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Can stress cause an irregular heartbeat: Understanding the Signs of an Irregular Heartbeat


Understanding the Signs of an Irregular Heartbeat

If you had an irregular heartbeat, would you be able to tell on your own? Or would you attribute the signs to something else, like anxiety, panic attacks or stress?

Many people often confuse the symptoms of a panic attack with those of a heart rhythm problem like atrial fibrillation (AFib). Study results1 published in the journal Heart Rhythm found this to be true. Specifically, the study found that a large number of participants either overestimated or underestimated their symptoms. Among those who overestimated, a majority were those previously diagnosed with an anxiety or depression disorder.

This means that people with anxiety may think they have signs of an irregular heartbeat, but it is actually their own anxiety or panic attacks that are causing the symptoms.

The study also found that participants who had atrial fibrillation may experience a positive feedback loop, resulting in heightened anxiety which leads to increased atrial fibrillation symptoms. For some patients, atrial fibrillation can actually trigger a panic attack.

“Sometimes, it can be difficult to determine which came first, the panic or the tachycardia [rapid heart rate],” said heart rhythm specialist John Day MD, in an Everyday Health article2. “With a heart monitor we can usually determine if it is really a panic attack or an arrhythmia.”

One way to determine if what you’re experiencing is atrial fibrillation or anxiety is to understand both sets of symptoms. AFib symptoms may include:

  • Heart palpitations (sudden pounding, fluttering, or a racing feeling in the chest)
  • Lack of energy
  • Lightheadedness
  • Confusion
  • Chest discomfort
  • Shortness of breath, even at rest

While similar, anxiety or panic attack symptoms may include:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed, or faint
  • Chills or heat sensations
  • Paresthesia (numbness or tingling sensations)
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or “going crazy”
  • Fear of dying

You can see that panic attacks may exhibit more mental or emotional symptoms, such as feelings of unreality or a fear of losing control. These are the symptoms that set panic attacks a part from atrial fibrillation in most circumstances, but it’s still best to consult a doctor if you are unsure whether you may be experiencing anxiety or atrial fibrillation.

Life Line Screening offers an atrial fibrillation screening for those who may be at risk, including those with high blood pressure, overactive thyroid, heavy alcohol or caffeine consumption, those who smoke, have extreme stress or fatigue, have heart disease, lung disease, sleep apnea or diabetes, and those who are obese. If this sounds like you, learn more about our atrial fibrillation screening and take a proactive approach to your health today.

1National Center for Biotechnology Information, http://www.ncbi.nlm.nih.gov/pubmed/25595926/

2Everyday Health, https://www.everydayhealth.com/wellness/united-states-of-stress/ways-reduce-stress-when-you-have-atrial-fibrillation/

Acute Emotional Stress and the Heart | Cardiology | JAMA

Experiencing emotional or physical stress causes an increase in heart rate, elevation of blood pressure, and release of stress hormones. All these result in a greater workload for the heart, which can be dangerous. Stress can cause a heart attack, sudden cardiac death, heart failure, or arrhythmias (abnormal heart rhythms) in persons who may not even know they have heart disease. Individuals with congestive heart failure, coronary heart disease, known arrhythmias, or other heart or blood vessel diseases should avoid emotional stress whenever possible and learn to manage the effects of stress. Excessive physical exertion and emotional stress may cause problems in both men and women, but women seem to be particularly susceptible to developing heart problems in the face of emotional stress. Ask your doctor about any limitations on physical activity or vigorous exercise if you have heart disease.

The July 18, 2007, issue of JAMA includes an article about acute emotional stress and its effects on the heart.

Effects of stress on the heart

  • Increased heart rate

  • Increased blood pressure

  • Release of catecholamines (stress hormones, including epinephrine, which is also known as adrenaline) from the adrenal glands

  • Increased oxygen demand on the body (temporarily higher metabolic rate)

  • Lower threshold for abnormal heart rhythms including ventricular tachycardia, ventricular fibrillation, and atrial fibrillation. Electrical instability in the heart makes it easier for these abnormal heart rhythms to occur.

  • Spasm of coronary (heart) blood vessels, leading to ischemia (inadequate blood flow to the heart)

Preventing and managing stress

  • Avoid situations that you know will cause stress.

  • Incorporate some type of exercise into each day.

  • Eat a healthful diet rich in fruits, vegetables, and whole grains.

  • Do not smoke.

  • Use alcohol only in moderation.

  • Quiet time, meditation, prayer, reading, yoga, and relaxation techniques (including biofeedback) can help in stress management.

  • Family and friends can provide needed support. Talking about problems can help to reduce conflict and express feelings.

  • If you have heart disease, your doctor may prescribe a beta-blocker, a type of medication to help lower the heart rate and control abnormal heart rhythms.

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA‘s Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on cardiac arrest was published in the January 4, 2006, issue; one on risk factors for heart disease was published in the August 20, 2003, issue; one on automated external defibrillators was published in the August 9, 2006, issue; and one on implantable cardioverter- defibrillators was published in the May 2, 2007, issue.

Sources: American Heart Association; National Heart, Lung, and Blood Institute

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.


The Link Between Stress and AFib

Atrial fibrillation is an abnormal heart rhythm condition affecting millions of people every day. Medicines and treatments like catheter ablation are available for patients, but they don’t provide a full cure for the condition. Everyday stresses can cause problems for patients dealing with this heart arrhythmia. Managing stress levels can be a great way to improve episodes and overall quality of life. Understanding the link between stress and AFib can help you manage your health.

How Stress Relates to AFib

While stress does not directly cause atrial fibrillation, it can have an effect on a patient’s episodes. The most common risk factors for AFib are high blood pressure, diabetes, age, or a family history of AFib. Stress can have a great effect on a patient’s condition and lead to increased AFib episodes.

Patients may notice longer or more severe AFib episodes during times of stress. Studies have shown that a high percentage of people with AFib experience increased levels of stress. AFib is also linked to other effects on mental health, including depression.

How Stress May Trigger an AFib Episode

During times of stress, your body releases stress hormones that can increase your blood pressure and trigger an AFib episode. Stress can arise from many aspects of your daily life. The two main types of stress, physical and emotional, have varying effects on your body.

Physical stress includes sleep deprivation, sickness, injury, and dehydration. Emotional stress occurs when you experience negative emotions including sadness, anger, and fear.

It is very common for unhealthy habits to arise from stress. Habits such as poor diet and alcohol or caffeine consumption can increase your blood pressure and trigger an episode. In order to manage your episodes, it’s necessary to find healthy ways to manage your stress.

How to Calm an AFib Episode

While there is no cure for AFib, medical professionals focus on symptom relief and complication prevention. There are many at-home methods to consider to help calm AFib episodes.

Engaging in relaxing activities, such as light exercise or yoga, deep breathing and meditation can help your body deal with stress. Overall, make sure to get enough rest and take care of your body, eat healthily, and stay hydrated. If you start a new exercise regime that may be stressful on your body, consult with your doctor first.

If you are suffering from a heart rhythm disorder, consider visiting the cardiac electrophysiologists of Heart Rhythm Consultants. Our care coordinators can give you more information about testing and treatment options, including cardiac ablation therapy. We value your health and well-being above all else. Speak with a care coordinator today.

About Heart Rhythm Consultants, P.A.

The experienced electrophysiologists of Heart Rhythm Consultants, P.A. have been serving West Florida including Sarasota, Venice, Tampa, Port Charlotte, and Sun City Center for over 15 years. Our specialty cardiologists, or EP doctors, help patients manage their abnormal heart rhythm conditions, whether they suffer from arrhythmias like atrial fibrillation (AFib), or other irregular heartbeats. Dr. Dilip J. Mathew, Dr. Antonio Moretta, and Dr. Rajesh Malik perform arrhythmia treatments like cardiac ablation, cryoablation, and implanting pacemakers or defibrillators. Dr. Mathew has performed nearly 5,000 complex cardiac ablations. View our office locations in Sarasota and Venice, Florida.

My Pounding Heart: Is it Anxiety or Atrial Fibrillation?

Dr Kenneth Ng, cardiologist at Mount Elizabeth Hospital, explains the possible causes of heart palpitations and what atrial fibrillation is.

What are palpitations?

Palpitation is a general description of an increased awareness of our own heart beat. We may feel that the heart is beating faster, beating harder, skipping beats or beating irregularly. Some patients even describe their heart beats as ‘fluttering’ or ‘popping out of the chest.’

Are palpitations always abnormal?

Palpitations are not always abnormal. Some patients may feel their heart beating fast or differently but upon monitoring the heart rhythm, no abnormalities are found. These palpitations may be psychological.

What are the causes of palpitations?

Palpitations can have triggers. They can be triggered by anxiety or emotional stress. Stimulants such as coffee or tea or exercise can also bring on palpitations. Traditional medicine products, eg. ginseng or mah huang, have stimulants which can also cause palpitations. Certain medical problems can also cause palpitations, the most famous of which are thyroid overactivity or thyrotoxicosis which is due to an excess of thyroid hormones.

Atrial fibrillation is a condition that can cause palpitations as it can cause the heart to beat very fast and irregularly. The major clue is that the patient will complain of an irregular heart beat.

What is atrial fibrillation?

Atrial fibrillation is an irregular and often rapid heart beat. It is due to the chaotic and irregular beating of the 2 upper chambers of the heart. The irregular beating can come and go and the duration of the abnormal heart beat can be from seconds to hours to days. The heart rate can vary between 100 to 200 beats per minute.

What are the symptoms of atrial fibrillation?

The most common symptom of atrial fibrillation is that of a fast and irregular heart beat. It can also lead to giddiness, shortness of breath, confusion, chest pain, and fatigue. However, in many cases, it does not cause any symptoms and is only picked up during a routine examination of the pulse or the electrocardiogram.

What are the causes of atrial fibrillation?

The most common cause is that of old age where there is degeneration of the body’s pacemaker and the heart beat goes wonky. Abnormalities and damage to the heart can also cause atrial fibrillation and these would include heart attacks, high blood pressure, congenital heart problems, abnormal heart valve, post-heart surgery, lung diseases, infections, sleep apnea, over active thyroid and exposure to stimulants such as alcohol.

