry the definition of an alcohol includes many other compounds. ... For other uses, see Caffeine (disambiguation). ... This article is about the medical term. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ... Mitral stenosis is a narrowing of the orifice of the mitral valve of the heart. ...


Nearly everyone experiences an occasional awareness of their heart beating, but when it occurs frequently, it can indicate a problem. Palpitations may be associated with heart problems, but also with anemias and thyroid malfunction. This article discusses the medical condition. ...


Attacks can last for a few seconds or hours, and may occur very infrequently, or more than daily. Palpitations alongside other symptoms, including sweating, faintness, chest pain or dizziness, indicate irregular or poor heart function and should be looked in to.


Palpitations may also be associated with anxiety and panic attacks, in which case psychological assessment is recommended. This is a common disorder associated with a lot of common medications such as anti-depressants.

Contents

Causes of palpitation

Palpitations can be attributed to one of three main causes:
1- Hyperdynamic circulation (Valvular Incompetence, Thyrotoxicosis, Hypercapnia, Pyrexia, Anemia, Pregnancy...)
2- Sympathetic overdrive (Panic disorders, Hypoglycemia, Hypoxia, Levocetirizine antihistamines, Anemia, Heart Failure, Mitral valve prolapse.[1]..)
3- Arrhythmias (AF, SVT, Ventricular tachycardia, Ventricular fibrillation, Heart block...) Hyperthyroidism (thyrotoxicosis or fast thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) and free triiodothyronine (T3), or both. ... // Hypercapnia (from the Greek hyper = above and kapnos = smoke), also known as CO2 Poisoning, is a condition where there is too much carbon dioxide (CO2) in the blood. ... Fever is also the name of an album by Kylie Minogue. ... This article discusses the medical condition. ... This article is about human pregnancy in biological females. ... Panic Disorder is a mental condition that causes the sufferer to experience sporadic bouts of frightening symptoms, such as racing heart, shortness of breath, or a feeling of hopeless loss of control. ... Hypoglycemia (hypoglycaemia in British English) is a medical term referring to a pathologic state produced by a lower than normal level of glucose (sugar) in the blood. ... Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia) or region of the body (tissue hypoxia) is deprived of adequate oxygen supply. ... Xyzal Levocetirizine (as levocetirizine dihydrochloride) is a third generation non-sedative antihistamine, developed from the second generation antihistamine cetirizine. ... An antihistamine is a drug which serves to reduce or eliminate effects mediated by histamine, an endogenous chemical mediator released during allergic reactions, through action at the histamine receptor. ... This article discusses the medical condition. ... Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood through the body. ... Mitral valve prolapse (MVP) is a heart valve condition marked by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole. ... // AF, aF, af or . ... Sveriges Television- Swedish Television Ford Special Vehicle Team Supraventricular tachycardia Samozaryadnaya Vintovka Tokareva, a WW2 semi-automatic rifle Categories: Disambiguation ... Ventricular tachycardia (V-tach or VT) is a fast rhythm that originates in one of the ventricles of the heart. ... Ventricular fibrillation (V-fib or VF) is a cardiac condition which consists of a lack of coordination of the contraction of the muscle tissue of the large chambers of the heart that eventually leads to the heart stopping altogether. ... A heart block is a disease in the electrical system of the heart. ...


Types of palpitation

People describe their palpitations in many different ways, but there are some common patterns:


The heart "stops"

Those who experience palpitations may have the feeling that their heart stops beating for a moment, and then starts again with a "thump" or a "bang". Usually this feeling is actually caused by an extra beat (premature beat or extrasystole) that happens earlier than the next normal beat, and results in a pause (called a Compensatory Pause) until the next normal beat comes through. People are not usually aware of the early, extra beat, but may be aware of the pause, which follows it (the heart seems to stop). The beat after the pause is more forceful than normal (due to filling with more blood than usual during the Compensatory Pause), giving the "thumping" sensation. Extrasystole Systole is a medical name for a contraction most often used in the description of the way the heart beats. ...


