Why does heart palpitations occur?

An increased heart rate (HR) can be a normal response of the heart muscle to various circumstances, or it can be a consequence of a number of diseases.

Thus, the heart rate increases at ² :

Physical activity

Strong emotional tension, stress

Elevated body temperature

Dehydration

Hormonal changes (during menstruation, pregnancy or menopause)

Taking medications

Consumption of foods (coffee, chocolate, alcohol) containing substances that stimulate the heartbeat

Periodic attacks of rapid heartbeat can be a symptom of a number of diseases, primarily heart disease:

1. 1Arrhythmias areone of the most common causes of increased heart rate—arrhythmia. This is a group of disorders that occur when the electrical impulses that coordinate the heartbeat are disrupted. Depending on where the impulse originates, in what sequence, and how often it occurs, several types of arrhythmia are ^{distinguished} .
2. 2Extrasystoles arepremature contractions that can be detected on an ECG. They are the most common heart rhythm disorder, often detected in healthy individuals. Normally, approximately 200 supraventricular and 200 ventricular extrasystoles can occur per day . ⁴

   Extrasystoles can be triggered by smoking, strong tea, coffee, and alcohol consumption, and emotional stress. Asymptomatic extrasystoles are considered harmless. They are even called “cosmetic” arrhythmia to emphasize the lack of any health threat . ⁴

3. 3Paroxysmal supraventricular tachycardia (PSVT) isa condition characterized by episodes of abnormally rapid heart rate. It is a common type of arrhythmia that rarely poses a health risk but can cause some discomfort. It often occurs in young people. The main symptoms are intermittent rapid heartbeat, shortness of breath, and chest pain . ⁵
4. 4Ventricular tachycardia isa disorder that disrupts the normal heart rhythm, characterized by an increased ventricular rate. It manifests as a rapid heartbeat in adults (less commonly in children), shortness of breath, a feeling of pressure, and chest discomfort. Sustained ventricular tachycardia typically develops in heart disease, such as myocardial infarction . ⁵
5. 5Supraventricular tachyarrhythmias area group of arrhythmias characterized by at least three consecutive abnormal heartbeats. The total heart rate exceeds 100 beats per minute. Attacks can be paroxysmal, meaning they begin and end suddenly, or persistent (non-paroxysmal) ⁶ .
6. 6Atrial fibrillation (AF) isone of the most common arrhythmias. Atrial fibrillation is characterized by uncoordinated electrical activity of the atria and deterioration of their function. Symptoms include chest pain, increased heart rate at rest and during exercise, and shortness of breath. The condition can lead to myocardial dysfunction and the development (or progression) of heart ^failure .
7. 7Atrial fibrillation (AF) isa regular atrial rhythm with a rate higher than normal—more than 200-250 beats per minute. It is a common cause of rapid heartbeat and is more common in men than in women. The risk of developing it increases with age. It typically occurs due to structural changes in the myocardium in patients with coronary artery disease and other chronic conditions (thyroid dysfunction, rheumatism, chronic lung disease, etc.) . ^Atrial

   fibrillation is characterized by a sudden sensation of rapid heartbeat, shortness of breath, general weakness, chest pain, and sometimes dizziness, low blood pressure, and even cardiac arrest. Due to impaired blood flow, cardiac function is impaired, leading to the development of heart ^failure .

8. 8Ventricular fibrillation isa rapid (more than 300 beats per minute) irregular heartbeat. It is an extremely dangerous condition that can lead to cardiac arrest . ⁹

Why do arrhythmias occur?

Some types of arrhythmias (for example, extrasystole) occur in healthy people in the absence of any cardiovascular diseases.

But a number of heart rhythm disorders develop against the background of various diseases, including ¹⁰ :

• heart and vascular diseases – coronary heart disease, myocardial infarction, heart defects, arterial hypertension and others;
• thyroid dysfunction;
• diabetes mellitus;
• genetic predisposition;
• obstructive sleep apnea syndrome (stopping breathing during sleep);
• smoking;
• abuse of alcohol and caffeinated drinks;
• side effects when taking medications (including over-the-counter medications).

When to see a doctor?

^{There are 2} danger signals that require calling a doctor :

• episodes of persistent increase in heart rate;
• fainting;
• sharp pain in the chest;
• severe shortness of breath;
• severe dizziness.

If the sensation of increased heart rate occurs only occasionally and lasts a few seconds, it is usually not serious. However, if symptoms occur alongside heart disease (hypertension, angina) or if the condition gradually worsens, you should consult a ^doctor .

Diagnosis and treatment

The doctor clarifies the anamnesis, questions the patient, finding out the symptoms in detail, conducts a physical examination – measures the pulse, blood pressure, body temperature, listens to the heart, lungs, and, if necessary, prescribes instrumental and laboratory tests ² :

• electrocardiography;
• Holter monitoring;
• magnetic resonance imaging of the heart;
• electrophysiological study;
• sometimes – laboratory blood tests.

If the heart rhythm disturbance is not related to cardiovascular disease, treatment may not be necessary. Recommendations in such cases may be based on lifestyle changes (e.g., limiting coffee consumption, avoiding alcoholic beverages, and quitting smoking) ^2,4