How to diagnose your own palpitations

hi guys um my name is sanup I'm a consultant cardiologist and uh over the past few months I've been doing a lot of work with um people who suffer from palpitations and um one of the common problems I face is that people get palpitation and then um uh they they seek help but by that time the palpitations have gone and um because the palpitations have gone they have an ECG the ECG comes out as normal and therefore they're none the wiser as to what the palpitations were and they're then told by their doctor well wait till you have your next set of palpitations and then we'll do some monitoring the problem with palpitations are that they can the problem with palpitations is that they can come on at any time and often not when it's convenient to be monitored so today I thought I'd do a little video on how you can diagnose the cause of your palpitations Yourself by careful observation okay uh and it's generally quite easy now um the the first thing to say is that it's important to understand what palpitations is okay what palpitations are palpitation is essentially an awareness of your heartbeat to the point that it feels abnormal or worries you okay uh so you can be aware of your heartbeat but if it feels abnormal or if it starts worrying you then that's what a palpitation is that doesn't mean that your heartbeat is abnormal it means that it just seems abnormal to you so palpitations can be caused by completely normal heart beats but can also be caused by abnormal heart beats and there are certain features which may help you distinguish between Normal and abnormal when you're having them uh uh at that time uh it is very important to tell you though that if you feel very unwell with the palpitations okay if you are feeling hideously abnor unwell if you're clammy if you're getting chest pains if you're blacking out with the palpitations please please please the best thing is to call an ambulance and come into hospital however a lot of people get palpitations and it worries them but they don't feel unwell with the palpitations okay in and so this video is for those people say you're lying in bed you start noticing it you say that's not right what's going on and they and you notice them more and more but you're not unwell unwell with them but they just worry you so this video for those people all right so there's a few things to point out here okay when whenever you're dealing with palpitations there are a few things you should pay attention to uh number one how they start do they start suddenly or gradually okay number two when they're happening do they feel regular or irregular number three when they're happening how fast is your heart rate when this is obviously easily done by feeling your pulse so you put your fingers on your wrist like this you feel your pulse and you count over 15 seconds multiply whatever number you've count it by four and that will tell you your pulse rate okay so it's important to do that and then finally to see how they go away do they go away suddenly or do they go away gradually and those are the four features I would look for when I'm trying to work out what my palpitations are so as long as you pay attention to those four features it'll help you considerably to try and work out why you're getting palpitations so let's get started okay so the first thing to say is the palpitations can happen from anywhere okay and the way the heart works is that you have the pacemaker the sinoatrial node which is where all your pulses are usually generated uh and then from there the pulse goes down the two Chambers at the top called the Atria and then from there the impulse goes down to the atrioventricular node and then down to the ventricles and if your palpitation starts from any if if an Impulse is released from any of those points that can cause palpitation so uh how palpitations are defined or how they're named is dependent on where they have started where they're being generated where the abnormal impulse or the normal impulse is being generated so let me tap out a few things that can that and then I'll talk about them all right say you're lying in bed all right and you notice this okay so this is something which is gradual okay it's gradual and it goes away gradually but when it's happening it's more noticeable it doesn't feel fast okay it feels regular so gradual onset gradual offset regular and not fast by that I mean with a rate between 60 and 100 if the heart rate is between 60 and 100 then that's normal anything below 100 should be fine so that is probably likely to be sinus rhythm normal sinus rhythm that is a normal heartbeat okay everyone most people would you know have sinus rhythm which means that the the impulse is being produced in the sinoatrial node or the pacemaker and it's being conducted downwards however even sinus rhythm at a normal rate can be felt as palpitation because if you are lying there and you're very worried and you pay attention to your heart you could notice this and it may feel abnormal and the Heart may feel like it's jumping out of your chest because it's beating a lot louder but that is probably sinus rhythm all right then there is something like this all right here you go so here it was a gradual onset the heart was regular but it was fast and then the offset was gradual all right so gradual onset fast gradual offset but regular throughout that is sinus tachicardia sinus tachic cardia is what happens