When are palpitations dangerous?

hi guys my name is Sanjay Gupta I'm a cardiologist and York this is like me and today I thought I'd do a little video on palpitations and indicators of high risk or which palpitations or what features suggest that your palpitations could be dangerous now the first thing to say is that any condition can do one of two things or both okay it can affect your quality of life ie it can cause symptoms and secondly it can affect your length of life ie it can affect your life span or prognosis so it can make you feel unwell and it can you know shorten your life your length of life these are two separate things and it's really important to bear that in mind not everything that makes you feel hideous is going to shorten your lifespan and there are other things which you may not even know about which in shorten your life span so a typical example is migraine for example migraine is horrible you know it can cause incredible discomfort for people it affects their quality of life in a terrible way but generally people live a normal lifespan whereas a brain tumor can be completely silent and may not necessarily affect a person in terms of symptoms but can certainly shorten the life span so when people get palpitations the obvious feeling is oh my god I'm having palpitations they make me feel unwell am I going to die okay and the number of people I've had saying oh well I'm having these palpitations and my biggest anxiety is that I may have a heart attack or my heart may just stop and so I often say to them that look you know the first thing is just because you feel awful doesn't necessarily mean that these are going to shorten your lifespan the second thing to understand is that people are often worried about heart attacks with palpitations in general palpitations don't cause heart attacks the heart attacks are a plumbing issue with the heart palpitations are an electrical issue with the heart now sure if you have dodgy plumbing and the electrics become a bit faulty then yes you can cause a heart attack but that is usually something that happens in very old people or people who have bad heart artery narrowings okay young people otherwise healthy people it's very unlikely that the palpitations will cause a heart attack so I don't think you need to be too worried about having a heart attack with your palpitation okay what is more relevant and more likely is that if palpitations can cause the heart to stop I can cause sudden death and whereas the majority of palpitations that we see are benign and don't cause sudden death there are certain features that we always think about when we are worried about this question you know what are the things that make me worry about sudden death and that's what I wanted to discuss today I wanted to lay across a few features that I would be done would concern me if someone came and spoke to me about palpitations so the first feature that I think is really really important to highlight and certainly indicates the need to get cheap getting checked out you know if you have this you need to get checked out and truthfully if you have this and even if you don't get palpitations you need to get checked out and that is a family history of premature sudden death okay so in a in a young person in your family be that your first-degree relative or a cousin or anyone if someone has dropped down dead at a young age without explanation then you need to get checked out regardless of whether you have palpitations or not but if you have palpitations and you certainly need to get checked out why because sometimes you can inherit a similar gene and the palpitations may be a marker of something brewing so when I say you know a lot of people say yeah my my aunt died at the age of 80 with a heart attack that's not what I'm talking about what I'm talking about is if you have a cousin who was playing football at the age of 13 and suddenly dropped down dead if you have a great-uncle who you know at the age of 35 suddenly dropped down dead that is a real worry or even if someone had a cardiac arrest which was successfully resuscitated from it then that is again a worry anyone who may have had a cardiac arrest at a young age by young I say less than at the age of 50 where the diagnosis was not an obvious heart attack but you know sudden death for some unknown reason you need to get checked out the other thing it's worth getting checked out is if you have a family history of people requiring pacemakers at a young age now pacemakers are very common in older people so I don't think that you need to worry about if an 80 year old aunt had a pacemaker but if you have a 13 year old cousin who's had to have a pacemaker or if you've had a 20 year old cousin or uncle who had a pacemaker that you know you just want to get checked out by a cardiologist to just to be a sure that you haven't inherited anything another thing that's worth bearing in mind is if there's a family history of things like hypertrophic cardiomyopathy okay hypertrophic cardiomyopathy or muscular dystrophy then it's always worth getting checked out okay so if I had a patient who came in with palpitations and said to me I have an uncle who dropped down dead suddenly at the age of 15 that would worry me that would worry me and I would be very very particular about making sure that they went through a very rigorous check to ensure that they haven't inherited some kind of gene which could expose them to sudden death so family history is really important and it's always good if you're gonna go and see your doctor or cardiologist that you had do a little bit of research about your family history and know exactly you know if there is any such history in your family number two okay number two if there is a history of blackouts with your palpitations then that is again an important and possibly a high risk feature okay if your palpitations are associative blackouts it's very important to understand what I mean by a blackout a blackout is almost like a light switch turning off everything going black and the patient's falling to the floor and often it results in an injury some people mistake collapses for blackouts in their collapse the person gets enough warning they lie down they slump they feel faint they usually don't sustain an injury but with a blackout which usually results in an injury so if you have had palpitations associated with blackouts then clearly it's dangerous because if you're blacking out then that tells you that there's a significant compromise to the blood around the body and therefore the Bloods not getting to the brain but secondly as you black out you could sustained a significant injury and you could sustain that even perhaps when you're driving for example in which case you risk other people's lives so that's really important the third thing I'd say is blackouts whilst exercising regardless of whether you get palpitations or not if you are blacking out when exercising even if you've had one blackout during exercise it's well worth going and getting checked out as soon as possible and your GP or your doctor will need to refer you to a cardiologist and please have a heart scan and an ECG and probably more monitoring just to ensure that that does not signify a heart a dangerous heart rhythm anything that causes such ace significant reduction in output from the heart that it doesn't get to the brain and the patient blacks out is potentially very dangerous well worth looking into the fourth thing is to say that if you had evidence of structural heart disease and you get palpitations now I keep going on about this if you were born with congenital heart disease if you have had a heart attack at a relatively young age if you have heart failure if you have called your myelopathy it's well worth getting checked out because again in that setting competitions can be dangerous so those are the four high-risk features that that really worried me I see a ton of people who have palpitations some of them have heart rhythm disturbances but nothing worries me more than coming across people with one of these four features and particularly the family history is really really important and and I suppose that's about it so I think I think it's also worth saying that if you get palpitations it's always a good idea to have at least arresting ECG now the resting ECG does not necessarily tell you why you're getting the palpitations but the resting ECG can be very useful because if it is abnormal it can indicate sometimes it can indicate electrical problems within the heart some of these are inherited electrical issues which can sometimes predispose to very fast and dangerous rhythms things like long QT syndrome Brugada syndrome wolff-parkinson-white these can all sometimes these can usually be picked up on just a resting 12-lead ECG so if you have a normal 12 lead ECG that is very reassuring if you have an abnormal 12 lead ECG undoubtedly in the setting of palpitations that needs to be investigated further and that's about it that's all I wanted to say for this as again once again I hope that you found this useful my name is Sanjay Gupta again making now I did have a Facebook page but now Facebook have changed their real name policy and so I'm hoping that they'll let me keep my your cardiology Facebook page otherwise I'm gonna have to make a new phage but in the interim you can certainly get through to me on my website or you can ring my secretary jennette on a one-liner for seven two five eight one one I also have Twitter but I don't really go on it but my website's the best way to get in touch with me all right well I wish you all a happy someday and I look forward to coming back and chatting to you more in the near future take care bye you

Channel: York Cardiology

Views: 172,577

Keywords: #hangoutsonair, Hangouts On Air, #hoa, heart palpitations, dangerous, high risk features, sudden death, heart disease, cardiologist, heart advice, palpitations, worried, heart attack, Ventricular ectopics

Id: -4_eEacVn3s

Length: 11min 10sec (670 seconds)

Published: Sun Nov 08 2015