Summary about Disease
Functional palpitations refer to the sensation of a rapid, fluttering, or pounding heart when no underlying structural or electrical heart abnormality is present to fully explain the symptoms. While palpitations are a common experience, in functional palpitations, extensive cardiac testing reveals no identifiable cause, leading to the conclusion that psychological or lifestyle factors are primarily contributing to the sensation.
Symptoms
The primary symptom is the awareness of one's own heartbeat. This can manifest as:
Rapid heart rate (tachycardia)
Skipped beats
Pounding or forceful heartbeats
Fluttering sensation in the chest or neck
Irregular heart rhythm (perceived) These sensations may occur at rest, during activity, or seemingly without any trigger.
Causes
The exact cause of functional palpitations is often multifactorial and not fully understood. Contributing factors may include:
Psychological factors: Anxiety, stress, panic disorder, depression.
Lifestyle factors: Caffeine intake, alcohol consumption, nicotine use, dehydration, lack of sleep, intense exercise.
Hormonal changes: Menstruation, pregnancy, menopause.
Certain medications: Decongestants, asthma inhalers, diet pills.
Medical conditions: Anemia, thyroid disorders (even if mild and not fully diagnosed), low blood sugar.
Heightened awareness: Increased focus on bodily sensations.
Medicine Used
Treatment focuses on managing underlying contributing factors and reducing the perceived severity of the palpitations. Medicines may include:
Beta-blockers: To reduce heart rate and blood pressure, which can alleviate the sensation of palpitations (used with caution, as they can sometimes worsen symptoms in some individuals).
Anti-anxiety medications (Anxiolytics): If anxiety is a significant contributing factor (e.g., SSRIs, SNRIs, benzodiazepines - benzodiazepines used short-term and with caution due to potential for dependence).
Magnesium supplements: Some studies suggest a possible benefit in reducing palpitations, but further research is needed.
Other medications: Treatment for underlying medical conditions (e.g., thyroid medication for hyperthyroidism, iron supplements for anemia).
Herbal Remedies: Some people find relief from certain herbal remedies such as Valerian Root. Note: Medicine use should always be guided by a doctor.
Is Communicable
Functional palpitations are not communicable. They are not caused by an infectious agent and cannot be spread from person to person.
Precautions
Identify and manage triggers: Keep a diary to track palpitations and potential triggers (e.g., stress, caffeine, specific foods).
Stress management: Practice relaxation techniques (e.g., deep breathing, meditation, yoga).
Limit stimulants: Reduce caffeine, alcohol, and nicotine intake.
Stay hydrated: Drink plenty of water.
Ensure adequate sleep: Aim for 7-9 hours of quality sleep per night.
Regular exercise: Engage in regular physical activity, but avoid overexertion.
Medical evaluation: Consult a healthcare professional to rule out underlying medical conditions.
How long does an outbreak last?
Functional palpitations do not have a defined "outbreak" period like an infectious disease. The duration of palpitations can vary widely:
Short-lived: Palpitations may last for a few seconds or minutes.
Prolonged: They can persist for hours or even days.
Intermittent: Palpitations may come and go over time. The duration is often related to the triggering factors and the individual's response to them.
How is it diagnosed?
Diagnosis typically involves a process of elimination:
Medical history and physical examination: The doctor will ask about your symptoms, medical history, and lifestyle.
Electrocardiogram (ECG/EKG): To assess heart rhythm.
Holter monitor: A portable ECG that records heart rhythm over 24-48 hours or longer.
Event monitor: A device that records heart rhythm when you experience symptoms.
Echocardiogram: An ultrasound of the heart to assess its structure and function.
Blood tests: To check for thyroid abnormalities, anemia, and other underlying medical conditions.
Stress test: To evaluate heart function during exercise. If all tests are normal and no structural or electrical heart problems are found, the diagnosis of functional palpitations may be considered. It's a diagnosis of exclusion.
Timeline of Symptoms
The timeline of symptoms is highly variable. There is no set pattern:
Sudden onset: Palpitations may start abruptly.
Gradual onset: They may develop gradually over time.
Sporadic: Occur infrequently.
Frequent: Occur regularly.
Triggered: Occur in response to a specific event (e.g., stress, caffeine).
Unpredictable: Occur without any apparent trigger.
Important Considerations
Ruling out cardiac causes is crucial: Functional palpitations are a diagnosis of exclusion. It is essential to ensure that no underlying heart condition is responsible for the symptoms.
Psychological factors are significant: Addressing anxiety, stress, and other psychological factors is a critical part of management.
Lifestyle modifications are often effective: Identifying and modifying lifestyle triggers can significantly reduce the frequency and severity of palpitations.
Patient education is important: Understanding the nature of functional palpitations and the benign prognosis (once serious causes are ruled out) can help reduce anxiety and improve quality of life.
Second opinions are appropriate: If you are concerned about your diagnosis or treatment plan, seeking a second opinion from another healthcare professional is always advisable.