This is an increased action of the heart both in force and frequency that causes the patient distress.
Etiology: It is observed more in the young than in the aged, and in those who are anemic and suffer from reflex gastro-intestinal causes, and emotional and mental disturbances during the climacteric period. The toxic condition of the blood — the result of the infective disease, has often been noticed as a cause, as well as alcohol, tobacco, tea, and coffee. Regarding the sexes, the female suffers most during puberty and the menopause; while in the male it appears most during the middle and later period of life; when worry and business care are heavy. Hypertrophy of the heart is frequently a cause of palpitation.
Symptoms: It is usually paroxysmal, being seldom constant. Preceding the attack there is a slowing of the heart’s action and a pallor of the skin. This is followed by a sense of an increased force and rapidity of the heart with mental anxiety of dyspnea.
Physical Signs : There is seen a throbbing of the vessels and the cardiac impulse is diffused. The pulse is rapid, full and strong (110 to 150). The area of cardiac dullness may be enlarged. The valvular sounds are more distinct than is natural. Cardiac palpitation should not be mistaken for those forms where there is great rapidity and irregularity of the heart’s action without the patient knowing it. The palpitation due to valvular disease should not be mistaken for that due to nervous derangement.
Prognosis : There is no real danger in itself but hypertrophy may ensue.
Treatment: To arrest the attack the patient should be placed in bed where it is quiet and all clothing loosened over the precordial region. In some cases cold, while in others hot drinks relieve it.
Aconite: This remedy is indicated when the palpitation is the result of fright, excessive physical exertion, functional or structural disease of the heart, lungs or stomach, in young, plethoric, robust individuals with an excitable temperament.
Arsenicum alb : Violent palpitation of the heart, the paroxysms being worse just after midnight. They are often accompanied by a paroxysm of nervous asthma and are attended with great restlessness and anxiety. There is frequently a periodicity about the attacks in those who are chlorotic and addicted to the excessive use of alcohol.
Arsenicum iod : This remedy should be studied where the arteries and heart show indications of degeneration.
Nux vomica: This remedy is often indicated when the palpitation is the result of a deranged stomach, liver or bowels, or from the abuse of alcohol, tea, coffee, or the result of excessive study.
Spigelia: When this remedy is indicated there is violent palpitation which is audible to the patient. The action of the heart is irregular both in rhythm and impulse, giving it an undulating motion. The palpitation is associated with shooting pains about the heart, rheumatism and intestinal worms.
Cinchona: When palpitation appears as a result of debilitating losses from diarrheas and hemorrhages or fevers, study this remedy.
Ignatia: When violent emotions or grief is acute; also, asafoetida, nux moschata and cocculus.
Pulsatilla: This remedy is to be thought of when palpitation appears as a result of menstrual derangement, or when fatty food has been taken.
Ferrum: This remedy is adapted to anemic patients. The face changes color frequently and is red at the beginning of an attack. These patients are often tubercular; are easily excited, and if females, the menses are scanty and uterine catarrh is present.
Digitalis : We have no remedy so frequently indicated in palpitation resulting from self abuses as this. It not only relieves the palpitation but it also diminishes and arrests the nightly emissions that so frequently accompany it.
Cannabis sat : This remedy should be thought of in those cases of palpitation of the heart that are the result of self abuse. It is second only to Digitalis in the relief of the palpitation from this cause and in its control over the sexual excitement.
Coffee: The palpitation is strong and visible; the patient is restless and weary, yet cannot sleep.
Calcarea carb. and Sulphur: — Should be studied in chronic cases.
Chamomilla and Opium, for cases that are the result of fright.
Platina: In cases of menstrual irregularity, retention of the menses and in cases of great sexual excitement.
Excerpted from From: Diseases of the Heart – Dr. A.L. Blackwood