Sunday, December 29, 2013

Heart Palpitations (Irregular Heartbeats) are Common at Menopause

Are you a woman age 35 years or older who sometimes experiences skipped heart beats or a racing heart even when you’re not exerting yourself? Do you sometimes awaken with a racing heart? If you answered yes to either of these questions, you are likely experiencing common symptoms of perimenopause or menopause.

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Normal heart rate

The heart’s rhythm is coordinated by its own electrical system. With each heartbeat, the electrical impulse begins at the sinus (or sinoatrial, SA) node, also called the heart’s natural pacemaker. The SA node is a cluster of specialized cells, located in the right atrium. The SA node produces the electrical impulses that set the rate and rhythm of your heartbeat. The impulse spreads through the walls of the right and left atria, causing them to contract, forcing blood into the ventricles.

The impulse then reaches the atrioventricular (AV) node, which acts as an electrical bridge allowing impulses to travel from the atria to the ventricles. There is a short delay before the impulse travels on to the ventricles.

From the AV node, the impulse travels through a pathway of fibers called the HIS-Purkinje network. This network sends the impulse into the ventricles and causes them to contract. The contraction forces blood out of the heart to the lungs and body. The SA node fires another impulse and the cycle begins again. The heartbeat is triggered by electrical impulses that travel down a special pathway through your heart muscle.

What are heart palpitations?

Palpitations are irregular heartbeats that can include skipped beats, extra beats (as many as 8 to 16 beats a minute), and a racing heart (as many as 200 extra beats a minute). Many people suggest that having palpitations makes them "aware of their heart beating."

Women and men can have heart palpitations. In healthy people, they are most common in perimenopausal and menopausal women as a result of fluctuating hormones such as estrogen and progesterone. Some perimenopausal and menopausal women suggest their palpitations occur during or after a hot flash.

"Palpitations usually last only a few seconds to a minute or two," says Summit Medical Group cardiologist Andrew D. Beamer, MD, FACC. "If you have palpitations that are frequent and last for long periods, you should see your cardiologist immediately. Even if your palpitations are associated with perimenopause or menopause," says Dr. Beamer, "there are treatments such as beta blockers that can help reduce their frequency and intensity."

Symptoms of irregular heart rhythms

An arrhythmia may be "silent" and not cause any symptoms. A doctor can detect an irregular heartbeat during an examination by taking your pulse, listening to your heart or by performing diagnostic tests.

If symptoms occur, they may include:
* Palpitations -- a feeling of skipped heart beats, fluttering, "flip-flops" or feeling that the heart is "running away"
* Pounding in the chest
* Dizziness or feeling light-headed
* Shortness of breath
* Chest discomfort
* Weakness or fatigue (feeling very tired)

Symptoms of palpitations represent 15-25 percent of all the symptoms reported by female heart patients. 

They are associated with:
* Premenstrual syndrome
* Pregnancy
* Perimenopausal period

When palpitations are present, the doctor begins his or her evaluation by looking for underlying heart disease. The importance of palpitations and the need for treatment is determined by the presence of underlying heart disease, the type of irregular heartbeats that are occurring and other symptoms that are present.

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Common causes

Common causes of heart palpitations include:
* Alcohol
* Caffeine
* Pseudoephedrine, a stimulant in decongestants
* Dehydration, causing an electrolyte embalance
* Phentermine, ephedrine, and caffeine in diet pills
* Emotional stress, which releases adrenaline
* Hormonal changes
* Hormone replacement therapy (HRT), especially when first beginning treatment
* Monosodium glutamate in Chinese food, processed foods, canned vegetables, canned soups, and processed meats
* Nicotine

In most cases, palpitations associated with menopause are not an indication of heart problems. Palpitations often go away after several months, but even they can recur from time to time.

Although heart palpitations can be disconcerting, remember that most often they are a normal part of aging. Try to remain calm when you have them and focus on your breathing. If you have heart palpitations when you are active, stop what you are doing and sit down or lie down and breathe deeply and slowly through your nose and out your mouth. Your normal heart rate should return within a few minutes.

Why does menopause cause irregular heartbeats?

During the menopause, the amount of the hormone estrogen gradually declines. However, this decline is not steady and often there are erratic fluctuations during the perimenopause and menopause.
 Estrogen has an effect on the dilation of the coronary arteries. When low, the arteries contract, and when high, they dilate. This can lead to changes in blood pressure and heart rhythm.

Estrogen also has an effect on the autonomic nervous system which regulates the unconscious functions of the body such as heart rate and breathing. Changes in oestrogen levels mean that the nervous system fluctuates between being highly stimulated to being stimulated very little, having a direct impact on heartbeat regularity.

How are arrhythmias diagnosed?

If you have symptoms of an arrhythmia, you should make an appointment with a cardiologist. You may want to choose an electrophysiologist, a cardiologist who has received additional specialized training in the diagnosis and treatment of heart rhythm disorders.

After evaluating your medical history and discussing your symptoms, a physical exam will be performed. The cardiologist also may perform a variety of diagnostic tests to help confirm the presence of an arrhythmia and determine its causes.

If your heart rate is very fast,
if you are feeling dizzy or faint,
or if you feel tightness or pain in the chest or neck,
you should get immediate emergency treatment.

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Underlying Dangers of an Irregular Heartbeat

Experiencing an irregular heartbeat during menopause is not something that is dangerous in itself. Usually, irregularities in your heartbeat will last between a few seconds and several minutes, but they will correct themselves. Irregular heartbeats as a result of menopause will usually come to an end once you reach postmenopause.

However, though irregular heartbeats can often pose no danger, they can be a sign of an underlying condition, such as:
* Overactive thyroid. This will also be accompanied by other symptoms such as mood swings, diarrhea, and hyperactivity.
* Anemia. Hair loss, itchy skin, and headaches will usually accompany this condition.
* Dehydration. Dehydration is associated with tiredness, a dry mouth, and concentrated urine.

If you are concerned that your irregular heartbeat is a symptom of another condition, then you should consult a medical practitioner.

Emotional Impact of an Irregular Heartbeat

An irregular heartbeat does not just have an effect upon your physical health; it can also present dangers to your emotional and mental health as well. Suffering from an irregular heartbeat can heighten stress levels, since they may make you worry about what it is and what is causing it. Stress itself heightens your risk of suffering from an irregular heartbeat, so it can become a vicious circle. Heightened stress, anxiety, and panic can lead to panic attacks, which cause heart palpitations as well as nausea and fear, symptoms that have been known to be confused for heart attacks.

What Can You Do about an Irregular Heartbeat?

Despite an irregular heartbeat not being dangerous the majority of the time, it is worth avoiding lifestyle habits that could trigger them. Try to cut down on caffeine and alcohol, as well as rich, spicy foods. Smoking or the use of recreational drugs can easily exacerbate the problem, as well as precipitating more dangerous conditions. Maintaining a regular exercise regime will work toward keeping your heartbeat steady and will improve your overall health at the same time.

The most immediate way to deal with rapid or irregular heartbeat when it occurs is to try to relax. Take deep breaths, practice yoga or meditation, or employ other relaxation techniques.

Experiencing an irregular heartbeat can be frightening and stressful. Fortunately, irregular heartbeats during menopause are usually caused by hormonal imbalances and present no danger. However, if you are experiencing irregular heartbeats regularly, if they are accompanied by dizziness or shortness of breath, or if you are concerned about your symptoms, then it is best to consult with a physician.

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