What causes palpitations - hyperthyroidism or an irregular heartbeat?

Palpitations and abnormally fast heartbeats can be caused by many factors, ranging from stress, insufficient rest, and drinking caffeinated beverages to thyroid hormone disorders and heart disease especially hyperthyroidism and arrhythmia. These conditions have similar symptoms and can be difficult to distinguish, so you should observe and recognize the condition in order to cope properly.

What are palpitations?

Palpitations (Heart Palpitations) are abnormal heartbeats, such as a fast heartbeat, forceful heartbeat, irregular rhythm, or uneven heartbeat. They can occur and may be accompanied by chest pain, easy fatigue, dizziness, or fainting. If palpitations are severe or do not stop, you should see a doctor as soon as possible because they can be life-threatening.

What symptoms are considered palpitations?

Palpitations may last only a few seconds or up to many minutes, depending on different causes in each person.

- Abnormally fast heartbeat

- Forceful heartbeat

- Skipped beats/irregular rhythm

- Uneven heartbeat

What causes palpitations?

- Stress, anxiety, insufficient rest, irregular sleep schedule

- Caffeinated beverages, energy drinks, certain stimulants

- Certain medications such as decongestants, bronchodilator inhalers, medications that stimulate the nervous system

- Dehydration and electrolyte imbalance

- Anemia

- Hyperthyroidism

- Arrhythmia

How can hyperthyroidism cause palpitations?

The thyroid gland produces hormones that regulate many body systems, especially energy metabolism. When thyroid hormone levels are too high, they stimulate the heart muscle and electrical system to beat faster and more forcefully, increasing the speed of contraction of the heart. When stress occurs, the heart rate increases, which can lead to palpitations.

Hyperthyroidism symptoms to watch for

- Palpitations, rapid heartbeat

- Hand tremors

- Easy sweating, heat intolerance

- Fatigue, easily tired

- Weight loss, frequent bowel movements, diarrhea

- Irritability, restlessness, anxiety, mood swings

- Insomnia

- Muscle weakness

- Irregular menstruation

- Bulging eyes

How can arrhythmia cause palpitations?

Arrhythmia (Arrhythmia) is a condition in which the heart’s electrical system functions abnormally, causing an abnormal heart rate or heart contraction rhythm. This can make the heart beat irregularly too fast, too slow, or unevenly leading to palpitations.

Common arrhythmia symptoms

- Abnormally fast or forceful heartbeat

- Skipped beats

- Uneven heartbeat

- Intermittent palpitations

- Easily tired, difficulty breathing

- Dizziness, lightheadedness, fainting

- Chest pain, loss of consciousness

How are hyperthyroidism and arrhythmia different?

Topic	Hyperthyroidism	Arrhythmia
Symptoms	Palpitations along with persistent rapid heartbeat or an irregular heartbeat in severe cases	Sudden rapid or irregular heartbeat that may stop abruptly or occur in episodes
Associated symptoms	Heavy sweating, hand tremors, frequent hunger, weight loss, changes in bowel movements	Skipped beats, irregular pulse, intermittent palpitations, easy fatigue, lightheadedness
Diagnostic tests	Blood tests to measure TSH and Free T4, including Free T3 as indicated	Electrocardiogram (ECG/EKG) or use of a portable ECG recorder

Note: The same patient may have both hyperthyroidism and arrhythmia at the same time.

What kind of palpitations should prompt you to see a doctor?

- Frequent or recurrent palpitations with an unknown cause

- Rapid heartbeat without exertion

- Palpitations with weight loss, hand tremors, unusually heavy sweating

- Palpitations with easy fatigue, dizziness, unusual weakness

- Palpitations with chest pain or tightness, difficulty breathing, severe lightheadedness, loss of consciousness

Diagnosing palpitations

The doctor will diagnose each patient based on symptoms and severity. There are several methods, including:

- Taking a history and performing a thorough physical examination

- Complete blood count, electrolyte levels, kidney function tests

- Testing TSH, FT4, FT3 or T4, T3 to assess thyroid gland function

- Electrocardiogram (ECG/EKG) to assess heart rate and rhythm. If no abnormality is found but there are indications, the doctor may use a portable ECG recorder to detect abnormalities.

- Cardiac ultrasound (Echocardiogram) when structural or functional abnormalities of the heart are suspected

How are palpitations treated?

Treatment for palpitations depends primarily on the cause.

- Treating palpitations from hyperthyroidism The doctor may treat with anti-thyroid medications, radioactive iodine, or surgery. If a rapid heartbeat is also present, the doctor may consider medications to control heart rate, based on evaluation of comorbidities and treatment limitations.

- Treating palpitations from arrhythmia The doctor will treat according to the type of arrhythmia. Treatment may include medications, catheter-based cardiac ablation (Catheter Ablation), or other treatments as indicated.

How to take care of yourself when you have palpitations

- Record the time symptoms occur, their duration, associated symptoms, and what you were doing before symptoms started

- If palpitations recur or there are warning symptoms, you should see a doctor to determine the true cause

- Do not buy heart rate controlling medication or stop your regular medications on your own

- Reduce or avoid caffeinated beverages; avoid energy drinks

How can palpitations be prevented?

- Get enough sleep and keep regular sleep hours

- Observe triggers that cause palpitations, such as caffeine, stress, and energy drinks

- Manage underlying conditions, especially thyroid and heart disease

- Eat a varied and balanced diet

- Drink enough water each day

- Exercise regularly

 

 

Reference :

Bangkok Hospital What causes palpitations - hyperthyroidism or an irregular heartbeat?

ArokaGo Providers Bangkok Hospital