For Your Health
The Truth About Palpitations
Caffeine, stress and nicotine could be just some of the reasons why your heart is racing
Some years ago I was having a stress test during a company physical. Everything seemed to be going fine, but afterwards, the doctor sat me down and told me that my ECG had shown palpitations and recommended I have an echocardiogram to check them out. Following him out the door, the nurse poked her head back in long enough to say, “Before you order up the test, try quitting coffee.”
Thank heavens for nurses. She was 100 percent right. As soon as I quit caffeine, the palpitations, which I’d had as long as I could remember, stopped. When I told this story to my friend Mary, who complained of palpitations one day when we were cycling together, she stopped drinking coffee too. Problem solved.
Just last week, palpitations hit my friend Dawn hard. Increasing over a couple of months, they actually woke her up two nights in a row. When she called her doctor to make an appointment, he sent her straight to the emergency room. She spent a night in the hospital while they monitored her heart. So far, everything looks good, but they’re still checking to make sure she doesn’t have an arrhythmia serious enough to require treatment. At the same time I was hearing Dawn’s story, I read about a new drug, Multaq, that has just been approved for treating atrial fibrillation, a serious form of arrhythmia that can generate palpitations. All this sent me off on the research trail to find out more about palpitations, how serious they are and what they can mean.
My palpitations felt like a skipped beat, but they can also present as either fluttering or pounding heartbeats. In most cases, they don’t cause any further trouble. The Mayo Clinic suggests seeing a doctor if you’re experiencing dizziness, shortness of breath, fainting or chest discomfort.
Turns out caffeine is not the only trigger. Other stimulants contained in OTC cough and cold meds or asthma inhalers can cause palpitations, as can nicotine. Not surprisingly, stress can induce them, too (they’re a classic symptom of panic attacks), as can strenuous exercise. To see whether palpitations are benign, doctors can use a variety of tests, including Holter monitoring, which my friend Dawn is about to undergo; she’ll be hooked up to a portable device that will record her heart’s performance, just like an ECG, for 24 hours or more. Your physician may also choose to take a closer look at your heart, via an X-ray or an echocardiogram, an ultrasound image.
In many cases, like mine, palpitations have an easily avoidable cause. For others, like Dawn, more investigation is warranted to rule out serious conditions. For instance, some arrhythmias, such as atrial fibrillation, can cause strokes, when blood pools in the heart and then clots. Hyperthyroidism (your thyroid gland is overly active) can also cause palpitations. So if a lifestyle remedy doesn’t do the trick, it’s best to check it out with your doctor. Meantime, there’s an excellent rundown of symptoms and treatments on mayoclinic.com.