HEART-RHYTHM IRREGULARITY

General Information

DEFINITION--Abnormalities in the rhythm of the heartbeat. The heart may beat too slowly (bradycardia) or too rapidly (tachycardia) and the condition may be benign or serious.

BODY PARTS INVOLVED--Heart; nerves that transmit impulses to coordinate heart-muscle contractions.

SEX OR AGE MOST AFFECTED--All ages, but most likely over age 65.

SIGNS & SYMPTOMS

• Awareness of one's own heartbeat (palpitations), including whether it skips, is always fast, slow, irregular, or suddenly changes rhythm.
• Shortness of breath.
• Sudden faintness or weakness.
• No symptoms (frequently).

CAUSES

> Heart diseases, such as: rheumatic fever; congenital heart disease; cardiomyopathy; previous heart attack; or heart-muscle inflammation.

• Endocrine disorders, especially thyroid and adrenal-gland diseases.
• Fluid and electrolyte imbalance, especially too little or too much potassium.
• Side effects of certain drugs, especially digitalis, beta-adrenergic blockers, stimulants and diuretics.
• Overdose of certain drugs, including antidepressants, marijuana and cocaine.
• Postoperative effects following chest or heart surgery.

RISK INCREASES WITH

• Stress; chronic kidney disease; hypertension; smoking.
• Use of certain drugs, such as caffeine, alcohol, amphetamines and many non-prescription cough and cold remedies.
• Fatigue, overwork or sleep deprivation.

HOW TO PREVENT--If you have any disorders listed as causes or risks, follow your treatment program carefully to control the disease. If medication is part of your treatment, consult your doctor about having blood levels monitored and electrolytes measured periodically.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood studies.
• ECG and sometimes, a 24-hour Holter monitor (See Glossary for both).
• Radioactive technetium 99 scan, angiography (See Glossary), and measurement of enzymes released into blood from damaged heart muscle.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Psychotherapy or counseling, sometimes.
• DC cardioversion (See Glossary).
• Surgery to correct some heart problems.

POSSIBLE COMPLICATIONS

• Fainting; congestive heart failure.
• A few arrhythmias are fatal unless cardiopulmonary resuscitation (CPR) is performed immediately.
• Death from prolonged (more than 3 to 6 minutes) cardiac arrest.

PROBABLE OUTCOME--

• Very occasionally irregular heartbeats are harmless and require no treatment.
• Most other rhythm disturbances can be controlled with treatment.

How To Treat

GENERAL MEASURES--

• Consider lifestyle changes. Ask for professional help if needed.
• Stop smoking.
• Take a course to learn CPR, especially if someone in your home or neighborhood has heart disease.
• Wear a Medic-Alert bracelet or pendant (See Glossary) showing the name of your condition.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe antiarrhythmic medications. You may need to try several to find the most effective one. Certain arrhythmias (atrial fibrillation) will require anticoagulant medicine.

ACTIVITY--Resume most normal activities as soon as symptoms improve. Consult your doctor about an exercise program.

DIET--

• Some heart medicines require extra potassium, found mostly in citrus fruits, bananas, dried apricots or peaches, raisins, lentils and whole-grain cereals. Ask your doctor if you need to eat more of these.
• Avoid caffeine-containing beverages, such as coffee, tea, cola or chocolate. Avoid alcohol.

Call Your Doctor If

• You have symptoms of heart-rhythm irregularity.
• New, unexplained symptoms develop.