The heart is "fluttering" in the chest

Any rapid heartbeat (or tachycardia) can give rise to this feeling. A rapid, regular fluttering in the chest may be associated with sensation of pounding in the neck as well, due to simultaneous contraction of the upper, priming chambers of the heart (the atria) and the lower, main pumping chambers (the ventricles). If the fluttering in the chest feels very irregular, then it is likely that the underlying rhythm is atrial fibrillation. During this type of rhythm abnormality, the atria beat so rapidly and irregularly that they seem to be quivering, rather than contracting. The ventricles are activated more rapidly than normal (tachycardia) and in a very irregular pattern. This article or section does not cite any references or sources. ... Atria may refer to: Atria is an alternative spelling for the Etruscan city that is now Adria in the Veneto region of Northern Italy. ... In anatomy, a ventricle is a part of the body filled with fluid. ... Atrial fibrillation (AF or afib) is a cardiac arrhythmia (abnormal heart rhythm) that involves the two upper chambers (atria) of the heart. ...


Minor

Some people may experience what is known as a minor palpitation, where the heart feels like it skips a beat. These are generally easy to ignore, but cause the person to worry more if their symptoms have not been diagnosed by a doctor.


Types

Palpitations may be associated with feelings of anxiety or panic. It is normal to feel the heart thumping when feeling terrified or scared, but it may be difficult to know whether the palpitations or the panicked feeling came first. Unfortunately, since it can take some time before a clear diagnosis is made in a patient complaining of palpitations, people are sometimes told initially that the problem is anxiety.


Stressful situations cause an increase in the level of stress hormones, such as adrenaline, circulating in the blood, and there are some types of abnormal heart rhythm that can be stimulated by adrenaline excess, or by exercise. It may be possible to diagnose these sorts of palpitations by performing simple tests, such as an exercise test, while monitoring the ECG. Epinephrine (INN) or adrenaline (BAN) is a hormone and a neurotransmitter. ... ECG may also refer to the East Coast Greenway Lead II An Electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphic produced by an electrocardiograph, which records the electrical voltage in the heart in the form of a continuous strip graph. ...


Some types of abnormal heart rhythm seem to be affected by posture. For many people, standing up straight after bending over can provoke a rapid heart rate. Often these attacks can be abolished again by lying down. Many people, if not all, are more aware of the heartbeat when lying quietly in bed at night. This is partly because at that time, the attention is not focused on other things, but also because the slower heart beat at rest can allow more premature beats to occur.


Symptoms

Many times, the person experiencing palpitations may not be aware of anything apart from the abnormal heart rhythm itself. But palpitations can be associated with other things such as tightness in the chest, shortness of breath, dizziness or light-headedness. Depending on the type of rhythm problem, these symptoms may be just momentary or more prolonged. Actual blackouts or near blackouts, associated with palpitations, should be taken seriously because they often indicate the presence of important underlying heart disease.


Diagnosis

The most important initial clue to the diagnosis is one's description of the palpitations. The approximate age of the person when first noticed and the circumstances under which they occur are important, as is information about caffeine intake (tea or coffee drinking). It is also very helpful to know how they start and stop (abruptly or not), whether or not they are regular, and approximately how fast the pulse rate is during an attack. If the person has discovered a way of stopping the palpitations, that is also helpful information. For other uses, see Caffeine (disambiguation). ...


The diagnosis is usually not made by a routine medical examination and electrical tracing of the heart's activity (ECG), because most people cannot arrange to have their symptoms while visiting the doctor. Nevertheless, findings such as a heart murmur or an abnormality of the ECG, which could point to the probable diagnosis, may be discovered. In particular, ECG changes that can be associated with specific disturbances of the heart rhythm may be picked up; so routine physical examination and ECG remain important in the assessment of palpitations. Murmurs are abnormal heart sounds that are produced as a result of turbulent blood flow which is sufficient to produce audible noise. ...