What problems can atrial fibrillation cause?

Atrial fibrillation results from the chaotic electrical beating of the upper chambers of the heart. As such, the chambers are not really contracting but merely quivering. This cause the blood in the upper chamber of the heart to stagnate and form tiny clots. These clots can then migrate up to the brain and cause strokes.

Atrial fibrillation also causes the heart to beat very fast. If the heart continues to beat very fast for a long period of time, the heart function can weaken and it will then lead to the development of heart failure.


Article contributed by Dr Kenneth Ng, cardiologist at Mount Elizabeth Hospital

Understanding When Heart Palpitations Become Problematic

The past few months have been challenging. As a result, many of us, including children, parents, and seniors, are experiencing feelings of anxiety and uncertainty.

Occasional anxiety over recent events, on top of additional personal stress, is normal. However, the feelings of anxiety caused by an anxiety disorder, do not go away and can worsen over time. These feelings of anxiety can interfere with your daily life and may be difficult to control.

Knowing the difference between normal fears or worries and anxiety disorders is important and can help you recognize them and seek treatment.

Different Types of Anxiety Disorders

Each type of anxiety disorder has its own unique symptoms:

Generalized Anxiety Disorder

A person with generalized anxiety disorder (GAD) has frequent or constant feelings of worry and anxiety about issues, such as health, work, social interactions, or everyday situations. These feelings can cause problems in areas of your life such as school, work, and social interactions. In some cases, people with GAD have experienced these feelings since childhood or adolescence, while in other cases, they may have been triggered by temporary stress.

Symptoms include:

  • Fatigue
  • Feeling irritable
  • Difficulty controlling feelings of worry
  • Feeling restless, wound-up, or on-edge
  • Difficulty concentrating
  • Tense muscles
  • Trouble falling or staying asleep, restlessness, or unsatisfying sleep

Panic Disorder

Panic attacks are periods of intense fear that can occur suddenly. Over time, they can be triggered by certain situations. A person with panic disorder has repeated and unexpected panic attacks, and often worries about when the next attack will happen.

During a panic attack, some people may experience:

  • Feelings of impending doom
  • Feelings of being out of control
  • Heart palpitations, a pounding heartbeat, or an accelerated heart rate
  • Sensations of shortness of breath, smothering, or choking
  • Sweating
  • Trembling or shaking

Phobia-related Disorders

A phobia is an intense fear caused by a specific object or situation. Common phobias include flying and heights, but people can develop phobias regarding almost anything. People with phobias feel fear that is out of proportion to the actual danger caused by that situation or object. People with a phobia may:

  • Experience an irrational or excessive worry about encountering the feared object or situation
  • Endure unavoidable objects and situations with intense anxiety or dread
  • Experience immediate, intense anxiety upon encountering the feared object or situation
  • Take steps to avoid the feared object or situation

Know the Risk Factors

The risk factors for each type of anxiety disorder can vary, but some general risk factors for all types of anxiety disorders can include:

  • A family or genetic history of anxiety or other mental illnesses
  • Consumption of caffeine or medications (such as certain steroids or over-the-counter cold remedies) that can produce anxiety-like effects
  • Exposure to stressful and negative events in early childhood or adulthood
  • Health conditions, such as thyroid problems or heart arrhythmias

Actions You Can Take

While you can’t predict what will cause anxiety disorders to develop, you can take the following steps to help reduce the impact of symptoms if you are anxious:

  • Avoid alcohol or drug use since it can cause or worsen anxiety.
  • Make it a priority to get a good night’s sleep, since poor sleep quality, insomnia, or sleep deprivation may increase your risks.
  • Our social interactions have been limited during the last few months but talking with friends over the phone and doing things that you enjoy while staying safe may help reduce your worries.
  • Seek help early if you are experiencing symptoms that don’t go away.

If you have an anxiety disorder, you should work with your doctor to choose the best treatment for you. In addition to psychotherapy or medication, there are other ways that you may benefit from when dealing with an anxiety disorder.

  • Support groups. A support group alone is not a substitute for therapy. But, in conjunction with other treatment, joining a support group and sharing your experiences with others could benefit you.
  • Meditation and techniques to manage stress. These can help people with anxiety disorders calm themselves and enhance the effects of therapy.

We Are Here to Support You

Your mental health is important. If you are unsure whether you are experiencing occasional anxiety or an anxiety disorder, you can call AltaMed Behavioral Health Services directly at (855) 425-1777. We are here for you, and together we can find the answers you need.

AltaMed can provide information to you and your family about the best way to protect yourself and your family from COVID-19. To receive the latest news and information about the coronavirus pandemic, sign up today.

Heart Palpitations – Managing Side Effects


Care During Chemotherapy and Beyond

What Are Heart Palpitations?

Palpitations are the uncomfortable feeling that you are aware of your own heart
beating. Symptoms include that your heart may feel like it is beating
faster or harder than it usually does, or that it may be skipping a beat (irregular

Heart palpitations are normal, and occur in times of stress, anxiety,
fear or exercise. You may also notice heart palpitations and an irregular
heartbeat if:

  • You are drinking too much caffeine or alcohol
  • You smoke tobacco
  • You have anemia
  • You have thyroid problems
  • You are diabetic, and are experiencing a low blood sugar level
  • You are taking certain medicines, such as diet pills, and decongestants
  • You have certain heart conditions, such as mitral valve prolapse

Heart palpitations may be normal, or they could be associated with
a serious health problem. Call your healthcare provider if your heart
palpitations last longer than a few hours, or if the irregular heartbeat
occurs frequently.

Heart Palpitation Symptoms:

  • You may feel anxious, or “stressed out.” You may feel your heart pounding in your
    chest or throat, which may cause pain or mild discomfort. You may also feel your
    heart “fluttering”, and it may seem as if it is skipping a beat or beating irregularly.
  • Some people may have chest pain in addition to their heart
    palpitations, which may range from excruciating, to a mild discomfort. The severity
    of pain does not indicate how severe the damage to the heart muscle may be. If you
    experience chest pain with your heart palpitations, seek
    emergency help immediately.

Things You Can Do To Avoid Heart Palpitations:

  • Make sure you tell your doctor, as well as all healthcare providers, about any other
    medications you are taking (including over-the-counter, vitamins, or herbal remedies).
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver,
    kidney, or heart disease.
  • If you have a family history of heart disease, stroke, high blood cholesterol, or
    high blood pressure, in a first or second-degree relative, you may be at risk for
    certain problems. Notify your healthcare provider if you have any of these diseases
    in your family.
  • Smoking can cause heart palpitations. If you smoke, be
    sure to quit. Smoking can also increase the chance of developing heart vessel damage.
  • Caffeine and alcohol can cause heart palpitations. Eliminate
    caffeine and alcohol from your diet, and your palpitations may resolve.
  • Keep a diary of your irregular heartbeat or heart palpitations,
    if they are occurring regularly. Write down the foods that you have eaten, the exercise
    or activity you were undergoing when the rapid or irregular heartbeats occurred,
    and how you felt before they occurred. This diary may be valuable in determining
    the cause of your irregular heartbeat.
  • Questions to ask yourself, may include:
    • Did the irregular heartbeat or palpitations occur gradually,
      or did this episode come on all of a sudden? Was I feeling anxious? Did I perform
      any kind of activity, or was I resting?
  • Make sure to exercise, under the supervision of your healthcare provider. Walking,
    swimming, or light aerobic activity may help you to lose weight, and promote the
    flow of oxygen in your lungs and blood. It will also promote relaxation.
  • Anxiety can cause heart palpitations. Use relaxation techniques
    to decrease the amount of anxiety you have. If you feel anxious, place yourself
    in a quiet environment, and close your eyes. Take slow, steady, deep breaths, and
    try to concentrate on things that have relaxed you in the past.
  • If you are ordered a medication to treat your heart palpitations, do
    not stop taking any medication unless your healthcare provider tells you to. Take
    the medication exactly as directed. Do not share your pills with anyone.
  • If you miss a dose of your medication, discuss with your healthcare provider what
    you should do.
  • If you experience symptoms or side effects, especially if severe, be sure to discuss
    them with your health care team. They can prescribe medications and/or offer
    other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs That May Be Prescribed By Your Doctor:

  • ACE inhibitors – These drugs work by opening, or dilating, your
    arteries. They will lower your blood pressure, and improve blood flow to your
    kidneys, and throughout your body, thus lowering the risk of heart palpitations.
    Your healthcare provider may also prescribe these medications if you have diabetes
    or protein in your urine, to protect your kidneys. Some examples of this medication
    may include: enalapril maleate (Vasotec®), lisinopril
    (Zestril®), and fosinopril sodium (Monopril®)
  • Antianxiety medications: If your heart
    palpitations are due to anxiety, your healthcare provider may prescribe an anti-anxiety
    medication, called an anxiolytic. These medications will help you to relax.
    These may include lorazepam (Ativan®), or alprazolam
    (Xanax®). It is important to take these medications
    only when you are feeling anxious. Do not operate heavy machinery, or drive an automobile
    while taking these. If you are still experiencing palpitations while taking these
    medications, discuss this with your doctor.
  • Beta-blockers – These can be used to slow down your heart
    rate, and improve blood flow through your body, thus reducing your risk of palpitations.
    You may take this drug if you have been diagnosed with irregular heartbeats, or
    high blood pressure. Some examples of this medication may include: metoprolol (Lopressor®), propranolol (Inderal®),
    and atenolol (Tenormin®).
  • Calcium Channel Blockers – These medications may be given to treat
    chest pain, high blood pressure, or irregular heartbeats. A few common drugs include
    verapamil HCL (Calan®), and diltiazem (Dilacor
  • Digoxin – Also called digitalis, this medication works by slowing
    down the heart rate, and making it beat more effectively. This will pump blood throughout the body better. It is also called Lanoxin®.
    You will receive this medication if your palpitations are due to an irregular heartbeat.
  • Diuretics – may be known as “water pills” as they work to prevent
    heart failure by making you urinate out extra fluid. Some examples of this medication
    may include furosemide (Lasix®), and hydrochlorthiazide.
    You may receive this medication alone or in combination with other medications,
    if your palpitations are caused by irregular heartbeats.
  • Do not stop any of these medications abruptly, as serious side effects may occur

When to Contact Your Doctor or Health Care Provider:

Call your doctor with the following symptoms:

  • Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection).
  • Shortness of breath, chest pain or discomfort; swelling of your lips or throat should
    be evaluated immediately
  • Feeling your heart beat rapidly (palpitations) or irregularly
  • Any new rashes on your skin, especially if you have recently changed medications
  • Any unusual swelling in your feet and legs
  • Weight gain of greater than 3 to 5 pounds in 1 week.

Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.

Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org

Heart palpitations: Frequently asked questions

The symptoms of palpitations vary from patient to patient with some common features.

A perception of irregularity of the pulse, an uneasiness in the chest, a flip-flopping in the chest; frequently people describe their palpitations as “my heart stops. ” Certainly a feeling of strong pulse throughout the chest, head, and neck could well be described as a palpitation.

Occasionally palpitations can be perceived in unusual ways including a general sense of uneasiness, and, rarely, palpitations are associated with lightheadedness or even loss of consciousness.

Can something I eat or drink cause heart palpitations?

A common substance associated with palpitations is caffeine. Some people are sensitive to any amount of stimulant, but we began to see more caffeine-related palpitations when espresso-based drinks like cappuccinos and lattes became popular in the 1990s. Frequently reducing or eliminating beverages that contain caffeine such as coffee or soda can improve palpitations.

Some patients complain of palpitations when they eat too much chocolate, and some patients respond with palpitations around the holiday when they tend to drink too much alcohol.

Some over-the-counter medications such as cold and allergy remedies that contain decongestants (pseudoephedrine) often can precipitate palpitations.

Frequently, palpitations occur without any obvious precipitating factor, although fatigue, stress, and lack of sleep also cause palpitations to occur or worsen.

How does the physician evaluate palpitations?

The evaluation usually starts like any other complaint, with a good history focused on things like the types of food, beverages, and over-the-counter medications. This is followed by a thorough physical examination focusing on the heart and lungs.

Diagnosing heart palpitations

In terms of laboratory studies, those will be determined by the overall condition and the findings of the physical exam. In most cases, palpitations have a very benign origin, and nothing more than a thorough history and physical examination, an ECG, and perhaps some basic blood lab work is needed.

Diagnosing heart palpitations with severe symptoms

If the patient’s symptoms are more severe, such as significant lightheadedness or loss of consciousness associated with palpitations, a more comprehensive evaluation is warranted. That type of evaluation might well involve an ultrasound of the heart, a treadmill test, more sophisticated blood tests including thyroid tests, and an ambulatory EKG or Holter monitor. Some patients may require invasive studies if a serious heart condition is suspected to underlie the symptom of palpitations.

Could heart palpitations accompanied by shortness of breath be serious?

Heart palpitations can certainly be associated with shortness of breath, that is, the two symptoms together without a serious condition being present. That usually indicates that the irregularity of the heart rhythm is significant and may signal the need for a more comprehensive evaluation.

In general, the more serious the symptoms, such as lightheadedness, loss of consciousness, chest pain, shortness of breath, the more seriously one needs to take the problem.

If a patient has known heart disease such as a previous myocardial infarction, congestive heart failure (CHF), hypertrophic cardiomyopathy (HCM), and others, the symptoms of palpitations will require a thorough evaluation.

What are the health risks of experiencing heart palpitations?

The irregularity of the heart rhythm per se usually does no damage to the heart itself. Patients with a very rapid heart over a long period of time do run a risk of developing enlargement and failure of the heart.

We see heart enlargment with a very common cause of palpitations called atrial fibrillation. Patients can be in atrial fibrillation for many years without harm, but some patients with very little symptoms may have too rapid and irregular a rhythm present with symptoms of heart failure. There may also be some increased risk of stroke because of blood clots that can form in association with atrial fibrillation.

Are premature ventricular contractions (PVCs) life threatening?

If someone has normal heart function and no evidence of structural heart disease, the PVCs are a nuisance, but benign. If the PVCs are so symptomatic as to be disruptive, try eliminating all of the factors such as caffeine, certain foods, stress, before considering any treatment with medications. When we do treat with medications, we usually try to use simple medications such as beta-blockers first before going on to specific anti-arrhythmic agents. Very frequently, this is enough to improve patients’ symptoms.

PVCs are common

In summary, PVCs are common. In the vast majority of cases, they are of no prognostic significance and frequently go away on their own without any treatment beyond being reassured by your doctor.

How are exercise and PVCs related?

The relationship between extra beats and exercise is a complicated one. Many patients experience PVCs or palpitations before and after exercise, but not during exercise.

When most patients start to exercise, their own heart rate rises and the PVCs or other extra beats disappear at higher heart rates. After exercise, the body’s natural adrenalin level remains high for a period of time while the heart rate begins to go down during rest. This period of time often permits the extra beats to come back, and sometimes their rate and frequency are higher than before exercise.

If the other symptoms are mild or not present, usually there is not any reason for serious concern. If other symptoms accompany the palpitations such as shortness of breath, chest discomfort, or severe lightheadedness or loss of consciousness, those symptoms with palpitations in any setting are a cause for concern and require further evaluation.

How accurate are electrocardiograms (EKGs)?

An electrocardiogram is a representation of the electrical activity of the heart in multiple views. It records about 12 seconds and patients with palpitations may or may not have an abnormality on their EKG during that time. That is why many physicians use ambulatory EKGs or Holter monitors to try to make a diagnosis.

The other benefit of the standard EKG is that it may reveal evidence of other things that may be wrong with the heart such as an old heart attack or other electrical abnormalities that may provide important clues to an underlying diagnosis that the palpitations represent. So an electrocardiogram is a valuable part of a heart evaluation, but is not particularly sensitive for detecting heart rhythm abnormalities.

Holter monitoring

Other approaches include using a monitor that is hooked up quickly when symptoms occur but is otherwise carried in the pocket or purse for up to a month at a time. This permits better correlation of the symptoms of palpitations and the heart rhythm at the time symptoms are being experienced. On rare occasions we will implant a loop recorder under the skin that can record your heart for up to three years and capture arrhythmias that occur rarely or in situations where wearing a monitor isn’t practical, such as competitive sports, swimming, etc.

Can pregnancy cause heart palpitations?

I have had a number of patients in my practice that had their first episode of rapid heart action and palpitation during pregnancy. This is understandable in that the state of pregnancy causes significant shifts in blood volume and also puts a new stress on the heart that may bring out a tendency for rapid heart action that was not manifest prior to pregnancy.

After the pregnancy, the patient may not experience palpitations or may begin to see palpitations occur under other stressful circumstances. There certainly doesn’t need to be anything wrong with the heart in order for palpitations to occur during pregnancy.

One the other hand, women with a history of heart rhythm problems or syncope prior to pregnancy will often have a marked decrease in their symptoms during pregnancy as their cardiac output increases and blood volume increases.

What medications are usually prescribed to prevent palpitations?

There are a large number of medications that are used by physicians that are used to treat more serious types of heart rhythm disorders. These are usually prescribed by a heart specialist because they do have significant side effects and if not used correctly can cause serious cardiovascular problems, even a cardiac arrest or sudden death.

When used correctly, these powerful medications can prevent serious heart rhythm disorders from occurring and can be quite useful, although most patients would prefer not to be on them because of their cost, side effects, and they often must be taken multiple times a day.

How could a pacemaker improve heart palpitations?

In recent years, patients with the most severe types of heart rhythm disorders have benefited from sophisticated pacemakers and devices capable of correcting the heart rhythm with an electrical shock delivered automatically after the heart rhythm disorder occurs. Obviously, these are highly specialized devices, and they are normally prescribed and tested by heart specialists.

Can herbal remedies help prevent heart palpitations?

In terms of herbal remedies, I am not aware of an herbal remedy specifically effective for heart palpitation. I should say that low levels of potassium or magnesium in the body may be associated with palpitations and occasionally even more severe heart rhythm disorders, and in those cases supplements or foods high in potassium and magnesium are quite helpful.

Can I experience heart palpitations during panic attacks?

The startle effect releases substances in the body such as adrenaline which cause the heart rate to increase and the heart to beat more vigorously, creating a sensation of panic, heart pounding and heart racing. This is the experience of becoming aware of a natural or normal functioning of the nervous system. Anxiety, panic, and startling cause the adrenaline level to rise and create the sensation of palpitation.

Why do I experience heart palpitations when I bend forward?

When bending over, there is increased intra-abdominal pressure and this is transmitted up the esophagus (or a hiatal hernia) which lies directly against the back of the left atrium. This is the most common cause of non-cardiac palpitations.

Esophageal mobility disorders

Persons with esophageal motility disorders will also have a frequent palpitations and the will be no cardiac rhythm abnormality present. The brain doesn’t have the ability to differentiate cardiac palpitations from the stomach, esophagus, or sometimes even the chest wall muscles. These in and of themselves are normal and natural and don’t require any specific treatment in the vast majority of cases.

Are PVCs that I can feel more significant than those I can’t?

There is no prognostic difference between the PVCs that are felt by the patient and those that are not. Obviously the symptomatic PVCs are of more concern to the patient because they can be annoying and distracting. Beyond that, the PVCs are all the same, prognostically. In most patients who are otherwise healthy, PVCs on a Holter are of little prognostic value regardless of whether they’re experienced or not.

What should I do if my 9-year-old is complaining of “skipped beats?”

The same types of recommendations apply to children and in the vast majority of children, the causes of skipped beats are usually benign and do not require treatment. They should not be ignored, however, as electrical or structural abnormalities of the heart need to be ruled out.

