What is a fluttering heart?
Fluttering heart is a nebulous term that can mean different things when used by a patient or a doctor. It is not a medical term. Fluttering heart is used to describe a variety of cardiovascular conditions and chest symptoms. The most common use of the term “fluttering heart” is to refer to palpitations in the chest, which are conscious perceptions of heartbeats that result from abnormally fast or hard contractions of the heart. Palpitations may also occur in a person with normal heart rate, heart rhythm and heart contractility.
Meaning of Fluttering Heart
The term “fluttering heart” is also used to describe atrial flutter, which refers to abnormal heartbeat rhythms (also known as arrhythmia) caused by abnormally fast contractions of the atrial chambers of the heart. This condition is caused by an abnormality in the electrical conduction system of the heart that is responsible for initiating and coordinating normal heartbeat patterns.
Atrial flutter disrupts the normal blood flow through the heart and can also manifest itself as palpitations. However, atrial flutter and palpitations need to be distinguished from each other. Palpitation is a symptom, whereas atrial flutter is a medical condition. And both may be described with the term “fluttering heart”. It is important to clarify that not all cases of atrial flutter lead to palpitations. Some cases of atrial flutter can be asymptomatic.
Apart from heart palpitations and atrial flutter, the term “fluttering heart” may also be used to refer to certain other conditions. These conditions include mitral valve prolapse, chest discomfort experienced during stress or anxiety, heartburn, and angina. However, the usage of the term “fluttering heart” to refer to these conditions is comparatively uncommon.
Signs and Symptoms
The most common symptom that may be described as a fluttering heart is palpitation in the chest. These palpitations may also be accompanied by other symptoms such as:
- Pain in the chest
- Shortness of breath
- Syncope (fainting)
The symptoms mentioned above are commonly felt in arrhythmic conditions such as atrial flutter and atrial fibrillation.
Causes of a Fluttering Heart
The heart is a muscular organ that is responsible for pumping blood throughout the body. The human heart is subdivided into four separate chambers: two atria and two ventricles. The blood enters the heart through the upper atria. Contraction of atria pushes the blood down into the ventricles.
Contraction of ventricles then pushes the blood out of the heart and into the arteries supplying various tissues and organs of the body. The blood from the tissues and organs of the body then returns to the heart and enters the atria. This cycle repeats again. The unidirectional blood flow in the circulatory system is maintained by the presence of valves in the heart and the blood vessels.
How does the heart beat?
The beating of the heart is not a random process. There is a rhythm to it, which consists of sequential contractions of atria and ventricles. This rhythmic contraction of atria followed by contraction of ventricles is controlled by the electrical conduction system of the heart. The electrical impulse that begins the contraction cycle arises in a region of the heart known as the sinoatrial node (also known as the SA node).
The sinoatrial node is also called the natural pacemaker of the heart. The electrical impulse generated in the sinoatrial node spreads to the atrioventricular node (also known as the AV node), and then to the rest of the heart through the atrioventricular bundle (also known as the AV bundle). This systematic flow of electrical impulse ensures the rhythmic contraction of atria followed by that of ventricles.
Problems with Heart Beat
Any disruption in the generation or flow of electrical impulses through the heart results in arrhythmias, characterized by out-of-sequence contractions of atria and ventricles. Normally, the heartbeats are not perceptible. In arrhythmias, however, irregular heartbeats become perceptible as palpitations, leading to the feelings described variously as fluttering heart, racing heart, thumping or pounding heart, or skipped beats.
A fast beating heart can also occur in normal physiological conditions. Strong emotions (such as fear, anxiety, excitement or shock), psychological stress and strenuous physical activity can cause the heart to beat harder and faster. But these normal physiological causes do not result in feelings of palpitations or fluttering heart. It is important to note that feelings of palpitations or fluttering heart can also be felt at rest, and are indications of some underlying pathological cause.
Reasons for a Fluttering Heart
The following are some of the reasons for disruption of electrical conduction in the heart that may result in a fluttering heart.
- Drugs: A variety of drugs can interfere with the normal functioning of the heart and result in arrhythmias. Examples include narcotic drugs, alcohol, caffeine, nicotine, diet pills, cold medicines such as pseudoephedrine, and drugs that stimulate thyroid function. These drugs can enter the body through either medical treatments or through substance abuse. Abnormal heart rhythms and heart rate may result in either case.
- Diseases: Some medical conditions could also be accompanied by a fluttering heart. Examples include high fever, atrial flutter, atrial fibrillation, tachycardia (rapid heart rate), bradycardia (abnormally low heart rate), and iron deficiency anemia.
- Causes specific to women: Fluctuations in hormonal levels that accompany physiological states such as pregnancy and menopause can cause arrhythmia and fluttering heart in women. Women undergoing pre-menopause or menopause are often not aware of the changes that are taking place in their bodies. Symptoms other than a fluttering heart that may occur in menopause include mood swings, hot flashes, vaginal dryness and irregular periods.
Treatment of Fluttering Heart
Palpitation or fluttering heart is a symptom rather than a disease. Therefore, it cannot be treated effectively without knowing the underlying cause. Also, since fluttering heart symptom can be caused by a variety of conditions, no standard treatment can be prescribed for all cases.
Different treatments need to be cater for a fluttering heart caused by diseases, drugs, and hormonal changes. For example, treatment of atrial flutter may include defibrillation, medications and surgery to restore the normal heart rhythm. The treatment of palpitations caused by a drug may involve discontinuing that drug.
The exact cause of fluttering heart may not be identifiable in all cases. For example, the majority of arrhythmias go unnoticed for long periods. Changes associated with pre-menopause and menopause are not immediately identified in many cases. When no specific cause can be identified for a particular case of fluttering heart, the following treatment measures could be undertaken:
- Managing stress levels
- Anti-anxiety treatment
- Avoiding stimulants such as caffeine and nicotine
- Avoiding alcohol
- Discontinuing dieting pills and common cold medications
- Taking iron supplements in case of anemia
These are general conservative measures that may help in reducing the incidence of a fluttering heart. It does not preclude the need for medical and/or surgical treatment.