Blood tests, particularly tests of thyroid gland function are also important baseline investigations (an overactive thyroid gland is a potential cause for palpitations; the treatment in that case is to treat the thyroid gland over-activity). The thyroid gland and its relations In anatomy, the thyroid (IPA θaɪɹoɪd) is an endocrine gland. ...


The next level of diagnostic testing is usually 24 hour (or longer) ECG monitoring, using a form of tape recorder (a bit like a Walkman) called a Holter monitor, which can record the ECG continuously during a 24-hour period. If symptoms occur during monitoring it is a simple matter to examine the ECG recording and see what the cardiac rhythm was at the time. For this type of monitoring to be helpful, the symptoms must be occurring at least once a day. If they are less frequent then the chances of detecting anything with continuous 24, or even 48-hour monitoring, are quite remote. Holter monitor In medicine, a Holter monitor (also called an ambulatory electrocardiography device), named after its inventor, Dr. Norman J. Holter, is a portable device for continuously monitoring the electrical activity of the heart for 24 hours or more. ...


Other forms of monitoring are available, and these can be useful when symptoms are infrequent. A continuous-loop event recorder monitors the ECG continuously, but only saves the data when the wearer activates it. Once activated, it will save the ECG data for a period of time before the activation and for a period of time afterwards - the cardiologist who is investigating the palpitations can program the length of these periods. A new type of continuous-loop recorder has been developed recently that may be helpful in people with very infrequent, but disabling symptoms. This recorder is implanted under the skin on the front of the chest, like a pacemaker. It can be programmed and the data examined using an external device that communicates with it by means of a radio signal. ... A pacemaker, scale in centimeters A pacemaker (or artificial pacemaker, so as not to be confused with the hearts natural pacemaker) is a medical device which uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart. ...


Investigation of heart structure can also be important. The heart in most people with palpitations is completely normal in its physical structure, but occasionally abnormalities such as valve problems may be present. Usually, but not always, the cardiologist will be able to detect a murmur in such cases, and an echo scan of the heart (echocardiogram) will often be performed to document the heart's structure. This is a painless test performed using sound waves and is virtually identical to the scanning done in pregnancy to look at the fetus. The echocardiogram is an ultrasound of the heart. ... For other uses, see Fetus (disambiguation). ...


Treatment

Treating heart palpitations depends greatly on the nature of the problem. In many patients, caffeine intake triggers heart palpitations. In this case, treatment simply requires caffeine intake reduction. If it's been determined that caffeine is not the cause, another dietary consideration is too little magnesium, particularly in pre-menopausal women. A supplement of equal dosages of magnesium and calcium may be helpful in eliminating palpitations. For severe cases, medication is often prescribed.


A variety of medications manipulate heart rhythm, which can be used to try to prevent palpitations. If severe palpitations occur, a beta-blocking drug is commonly prescribed. These block the effect of adrenaline on the heart, and are also used for the treatment of angina and high blood pressure. However, they can cause drowsiness, sleep disturbance, depression, impotence, and can aggravate asthma. Other anti-arrhythmic drugs can be employed if beta-blockers are not appropriate. Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... angina tonsillaris see tonsillitis. ...


If heart palpitations become severe, antiarrhythmic medication can be injected intravenously. If this treatment fails, cardioversion may be required. Cardioversion is usually performed under a short general anaesthesia, and involves delivering an electric shock to the chest, which stops the abnormal rhythm and allows the normal rhythm to continue. Through electricity or drug therapy, cardioversion converts heart arrhythmias to normal rhythms. ... In modern medical practice, general anaesthesia (AmE: anesthesia) is a state of total unconsciousness resulting from general anaesthetic drugs. ...


For some patients, often those with specific underlying problems found in ECG tests, an electrophysiological study may be advised. This procedure involves inserting a series of wires into a vein in the groin, or the side of the neck, and positioning them inside the heart. Once in position, the wires can be used to record the ECG from different sites within the heart, and can also start and stop abnormal rhythms to further accurate diagnosis. If appropriate, i.e. if an electrical "short circuit" is shown to be responsible for the abnormal rhythm, then a special wire can be used to cut the "short circuit" by placing a small burn at the site. This is known as "radiofrequency ablation" and is curative in the majority of patients with this condition. Electrophysiology is the study of the electrical properties of biological cells and tissues. ... Radiofrequency ablation (RFA) uses radiofrequency energy to destroy abnormal electrical pathways in heart tissue. ...