If a child simply notices an occasional “skipped beat” and is otherwise healthy and keeps up with their friends on the playground, it’s unlikely that anything serious is going on.

Symptoms that require medical attention

  • Chest pain
  • Shortness of breath
  • Lightheadedness
  • Fainting spells

Nonetheless, their pediatrician should see children with these types of complaints, and some of them will need to be seen by a pediatric cardiologist.

What do people mean by sudden death?

Sudden death is used to describe a situation in which a patient loses cardiac function and essentially will die within minutes if assistance is not provided. By assistance, I mean cardiopulmonary resuscitation (CPR) and frequently, electrical cardioversion to restore the heart rhythm to normal. Obviously, patients where these efforts are successful will require extensive evaluation to determine the cause of cardiac arrest and to prevent it from occurring in the future.

The internal defibrillator devices that have become commonplace in the care of these types of patients have proven to be very effective in preventing death from heart arrhythmias in patients who have already had one or more episode of attempted sudden death.

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90,000 9 tips to help with tachycardia

In most adults, the heart beats 60 to 100 times a minute. When the pulse is more than 100 times a minute, this is already tachycardia. There are four types of this disease in total

The danger of tachycardia depends on the cause, heart rate, and the presence of an underlying heart condition. Ventricular tachycardia is considered the most serious condition and requires treatment. In this case, an irregular heartbeat allows the blood to clot, which can lead to a stroke.

  • Avoid food irritants. Major triggers are foods that increase your heart rate. The leaders are caffeine and alcohol, table salt, spicy food, sugar, monosodium glutamate.

  • Maintain a healthy weight. Research shows that losing weight can help lower your heart rate. A diet rich in fruits, vegetables and whole grains is always good for the body.

  • Get involved in physical activity. Any form of moderate exercise will do with 150 minutes a week. Recommended activities include cycling, dancing, walking, swimming.

  • Do not take medicines without a doctor’s prescription. Certain drugs can increase heart rate, including: decongestants, some antidepressants.Moreover, if you are taking medications for tachycardia, which can lead to side effects.

  • Find the causes that can cause tachycardia. With the help of your doctor, try to find and rule out the underlying causes of heart palpitations. These can include: anemia, diabetes, sleep apnea, thyroid disease.

  • Avoid overheating and dehydration. Heat increases heart rate and dehydration puts additional strain on the heart. If you live in hot climates, exercise outdoors in the morning or evening and stay hydrated.

  • Try to be less nervous. Excessive stress and anxiety can cause your heart rate to rise. Use techniques that can help you manage stress, such as breathing techniques, yoga and meditation, and relaxing music.

  • Monitor your pulse.
    Knowing the behavior of your heart rate during the day and during certain activities will help you control your condition.

  • See your doctor more often. After you have been diagnosed with tachycardia, do not delay a visit to the doctor if the episodes of tachycardia become more frequent. This lasts for a few seconds, minutes, or longer, and the heart rate can be between 150 and 220 beats per minute during an episode.Tachycardia interferes with your daily activities and is emotionally depressing.

  • 90,000 Why do healthy people have strokes?

    Photo caption,

    According to doctors, strokes can occur even in babies

    in total, smokes.

    Age is one of the most significant risk factors, however, as practice shows, stroke – an acute violation of cerebral circulation – can occur in a person at any stage of life.

    In Britain, strokes are diagnosed annually in more than 150 thousand patients, a quarter of whom are under the age of 65. Some of them are young and in good physical shape.

    Moreover, according to doctors, strokes happen even in children.

    Risk factors such as smoking, addiction to alcohol, and work involving heavy lifting do not cause stroke overnight, but they increase its likelihood from year to year.

    There are other causes of stroke that are crippling for young and healthy people.

    Birth defects

    Stroke occurs in the brain as a result of oxygen deprivation caused by the cessation of blood supply or insufficient blood circulation.

    In ischemic stroke, which is diagnosed in 80% of cases, the blood supply to the brain is impaired due to blockage of the vessel by a blood clot. In a hemorrhagic stroke, a cerebral hemorrhage occurs due to a ruptured vessel.

    Recently, the number of people under the age of 65 who have experienced this type of stroke has increased significantly.Such strokes occur in 50% of cases.

    Congenital defects of the circulatory system often lead to hemorrhagic stroke. In this case, a time bomb “embedded in the brain” can detonate at any moment.

    One of the examples of such “bombs” is arteriovenous malformation, when the arteries are directly connected to the veins due to the absence of a capillary network, which means that the pressure inside them is too great for the blood vessels. When unable to withstand it, the vessels burst, a cerebral hemorrhage occurs.

    Sudden surges in blood pressure are also a risk factor for young people, especially those with high blood pressure.

    Even simple stress can raise blood pressure to levels that cause a stroke. Scientists also concluded that consuming large amounts of coffee can lead to a similar effect.

    An irregular heartbeat, also called atrial fibrillation, can lead to ischemic stroke. Part of the heart can beat so quickly that the organ stops pumping blood efficiently.

    As a result, it begins to accumulate inside the heart, forming a clot, which reaches the brain, causing a stroke.

    And in the end, genes remain an inevitable factor.

    Some people are more prone to strokes than others and this can be inherited.

    Infants among the victims

    Dr. Claire Walton of the Stroke Research Association debunks the prevailing view of stroke as a disease of the elderly: “I would say it is a common misconception that it is a phenomenon of old people.A quarter of strokes occur in people of working age, and even children and babies can survive it. ”

    “ We must recognize that everyone has a risk of having a stroke, not only in older people, ”the expert adds. Stroke is not possible, but a healthy diet, regular exercise, moderate alcohol consumption and abstinence from smoking significantly reduce the risk.

    Ironically, however, some people with impeccably healthy lifestyles can collapse with a stroke, while others who their perfect opposite, they will calmly live to the end of their days.

    Stress kills the heart. The doctor – how to cope with nervous tension | HEALTH

    They say all diseases are from the nerves. And the longer the nervous tension, the more serious the consequences: hypertension, coronary heart disease, etc. A pandemic that has been going on for several months now causes chronic stress in many. How to save your heart in this difficult time, told cardiologist Inna Belan .

    From bad mood to heart attack

    Olga Kisileva, AiF-Yug: Inna Aleksandrovna, how does stress affect the state of the body?

    Inna Belan : A person’s reaction to stress is purely individual, and far from always the “stressful” factor is really dangerous.After all, different people react differently to the same event. Accordingly, with an initially favorable background and normal stress resistance, a person can adequately respond to negative factors.

    The main signs of a nervous state: irritability, excessive excitability, emotional breakdown, lack of concentration, attention, memory loss. Under stress, often chronic, sleep is disturbed, and with it the working capacity, negative, pessimistic thoughts prevail.Symptoms can include shortness of breath, headache, chest pain, and gastrointestinal dysfunction. Changes in appetite, both in the direction of refusing food, and, conversely, “seizing” stress, in turn, can lead to changes in weight, menstrual cycle, hormonal levels, decreased libido.

    In modern clinical practice, we are increasingly encountering a combination of cardiovascular diseases and depression, mainly of an anxiety type. Studies show that more than 84% of patients with stable coronary heart disease have anxiety-depressive, asthenic, panic and phobias.

    Acute stress can provoke myocardial infarction, arrhythmias, sudden death. It increases mortality from several hours to several months after a difficult event experienced, for example, the death of a loved one, an animal, after a natural disaster, military or terrorist attacks, or violence. Moreover, even if you initially do not have heart problems, then each additional stress can increase the risk of developing diseases by 15%. If the disease is already present, then the risk of complications doubles.

    In general, by its nature, stress can be physiological, emotional or psychological – nervous. Physiological is the body’s response to external factors: heat or cold, hunger and thirst, physical strain, injury, surgery, disease. Emotional arises as a result of unfavorable relationships at work, in the family, with financial difficulties, conflicts with colleagues, bosses. Nervous – with excessive strain, depends on the characteristics of the human nervous system, the ability to cope with changing circumstances.

    Chronic stress is the most dangerous form of stress. A person almost completely loses the ability to control his emotional state, is in constant tension even in the absence of negative factors. This leads to the development of depression, nervous breakdowns, exacerbation of chronic and development of acute diseases.

    “Urgent vacation!”

    – How to help a person in such a situation?

    – To resist unpleasant emotions, we must have enough energy resources, which we most often draw from positive emotions.It can be leisure, hobby, sports, loved one, travel, etc. If such a resource is not enough, for example, an unloved work, and even without a long vacation, irregular schedule, night shifts, quarrels, betrayal in the family, conflict children, loans, debts, then a pathological chain of events is triggered, eventually leading to chronic stress.

    Creativity, sports, sleep and travel can help you cope with negative emotions.

    In general, a person in a state of emotional overload goes through three stages.The first is a feeling of anxiety, a subconscious willingness to resist a stressful factor. The body is mobilized, breathing quickens, blood pressure rises, muscles tense. At the second stage, resistance is rendered, adaptation of the organism. And with a decrease in the energy of resistance, depletion of the organism occurs. This is the third stage.

    Want to cry? Don’t hold back!

    – Is it possible to relieve stress, shall we say, at home?

    – Breathing exercises, physical exercises, massage will help.Treatments should be fun and distracting. If a trigger of a strong emotional coloring, for example, a serious illness or the death of a loved one, you want to cry, speak out, then you must definitely do this.

    It is recommended to wash with cool water, drink a glass of warm tea or water. If possible, change the environment, and possibly the occupation. In this case, in no case should you drink alcohol or smoke. Bad habits further aggravate the state of health and the current situation.

    It is also necessary to normalize the mode of work and rest, sleep at least 7-8 hours a day, alternate active work with periods of rest, calendar leave. It has been proven that people with workload are more likely to have risk factors such as smoking, low physical activity, obesity. Therefore, it is extremely important to give up bad habits, increase physical activity. If you understand that the nervous situation is dragging on, immediately take a vacation and radically change the situation.

