Palpitation is the term used of the condition in which a person becomes painfully aware of the beating of his own heart. This occasionally happens even when the heart's action is appar- ently quite natural; but much more generally the pulsations are found to be greatly increased in force, and in most cases in frequency as well. It may be either functional or a symptom of organic disease of the heart. Here we shall merely consider it as a functional disorder. Although it may be persistent, it far more frequently comes on in paroxysms, which usually terminate within half an hour, recurring afterwards quite irregularly, sometimes daily or several times a day, and sometimes not till after a long interval. The attack often comes on under some mental or physical excitement, but sometimes when the patient is quite composed, or even asleep. If the paroxysm is a severe one the heart feels as if bounding upwards into the throat; and there is a sensation of oppression over the cardiac region, with hurried or difficult respiration. Excluding organic diseases, the causes of this affection are either (1) an abnormally excitable condition of the nerves of the heart, or (2) an unhealthy condition of the blood.
(1) Amongst the causes of disturbed innervation may be especially noticed the abuse of tea (especially green tea), coffee, spirits, and tobacco. Any irritation of the stomach and intestinal canal may be reflected to the heart; and hence palpitation may frequently be traced to flatulence, undue acidity, and intestinal worms, especially tapeworms. Everything that causes pressure on the heart, such as tight-lacing, abdominal dropsy, or an enlarged uterus, is also liable to occasion this affection.
(2) If the blood is abnormally rich and stimulating it may give rise to palpitation, as in Plethora (q.v.); but the opposite condition, known as Anæmia (q.v.), is a much more common cause of this affection. In anæmia the blood is watery and deficient in fibrine, and (far more) in red colouring matter; and, being thus in an unnatural state, it acts as an unnatural stimulant, and induces frequent and abnormally strong pulsations.
The age at which palpitation most usually comes on is from fifteen to twenty-five; and the affection—especially if it arise from anæmia—is very much more common in the female than in the male sex.
The treatment of palpitation must entirely depend upon its cause. The use of all nervous stimulants (tea, coffee, alcohol, and tobacco) should be suspended or abandoned. If the patient is clearly plethoric, with a full strong pulse, he should take saline cathartics, and live upon comparatively low diet (including little animal food) until this condition is removed. When, on the other hand, the palpitation is due to an anæmic condition, the remedies are preparations of iron, aloeetic purgatives, an abundance of animal food, bitter ale, the cold shower-bath, and moderate exercise.