While most of us experience occasional heart palpitations or fluttering at one time or another, nearly 4 million Americans have recurring heart rhythm problems that warrant a doctor’s care.
Called “arrhythmias,” such chronic disorders of the rate or rhythm of the heartbeat occur when the electrical impulses that control the heartbeat don’t function properly. This malfunction can cause the heart to beat too fast, too slow or irregularly. In either case, the condition can reduce the heart’s ability to pump enough blood to the body, risking damage to organs, stroke, sudden cardiac arrest or even death.
Causes of arrhythmias vary. Smoking, heavy alcohol use, use of certain illicit drugs (such as cocaine or amphetamines), use of certain prescription or over-the-counter medicines, or too much caffeine can lead to arrhythmias in some people. Also, strong emotional stress or anger, which can make the heart work harder, raise blood pressure, and release stress hormones, can lead to arrhythmias in some people.
A heart attack or an underlying condition that damages the heart’s electrical system, such as high blood pressure, coronary heart disease, heart failure, an over- or under-active thyroid gland, and rheumatic heart disease also can cause arrhythmias.
Some people can also be born with abnormal electrical circuits in the heart which lead to arrhythmias. In some arrhythmias, such as Wolff-Parkinson-White syndrome, the underlying heart defect that causes the arrhythmia is congenital (present at birth). However, symptoms may not develop until later in life.
Other times, the exact cause of arrhythmia is unknown.
While many arrhythmias can exist without signs or symptoms, the most common symptoms are palpitations (feeling that your heart is skipping a beat, fluttering, or beating too hard or fast), a slow heartbeat, an irregular heartbeat or feeling pauses between heartbeats.
More serious signs and symptoms include anxiety, weakness, dizziness, lightheadedness, fainting or nearly fainting, sweating, shortness of breath, or chest pain.
“Dizziness, syncope (passing out) or pre-syncope (almost passing out) could be a serious warning sign of an abnormal rapid or slow heart rhythm,” said Andrea M. Russo, M.D., Director of Cardiac Ablation and Arrhythmia Services at Cooper. “Either fast or slow rhythms can be life-threatening if not adequately treated,” she said.
Specializing in cardiology and electrophysiology (the evaluation, diagnosis and treatment of the electrical activities of the heart), Dr. Russo has researched and published extensively on gender differences in cardiac arrhythmias. In addition to physiological variances, Dr. Russo has noted a discrepancy in the proportion of symptomatic males and females who are referred by physicians for cardiac evaluation and treatment. “Females are underrepresented by about 23 percent with respect to more invasive treatment of one abnormal heart rhythm arising from the upper chambers of the heart, called ‘atrial fibrillation’,” she said.
“Women and men may present with similar symptoms,” Dr. Russo said, “but in women, some symptoms, such as palpitations, may be taken less seriously. Women are more likely to be diagnosed with anxiety than men.”
Regardless of gender, Dr. Russo advises anyone with recurring heart rhythm issues to:
- Talk with your doctor.
- See a heart specialist (a cardiologist or electrophysiologist).
- Develop a plan for evaluation and treatment with your doctor and follow recommendations.
“Proper evaluation and treatment can often control or eliminate irregular heartbeats and extend your life,” Dr. Russo said.