    Creativity and sports are also useful. Dreamed of learning to draw – go to art courses, love to sing – to vocal lessons or at least karaoke, love to swim – more likely to the pool, or even better to the sea. For many people, after resolving a long-term stressful state, new abilities and opportunities open up, sometimes changing their entire subsequent life. Despite a very difficult emotionally and physically year, everything is in our hands.

    How to develop stress resistance?

    1. Do not worry about factors that are beyond your control (bad weather, nature, etc.)e).
    2. Do not “think up”, do not “cheat”, do not “escalate” problems (from the category of “it seemed”, “probably”, “maybe”, “it would be better this way and not otherwise”).
    3. Solve problems as they arise (what if they don’t appear?).
    4. Accept the fact of what happened (the past cannot be changed, but the attitude towards it is possible).
    5. Be able to recognize and express your own emotions, and not suppress them (be able to rejoice and be sad, communicate with others, grieve when necessary).
    6. Limit viewing of channels and social networks with negative news. In your free time, watch good old films, practical programs, read the posts of positive bloggers.
    7. Refrain from discussions on topics that are unpleasant to you (if it is difficult for the interlocutor to prove something, but is it necessary?).
    8. Limit communication (as much as possible) with pessimistic, negative people (they may be the source of your stress).
    9. Know how to forgive (everyone! Absolutely everyone!)
    10. Don’t try to change the people around you.Each person is able to change his attitude to the world himself. You just need to learn to look at the world positively.
    11. Do what you love or invent for yourself (swimming, cycling, embroidery, etc.).
    12. Set yourself realistic plans, try to implement them smoothly. Thus, the meaning of the stages of life appears.
    13. Kindness and mercy always give only positive emotions (participation in charity events, foundations, and just to feed a homeless kitten).
    14. When an unpleasant situation arises, it is helpful to visualize an even worse state of affairs. After that, the understanding often comes that not everything is so bad. But don’t overuse it.
    15. It is necessary to learn to relax, find time for sports, leisure with loved ones, and meditate.
    16. Eat right (it’s better to cook your own food), eat seasonal fruits and vegetables, move more, give up bad habits, and better get yourself some useful water, for example, drink water by the hour (you can install the application on your smartphone).This is motivating.
    17. Praise yourself for every step you take to your new self.
    18. In some cases, a complete change of lifestyle helps (marry / get married, change profession, car, city)

    90,000 Beta blockers to prevent death or serious events after non-cardiac surgery

    This review assessed evidence from randomized controlled trials (RCTs) on whether beta blockers reduce mortality or other serious events in carrying out surgical operations, except for heart operations.Results from cardiac surgery are discussed elsewhere.


    Surgical interventions increase the stress of the body, which responds by releasing the hormones adrenaline and norepinephrine. The stress of surgery can lead to death or other serious events such as heart attacks (heart attacks), stroke, or irregular heartbeat. For surgical procedures that do not involve the heart, it is estimated that 8% of people may have heart problems during surgery.Beta blockers are medicines that block the effects of epinephrine and norepinephrine on the heart. Beta blockers can slow down the heart and lower blood pressure, and this can lower the risk of serious events. However, beta blockers can cause very low heart rates or very low blood pressure, which can increase the risk of death or stroke. Prevention of early complications after surgery is important, but the use of beta-blockers to prevent these complications is controversial.

    Characteristics of research

    Evidence is current to 28 June 2019. We included 83 RCTs involving 14,967 adults who had undergone a variety of surgeries other than heart surgery. Eighteen studies are awaiting classification (because we did not have enough details to evaluate them), and three studies are ongoing. The types of beta blockers used in research are propranolol, metoprolol, esmolol, landiolol, nadolol, atenolol, labetalol, oxprenolol, and pindolol.Studies have compared these beta blockers to both a placebo (a drug that looks like a beta blocker but does not contain any medication) and standard treatment.

    Key Outcomes

    Beta blockers have little or no effect on the number of people who die within 30 days of surgery (16 studies, 11,446 participants; low certainty evidence), number of people with stroke (6 studies, 9,460 participants; evidence low-certainty) or previous ventricular arrhythmias (irregular heartbeats starting in the main chambers of the heart that are potentially life-threatening and may require immediate treatment; 5 studies, 476 participants; very low certainty evidence).We found that beta blockers can reduce the incidence of atrial fibrillation (irregular heartbeats starting in the atria that increase the risk of stroke if left untreated; 9 studies, 9080 participants; low-certainty evidence) and the number of people with heart attacks (12 studies, 10 520 participants; low-certainty evidence). However, taking beta blockers can increase the number of people with very low heart rates (49 studies, 12,239 participants; low-certainty evidence) or very low blood pressure (49 studies, 12,304 participants; moderate-certainty evidence) during surgery.

    In several studies, we also found little or no effect on the number of people who died after 30 days who died from heart problems or had heart failure. We found no evidence that beta blockers affect length of hospital stay.

    There were no studies that evaluated whether the quality of life of people given beta blockers was better after heart surgery.

    Certainty of evidence

    The certainty of the evidence in this review was limited to including some studies at high risk of bias, and we noticed that some of our results differed if we included only placebo-controlled studies or studies that reported how participants were randomized.We also found one large, well-conducted international study that differed from studies with fewer participants. It showed a decrease in heart attack rates and an increase in stroke and all-cause mortality when beta-blockers were used, while other studies did not show a clear effect. We were also less confident about the outcomes in some studies, such as for ventricular arrhythmias.


    Although beta blockers may have little or no effect on the number of people who die within 30 days, have a stroke, or have ventricular arrhythmias, they can reduce the incidence of atrial fibrillation and heart attacks.Taking beta blockers can increase the number of people with very low heart rates or very low blood pressure during surgery. Further evidence from large, placebo-controlled trials is likely to enhance the certainty of these findings, and we recommend that an assessment of the impact on quality of life be undertaken.

    Treatment of cardiac arrhythmias – symptoms, diagnosis and treatment

    The heart consists of four chambers – two upper chambers (atria) and two lower chambers (ventricles).The heart rate is controlled by the natural pacemaker (sinus node) located in the right atrium. The sinus node produces electrical impulses that trigger each heartbeat. These impulses cause the muscles of the atria to contract and pump blood into the ventricles. The electrical impulses then travel to a cluster of cells called the atrioventricular (AV) node. The AV node slows down the electrical signal before sending it to the ventricles. When electrical impulses reach the muscles of the ventricles, they contract, causing the ventricles to pump blood either to the lungs or to the rest of the body.

    For a person with a healthy heart, the heart rate should be 60-100 beats per minute during rest. The more trained a person is, the lower their heart rate. For example, in Olympic athletes, the resting heart rate is often less than 50 beats per minute, this is a completely normal condition.

    Cardiac arrhythmias

    Cardiac arrhythmias occur when the electrical impulses that set the rhythmic heartbeat do not work properly, causing your heart to beat too fast or very slowly or irregularly.Some arrhythmias are so short (such as a temporary pause or premature contraction) that the overall heart rate or rhythm is not affected. But if the arrhythmia lasts longer, the heart rate becomes too slow or too fast, which makes the heart less efficient.

    Facts about arrhythmia

    • Often arrhythmias are hidden, for a long time they do not manifest themselves in any way.
    • Symptoms of arrhythmia are usually dizziness, shortness of breath, palpitations, fainting.
    • Causes of cardiac arrhythmias include high blood pressure, diabetes mellitus, mental stress, and smoking.
    • Most arrhythmias are not serious, but some can lead to stroke or cardiac arrest.

    Types of arrhythmias


    • Slow heartbeat: bradycardia when the resting heart rate is less than 60 beats per minute
    • Rapid heartbeat: tachycardia when the resting heart rate exceeds 100 beats per minute
    • Irregular heartbeat: flutter or fibrillation
    • Premature contraction of the heart: extrasystole
    • Pauses in the contraction of the heart: blockade

    Not all tachycardias or bradycardias mean you have heart disease.For example, during exercise, your heart rate can speed up to 200 beats per minute as your heart speeds up to provide oxygen-rich blood to your tissues. During sleep, your heart rate often slows to less than 40 beats per minute.

    There are several types of arrhythmias:

    Atrial fibrillation (atrial fibrillation)

    This is a very frequent irregular contraction of the atrial chambers, which leads to an irregular heart rhythm.Atrial fibrillation is common, mostly in older patients. This type of arrhythmia in the absence of treatment is sooner or later complicated by a stroke.

    Atrial flutter

    While atrial fibrillation is a multitude of random electrical impulses originating in the atria, atrial flutter usually originates from a single area in the atrium. As in the case of atrial fibrillation, with flutter, the myocardium contracts irregularly, which leads to thickening of blood in the atria and the formation of blood clots.In many patients, both types of arrhythmias occur — atrial flutter and atrial fibrillation.

    Supraventricular tachycardia (SVT)

    Regular abnormally fast heartbeat. The patient experiences a burst of accelerated heartbeat for several seconds and up to several hours. Typically, a patient with SVT has a heart rate of 160-200 beats per minute.

    Ventricular tachycardia

    Ventricular tachycardia is ≥ 3 consecutive ventricular beats at a rate of ≥ 120 beats per minute.This arrhythmia often occurs if there is a “scar” in the heart muscle from a previous myocardial infarction. Symptoms depend on the duration, it can be either their complete absence or a feeling of palpitations, collapse of hemodynamics and death.

    Ventricular fibrillation

    An irregular heart rhythm consisting of very fast, uncoordinated ventricular contractions. The ventricles are not pumping blood properly, they just flicker. Ventricular fibrillation is always life-threatening, usually associated with heart disease.

    Long QT interval syndrome

    An abnormal heart rhythm that causes fast, uncoordinated heartbeats. This can lead to fainting, sudden death. Long QT syndrome is often caused by either genetic abnormalities or certain medications.

