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Irregular heartbeat

By Flavia Nassaka

When the heart skipping a beat is a real health threat

Arapha Nansimbi is a healthy looking normal-sized teenager. She just celebrated her eighteenth birthday in May and, among other things, enjoys playing football and cycling. However, she sometimes she cannot do this because of her heart. Since she was 14, it has sometimes suddenly started beating very fast even when she in not engaged in any physical activity. It’s quite confusing because her medical checkup results always show she suffers no abnormality.

Dr. Emmy Okello, a Consultant Cardiologist at the Uganda Heart Institute says Nansimbi’s condition is quite common and occurs in many forms. Some people experience hard heart beats, skipped beats, pounding sensations in the chest and neck, fast beats, or merely irregular beats. The condition is collectively referred to as heart palpitations. It means someone develops a consciousness of his/her heart pumping.

Heart palpitations are extremely common. Though unpleasant, palpitations can be completely normal especially when one gets a palpitation immediately after a physical exercise, is scared, or anxious. It is expected to get back to normal when the situation goes away.

They also differ from one person to another depending on age, level of fitness and whether they have heart disease or not.

He says teenage girls commonly suffer from anxiety related palpitations even when there is no apparent danger. But in adults this can be an indicator of a more serious heart disease since as people get older, they start suffering from a wide range of cardiovascular complications.  However, he explains that the kind of lifestyle one lives may also predispose him/her to heart palpitations.  For instance, although under normal circumstances, the heart beats at a rate of 60 – 100 times per minute, in people who exercise routinely like marathon runners, the heart rate may drop to below 55 beats per minute without any problem.

People who do not tolerate coffee may have their heart rate going above 100 beats per minute due to the effect caffeine has on the heart. Alcohol too causes palpitations by altering the blood vessel size and by directly affecting heart muscle cells. In heavy drinkers that can eventually lead to high blood pressure and enlargement of the heart resulting in heart failure.  Another cardiologist Dr. Victor Mugarura explains that diseases like high blood pressure and diseases of the heart valve can cause serious palpitations because they change the structure of the heart leading to irregular beating.  “Heart valve diseases such as rheumatic heart disease cause the upper chambers of the heart (the atria) to enlarge, leading to common irregular beating called atrial fibrillation. In this case, heart beats are usually accompanied by breathing difficulty, dizziness, fainting, and chest pains”.

He explains that people with certain altered hormone illnesses such as hyperthyroidism also suffer from severe palpitations although their hearts may be normal. He says such patients need to be taken care of by a physician. The complication comes as a result of increased levels of a hormone – thyroxine   being released from the thyroid gland stimulating the heart to beat more quickly and more strongly.

Dr. Okello says palpitations can also be caused by abnormal heart rhythms medically referred to as arrhythmia. He says these accounts for almost 40% of all the consultations at the institute and could lead to a heart attack or stroke.

He says in a certain group of people where palpitations occur on and off, a thorough medical examination by a cardiologist is warranted. This will usually involve taking history by the doctor followed a thorough physical examination. Tests will include a resting ECG (Echocardiography) and chest Xray. If no abnormality is found, a 24 hour ECG, called a Holter ECG is attached to the patient’s body to take home for 24 hours, this machine records the heart beating every second for 24 hours, it will usually pick any ‘hidden’ irregular heartbeats.

But the good news is that all this can be prevented when one gets in the habit of seeking regular checkups. Whenever you feel a change in your heartbeats while at rest, the doctor says, it is always important to seek medical assistance since under normal circumstances one is not supposed to feel the heartbeat.

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