Palpitation is the feeling of heartbeats that causes discomfort. The disturbing beats felt are not always abnormal beats. Most of the time, normal beats can create the perception of palpitations for various reasons. The heart muscles contract at a rate of 60-100 beats per minute at rest with the regular, rhythmic electrical current emanating from the sinus node.
The most common causes of palpitations are summarized below. In our patients who apply to our outpatient clinic with complaints of palpitations, non-physical-psychological reasons are almost the most common. Even in cases due to a physical disease, psychological reasons often appear as a factor that aggravates the situation and makes the complaint more disturbing.
Palpitation often develops without a serious heart disease. It is a harmless symptom. However, it can rarely be the first reflection of a life-threatening problem. For this reason, evaluating the palpitation and determining that it is related to the event is important in terms of ruling out a heart problem that may be especially important.
The most valuable data in the evaluation of palpitation is actually a test taken at the exact moment, that is, at the moment when the palpitation exists. heart chart. However, most of the time, this is not possible due to reasons such as the short duration of the palpitations, their rarity, or the lack of a health institution that can be reached in a short time. In this case, the most valuable data source for the physician is what the patient will tell about his palpitations.
An ECG (electrocardiography = heart radiograph) we will take during an ongoing palpitation will help us make the diagnosis. However, if the past is in turmoil where we do not know when it will happen again, there is often no evidence. So to speak, there is a situation with an unknown perpetrator, and we are detectives trying to reach the perpetrator by conducting our interrogation, based on clues. The story of the palpitations is as valuable to us as the place, time, before and after the incident, and the moment of the incident are to a detective. We ask some questions to evaluate. these questions Let's write here so that those who will come to us with the complaint of "palpitations" can come prepared. :)
1.) How would you describe the palpitations you feel?
Our patients usually describe palpitations in many different ways:
p>- I can hear my heartbeat.
- It beats very strongly, it shakes my body
- It beats very fast, as if it were going to come out of its place, like a butterfly fluttering
- A wave of excitement, a warmth, a feeling of falling into a void
and then a strong pounding, thumping
- It beats slowly but strongly
- It beats irregularly
p>
2.) When, What while, In what situation does it happen? Have any triggers caught your attention?
Palpitations that occur for no reason, at an ordinary time, without a triggering factor, usually occur with triggering factors such as excitement, stress, excessive tea-coffee-alcohol intake, exercise. The palpitations that occur give us clues for different situations.
3.) How often does it happen? How long does it take ?
There may be repetitive palpitations lasting two to three seconds, or there may be a feeling of constant palpitations.
4.) Have you noticed any other accompanying conditions-complaints?
Chest pain, shortness of breath, sweating, nausea, vomiting, dizziness, feeling like fainting? Whether or not conditions such as fainting or fainting accompany palpitations (before, during or after) are important clues for us.
5.) Do you have any previously diagnosed diseases and medications you use? ?
Some diseases, especially anemia, thyroid hormone disorders, lung diseases and psychiatric diseases, and sometimes the drugs used for them, can be the cause, trigger or aggravator of palpitations.
6.) Do you have any habits?
Tea, coffee, soft drinks, smoking, alcohol, substance use
7.) Check your pulse during palpitations. Could you count? Have you measured your blood pressure?
During palpitations (which is usually possible in palpitations lasting more than 2-3 minutes), the person who feels the palpitations or If the relative counts the pulse or measures it with an electronic blood pressure monitor (or now with the available applications of some smartphones), it will give us a serious clue in making a diagnosis. As you can see from the pictures, the pulse can be counted from the wrist, arm or jugular vein in the neck area. Counts made with a sphygmomanometer also allow us to know the current blood pressure value.
Yes, with the answers we receive to these and similar questions, sometimes without the need for another examination. We can strongly predict what happened. However, since we cannot act with guesses, even strong ones, we take steps to confirm the diagnosis one by one. Physical Examination, electrocardiography, echocardiography, rhythm holter, event recorders are other steps we use in the evaluation of palpitations.
Information such as "if you answered the above questions in the following way, the reason for your palpitations is this" is, of course, not the subject of this article. The diagnostic process, as always, should begin with face-to-face communication between the patient and the physician.
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