    Causes of arrhythmia

    Lead to malfunction of the heart:

    • high blood pressure
    • thyroid disease
    • sleep apnea, snoring
    • stress
    • smoking
    • alcohol abuse
    • diabetes mellitus
    • electrolyte imbalance
    • some medicines
    • Excessive consumption of coffee
    • some food additives
    • treatment with certain herbs
    • structural changes of the heart

    Symptoms of cardiac arrhythmias

    Arrhythmia may or may not be felt as a rapid, irregular heartbeat.You may feel a slow or irregular heartbeat, or notice pauses between heartbeats. If you have a fast heartbeat, you may feel like your heart has skipped a beat or how it “pounds” or pounds.

    More serious signs and symptoms include:

    • blurred vision
    • chest pain
    • shortness of breath, shortness of breath
    • fainting
    • fast fatigue
    • weakness and dizziness
    • alarm

    Many arrhythmias are harmless and occur without severe symptoms.However, if they are a consequence of heart disease, they can cause dangerous manifestations – fainting, dizziness, shortness of breath. Keep track of when and how often arrhythmia occurs, how you feel, whether your feelings change over time. These are all important clues your doctor can use to prescribe treatment.

    Arrhythmias that are not recognized or left untreated can cause life-threatening complications affecting the heart and brain.

    • Stroke. It often develops in patients with atrial fibrillation. With atrial fibrillation, blood can thicken in the left atrial appendage, causing blood clots to form. If a blood clot breaks off and enters the arteries of the brain, it always leads to a stroke.
    • Dementia. Alzheimer’s disease and vascular dementia are more common in people with arrhythmias. This may be due to a decrease in blood flow to the brain over time.
    • Heart failure.Repeated arrhythmias can rapidly decrease the heart’s ability to pump blood. Heart failure is especially common with arrhythmias when you already have heart disease.
    • Sudden cardiac arrest. The heart may suddenly and unexpectedly stop beating as a result of ventricular fibrillation.
    • Sudden Infant Death Syndrome. This syndrome can be attributed to a hereditary conduction disorder that causes cardiac arrest.

    How is cardiac arrhythmia treated by a doctor?

    Diagnosis of arrhythmia

    To diagnose arrhythmia, your doctor will ask you about symptoms, medical history, lifestyle, and any signs of arrhythmia in your family.To clarify the diagnosis, your doctor may order some of the following tests:

    • ECG is the most common test for detecting major rhythm and conduction disturbances
    • Blood tests to check the level of blood electrolytes (potassium, sodium), thyroid hormones, and assess kidney function.
    • Echocardiography to get information about the size and shape of your heart and how well it is working.
    • Holter ECG monitoring to record the electrical activity of your heart over time as you go about your normal activities.This study can last from 1 to 7 days.
    • Stress test to detect arrhythmias that occur at a time when the heart is working hard and beating quickly. If you are unable to exercise, you may be given medication to make your heart work faster.
    • Implantable Loop Recorder. This device sits under your skin and continuously records the electrical activity of your heart. The registrar can remotely transfer data to the doctor’s office.The implantable monitor helps doctors diagnose arrhythmias in very rare episodes of abnormal heart rhythms.
    • Sleep study (polysomnography) for the diagnosis of sleep apnea – a common cause of cardiac rhythm and conduction disturbances.
    • Electrophysiological research (EPI). During EPI, electrical stimulation of various parts of the heart and registration of electrocardiograms are performed. Allocate non-invasive and invasive EFI of the heart. Transesophageal electrophysiological examination is a non-invasive method of electrophysiological examination of the heart by introducing a diagnostic esophageal electrode through the nose or mouth to a depth of 40-50 cm and recording an ECG.The study is performed on an outpatient basis and usually takes no more than 20 minutes. With intracardiac EPI, a thin catheter is inserted through a blood vessel in the groin, which can send electrical impulses to the heart to beat at different rates, while simultaneously recording an ECG inside the heart. Once the source of the disorder has been accurately identified, treatment can be prescribed.
    • The tilt test is used to help find the cause of fainting spells. You are lying on a table that moves from a horizontal to a vertical position.Changes in body position can lead to fainting. The doctor monitors your symptoms, heart rate, ECG readings, and blood pressure throughout the test.
    • Coronary angiography is a diagnostic invasive procedure that is necessary to determine the condition of the vessels carrying blood to the heart. The study allows you to find out the degree of narrowing of the arteries of the heart. With an unfavorable development of events, these arteries for various reasons can narrow or clog.The supply of blood to the heart is significantly limited, which is the cause of ischemic disease, often manifested by various heart rhythm disturbances.

    Arrhythmia treatment

    Treatment of arrhythmias is required only if the disturbance in the rhythm and conduction of the heart can threaten life, lead to serious complications, or significantly affect the quality of your life. One of the principles of arrhythmia treatment is to search for the main causes of its development and to eliminate them.

    Treatment of bradycardia

    If bradycardia is well tolerated and does not threaten cardiac arrest, your doctor may suggest monitoring your condition, as well as actively looking for possible causes of a slow heartbeat (thyroid gland, kidney disease, electrolyte imbalance).If the cause of bradycardia is not found, or if your life is at risk, your doctor may advise you to implant a pacemaker. A pacemaker is a small device that is placed under the skin of your chest to help control abnormal heart rhythms. Pacemakers use electrical impulses to make the heart beat at its normal rate.

    Treatment of tachycardia

    Vagus techniques are the first line of medical care in the relief of attacks of supraventricular tachycardia in children and adults, which is associated with their ease of implementation, relative safety and the ability to avoid the introduction of antiarrhythmic drugs.

    Antiarrhythmic drugs. Substances belonging to different classes of chemical compounds can have a normalizing effect on the disturbed rhythm of heart contractions. These drugs will not cure the patient, but they are usually effective in reducing the number of tachycardias.

    Cardioversion. The restoration of the sinus rhythm of the heart is possible in two ways – using electric current or drugs. Electrical cardioversion – arresting an attack of arrhythmia by a defibrillator discharge synchronized with the ECG.Drug cardioversion – relief of an arrhythmia attack by the administration of antiarrhythmic drugs.

    Ablation is a line of surgical treatment of rhythm disturbances. This includes a number of methods in which the focus of arrhythmia is destroyed by heating with the help of exposure to electric current or cold (cryoablation).

    ICD (implantable cardioverter defibrillator) is a device designed to eliminate life-threatening arrhythmias and prevent cardiac arrest.The device is implanted near the left collarbone and monitors the heart rate; if the device detects an abnormally fast rhythm, it stimulates the heart to return to its normal rhythm.

    How to live with arrhythmia?

    Follow your doctor’s recommendations for lifestyle adjustments. Try to eat right and eat healthy foods, exercise regularly, quit smoking, minimize stress, and normalize your weight. Your doctor may also recommend that you reduce or stop your alcohol and coffee, tea, chocolate, or other sources of caffeine to avoid arrhythmias.

    Remember the importance of regular doctor visits. Write a list of all the medicines you take and show it to each doctor during consultations or in the emergency department. This will help your doctors know exactly what medications you are taking and reduce the risk of unwanted drug combinations.

    Ask your doctor if you can continue your daily activities without making any changes. Your doctor may recommend low to moderate activity; avoid competitive sports; Eliminating activities that can cause arrhythmias, such as swimming or diving.

    Your doctor may recommend anticoagulants to prevent stroke, even if your heart rate is normal. You may need regular blood tests to check the effectiveness and safety of anticoagulant therapy.

    Get regular shots, including flu and pneumococcal shots, over the age of 65. Remember to take your medications. High adherence to treatment significantly improves the prognosis of the disease.Tell your doctor if you have any side effects from the medication. Some of the medications can cause low blood pressure, slow heart rate, depression, or worsen heart failure.

    Tell your doctor if your symptoms worsen or you develop new symptoms. Over time, some arrhythmias may become more severe, last longer, or cause new arrhythmias to develop. Lie down if you feel dizzy or faint, or have a rapid heartbeat.Do not try to walk or drive a car. Tell your doctor about these symptoms.

    Carry your medical device identification card with information about your defibrillator or pacemaker and the contact information for the hospital you are seeing. Medical bracelets with information on anticoagulant treatment can also be helpful in an emergency.

    Consult a healthcare professional before taking over-the-counter medicines, dietary supplements, or cold and allergy medicines.Some of these foods can cause heart palpitations or interact poorly with antiarrhythmic drugs.

    Treatment of rhythm and conduction disorders at the European Medical Center

    Treatment of rhythm disturbances in our clinic begins after a comprehensive examination and is selected individually for each patient. Diagnostics and treatment of arrhythmias and cardiac conduction disorders at EMC are carried out by leading cardiologists-arrhythmologists under the guidance of Professor Farhad Rzayev.All doctors of the department are highly qualified specialists, doctors of sciences, professors, doctors of the highest category, who have undergone training in the best clinics in the world. The main goal of EMC arrhythmologists is to determine the type of heart rhythm disturbance, the degree of risk for the patient, and also to choose the optimal therapeutic tactics. The EMC Heart and Vascular Clinic is licensed by JCI, which makes the stay comfortable and safe for the patient. The EMC electrophysiology laboratory is equipped with the latest equipment to perform the full range of minimally invasive atrial fibrillation treatments, including radiofrequency and cryoablation.EMC has installed the only state-of-the-art SmartAblate system in Russia for RF and cryoablation.

    Eustress and Distress – Two Sides of the Same Coin | Dr. More

    Experts divide the usual concept of “stress” into negative (distress) and positive stress (eustress). When we talk about stress, we usually mean distress – for example, illness or death of a loved one, divorce. The birth of a child, an excellent defense of a diploma, a wedding is an eustress.Students are well aware of this state when the exam is successfully passed, and a sleepless night is immediately forgotten, the soul is singing, energies are overflowing.

    Athletes who have achieved record results also experience beneficial stress, while those who were left without a medal, but were one step away from it (fourth place syndrome) may experience severe negative stress.

    Much is in our hands, strong positive emotions can cause a new occupation for us, a change of profession, which we have long dreamed of.It is very useful to get out of the rut hackneyed for years, the body needs such a shake-up.

    However, stress of any sign puts a lot of stress on the nervous and immune systems. In the case of positive stress, this load can be beneficial, but not always.

    Die of happiness?

