Symptoms of Arrhythmias
Approximately one-third of people with arrhythmia do not exhibit any symptoms, preventing their timely diagnosis and treatment. For individuals who do have symptoms, these may include feelings of a racing or pounding heart, chest pain, shortness of breath, dizziness, lightheadedness, anxiety, fainting or near fainting, and reduced capacity to exercise, which can impair the quality of life (Schmidt 2011; NHLBI 2011b). In some cases, symptoms can be dangerous and life-threatening, and may even lead to sudden cardiac death (Sali 2007).
What are palpitations?
Palpitations are sensations or feelings of a racing or pounding heart that may be felt in the chest, neck, or throat (NHLBI 2011c). These may or may not be accompanied by an abnormal heart rhythm (NIH 2012c). Typically they are harmless, and in up to 16% of cases no underlying cause can be found (Abbott 2005; Raviele 2011). Palpitations can result from non-cardiac causes such as anxiety, drug use, low blood sugar, electrolyte imbalance, or fever. Caffeine, alcohol, tobacco, and certain drugs can also lead to palpitations, as can panic attacks. Avoiding these triggers typically resolves the condition (NIH 2012c; WebMD 2012).
When accompanied by dizziness or fainting, palpitations may indicate the existence of a more serious condition, such as tachyarrhythmia. However, most patients with arrhythmias do not report palpitations. Non-arrhythmia causes of palpitations include coronary heart disease and congestive heart failure.
An electrocardiogram can be used help determine the cause of palpitations. In cases where structural heart disease is absent, further monitoring of the heart beat using a Holter monitor (instrument that records the heart rate over a period of 24-48 hours) may be used to make a diagnosis (Abbott 2005).