“Something is wrong with my heartbeat. Is it serious?”
Every cardiologist and family practitioner gets this question from concerned patients. It usually refers to cardiac arrhythmias, a common occurrence that brings many people in to see their doctor. So here is a bit of basic information you need to know about cardiac arrhythmias.
There are many types of arrhythmias, but basically the term refers to an irregular heart rhythm, which can also be noted as an irregular pulse or heart rate.
Essentially, the heartbeat goes off cadence and this irregularity may or may not be felt in your body. Many people are aware of skipping, strongly palpitating, or rapid heartbeats, while other individuals may learn of an arrhythmia at a doctor’s office visit when it shows upon an electrocardiogram.
Very common. Cardiac arrhythmias can affect both sexes and all ages. About 20 or 25 percent of patients with arrhythmias are not in any danger.
Certain situations can trigger them, including:
Yes, there are several. The most common, called premature ventricular contractions (PVCs), occur when one of the two bottom chambers—the ventricles—of the heart contracts prematurely. We frequently see PVCs in women who have mitral valve prolapse. A premature atrial contraction is when the atrium (one of the two top chambers of the heart) contracts prematurely. These irregularities are usually not a problem for healthy people.
Atrial fibrillation is another arrhythmia that often develops with aging, where the heart is “regularly irregular,” though you may not feel it. For more info on "A-fib," check out my atrial fibrillation FAQs.
The “café coronary” has been documented in connection with fatty meals, alcohol, and stressful news. The combination can trigger a fatal series of rapid fired ventricular beats call ventricular tachycardia (or V-tach for short).
Ventricular tachycardia is an intense and prolonged racing of the heart—like a runaway PVC. And V-tach is dangerous because it can deteriorate into ventricular fibrillation or cardiac arrest. We use nasal oxygen and intravenous (IV) medication to prevent and to treat these lethal arrhythmias during a heart attack, which is just one reason to get yourself to a hospital quickly if you suspect you are having one.
In essence, during dangerously fast arrhythmias, the heart’s pumping mechanism loses traction; its rhythm becomes chaotic and it cannot supply its very own heart muscle (that does the pumping) orthe rest of the body with adequate blood.
I recall one of my patients, an Englishman who’d routinely overindulge on gin and end up developing tachycardia. Obviously lacking good judgment, he would drive himself to the emergency room for treatment: dangerous for him and everyone else on the road!
Despite warnings, he indulged himself one too many times and died when the tachycardia turned into deadly fibrillation, as it often does. These situations are particularly dangerous among patients with congestive heart failure or who have cardiomyopathy, where the heart muscle becomes inflamed, dilated, and doesn’t pump well, or where the left ventricle is dilated.
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