Your Health: Palpitations are mostly harmless but worth checking out

Patients who go to a doctor complaining of heart palpitations usually worry that they have some serious problem with their heart. They often describe a feeling that their hearts are “flip-flopping,” missing a beat, beating faster or beating irregularly.
Palpitations, whether harmless (as most of them are) or serious, should not be ignored. A medical evaluation is recommended, especially if they are associated with dizziness, shortness of breath, chest pain or fainting.
Palpitations are usually caused by the heart beating too soon before the next normal beat. When this happens, one feels a “flip-flop” sensation in one’s chest. Because the palpitation is only a skipped beat, the heart can still function normally, so there’s usually no health risk.
Quite often, a cause for palpitations is not found, but there are some known factors:
*Strong emotional responses, such as anxiety, stress or fear
*Use of caffeine, nicotine or alcohol
*Cold and cough medications that contain the decongestant pseudoephedrine (Sudafed), which can act as a stimulant
*Strenuous exercise
In rare cases, palpitations might be a sign of a potentially serious heart problem that requires treatment. Serious complications of palpitations can include the following:
*Fainting from a significant drop in blood pressure.
*Stroke from causing lack of oxygen rich blood to the brain.
*Heart failure from the heart pumping ineffectively.
*Cardiac arrest from a heart beating so irregularly that blood circulation stops.
A medical evaluation for palpitations will usually involve a physical exam, blood tests, and an electrocardiogram. The doctor might also order a portable heart monitor to be worn for 24 to 72 hours, which can detect palpitations not found on an EKG. The bottom line is that heart palpitations are usually more bothersome than they are serious, but it’s wise to check with a doctor, just to be safe.
Terry Hollenbeck, M.D., is an urgent-care physician at the Palo Alto Medical Foundation Santa Cruz in Scotts Valley. A doctor with 36 years’ experience, he invites readers to view his previous columns on his website, valleydoctor.wordpress.com. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.