Introduction
Everyone would have felt palpitations at least once in their life. In most of the cases, it happens when you are emotionally unstable like stressed or afraid or anxious. Palpitations feel scary when happening for the first time as you would feel like your heart is going to burst or you are going to die. But in most of the cases, it is just a temporary condition, similar to adrenaline rush. The discomforts would go away in a while. It is important to check for any underlying health issue while having palpitations.
Signs & symptoms
A feeling of the heart is Skipping beats or Fluttering rapidly or Beating too fast.
Causes
Strong emotional responses, such as stress, anxiety or panic attacks.
Depression.
Strenuous exercise.
Stimulants, including caffeine, nicotine, cocaine, amphetamines, and cold and cough medications that contain pseudoephedrine.
Fever.
Hormone changes associated with menstruation, pregnancy or menopause.
Pathophysiology
The sensation of palpitations can arise from extrasystoles or tachy-arrythmias. It is very rarely noted due to bradycardia. Palpitations can be described in many ways. The most common descriptions include a flip-flopping in the chest, a rapid fluttering in the chest, or pounding in the neck. The description of the symptoms may provide a clue regarding the etiology of the palpitations, and the pathophysiology of each of these descriptions is thought to be different. In patients who describe the palpitations as a brief flip-flopping in the chest, the palpitations are thought to be caused by extra systoles such as supraventricular or ventricular premature contractions. The flip-flop sensation is thought to result from the forceful contraction following the pause and the sensation that the heart is stopped results from the pause. The sensation of rapid fluttering in the chest is thought to result from a sustained ventricular or supraventricular arrhythmia. Furthermore, the sudden cessation of this arrythmia can suggest paroxysmal supraventricular tachycardia. This is further supported if the patient can stop the palpitations by using Valsalva maneuvers. The rhythm of the palpitations may indicate the etiology of the palpitations (irregularly irregular palpitations indicate atrial fibrillation as a source of the palpitations). An irregular pounding sensation in the neck can be caused by atrioventricular dissociation, and the subsequent atria are contracting against a closed tricuspid and mitral valves, thereby producing cannon A waves. Palpitations induced by exercise could be suggestive of cardiomyopathy, ischemia or channelopathies.
- Chest auscultation with a stethoscope
- Electrocardiogram (ECG).
- Holter monitoring.
- Echocardiogram.
Treatments
Uncomplicated heart palpitations seldom require treatment. Better to avoid the triggers that cause palpitations.
If the palpitations are caused by a condition, such as an arrhythmia, treatment will focus on correcting the condition.
Prognosis
The palpitations usually have a good prognosis. Other causes of palpitations may require medications or surgery to control the heart rhythm disturbance.
Complications
Fainting.
Cardiac arrest
Stroke
Heart failure
Disease & Ayurveda
Ayurveda does not mention a single disease as palpitations. As irregularity is the nature of Vaata, it can be attributed to derangement in Vaata dosha functions. Among Vaataja nanathmaja vikaara, hrud drava is the term explaining palpitations.
Nidana
Physical
Dry, cold and old food items
Excess travelling & exertion
Trauma/injury
Exposure to wind
Loss of sleep
Psychological
Mental trauma or grief
Fear
Anxiety
Purvaaroopa
Not mentioned
Samprapti
Due to either obstruction to channels, or depletion of body tissues, the movement of Vaata gets deranged. The normal functions of Vaayu when disturbed like this and gets lodged in hrudaya, it produces the signs and symptoms.
Lakshana
Hrud drava – Palpitations
Divisions
Not mentioned
Prognosis
Yaapya
Chikithsa
Ayurvedic treatment for palpitations depends upon the cause for Vaatakopa and any associated dosha present. If Vaata is vitiated due to obstruction in channels/Kapha is the associated vitiated dosha, first approach should be to remove the accumulated toxic metabolic waste (Aama) from the body. It can be done by drying up and body-lightening therapies like:
Lepanam with Rookshana dravyas over chest
Swedanam
Mild fasting
Samana
If the Vaatakopa is due to degeneration and Vaata-Pitta doshas are aggravated, only mild Aamapaachana with some medicines or diet modifications will be enough. The treatment with snehana swedana sodhana panchakarma and then bruhana will be more suitable in this case.
In palpitations, daivavyapasraya & sattwavajaya chikitsa are aso equally important as yuktivyapasraya chikitsa.
Sodhana
Snehana-swedana
Vamana
Virechana
Kashayavasti
Snehvaasti
Commonly used medicines
Drakshadi kashayam
Mridweekadi kashayam
Dasamoolam kashayam
Haridrakhsndam
Mridweekadi lehyam
Partharishtam
Arjunarishtam
Siva gulika
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
The most appropriate way to treat palpitations at home is to avoid the triggers that cause symptoms.
Reduce stress. Try relaxation techniques, such as meditation, yoga or deep breathing.
Avoid stimulants. Caffeine, nicotine, some cold medicines and energy drinks can make your heart beat quickly or irregularly.
Avoid illegal drugs. Certain drugs, such as cocaine and amphetamines, can bring on heart palpitations.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels.
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, fresh fruits and vegetables
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extremely cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Avoid stress and emotional hurricanes.
Yoga
Regular stretching and mild cardio exercises are advised upto the possible extent. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended to control Vaatadosha in the early stages.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://www.ncbi.nlm.nih.gov/books/NBK436016/#_article-26551_s5_
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
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