By Christopher Leet, MD, FACC Emeritus
Palpitations is a common complaint. Technically, the term refers to any feeling of thumping in the chest. Although it can be disconcerting, sometimes it is nothing more than a muscle twitch. Other times it may be a disturbance in the electric rhythm within the heart itself.
The best way to tell is to feel your pulse at the wrist. If there is an associated change in the pulse, this may be the heart. If not, it’s simply a muscle contraction.
The most common irregularity goes by a long name, abbreviated as “PVCs.” In this, an area of the heart gets stimulated “out of sync,” causing a contraction before the heart is ready to pump for the next beat. This is felt in the pulse as a pause, like the heart stopped. Of course, it didn’t, and the heart starts up again. This is a normal phenomenon, related to stress, adrenalin, caffeine, etc.
In someone with a normal heart, it is nothing more than annoying. Sometimes there is a definite history of cardiovascular disease, and it may be necessary to investigate further. Primary care doctors can screen for some conditions, but patients may need to consult with a cardiologist.
The other common type of palpitation is called “SVT,” felt as a rapid, regular pulse. Usually benign, this can still be discomforting and may need to be examined in an emergency room if it persists for more than an hour.
Additionally, there is an increasing incidence of a phenomenon called atrial fibrillation. This is felt as an inconsistent, rapid and irregular pulse, with weak and strong beats. While quite common in normal hearts, it may call for more in-depth treatment if it persists or reoccurs.
Generally, if there is a relationship to stress or caffeine, these need to be curtailed. If symptoms persist, or are associated with a fainting sensation, medical examination is required.
Manassas resident Dr. Christopher Leet, now retired, practiced medicine for nearly 40 years, specializing in cardiology and internal medicine.