    And happy moments can overload the body too much. There are tragic cases when people, having achieved the desired goal, fall ill or even suddenly die. The American media described a case when an elderly woman died of cardiac arrest a few hours after President Obama looked into her restaurant.This visit was an unexpected surprise for her …

    Cardiologists know that strong emotions, including positive ones, can lead to heart attack, stroke and other dangerous consequences. Severe emotional stress can cause irregular heartbeats or even cardiac arrest. In the risk group, first of all, people suffering from cardiovascular diseases.

    Too active, but not good health, football fans periodically become patients of cardiologists during important world-class matches.Eustress as strong as orgasm can also lead a man to a heart attack, even fatal.

    Fortunately, eustress still more often has a positive effect on the body, which cannot be said about its opposite – distress.

    How we deal with stress

    For greater clarity, scientists have described three main types of responses to stress, more precisely, to distress.

    • “Ox”. He patiently adjusts to life under stress, dutifully pulls his cart.Oxen people are usually hard workers.
    • Rabbit. Reacts even to minor troubles very sharply, but quickly “jumps out” of the experience.
    • “Lion”. Corresponding to the name, lions boldly rush into battle and show their best fighting qualities and energy in stress.

    Each person is naturally closer to one or another way of reacting to stress, but we can, by soberly assessing the situation, choose a new path for ourselves.

    To begin with, psychologists advise to answer 2 questions: “What can I do in this situation? How long will all this have to endure? “

    If the stress is short and you cannot do anything (unpleasant neighbors on the train, standing in a traffic jam), relax and be patient. If you see any opportunities to influence the situation, “turn on the lion” and boldly into battle. Remember the brave frog from the fairy tale, which almost drowned in a pot of sour cream, but whipped the sour cream into butter with its paws and got out of an almost hopeless situation.

    What to do if the stressful situation does not end in sight? Don’t act like an ox.Why? It turns out that enduring for a long time and being silent is the most dangerous for health. The accumulated negative emotions can cause the most serious diseases. Remember the old wisdom: “Better a terrible end than endless horror”, and you will have the strength to break the chain of unpleasant emotions and get out of the black life strip to the white one.

    What doesn’t kill us makes us stronger?

    Medicalxpress.com has published an article by Professor J. Robertson, neuroscientist and psychologist.He considers Friedrich Nietzsche’s aphorism as a guide to action in many stressful situations. Many eminent athletes, musicians and actors argue that it is necessary to be nervous before a responsible performance. The main thing is to keep the situation under control and make stress your ally, not your enemy. How can this be achieved? Robertson advises those in a stressful situation to think, “I’m excited” instead of “I’m nervous.” This will allow the brain to switch from problem-avoidance mode to competition mode.

    The scientist believes that moderate stress, if directed in the right direction, can improve attention, makes brain cells more active. In order for the brain not to degrade with age, but to continue to work effectively, it must solve complex problems. Robertson proves this with the example of research participants, people over 70 years old.

    The memory of all the subjects began to deteriorate, and when, after 2 years, a second examination was carried out, the state of their memory became even worse.The only exceptions were those people who, over the past 2 years, got into stressful situations, for example, a stroke in a husband or wife. Such a shake-up forced their brains to work “for two” and mobilize all resources.

    Robertson also believes that “greenhouse” upbringing is harmful for children when they are protected from all problems. In the future, they are at risk of depression due to the lack of “stress training”.

    Simple exercise in order to calm down in a stressful situation: take 5 deep breaths, then begin to alternately squeeze and unclench your right hand.

    In order not to get stuck in stress for a long time, the professor recommends setting the right goal for yourself, which is not too easy, but not too difficult to achieve.

    Read more about protection from stress in the materials “7 diseases on the basis of nerves and 7 ways to protect against them” and “How to stop being nervous: what to eat on hard days.”

    90,000 Exercise ECG Assessment System

    Multi-parameter Exercise ECG Assessment System for optimal stress ECG testing.


    The Medeia Stress ECG Testing System is a comprehensive PC-based ECG testing system equipped with state-of-the-art technology to capture the electrocardiogram during exercise under stress with maximum accuracy. This inexpensive, easy-to-use system allows users to simultaneously monitor 12 inputs on the screen using programmable reports and protocols. The main advantages of this system are listed below:

    • Use of wireless ECG sensors
    • Automatic creation and printing of reports
    • Taking blood pressure measurement
    • Configurable load protocols based on personal preference
    • Compliance with all standard
    load protocols
    • Generates ST measurements for modification before, during or following completion of the test

    What is an Exercise Electrocardiogram?

    An electrocardiogram taken during exercise under stress is a screening tool used to assess the effects of exercise on the heart and lungs.Because heart problems become apparent during exercise, the test uses a treadmill or stationary bike to produce results that can be tracked and measured. This non-invasive diagnostic test measures your heart rate, blood pressure, and electrocardiogram (or electrical activity of the heart) before, during, and after exercise. The exercise level is gradually increased during the test to determine if the heart and lungs are getting enough oxygen and functioning properly.

    Why Does It Work?

    The heart is a powerful muscle pump that delivers oxygenated blood to the body as needed. A natural, built-in electrical system produces pumping and contractions at the cardiac level. Exercise ECG evaluation measures this electrical activity to determine heart health. During exercise, the heart pumps vigorously to deliver more oxygen to the lungs and body, thereby increasing the heart rate.This increase in contractions reflects any potential coronary problems that cannot be detected when the body is at rest. This non-invasive, cost-effective system provides a valuable initial screening test for coronary artery disease and other abnormalities or potential risks.

    How to Prepare for the Test?

    The following recommendations are prescribed for the stress test:
    • Refrain from eating, drinking or smoking for at least two hours before the test (water allowed)
    • Talk to your doctor about any medications you are currently taking.Select medicines that may need to be discontinued before the trial begins.
    • Wear comfortable walking / running clothing and shoes.
    • Get a doctor’s advice on all unresolved issues.

    What Happens During The Test?

    Exercise ECG assessment is performed in a clinic, doctor’s office, or hospital. A trained practitioner or nurse attaches multiple suction electrodes to the subject’s chest. The wires from the electrodes go through the suction cups to the electrocardiograph.The blood pressure cuff is placed on the patient’s arm and the patient is instructed to move on the treadmill. During the entire test, electrodes send electrical signals from the heart to the testing system. The patient is monitored continuously until testing is complete.

    Exercise ECG Patient Information

    Before connecting the electrodes, the technician wipes the connection points with a swab moistened with alcohol for a secure connection.Each electrode is attached to a wire that exits the nipple and goes to the EKG system. The wires carry electrical signals from the heart to the testing system. In addition to the electrodes, you will have a blood pressure cuff around your arm. This will allow you to measure and monitor your blood pressure throughout the test.
    The technician will begin the test by taking your resting ECG. This measurement reflects cardiac activity at rest. Next, you will be instructed to start walking on a treadmill or pedaling on an exercise bike.After the transition from a state of rest to activity, the ECG system will record changes in cardiac activity.
    Periodically, speed, altitude, or resistance on the treadmill or stationary bike will increase, resulting in a corresponding increase in heart rate. Testing continues until your target heart rate is reached (i.e. 85% of your maximum heart rate as predicted based on your age). If you experience any heart rhythm abnormality, dizziness, or fatigue during this period, the test will be stopped immediately.
    After part of the stress test is complete, you will be prompted to keep moving at a slower speed until your heart rate returns to normal. The electrocardiograph and blood pressure cuff will continue to monitor and record your body’s activity. After the technician is satisfied with your recovery, the electrodes will be removed and the test will end. Some situations require the use of medication instead of exercise in order to increase your heart rate.In such cases, a drug is administered, then a no-load test is performed.

    Are There Any Risks?

    Exercise ECG assessment is generally considered safe when performed by a trained practitioner in a professional medical environment. With that said, the test does carry the lowest risk of heart attack (1 in 100,000). Any unexpected risks will be preceded by a number of predictive symptoms, including the following:
    – Changes in appearance, including gray, cold or clammy skin
    – Dizziness or feeling unsteady
    – Shortness of breath or chest pain
    – Heartbeat too fast, too slow, or irregular

    If any of these symptoms occur, the technician, nurse, or doctor should be notified immediately.

    ECG history under stress


    The heart is a powerful muscle that delivers oxygen and nutrient-rich blood throughout the body. The pumping movement used to transport blood is stimulated by natural electrical signals that travel through the heart.
    These electrical signals originate in the sinus node located in the right upper cavity or atrium. Signals follow a designated path, branching out to the left and right atria.This, in turn, pushes blood into the lower chambers or ventricles by muscle contractions through the atrioventricular node. The electricity travels down to the tissue separating the lower chambers, then finally returns to the ventricles. This last leg of the journey causes the heart to contract and pump blood to the lungs and the rest of the body.
    Any deviation from this typical current path indicates heart problems. There may be damage from myocardial infarction or existing heart disease.The doctor may require an electrocardiogram (EKG) to study the function of the heart. An ECG test involves placing electrodes on the chest to record electrical signals from the heart.
    Exercise ECG using a treadmill is the standard diagnostic tool for coronary artery disease. The test requires an ECG record of 12 leads at rest, during exercise, and after exercise. Through this testing, doctors can determine if there is a link between chest pain, exercise, and the typical ECG symptoms that signal myocardial ischemia.

    On-load ECG testing

    As soon as the electrodes are connected to the patient, he will be instructed to start the exercise. During the test, the exercise intensity will be gradually increased to induce an increase in the patient’s cardiac load. The patient’s ECG, blood pressure and other symptoms will be continuously monitored and recorded. Symptoms for which the test should be stopped include chest pain or discomfort, shortness of breath, dizziness, fatigue, and a drop in systolic blood pressure greater than 10 mmHg.Art., depression of the ST-segment more than 0.2 mV (2 mm), or the development of ventricular tachyarrhythmia.
    The attending physician or qualified professional must be present throughout testing to ensure patient safety and monitor important elements such as total exercise duration, when ST ischemic change begins, incidences of chest discomfort, depth of ST depression, and total time taken to complete. recovery from these ECG fluctuations.
    The risk associated with ECG testing is minimal, however 1 in 10,000 tests can lead to fatal complications and 2 in 10,000 tests can lead to non-fatal complications.Any signs of discomfort or irregularity should be detected and addressed immediately on site by doctors and technicians.

