The classic heartbeat of the first appointment or when we show up for an exam or a job interview we take it into account. It’s part of the natural state of turmoil that is a prelude to a (hopefully) happy ending. But we do not normally perceive the classic and rhythmic “tum-tum” of the heart, which is repeated on average 100,000 times a day.
The feeling of the heart beating in the throat
Unfortunately, however, when we have the palpitationsi, it happens to feel the beats in the throat. And it’s not a good feeling. In summer, perhaps you notice the phenomenon more because you pay more attention to your body and the signals it sends, since you are less absorbed by the rhythms of work. But above all because it happens to do a physical activity of a more intense level and more often than that practiced in the winter months, with a consequent increase in heart rate, especially in those who are not properly used to efforts.
Finally, very high temperatures can increase the sympathetic activity directed to the heart, also as a response to a lower pressure than usual for the heat, and this facilitates the onset of cardiac arrhythmias. In short, even in the season, palpitations are lurking.
Beware of extrasystoles
“When we clearly perceive the perception of the heartbeat, in general this appears strange, or even worrying,” he explains Gaetano Maria De Ferrari, full professor of Cardiology at the University of Turin. If we feel a beat faster than usual, or stronger and more intense or still irregular, we complain of feeling palpitations “.
First element to consider: in most cases the phenomenon is harmless. But it shouldn’t be underestimated. There are circumstances in which it can be a wake-up call of an underlying situation at risk, even if it is serious, and not recognizing these cases can have serious consequences. “It is useful to try to understand first of all what it is, that is, if you are in the presence of rhythmic beats (ie regular, with equal intervals between beat and beat) or irregular beats – the expert resumes. frequent is that of extrasystoles: in practice it is an added beat that occurs before the due, anticipated, which is followed by an interval longer than normal and a beat stronger than normal “.
The beat is stronger because the heart expels more blood by filling itself up more in the longer interval. This sensation is typical of isolated extrasystoles, which can also be frequent, for example two or three normal beats followed by an extrasystole to form what doctors call, respectively, a trigeminal rhythm o one quadrigeminal rhythm.
Atrial fibrillation and tachycardia
“A particular situation is that in which the heart is completely devoid of a basic rhythm, the sequence of intervals between one beat and the next is always different and chaotic, often at a higher heart rate than usual – notes De Ferrari. In this case it is likely that it is one atrial fibrillationan arrhythmia that deserves to be diagnosed promptly by performing an electrocardiogram “.
The case of the rhythmic palpitation, a circumstance in which the heart beats fast (over 120-130 beats per minute) but with regular intervals. A tachycardia of this kind is normal during physical exercise, and occurs progressively with the accentuation of the effort. Be careful though.
“It is abnormal to have an abrupt, sudden beginning of a heart that goes fast, from one beat to another, especially in the absence of physical effort – explains De Ferrari. In this case we are probably facing a paroxysmal tachycardia”.
Watch out for risk factors
The main criterion that must lead us not to underestimate palpitations is the presence of a possible underlying heart disease, even if not yet known. For example, the presence in the family of cases of fainting or death for cardiological reasons, in particular if of sudden death, must always lead to an in-depth study.
The same is true for the presence of a heart disease known as a previous heart attack, cardiomyopathy, valve disease. In all these cases and in those in which there are still important risk factors for an underlying heart disease even if not diagnosed, such as poorly controlled hypertension, long-standing diabetes, hypercholesterolemia, an important history of cigarette smoking, it appears necessary. a cardiological evaluation.
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The importance of feeling the pulse
“Every person should learn to feel their own pulse – warns De Ferrari. Or from the wrist, in fact, by placing the two index and middle fingers of the opposite hand on the front face of the wrist on the thumb side, or from the carotid, three centimeters to the side of the Adam’s apple. The heart rate and type of arrhythmia can then be noted. Then it is helpful to try to pay attention to circumstances that facilitate heartbeat, such as sudden stress, heavy eating, drinking alcohol, beer or fizzy drinks, the intake of many coffees, the post-meal or night period “.
Finally, it is very important to understand if the extrasystoles increase or disappear with physical exercise. In fact, in general (but unfortunately there are exceptions, as with every rule ..), the disappearance of exercise-related arrhythmias is a sign of their benignity, while the opposite is true for the aggravation of the arrhythmia during exercise.
Let’s check the “speed”
If the heart is like a car engine, remember the speed limits. And we keep in mind that in general terms at rest it should not exceed one hundred, possibly maintaining a suitable average, around 70. Providing that if we are particularly agitated or have just made an effort, the speed can increase further. Obviously we are not talking about the highway code, but about heartbeats.
The odometer, in this case, must be activated by each person and is the pulse measurement. The ideal is to do it once a week, perhaps as soon as you wake up, a few minutes after getting on your feet. It is important not to take the pulse after having breakfast to avoid “agitating” effects related to coffee and food intake, nor to wait for the first cigarette of the morning, since nicotine tends to accelerate the heartbeat.
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When we “listen” to the pulse, we remember that all pulsations should be the same: if you perceive that they change in intensity and are not regular, or in any case if you notice that you exceed one hundred beats per minute (just multiply the number obtained by two, considering a measurement takes thirty seconds), discuss this with your doctor. This detection is even more important if, from time to time, palpitations or breathlessness occur. Obviously, then, it is always better to check the pressure regularly, to see if the values are moving upwards on that front too.
Checks for the “stirring” heart
In the presence of palpitations, the cardiologist proposes a series of tests to be performed. “Almost always after the examination and the basic EKG, he will recommend an EKG Holter for 24 hours (a box to bring to life with electrodes attached to the chest to check the beats of a day) or a more prolonged electrocardiographic monitoring, as well as an echocardiogram – concludes De Ferrari. In more selected cases, or in what is defined as the second level, a cardiac magnetic resonance or an electrophysiological study with possible ablation of the arrhythmia (removal with a catheter of the anatomical substrate of the arrhythmia) may be indicated later “.
Caution. In these cases it is essential that a second level assessment is made only by cardiologists experienced in arrhythmias and who operate in high volume and highly experienced centers. Then, case by case, the specialist chooses the most suitable therapy.
Heart door
Bad habits for heart health, so an app will help us fight them
in collaboration with the Cardiology Network IRCSS & NExT-H
