Treatment of palpitations: first aid, what you can and cannot do

In simple cases, treatment is carried out with a group of drugs that strengthen the heart and blood vessels, as well as calm the nervous system:

• Magne B ₆, Novo-passit, Etazicin;
• Verapamil, Sotalex, Propranolol;
• Validol, Quinidine.

Among cardiac glycosides, the most famous are Digitoxin, Celanide. Such drugs are prescribed only by a doctor, since their irrational use can lead to disastrous consequences, up to cardiac arrest.

Such medications as Cordarone, Nifedipine, Amiodarone, etc. have an antiarrhythmic effect.

If the doctor diagnoses supraventricular arrhythmia, then most often the treatment regimen includes such drugs as Verapamil and ATP, which can successfully normalize the rhythm. In case of paroxysmal tachycardia, the use of Novocainamide and Cordarone is indicated.

If a patient is found to have a tendency to atrial fibrillation, this serves as an indication for the use of β-blockers.

What to do if you have a strong heartbeat at home?

The first thing to do is to minimize or completely eliminate provoking irritating factors. The main thing is to try to prevent the development of stressful situations that destroy nervous activity, increase the heart rate and even upset hemodynamics.

It is highly undesirable for people suffering from attacks of strong heartbeat to consume alcoholic and caffeinated drinks. It is best to replace them with fresh juices, herbal tea, and clean still water.

You should not overload your stomach: overeating with a large amount of fatty and salty food negatively affects the work of the cardiovascular system. You need to reduce the amount of salt consumed, and eat food in small portions, but more often than usual, approximately every 2.5-3 hours.

Home treatment will be more effective if you correctly distribute time for work and rest. Night sleep should last about seven hours continuously, and during the day it is optimal to take a nap of at least 40-50 minutes. Such rest will "reboot" the body, improve stress resistance and hemodynamic indicators.

If a person was actively involved in sports (for example, at a professional level), then they should “slow down” a little, and make physical activity more moderate.

If the above recommendations do not lead to any relief, you should consult a doctor without delay.

First aid

First aid can be provided already at the first, pre-hospital stage. If the heartbeat is really strong, and the person is clearly becoming ill, it is necessary to call an ambulance and try to carry out the following procedures:

• seat the patient, loosen the collar or tie, open a window to improve ventilation of fresh air;
• If chest pain is observed along with tachycardia, the patient can be offered nitroglycerin;
• They perform vagal procedures: deliberate straining, provoking the gag reflex, applying a cold compress or ice wrapped in a towel to the face.

Vagus procedures (tests) allow activating the function of the vagus nerve: in response to irritation, the heart rate slows down. The procedures should be repeated until the patient's well-being is normalized.

To provide emergency care in difficult situations, doctors perform cardiac stimulation with low discharges of 50 or 75 J. Seduxen can be used as a pain reliever.

Normalization of the heartbeat is also performed depending on the type of rhythm disturbance. The following medications may be used:

• Adenosine phosphate, Procainamide;
• Atenolol, Verapamil;
• Amiodarone.

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What to take for a strong heartbeat, medication?

Medicines for a strong heartbeat are prescribed only after the cause of the problem has been clearly established. In order to find out this cause, it is necessary to conduct a thorough diagnosis first.

Sample medical prescriptions are presented in the following table.

