Off Beat: Heart Arrhythmia is the Topic of this Month’s Healthline
By Regina Schaffer
Courier-Post | March 3, 2014
There is an expression that the heart can “skip a beat” when someone is newly in love, usually referring to the feeling of a racing heartbeat. That can be romantic, and usually is harmless.
It’s when the heart seems to skip a beat again and again — and again — that a person may want to consider seeing a doctor about a possible underlying heart condition.
A fast heartbeat, a slow heartbeat, an irregular heartbeat — all of these fall under the umbrella of what is known as heart arrhythmia. They can occur in perfectly healthy, normal hearts, but they may also signal signs of serious heart problems. Left unchecked, a recurring, abnormal heartbeat could leave a patient in real danger for heart attack, stroke or other medical emergencies.
The heart has its own electrical system, which controls the rate of the heartbeat, says Dr. Andrew Zinn, a cardiologist with Cardiovascular Associates of the Delaware Valley in Elmer.
An arrhythmia is defined as a heartbeat that is very fast (tachycardia, greater than 100 beats per minutes), very slow (bradycardia, less than 60 beats per minute), or irregular.
There are many causes behind heart arrhythmia, including high blood pressure, coronary artery disease, or congestive heart failure. Arrhythmias can also be caused by certain substances or medications, such as caffeine, nicotine, alcohol, diet pills and cough and cold remedies. Emotional states such as shock, fright or stress can also cause irregular heart rhythms.
“The most important thing is what the associated conditions are,” Zinn said. “So, it’s important to look at whether someone has a structurally normal heart, or has any other abnormalities that need to be treated.”
Many people will experience heart palpitations for many reasons, Zinn said, and oftentimes, it is harmless — particularly if the person experiencing the palpitations is young and otherwise healthy.
But it is important to be on the lookout for related symptoms that signal trouble.
“Be aware of dizziness, chest pain, shortness of breath … and be cognizant of any activities that induce these symptoms,” Zinn said. “Lots of people have palpitations, and oftentimes the palpitations are benign. But, with very fast and very slow heart rates, there could be associated symptoms. And in certain circumstance, it can be dangerous.”
Treatment for heart arrhythmia can vary, depending on what heart abnormality a patient is dealing with, Zinn said.
“A doctor will try to figure out exactly what type of arrhythmia it is, and whether it’s associated with abnormalities of the heart,” Zinn said. “Treatment is going to depend on what type of abnormality it is, and whether it keeps bad company.”
“So, the first thing is to treat any underlying causes,” Zinn said. “The second is to try to figure out whether the heart rate is very slow or very fast. With a slow heart rate, sometimes pacemakers are required. With a fast rate, sometimes medications are required.”
With some arrhythmia, there can also be a risk of stroke, Zinn said, requiring a patient to go on blood thinners.
“What people need to understand is that it can be very innocent, but it can be very dangerous,” Zinn said. “It’s that whole concept of structural heart disease. If a 15-year-old with a normal heart has palpitations, it’s unlikely to be dangerous. But if an older patient with heart failure has palpitations, it’s a problem.”
Regardless of the heart condition, Zinn said, lifestyle modification is key to lowering the risk for heart attack and stroke. Simple steps like quitting smoking, eating a healthy, balanced diet and regular exercise go a long way. A patient can work with their doctor to develop health goals and a fitness plan that meets their needs.
“The cornerstone of management of any cardiovascular condition … is appropriate management of cardio risk factors,” Zinn said. “There are many, many reasons why lifestyle modification may help. That’s the first thing we prescribe to basically anybody.”
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