I recall an eventful car ride home after a typical day of shopping with my mom and sisters. Suddenly Mom went pale and complained of a fluttering sensation in her chest. She pulled over and was taken to the hospital by ambulance while a friend took us home. My mother returned home that evening, much to our relief, with instructions to rest.
During later chats with her, I learned of the stress she was feeling at the time about her life in general. Since then, I've met many women who anxiously suffered similar symptoms and others who had less dramatic sensations, such as an occasional eerie feeling in their chest.
Many women suffer from palpitations, the medical term for this sensation, at some point in their lives. The word itself has the sense of a drumbeat, which is similar to the heartbeat we feel in moments of intense fear or exertion. Fear, exertion, stress-these are all normal circumstances that may cause palpitations. Typically, these types of palpitations manifest as a rapid heartbeat without any sense of skipping beats or pauses.
Sometimes, however, palpitations can be caused by an abnormal heart rhythm (arrhythmia), and these require evaluation.
The heart is an amazing, electrically wired muscle that needs an electric impulse to produce each of its beats. This impulse typically starts at the sinus node, a group of specialized cells in the upper chamber of the heart (the right atrium), which generates the electrical impulses that cause the heart muscle to contract. The electric impulse proceeds down a standard pathway to activate the heart muscle to make an organized and powerful contraction that pumps blood. This is called a normal sinus rhythm (NSR).
If, however, this electrical impulse starts and flows along a different pathway, then an arrhythmia is said to occur. An electrocardiogram (ECG or EKG), a test that records the electrical conduction system of the heart, can trace this electrical impulse and show whether the heart is firing normally or not.
If you feel the occasional palpitation, should you rush to the emergency department right away? Not at all. Many times throughout a typical day, most people experience normal arrhythmias that are considered benign and of no medical concern. These harmless arrhythmias are known as premature ventricular contractions (PVCs).
A PVC occurs when an early non-standard beat occurs and then delays the next regular impulse, which leads to the sensation of a missed beat or pause. These arrhythmias can happen individually or in brief spurts, and they can feel rather strange.
How can an arrhythmia ever be benign? Because no dreaded consequences, such as a heart attack, a stroke, or sudden death are associated with it. If you've noticed some palpitations for the first time and the symptoms are brief, then I suggest you talk with your general doctor that day or the next.
But if you have symptoms like passing out, chest pressure or heaviness, nausea, or difficulty breathing, then a visit to the emergency department is in order.
