Palpitations: What you need to know

The article was written by Specialist Doctor II Nguyen Bang Phong - Cardiovascular Center - Vinmec Times City International Hospital

There are 2 groups of causes of palpitations: heart disease and non-heart disease.
1.1. Cardiovascular disease is the leading cause of palpitations. Coronary artery disease. Heart failure . Electrical abnormalities: WPW syndrome, Brugada syndrome, long QT syndrome, complete atrioventricular block, pacemaker syndrome... Valve disease, cardiomyopathy, congenital heart disease. 1.2. Non-cardiac palpitations * Other conditions:
Adrenal medulloblastoma: palpitations accompanied by severe hypertensive crisis. Acute hyperthyroidism. Low blood sugar. Anxiety disorders . * Non-pathological: panic, exertion, caffeine, tobacco, alcohol, stimulants, some drugs like nifedipine, vasopressors...

Non-pathological palpitations are usually sinus attacks, which resolve spontaneously after a certain period of time, depending on the cause. The prognosis is usually not dangerous. Palpitations due to non-cardiovascular disease are also often sinus tachycardia, so the prognosis is usually good and does not recur if thoroughly treated for related diseases. Cardiovascular palpitations are usually atrial flutter - flutter, thickened ventricular extrasystoles or ventricular tachycardia, with a poor prognosis, which can cause syncope, acute heart failure, angina or even death. If palpitations are caused by WPW syndrome, they are usually supraventricular tachycardias, with a milder prognosis.

If it is well known that the palpitations are not due to a medical condition, then there is no need to go to the hospital, just appropriate rest. But most cases of palpitations are not known to be due to a disease or not, often with many potential causes of fainting, angina, shortness of breath or death, then we need to go to the hospital, it is best to go to the hospital. to emergency or cardiology facilities.
* Clinical examination to detect medical history, especially history of cardiovascular disease, thereby orienting diagnosis and doing related paraclinical techniques.

* Paraclinical techniques: depending on the situation to assign appropriate
Testing of electrolytes, blood sugar, blood and urine catecholamines, stimulants, thyroid hormone, heart enzymes. In addition, it is also necessary to do basic tests such as kidney function, liver enzymes... Electrocardiogram, Holter electrocardiogram. In some cases, electrocardiographic exploration of the chambers of the heart will be required to assess the nature of the arrhythmia causing the palpitations. Echocardiography, cardiac magnetic resonance to assess structural heart disease, stress testing electrocardiogram, stress echocardiography, coronary angiography to assess coronary artery status. * Indications for treatment
Depending on the nature of the type of arrhythmia causing palpitations, there are appropriate treatment methods.
If palpitations are not due to pathology: rest and relax, practice sports, quit smoking, limit alcohol, do not use stimulant drugs, do not use drugs that can cause heart palpitations (Nifedipine, drugs). adrenergic...). If palpitations are caused by noncardiac disease: optimal treatment of palpitations such as adrenal medullary surgery, treatment of hyperthyroidism, adjustment of diabetes medication to limit hypoglycaemic episodes, psychiatric treatment schizophrenic.

Cardiovascular palpitations: the most common and also have a poor prognosis, so it is necessary to treat these diseases very well (coronary artery disease, structural heart disease, electrical abnormalities). In addition, in case the palpitations are caused by some sudden death-threatening ventricular arrhythmias, there is an additional indication of implanting an automatic defibrillator to prevent sudden death (ICD: Implantable Cardioversion Defibrillator). Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology system. The hospital provides comprehensive, professional medical examination, consultation and treatment services, with a civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.