    Interpretation of Test Results

    In a normal test subject, exercise involves a gradual increase in heart rate and blood pressure. If the blood pressure does not increase, or if the blood pressure actually decreases, then this is indicative of ischemia and is an important adverse prognostic sign.This symptom may reflect global left ventricular dysfunction. Severe (> 0.2 mV) ST-segment depression with low exertion and / or concurrent pain that lasts at least 5 minutes after completion of the exercise component suggests severe coronary artery disease and predicts a high risk for future cardiac events.
    Ischemic ST-segment response produces square waves, flat plateau flat or downward slope. This flat ST depression is greater than 0.1 mV below baseline and typically persists for periods longer than 0.08 seconds.ST segment changes that do not depict this characteristic do not necessarily represent a positive test. Likewise, conduction disturbances, T-wave abnormalities, and ventricular arrhythmias that occur during exercise should be noted but are not diagnostic. In addition, in some situations where the pulse rate (i.e. 85% of the maximum heart rate depending on gender and age) is not achieved, a negative result is not considered diagnostic.
    These cases of negative or false positives occur in approximately 15% of all subjects; however, a positive result indicates a 98% chance that cardiovascular disease is present in men over the age of 50 with a history of typical angina. This cross section will also show chest discomfort during the test, however, the likelihood is significantly reduced if there is no pain during the test. The incidence of false-positive tests is also increasing among asymptomatic men under 40 years of age, in patients taking cardioactive medications (eg digitalizor quinidine), and in pre-menopausal women without risk factors for premature atherosclerosis.The overall sensitivity of the stress ECG is about 75%, since a negative result does not necessarily rule out cardiovascular disease. This, however, greatly reduces the likelihood of a 3-vessel or left primary CAD.
    In some cases, patients will undergo exercise during a standard ECG. This test uses a treadmill or exercise bike to induce an increase in your heart rate, ECG, and blood pressure. Exercise intensity is gradually increased during the ECG recording to determine the effect of exercise on the electrical activity of the heart.

    What is Exercise ECG?

    An electrocardiogram, or EKG, provides a visual representation of electrical activity occurring at the level of the heart. Each contraction and pumping is stimulated by a natural electrical signal that can be measured and analyzed with an ECG test system. An extension of this basic test is an exercise ECG or stress test, which uses exercise or medication to put an increased strain on the heart.By monitoring the heart’s response to stress, doctors can detect existing problems and predict potential future risks.

    Is ECG Safe Under Exercise?

    Exercise ECG is generally considered a safe test, however, like most medical procedures that stress the heart, it carries a small degree of risk. During testing, in very rare cases, the test subject may develop complications, including an abnormal heart rhythm. This disorder can lead to a heart attack, which can lead to injury or death.Therefore, this study should be carried out under the supervision of qualified specialists and doctors in order to solve any problems that arise.

    What Does It Talk About?

    An exercise ECG test is performed to determine how well the heart is working. It can be used to diagnose and assess the severity of coronary artery disease based on how well the heart performs during exercise.

    The test is also very valuable in the diagnosis and in the localization of any blockages that may be present in the coronary arteries.The blockage narrows the artery, thereby reducing the amount of oxygenated blood that is delivered throughout the body. This is often manifested by chest pain or abnormalities displayed on the ECG.

    Healthy subjects in optimal physical condition may be exposed to stress for longer periods of time. Subjects suffering from heart disease will not be able to withstand the same stress. Doctors use prolonged exercise to determine overall heart health.

    Many subjects feel tired or short of breath while exercising, however, significant symptoms may indicate more serious problems. If the patient is experiencing severe chest pain or sudden difficulty breathing, then this may indicate a heart problem.

    Blood pressure response
    During exercise, increases in blood pressure and heart rate are due to increased exercise.If the subject has an abnormal heart rate (too high or too low) or a drop in blood pressure, then this indicates a possible heart disease.

    ECG response
    Electrical activity at the level of the heart is measured and monitored during an exercise ECG. Arrhythmia or abnormal heart rhythm may indicate a lack of oxygen reaching the heart. This activity is monitored and monitored by an ECG and can be useful for diagnosis or evaluation.

    Test Preparation

    Refrain from eating or drinking for three hours before the trial period. Plain water is acceptable, food and other beverages can cause nausea during exercise.
    You should consult your doctor about your current medications. The test subject may need to stop taking certain medications for a short period of time before the test for more accurate results. Diabetics should also consult their doctor about all medications they are currently taking in order to get optimal test results.
    The test will require a high degree of mobility, so wear comfortable clothing that is appropriate for exercise. Men usually need to take off their shirt, and women tend to wear a supportive bra. Lightweight outerwear or a hospital shirt will suffice for any situation. It is recommended that you wear comfortable running shoes or trainers, as you will be actively working on the treadmill.
    All questions regarding the test should be clarified before starting. The attending physician should carefully explain each step so as to prepare the test subject for testing.The test subject will be asked to sign a consent form for the test.
    In order to monitor the activity of the heart, electrodes with suction cups will be attached to the subject’s body. Before attaching these suction cups, the skin on the chest and shoulders will be treated accordingly. If hair is present, the subject may be shaved to create a clean surface.

    Test Execution:

    An ECG test is performed in a standard medical environment such as a doctor’s office, clinic, or hospital. The test begins by taking readings at rest.After attaching the electrodes, the subject will be asked to lie on his left side with his left arm extended. Then, the doctor uses an ultrasound device called a transducer to check heart activity. The sensor uses a conductive gel that allows it to glide easily over the skin, making it easier to measure. This process is called resting echocardiography and is used as a control for a subsequent exercise test.
    The subject will be asked to start the exercise. In most cases, the exercise will be done on a treadmill, however some patients will use an exercise bike.In either case, the subject will be instructed to start slowly, then gradually increase in intensity.
    The physician must warn the test subject about the need to stop walking / running / pedaling in the following cases:

    • Reaching the target heart rate level (85% of the estimated maximum heart rate, depending on age).
    • In case of severe fatigue and the impossibility of continuing the exercise
    • Having significant symptoms such as shortness of breath, chest pain, abnormal heart rhythms, or unusual changes in blood pressure

    In some situations, exercise cannot be performed and the doctor will try to replicate the effect of the exercise with medication.Medicines such as dobutamine are given intravenously to increase heart rate and get comparable results.
    Throughout the entire process, the ECG testing system will track, monitor and display: blood pressure, heart rate and ECG (heart rate). An echocardiogram of the heart will be taken at rest, with increasing stress and during its peak, in order to clearly demonstrate problems or areas where the heart cannot work at its maximum potential.These problems indicate that the heart cannot get enough oxygenated blood due to arterial blockages.

    What the test is for:

    An EKG is used to determine if the heart is receiving enough oxygenated blood to function optimally while under stress. Because the heart is stressed during exercise, it requires an increased blood supply to supply blood to the rest of the body, but this flow can become a threat due to cardiovascular problems.
    Thus, an ECG will be required in the following cases:

    • If you have recently had a myocardial infarction
    • If there is chest pain (angina)
    • If the existing angina pectoris has worsened
    • If there are heart valve problems
    • If there is a high risk of heart disease and you are about to have surgery or start a new exercise program

    ECG provides a wide range of results and information about heart rate, blood pressure and ECG (heart rate).This information is very valuable, allowing the physician to determine the following:

    • The effectiveness of a particular treatment program
    o Determining how well the program is working and if an adjustment is required
    • Health and efficiency of the patient’s heart
    o Determination of efficiency and load on the heart
    o Determining whether the heart is enlarged or not
    • Diagnose coronary artery disease
    o Using the test results, find arterial blockages and diagnose

    What Happens During the Test?

    This standard test is performed in a professional medical environment, such as a doctor’s office, clinic, or hospital.A doctor, nurse, or qualified healthcare professional attaches suction cups to the subject’s chest and shoulders to take an ECG measurement. Electrodes transmit electrical signals from the subject’s heart to the ECG testing system, where they are monitored, monitored, and recorded. The subject also puts on a conventional cuff to obtain blood pressure data.
    For the exercise component, the subject will be asked to stand on the treadmill, then start walking. The exercise will start gradually, then the speed and intensity will gradually increase.
    The specialist must be present throughout the entire test and monitor the condition of the test subject. In addition, the ECG system will be constantly monitored to track and respond to any problems as quickly as possible. If, for any reason, abnormal symptoms such as pain, extreme fatigue, shortness of breath and dizziness occur, you should immediately report it.
    The test will end when the subject reaches the target heart rate or is unable to exercise due to significant symptoms.Once the exercise component is complete, the subject will be asked to leave the treadmill and sit on a chair or bed, where pulse, blood pressure and ECG will continue to be monitored.
    The entire test takes 45 minutes to one hour. This total time includes preparation, execution, and recovery.


    Typically, the doctor will examine the images at a later time and prepare a detailed report of the results. We will forward the report to the patient’s physician and notify the patient of the results.It can take 3-4 days to wait for a response from the doctor.

    Normal Results

    In normal subjects, exercise produces a typical increase in heart rate and blood pressure. This means that the blood is flowing properly and the heart is pumping efficiently, therefore, the coronary arteries are supposed to be healthy and normal. These results depend on age, medical history, health status, and the reason for the ECG test.

    What Abnormal Results Mean

    Because an exercise ECG test is performed to determine how well the heart is working, abnormal results indicate that the heart is not reaching its maximum potential.It may be due to reduced blood flow to the heart, usually caused by arterial blockages or constrictions. It can also be caused by a scar from a previous heart attack. Based on the test results, follow-up treatment may include the following:

    • Prescribing medication or changing the current treatment program
    • Coronary bypass surgery
    • Coronary angiography
    • Angioplasty and / or stenting