Female, 28 years old, chest tightness, shortness of breath, panic

Some female friends have poor physical fitness. If they don't take good care of their bodies, problems are likely to occur. The most common problem is feeling chest tightness and shortness of breath, accompanied by symptoms of palpitations. This may be due to some problems with their heart. In this case, it is more serious and requires some treatment measures and medications to protect the heart.

1. Increased heart rate

Increased heart contractility can cause palpitations. Palpitations can be physiological or pathological. Physiological ones can be seen in healthy people when they engage in intense physical activity or are overly mentally stressed. But it can also be seen in people who smoke, drink alcohol, drink strong tea or coffee, or use certain drugs such as ephedrine, caffeine, aminophylline, adrenaline, amphetamine, atropine, thyroid tablets, etc., and is often related to the amount of intake and individual sensitivity.

Pathologically increased heart rate may cause palpitations due to:

(1) Ventricular hypertrophy

Acquired heart diseases such as hypertensive heart disease, rheumatic aortic regurgitation, aortic regurgitation caused by syphilis or other reasons, rheumatic mitral regurgitation, etc., can cause palpitations due to left ventricular hypertrophy and increased cardiac contractility. In beriberi heart disease, both the left and right ventricles are enlarged, the disease progresses rapidly, and palpitations are often obvious and strong.

(2) Other diseases that cause increased cardiac output

Anemia, high fever, hyperthyroidism, etc. can all cause the heart rate to increase, the heartbeat to strengthen and cause palpitations. In anemia, the blood carries less oxygen, causing organs and tissues to be deprived of oxygen. The main compensatory mechanism is to ensure oxygen supply by speeding up the heart rate and increasing cardiac output. Palpitations caused by acute hemorrhagic anemia are particularly obvious. When the fever is high, the body's basal metabolic rate increases and tissue oxygen consumption increases, so the heart rate is accelerated to ensure oxygen supply, and the increased heart rate causes palpitations. Hyperthyroidism often causes palpitations due to increased basal metabolic rate and increased sympathetic nerve excitability.

Patients with active pulmonary tuberculosis are prone to palpitations even though they do not have obvious fever. Palpitations are one of the symptoms of tuberculosis poisoning and are mainly related to increased sympathetic nerve excitability. In addition, rheumatic carditis, infective endocarditis, brucellosis, hypoglycemia, etc. are all likely to cause palpitations.

When pheochromocytoma causes paroxysmal increases in blood pressure, palpitations may occur, which is related to the sudden increase in catecholamine levels in the blood and the excitement of the sympathetic nerves.

2. Arrhythmia

(1) Tachycardia

Sinus tachycardia, tachycardia-type atrial fibrillation or atrial flutter caused by various reasons, especially those occurring suddenly, can easily cause palpitations.

(2) Bradycardia

High degree of atrioventricular block, atrioventricular junctional rhythm, spontaneous ventricular rhythm, sick sinus syndrome, excessive vagal nerve excitability, etc., due to slow heart rate, prolonged diastole, increased ventricular filling, resulting in strong and powerful heartbeats, can cause palpitations. But palpitations are more common when the heart rate suddenly slows down.