Heart Palpitations or Something More?

iha_dsc_7523_radmira_greenstein_for_print_useIn the past, women were told that a racing heart was nothing more than a panic attack, when often it was a symptom of an arrhythmia or a heart rhythm disorder.  Radmira Greenstein, MD, a cardiovascular disease and electrophysiology specialist at Michigan Heart, says a thorough health history is the first step to diagnosing the problem.

“If you are having racing heartbeats before you go on stage to give a talk, it’s probably anxiety. When your heart starts racing out of nowhere, it’s less likely to be related to a panic attack,” Dr. Greenstein explains. “In general, women tend to have more palpitations than men as a result of hormonal changes.”

An examination may lead to additional testing, including an ultrasound of the heart and heart monitoring, Dr. Greenstein points out.

“If you are having palpitations every day, we will recommend a 24-hour monitor that you wear at home. We ask you to keep a diary and note when you are having episodes so that we can correlate the heart rhythm at the time that you were feeling symptoms.”

If you are not having symptoms every day, Greenstein recommends a monitor that can be used for up to 30 days or even implanting one that can last more than two years.

If you are experiencing intermittent palpitations, Dr. Greenstein recommends a visit to your primary care physician. When symptoms continue and include lightheadedness, dizziness or chest pain, you should go to the hospital.

“I provide individualized care guided by the patient and inclusive of the patient’s family,” she says.

About Dr. Greenstein

Radmira S. Greenstein, MD has been practicing in the Ypsilanti and Jackson, Mich. area for more than a decade. She is a member of the American College of Cardiology as well as a member of the admissions committee at the University of Michigan Medical School. In addition to her cardiology practice, Dr. Greenstein volunteers as a Russian language translator.

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The Science of Stress on the Heart

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Stress in all of its many forms can be harmful to your heart. Whether its relationship problems or the pressures at work, the body tends to shift into a primitive protective gear called “fight or flight.”

Mark Bernstein, MD, a cardiovascular disease specialist at Michigan Heart, offers tips for identifying stress and how to find healthy avenues to avoid its negative physical effects.

In scientific terms, stressful events or feelings trigger a part of the brain called the locus coeruleus, which processes sensory input and can increase or decrease awareness of surroundings through its autonomic nervous system.

The hypothalamic/pituitary/adrenal axis will cause hormones to be excreted that will aid in the “fight or flight” response.  CRF is secreted by the hypothalamus, which in turn secrets ACTH, which will in turn secrete cortisol, which increases the availability of sugar to the body.

The adrenal gland will also secrete epinephrine, which will increase heart rate and increase blood supply to the muscles and shuts down digestion and sexual system until stress is relieved.

For a short time these responses are appropriate and beneficial, however, if present for a prolonged time the can lead to increased blood sugar, elevated blood pressure, fluid retention, activated platelets (which can lead to heart attacks) and decreased immune response, which can lead chronically stressed people to be more prone to illness.

Why is stress bad for the body?
When dealing with relationship issues and the pressures of work, the body shifts into a primitive protective gear called “fight or flight.” The brain stimulates sugar production in the body, increases the heart rate and shuts down the digestive system and sexual system until stress is relieved. These defensive measures offer short-term relief but prolonged stress drives up the risk of heart attack and lead to chronic illnesses.

How do people react to stress?
People react to stress in different ways. Some people experience physical reactions such as heart palpitations, headaches, ulcers, lack of appetite, overeating, anxiety and depression. These conditions are exacerbated by the use of alcohol, tobacco, drugs and lack of sleep.

What are some ways to reduce the physical effects of stress?
For starters, reducing or eliminating bad behaviors can lower risk of developing heart disease. Anxiety medications are an option but they are not a good long-term solution. There are a variety of ways to help people reach a sense of relaxation and well-being. These techniques include meditation, yoga, Tai Chi, music, reading, religion, exercise, healthy eating, and social interaction.

For more information, visit http://www.michiganheart.com.