Beta-blockers
Metoprolol	An antianginal, antiarrhythmic and antihypertensive drug, which is taken on average 100-150 mg per day in several doses. If necessary, the doctor can increase the dosage. The course of treatment is usually long. Possible side effects: feeling tired, thirst, depressive states, sleep disturbances.
Atenolol	A drug that reduces myocardial contractility and excitability, reducing the frequency of contractions. Tablets are taken before meals, the dosage is selected individually (on average - from 25 to 200 mg per day). Side effects are rare and go away on their own a few days after the start of treatment: this may be weakness, anxiety, fog before the eyes, inattention.
Propranolol	An adrenergic blocker that reduces the heart muscle's need for oxygen and reduces its contractile properties. The drug is taken orally, starting with 0.02 g three times a day, under the supervision of a doctor. The dosage is then increased and adjusted individually. Treatment is completed gradually, avoiding abrupt withdrawal. The drug is not taken simultaneously with tranquilizers and neuroleptics.
Calcium channel blockers
Diltiazem	A calcium ion antagonist that is successfully used for hypertension and myocardial ischemia. Tablets are taken orally, 0.03-0.3 g per day. Most patients tolerate the drug well, only in some cases individual intolerance is observed.
Verapamil	The drug, a derivative of phenylalkylamine, successfully eliminates paroxysmal supraventricular tachycardia. The dosage is selected individually for each patient. The tablets are washed down with water immediately after meals: it is prohibited to use grapefruit juice and St. John's wort infusion for washing down.
Sodium channel blocker
Novocainamide	A drug that reduces myocardial excitability, suppressing ectopic excitation zones. It can be recommended for oral administration, as well as for intravenous or intramuscular injections, depending on the doctor's decision. Side effects during treatment: hypotension, severe weakness, headache, sleep disturbance.
Disopyramide	A drug with an effect similar to Quinidine. The drug is taken 0.1 g three times a day, and it is better to take an increased dosage for the first dose (for example, 0.3 g), after which proceed to the usual amount of the drug. Intravenous administration of the drug is also allowed - in severe situations. Side effects are limited to allergies, thirst, and digestive disorders.
Mexiletine	A drug structurally similar to Lidocaine. To eliminate an acute attack of severe palpitations, the drug is administered intravenously, at an individual dosage. In other situations, oral administration is prescribed. Treatment may be accompanied by taste changes, dyspeptic disorders, accommodation disorders, finger tremors, numbness, and sleep disturbances.
Refractory period stabilizers
Amiodarone	A remedy for easing the work of the heart, slowing myocardial contractions, and lowering blood pressure. Tablets are taken starting with 0.2 g three times a day with food. After 1-2 weeks, the same amount of the drug is taken up to 2 times a day. After every five days of taking it, it is necessary to take a break - 2 days, to prevent the accumulation of the active component in the body.
Bretyllium tosylate	A drug that is especially effective against ventricular arrhythmia. It is administered intramuscularly or intravenously, in a dose determined by the doctor. A sharp drop in blood pressure may occur against the background of intravenous administration, so after the injection the patient should take a horizontal position for some time. A feeling of heat and nasal congestion may also occur.
Ibutilide	A drug that slows the heart rate and AV conduction. It is used in difficult cases, as an intravenous infusion - during an attack of severe palpitations associated with atrial flutter or fibrillation. The dosage is calculated as 1 mg per 60 kg of weight. Treatment with the drug is carried out in a hospital, under the supervision of a medical specialist.
Tranquilizers
Seduxen	A CNS sedative and muscle relaxant. Seduxen is most often taken orally, although intravenous and intramuscular administration is possible. The oral dosage is 2.5-10 mg twice daily.
Elenium	A medication based on chlordiazepoxide. It can be used if a strong heartbeat is associated with neuroses, stress, neurotic reactions. The standard dose is 5-10 mg per day, but the dose can be increased according to indications. Treatment is not discontinued abruptly, gradually reducing the dosage to a minimum. Among the most common side effects are a feeling of fatigue, constipation, and decreased sexual desire.
Phenazepam	Active tranquilizer, muscle relaxant. Taken in tablets, 0.25-0.5 mg up to three times a day. During treatment, drowsiness, ataxia, and dizziness may occur.
Sedatives
Corvalol	A combination remedy with a sedative and antispasmodic effect. For severe palpitations, take 30 drops up to three times a day. A feeling of drowsiness may be felt throughout the treatment period.
Validol	A coronary dilator and sedative that can eliminate a short-term attack of tachycardia. The tablet is held in the oral cavity until it dissolves. You can take one tablet up to three times a day. Frequent and/or long-term treatment with the drug may cause slight dizziness and nausea.
Novo-passit	A combined herbal remedy with a calming and anti-anxiety effect. The medicinal solution is taken one teaspoon three times a day, with water or drinks. If the treatment is accompanied by digestive disorders, the remedy is taken with food.
Altalex	A universal remedy that is used for digestive diseases, neuralgia, neurosis, and palpitations. The drug is taken 1 teaspoon with water or tea at the first signs of palpitations. There is no information on side effects.
Potassium bromide	A sedative taken 0.1-1 g daily (can be combined with potassium iodide). Side effects: feeling tired and sleepy.

Vitamins

As an additional treatment for a strong heartbeat, the doctor may prescribe vitamin and mineral complexes. Many of them contain the most essential substances for the cardiovascular system, as well as plant components (extracts of rose hips, hawthorn, ginger, mint, etc.).

