7 Ways to Control Them

In the language of romance, a racing, thumping heart is a sure sign that you're in love. In the language of medicine, those same symptoms indicate that your heart's rhythm is out of whack. One commonand altogether normalalteration is a speeding up of the heart rate during exercise or during an intense emotional experience. All of the body's cells and tissues demand more oxygen rich blood at such times, and the heart accommodates by accelerating the delivery process. In spite of a rapid heartbeat, the normal rhythm stays steady: Once you have stopped exercising, the heartbeat will slow to what is called the resting heart-beat 72 regular beats a minute is the average, although an individual's resting rate may be as low as 40 (during sleep or in athletes) or as high as 100.
Another common disturbance in heart rhythm is called a premature beat or extrasystole. In this situation, a beat, which originates in the upper or lower chamber of the heart, happens a little earlier than anticipated. It may be followed by an unnervingly long pause, in which you sense a little flutter in the neck and chest and a sudden empty feeling in the stomach. Then there is the noticeable thump of another heartbeat, whereupon the symptoms disappear as quickly as they started. (Such extra beats may also occur without noticeable symptoms.)
Everyone has experienced at least one episode of premature heartbeat. Sometimes, the sensation is so vague and fleeting that the event may pass unnoticed. Such episodes may be more noticeable when you are at rest and your attention is not otherwise occupied. If you are trying to fall asleep, the sensation may prevent you from doing so. Premature beats occur in normal hearts as well as in those that have been damaged by some form of heart disease. While they are bothersome, they are not usually serious. (If you experience irregular heartbeats on a regular basis or if they are associated with pain, breathlessness, dizziness, and/or nausea, see Heartbreakers.) Still, then are some steps you can take that may help keep your heartbeat steadier.
Consider your caffeine intake.
Caffeine is a nervous-system stimulant that is present in coffee, tea, and cola-type soft drinks as well as in chocolate. In small amounts, caffeine may rev you up and even keep you from falling asleep at your desk. In large doses or in sensitive individuals, however, it may cause palpitations and other unpleasant side effects. Since caffeine is habit forming, it may be difficult to wean yourself away from the different caffeine-containing products you use in the course of a day, but the positive result will be worth it, says Jonathan S. Steinberg, M.D., director of the Arrhythmia Service at St. LukesRoosevelt Hospital Center in New York.

How much caffeine is too much?
Keep your caffeine intake below 500 milligrams a day, advises Steinberg. A five-ounce cup of drip coffee contains about 150 milligrams of caffeine. A five-ounce cup of tea brewed for three to five minutes contains 20 to 50 milligrams of caffeine. Cola drinks generally contain about 35 to 45 milligrams per 12-ounce can. As you tally up your caffeine intake, keep in mind that cough and cold products, menstrual-discomfort products, and pain medications may contain appreciable amounts of the stimulant; check the labels.

Nix the nicotine.
In addition to the havoc nicotine wreaks on other parts of the body, it also speeds up the heart rate and can cause it to become irregular. So, if you have not stopped smoking yet, don't wait a minute more!

Ease up.
One of the most common causes of palpitations is anxiety. Worry and tension may actually cause the heart rate to increase, notes Lynda E. Rosenfeld, M.D., associate professor of medicine and pediatrics at Yale University School of Medicine in New Haven, Connecticut. What's more, anxious individuals may have a heightened awareness of body functions, such as heartbeat, even if those functions are normal.

Turn in earlier.
If you have been trying to get by on too little sleep, your palpitations may be your heart's way of telling you to slow down. During a long night's sleep, your body's demand for oxygen-rich blood is reduced so that your heart can relax just a little in its never-ending pumping job. After a few nights of uninterrupted sleep, you may find that your palpitation problem has resolved, says Steinberg.

Check your iron.
Palpitations may reflect a case of severe iron-deficiency anemia A major function of your blood is to transport oxygen via red blood cells to every part of your body. When you are deficient in red blood cells or in iron, which is the mineral in red blood cells that carries the oxygen, the tissues in your body become undernourished. Consequently, your heart beats faster, trying to send more of the iron-poor blood to the organs in an effort to make up for in quantity what is lacking in quality. If you are severely anemic, you may also be feeling extremely fatigued in general and be noticing that your skinespecially on the palms of your hands is pale, notes Arnold J. Greenspon, M.D., clinical professor of medicine and director of the Cardiac Electrophysiology Laboratory at Thomas Jefferson University Hospital in Philadelphia. While eating iron-rich foods, such as green, leafy vegetables, can help, the best way to get a diagnosis and a treatment is to see your doctor. Once your anemia has been diagnosed and corrected, your heart palpitations should abate, as well.

Dump the diet pills.
If you are trying to lose weight with over-the-counter diet pills, you may be losing a steady heart rate in addition to pounds. The active ingredient in these products phenyl-propanolamine, or PPA should not be used by people with heart-rhythm problems. Drugstore aids for weight loss tend to lose their effectiveness in a very short time, notes Greenspon. Thus, you take more and more of them with a further increase in heart rate. (Diet pills are not the only drugs that can cause heart palpitations, however; see Runaway Heartbeats").

While occasional palpitations especially when the episodes can be traced to a specific reason, such as exercise or excitementare no cause for concern, some heart-rhythm disturbances are extremely worrisome and should be brought to the immediate attention of a doctor, says Jonathan S Steinberg, M.D.
Which palpitations warrant medical attention? The answer depends on what else is going on. If the symptoms come on out of the blue, if they happen repeatedly in a very short time span, and if the heartbeat is very rapid, very intense, and long lasting or if the sensations are accompanied by light-headedness or fainting, you should contact your doctor
If three or more premature beats occur, the condition is called a tachycardia, which can originate in any one of the heart's four chambers. Abnormal heart rhythms can also result from conduction abnormalities that slow the heart down or even cause the heart to stop sending out signals altogether Any of these situations are potentially dangerous and should be carefully evaluated. The doctor may recommend that you wear a portable heart monitor. which records the heart's electrical activity, for 24 hours or more in order to detect and evaluate the abnormality Other specialized tests may also be performed.

Runaway Heartbeats
Several types of prescription and nonprescription drugs have a stimulant effect, which can cause a rapid or pounding heartbeat as well as other symptoms. If you are taking any of the following types of medications and have experienced heart palpitations, there is probably a link. Don't stop taking a prescription medication on your own, however, call your doctor or mention it during your next regular visit.
Monoamine oxidase (MAO) inhibitors (antidepressant medications)
Appetite suppressants (amphetamine and non amphetamine types)
Asthma medications (sympathomimetics and theophyllines)
Cough/cold medications (oral, nasal drops, spray, and inhalers containing nasal decongestants)
Attention deficit disorder medications
Narcolepsy medications
Thyroid medications