How is frequent palpitation?

Palpitation is a feeling of discomfort or palpitation caused by conscious heart beating. I feel uncomfortable when my heart rate increases, and I feel strong when my heart rate is slow. When flustered, the heart rate can be fast or slow, and there can be arrhythmia. People with normal heart rate and rhythm may also be flustered.

[etiology]

1. The palpitation with enhanced myocardial contractility caused by heart beat can be physiological or pathological. Physiologically, they can be shown as follows: ① Healthy people are under strenuous exercise or excessive mental stress; 2 after drinking, strong tea or coffee; ③ Use some drugs, such as adrenaline, ephedrine, caffeine, atropine and thyroid tablets. Pathological cases appear in the following situations:

(1) Ventricular hypertrophy: hypertensive heart disease, aortic regurgitation, mitral regurgitation, etc. Leading to left ventricular hypertrophy and increased myocardial contractility. Patent ductus arteriosus and ventricular septal defect regurgitation increase the load on the heart, leading to ventricular hypertrophy and palpitation.

(2) Other diseases that cause increased heartbeat: ① Hyperthyroidism, which is due to the increase of basal metabolism and sympathetic nerve excitability, leads to an accelerated heart rate. ② Anemia, especially palpitation during acute blood loss. When anemia occurs, the oxygen carrying capacity of blood decreases. Hypoxia in organs and tissues. In order to ensure the supply of oxygen, the body compensates by raising the heart rate and increasing the output. Increased heart rate can lead to palpitations. 3 fever, at this time, the basal metabolic rate increases, the heart rate increases, and the cardiac output increases, which can also cause palpitations. ④ Hypoglycemia and pheochromocytoma lead to increased adrenaline release, increased heart rate and palpitation.

2. Arrhythmia When tachycardia, bradycardia or other arrhythmia occurs, palpitations may occur.

(1) Tachycardia: Sinus tachycardia, paroxysmal supraventricular tachycardia or ventricular tachycardia caused by various reasons can cause palpitations.

(2) Bradycardia: high atrioventricular block (Ⅱ, Ⅲ degree atrioventricular block), sinus bradycardia or sick sinus syndrome, which causes palpitation due to slow heart rate, prolonged diastolic period, increased ventricular filling and strong heartbeat.

(3) Other arrhythmias: premature beats, atrial flutter or fibrillation, etc. Because the heart beats irregularly or intermittently, the patient feels palpitation and even has the feeling of stopping beating.

3. Cardiac neurosis is caused by autonomic nervous dysfunction, and the heart itself has no organic lesions. More common in young women. In addition to palpitation, clinical manifestations often include increased heart rate, dull pain in precordial area or apex, neurasthenia such as fatigue, insomnia, dizziness, headache, tinnitus and memory loss. And it is more likely to happen in the case of anxiety and emotional excitement. Beta adrenergic receptor hyperactivity syndrome is also related to autonomic nervous dysfunction, which is easy to occur when nervous. In addition to palpitation, tachycardia, chest tightness and dizziness, ECG can also have some changes, such as sinus tachycardia, mild st segment depression, flat or inverted T wave, which is easily confused with organic heart disease. Propranolol test can be used to differentiate this disease. β -adrenergic receptor hyperactivity syndrome can be distinguished. After propranolol application, the ECG changes can return to normal, indicating that the changes are functional.

【 Mechanism 】 The heart and its mechanism have not been fully understood. It is generally believed that excessive cardiac activity is the basis of palpitation, which is often related to the changes of heart rate and cardiac output. During tachycardia, the diastolic period is shortened and the ventricle is not fully filled. When the ventricle contracts, the tension between the ventricular muscle and the heart valve suddenly increases, which can lead to the rapid heartbeat and palpitation. Arrhythmias, such as premature beats and ventricular contraction after a long compensatory period, are often very strong and can lead to palpitations. The occurrence of palpitation is related to arrhythmia and its duration, such as sudden paroxysmal tachycardia, which often has obvious manifestations, while in chronic arrhythmia, such as atrial fibrillation, there is no obvious palpitation due to gradual adaptation. The occurrence of palpitation is often related to mental factors and attention, and it is easy to appear when you are anxious, nervous and focused. Patients with heart disease can see palpitation, but it is not exactly the same as heart disease. Palpitation does not necessarily have a heart disease, and vice versa. For example, if there is asymptomatic coronary atherosclerotic heart disease, there will be no palpitations.

[Accompanying symptoms]

1. precordial pain can be seen in coronary atherosclerotic heart disease (such as angina pectoris and myocardial infarction), myocarditis and pericarditis, and also in cardiac neurosis.

2. Fever is found in acute infectious diseases, rheumatic fever, myocarditis, pericarditis and infective endocarditis.

3. Syncope or convulsion is seen in high atrioventricular block, ventricular fibrillation or paroxysmal ventricular tachycardia, sick sinus syndrome, etc.

4. Anemia is seen in acute blood loss caused by various reasons. At this time, sweating, weak pulse, blood pressure drop or shock often occur. Chronic anemia and palpitation are more obvious after fatigue.

5. Dyspnea can be seen in acute myocardial infarction, myocarditis, pericarditis, heart failure, severe anemia, etc.

6. Hyperthyroidism can be seen as emaciation and sweating.

[consultation points]

1. Seizure inducement, time, frequency and course of disease.

2. Pain, fever, dizziness, headache, syncope, convulsion, dyspnea, emaciation, hyperhidrosis, insomnia, anxiety and other related symptoms.

3. Have a history of heart disease, endocrine disease, anemia, neurosis, etc.

4. Do you like strong tea, coffee, tobacco and alcohol, and have a history of mental stimulation.