In my medical career, I have met many patients who are full of doubts and worries about premature heart beats, and often ask me: "Doctor, why does my heartbeat always feel wrong, is this serious?" Today, I would like to share the story of a patient to shed light on some of the faces of premature heart beats.
A few months ago, a middle-aged man came to my office in a hurry, his face full of unease. He told me that lately he has often felt his heart beat faster, sometimes accompanied by a brief feeling of dizziness. After the examination, it was found that he had premature heart contractions, but fortunately, after a detailed examination, including an electrocardiogram and an ultrasound of the heart, we confirmed that his premature contractions were benign and did not require special treatment, as long as some details of daily life were noted.
Identify the severity of premature contractions
Recognizing the severity of premature cardiac beats is a major concern for every patient and physician. While most premature heart beats are benign, in some cases, they may indicate a more serious heart problem. Here are a few key points to help us determine the severity of premature cardiac beats:
Frequency and duration: Occasional premature beats are usually not a major problem, but if they are very frequent or in clusters, such as more than six beats per minute, or if there are multiple premature beats in a row, further evaluation may be required.
Types of premature contractions: There are two types of premature cardiac contractions: ventricular and atrial contractions. In general, premature ventricular contractions (occurring in the ventricles) may be of greater concern than premature atrial contractions (occurring in the atrium) because they are sometimes associated with ventricular dysfunction.
Accompanying symptoms: If premature contractions are accompanied by chest pain, dyspnea, fainting, or coma, this may be a sign of a more serious heart condition and should seek immediate medical attention.
The patient's overall health: Patients with a history of heart disease (e.g., coronary heart disease, heart failure, etc.) or those with cardiovascular risk factors such as diabetes and hypertension may indicate a higher risk even if they have a mild premature beat.
Diagnostic tests: Electrocardiogram (ECG), 24-hour Holter monitor, or exercise ECG can help doctors more accurately assess the type and severity of premature beats, so that they can develop a treatment plan accordingly.
Which premature beats need to be treated
When dealing with premature cardiac beats, not all types require treatment. Certain premature contractions, especially those that are asymptomatic and occur occasionally, usually do not require specific intervention. However, there are cases where premature contractions require aggressive treatment, especially if they threaten the patient's health and quality of life. Here are a few premature beats that need to be treated:
Frequent premature ventricular contractions: If premature ventricular contractions are very frequent, such as thousands of them per day, especially in patients with heart disease, medication or other interventions may be needed to reduce their frequency, as frequent premature ventricular contractions over a long period of time have the potential to cause further deterioration of heart function.
Symptomatic premature contractions: if premature contractions are accompanied by significant symptoms such as syncope, chest pain, or severe palpitations, this usually indicates the need for treatment, which may include pharmacotherapy or electrophysiologic interventions such as radiofrequency ablation to eliminate the abnormal heart rhythm.
Premature contractions in structural heart disease: In patients with structural cardiac problems (e.g., cardiomyopathy, cardiomegaly, etc.), premature contractions may exacerbate these conditions and need to be controlled with medication or surgery.
Premature beats that precipitate other arrhythmias: Some premature beats can trigger more serious arrhythmias, such as ventricular tachycardia or ventricular fibrillation, which often require treatment to prevent potentially fatal arrhythmias.
Impact on quality of life: even if premature beats are not life-threatening in themselves, treatment may be required if they significantly affect the patient's daily activities and quality of life, such as causing restlessness, anxiety, or sleep disturbances.
Precautions in daily life
In their daily lives, people with premature cardiac contractions should follow some basic health guidelines to reduce the frequency of premature contractions and relieve possible symptoms. Here are some practical suggestions for daily living:
Eat wisely: Avoid foods high in fat, sugar, and caffeine, as these foods may trigger or exacerbate premature heart beats. It is recommended to eat more whole grains, vegetables, fruits, and lean meats to maintain a balanced diet.
Maintain moderate exercise: Regular moderate physical activity, such as brisk walking, swimming, or cycling, can boost heart function and reduce premature beats. But avoid overexertion and high-intensity anaerobic exercise.
Stress reduction and relaxation: Long-term stress and anxiety can induce premature heart beats, so it's important to manage stress in your life through yoga, meditation, deep breathing, or other relaxation techniques.
Regular work and rest: Get enough sleep and try to go to bed and wake up at the same time every day to help adjust your body clock and reduce stress on your heart.
Avoid alcohol and tobacco: Both tobacco and alcohol are potential triggers for premature heart beats, and these substances should be avoided or limited as much as possible.
Monitor your health: Have regular physical exams, especially electrocardiograms (ECGs) and, if necessary, heart function tests to monitor your heart health. In addition, learning to self-monitor your pulse can help detect irregular heartbeats in a timely manner.
Avoid over-the-counter medications: Certain over-the-counter medications, such as cold remedies and diet medications, may contain ingredients that stimulate the heart. Doctors should be consulted before using these drugs, especially if you have a premature heart beat.