Atrial fibrillation has been discussed in a separate article. Treatment may include medication to control heart rate, or cardioversion to support normal heart rhythm. Patients may require medication after a cardioversion to maintain a normal rhythm. In some patients, if attacks of atrial fibrillation occur frequently despite medication, ablation of the connection between the atria and the ventricles (with implantation of a pacemaker) may be advised. A very important risk of atrial fibrillation is the increased risk of stroke. Management of atrial fibrillation usually includes some form of blood thinning treatment. Atrial fibrillation (AF or afib) is a cardiac arrhythmia (abnormal heart rhythm) that involves the two upper chambers (atria) of the heart. ...


Very rarely, palpitations are associated with an increased risk of blackouts, and even premature death[citation needed]. Generally speaking, serious arrhythmias occur in patients who are known to have heart disease, or carry a genetic predisposition for heart disease or related abnormalities and complications.


Palpitations, in the setting of the above problems, or occurrences such as blackouts or near blackouts, should be taken seriously. Even if ultimately nothing is found, a doctor should be contacted immediately to arrange the appropriate investigations, especially if palpitations occur with blackouts or if any of the above conditions are noticed.


See also

“QRS” redirects here. ... Holter monitor In medicine, a Holter monitor (also called an ambulatory electrocardiography device), named after its inventor, Dr. Norman J. Holter, is a portable device for continuously monitoring the electrical activity of the heart for 24 hours or more. ... This article or section does not cite any references or sources. ... Bradycardia, as applied to adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min. ... This article does not cite any references or sources. ...

References

  1. ^ MedlinePlus Medical Encyclopedia: Heart palpitations

External links

  • Abnormal Heart Rhythms, BHF
  • British Heart Foundation
  • Medic8 Family Health Guide
  • MedlinePlus Medical Encyclopedia, NIH
In medicine, chest pain is a symptom of a number of conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). When the chest pain is not... Suffocation redirects here, for the band, see Suffocation (band). ... Pleurisy, also known as pleuritis, is an inflammation of the pleura, the lining of the pleural cavity surrounding the lungs, which can cause painful respiration (also called pleuritic chest pain) and other symptoms. ... Respiratory arrest is the cessation of the normal tidal flow of the lungs due to paralysis of the diaphragm, collapse of the lung or any number of respiratory failures. ... This article does not cite any references or sources. ... Rales,crackles or crepitation, are the clicking, rattling, or crackling noises heard on auscultation of the lungs with a stethescope during inhalation. ...

  Results from FactBites:
 
Early American Manual Therapy (12426 words)
In cases where the palpitation is purely secondary, as in anemia, from the changed state of the blood, and in acute infectious diseases, from the irritation of toxic substances circulating in the blood, the lesions belong to the primary disease.
The palpitation, dyspnea, small and irregular pulse, and cool extremities are due to the cardiac dilatation, and are benefited by treatment of that condition.
The palpitation of the heart may be quieted by the inhibition applied to the accelerators; the dyspnea by very cautious and gentle elevation of the ribs; the pain by inhibition of the local nerve supply of the part affected; other symptoms, according to their kind, may be met by the usual osteopathic procedures.
Palpitation - Wikipedia, the free encyclopedia (1179 words)
Palpitation is a sensation in which a person is aware of an irregular, hard, or rapid heartbeat.
A palpitation is an awareness of the beating of the heart, whether it is too slow, too fast, irregular, or at its normal frequency; brought on by overexertion, adrenaline, alcohol, disease (such as hyperthyroidism) or drugs, or as a symptom of panic disorder.
Palpitations may be felt with heart problems, but also in anemias and thyroid malfunction.
  More results at FactBites »

 
 

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