when we exercise it is just your normal heart which beat which is being produced in the right place but it's going faster now that is usually in response to something like adrenaline um so for example if you're stressed or if you're anxious or if you've got going through a marital breakup or if you're selling house and you're lying in the middle of the night and you start getting this this is probably sinus tachicardia gradual onset gradual offset um fast and the heart rate is usually above 100 beats per minute but usually doesn't go over 160 so it should be you know 100 120 beats per minute that's sinus techic cardia again a harmless heart rhythm it is not dangerous it is a normal response to something else happening in the body not a problem with your heart some people talk about this so what this is again this is regular but but the gaps may be slightly into dispersed okay so they're not exactly the same whereas a normal rhythm is completely regular you can have a little bit of irregularity that is called sinus arhythmia and that's a completely normal phenomena and occurs because of breathing variation so again it feels relatively regular but not completely regular the heart is not particularly going fast uh that is sinus arhythmia so those are normal heart rhythms all right then you can have something like this um mbeat thir thir thir and then goes away that is probably a Pac a premature atrial complex okay so that pulse is not being produced in your sinus node it's not being produced in your pacemaker but somewhere else that can happen in people who have usually who have lung disease uh but can also happen sometimes normally all right uh and this by far is something that is the most common cause of anxiety for a lot of people they'll be lying in bed and they'll notice one and they get more and more stress this is not dangerous this is a premature atrial complex it's not dangerous the heart PLS um misses and then thuds okay this is a completely normal thing it's your brain that is making you and notice this a bit more it should settle it does not indicate any major issues all right um provided you do not have any evidence of structural heart disease from before all right then you can have something like this see that that was sudden onset of the palpitation the heart is going fast it's going regular and then it the offset is sudden all right and the heart rate would be around about 120 or 130 beats per minute that is an atrial tachicardia okay that's an atrial tachicardia again it's not very dangerous but it can it is a heart rhythm disturbance and it is meable to cure by an ablation so it's not a dangerous Rhythm but it can be inconvenient and it is an abnormal heart rhythm all right so if you have an atrial techic cardia um you know you don't it's it's just something that is worth getting checked out because they can become more and more inconvenient over time and therefore it's best to get it sorted but it's not dangerous then here's another one you can get okay this is very similar to the previous Rhythm except that when you count the heart beat uh the heartbeat usually is around about 150 all right and that is called atrial flutter so it's faster than the atrial tachicardia it is a little bit more dangerous than the atrial tachicardia because in atrial flutter what happens is the heart beat leaps so it leaps in multiples so it can be 75 and then suddenly it'll go up to 50 and then it can go up to you know higher multiples and therefore atal flutter is more poorly tolerated than atrial tachicardia the other thing to say is in atrial flutter the Atria are just fluttering are not very effective and therefore this condition can over a number of years be associated with strokes and therefore if you're above the age of 7 65 if you're diabetic if you have high blood pressure if you have had previous stroke if you have heart failure or anything like that then it's a good idea to be on blood thinning medications for atrial flutter again this is something that is aable to treatment it can be cured um by an ablation all right then you have another condition and in this what happens is this that is called atrial fibrillation sudden onset sudden offset very fast and irregular now that is not dangerous except for the risk of Strokes in the long run so if you have atrial fibrillation yes it's inconvenient Etc as long as someone has stratified your risk calculated what your risk of stroke is and put you on blood thinning medication nothing else needs to be done so those are your atrial rhythms all right uh and what I will do is in my next series talk about how to diagnose the supr ventricular and ventricular rhythms so I hope this was useful um this is me and this is my Facebook page if it works and my Twitter and this is my website so all the best and I'll see you soon to do the second bot thanks

Channel: York Cardiology

Views: 280,088

Keywords: atrial fibrillation, pacs, atrial tachycardia, atrial flutter, palpitations, heart disease, dangerous, sudden death, heart palpitations, sanjay gupta, yorkcardiology, heart palpitations sound, heart palpitations symptoms, eptopics, atrial fibulation, heart palpitations video, heart palpitations cure, Heart racing, Heart flutter causes, Heart palpitations at night, Racing heart, Fluttering heart, Heart skipping beats, Irregular heartbeat symptoms, Anxiety palpitations

Id: 8sJIjPbzHro

Length: 13min 1sec (781 seconds)

Published: Sun Nov 08 2015