The most popular multivitamin preparations are:

• Ascorutin is a tablet containing ascorbic acid and rutin. Taking Ascorutin improves the quality of capillaries, strengthens the walls of blood vessels, and prevents inflammation and swelling.
• Asparkam is a combination drug that combines potassium and magnesium aspartate. Asparkam supports cardiac performance, eliminates arrhythmia, and can even be prescribed for myocardial infarction and angina.
• Vitrum Cardio is a preparation with a rich vitamin and mineral composition. In addition, the complex contains fish oil, plantain seed, and oat bran. Vitrum Cardio is able to prevent the development of atherosclerosis and myocardial ischemia. It is prescribed to speed up the recovery of patients who have suffered a heart attack or stroke.
• Napravit is a complex product, represented by B-group vitamins, magnesium and potassium aspartate, as well as extracts of rose hips, hawthorn flowers and ginkgo biloba. The substances indicated in the composition strengthen blood vessels, stabilize blood flow, improve the work of the heart muscle.
• Cardio forte is a multi-component drug, the effect of which is due to the vitamins, minerals, plant extracts, polyunsaturated fatty acids, L-arginine and L-taurine included in the composition. Cardio forte can prevent the development of neurocirculatory dystonia, hypertension and other cardiovascular pathologies.
• Doppelherz CardioVital is a remedy based on hawthorn extracts, which is successfully used to alleviate the condition of patients with angina pectoris.
• Cardiohealth is a combined vitamin and mineral preparation with anti-inflammatory, immunostimulating and hypotensive effects.

There are many other multi-component vitamin products that can help the heart and blood vessels. We have presented only some of them to your attention. Consult your doctor: perhaps he will prescribe you another, no less useful complex product to eliminate strong heartbeat.

Physiotherapy treatment

Physiotherapy can be used as a restorative measure for functional disorders of the cardiovascular system. Many of the procedures can improve coronary circulation and contractility of the heart muscle, its automatism and excitability.

Physiotherapy methods are appropriate during the patient’s recovery period after coronary heart disease, hypertension, neurocirculatory dystonia, cardiosclerosis, etc.

The choice of treatment method depends on the degree of functional disorder, the state of regulatory systems, and the presence of concomitant pathologies.

The work of the autonomic nervous system and neurohumoral regulation can be influenced by electrosleep sessions. In addition, patients are offered galvanotherapy and medicinal electrophoresis. Such treatment has a mild sedative and analgesic effect, stabilizes blood pressure. When conducting electrophoresis, drugs with an analgesic and vasodilatory effect are used.

Other treatments may also be recommended:

• ultra-high frequency therapy (frequency 2712 MHz);
• magnetic therapy (low-frequency magnetic field);
• low energy laser radiation;
• balneotherapy (carbon dioxide, nitrogen, hydrogen sulphide, radon, oxygen baths);
• hydrotherapy (therapeutic showers, wraps).

Almost any physiotherapeutic methods can be successfully combined with manual therapy and therapeutic exercise.

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Folk remedies

For preventive purposes, the following recommendations can be used to prevent heart problems:

• periodically drink herbal infusions based on mint leaves, chamomile flowers, lemon balm and motherwort;
• conduct treatment courses with a decoction of hawthorn or its tincture (10 drops daily);
• add herbal ingredients to tea: lemon balm, yarrow, valerian root.

It is good for the heart to regularly drink freshly squeezed fruit and vegetable juices, berry fruit drinks. The basis for drinks can be beets, tomatoes, pears, carrots, raspberries and cherries.

If a strong heartbeat is already bothering you periodically, then to alleviate the condition you can use this interesting recipe:

• peel a dozen garlic cloves;
• rubbed with juice squeezed from ten lemons;
• mixed with one liter of honey, kept for several days in a closed glass container;
• take the remedy daily, 4 teaspoons, for two months.

Another medicinal mixture can be prepared, consisting of lemon juice (from four fruits), 250 ml of honey, 10 g of hawthorn tincture, 10 g of valerian tincture, five camphor seeds, eighteen almonds, sixteen crushed geranium leaves. All ingredients are mixed, placed in a glass container and stored in the refrigerator. Take in the morning on an empty stomach half an hour before meals. Continue treatment daily until the medicinal mixture is finished.

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Herbal treatment

The main remedies prescribed for severe palpitations are preparations based on hawthorn, valerian root and motherwort. We will tell you in more detail how to take such remedies.

• Hawthorn is taken for a month (more is possible, but not less), three times a day. The medicine is prepared as follows: 1 tbsp. of crushed fruits is steamed in 200 ml of boiling water, kept on low heat until ½ of the volume evaporates. The resulting remedy is cooled and filtered, drink 40 drops three times a day before meals. Instead of fruits, you can also use hawthorn flowers: 1 tsp. of flowers is poured with 200 ml of boiling water, infused until cool, filtered. Take 100 ml 30 minutes before meals, three times a day.
• Valerian root can be used as follows: 1 tbsp. of crushed rhizome is infused for a couple of hours in a liter thermos. The infusion is drunk daily, a third of a glass three times a day. The last week of taking it should be characterized by a gradual reduction in dosage. Valerian infusion is excellent for dealing with episodes of rapid heartbeat caused by strong emotions and stress.
• Motherwort herb is an ideal plant for normalizing heart rate. The medicine is prepared as follows: pour 1 teaspoon of the herb into 200 ml of boiling water, keep under the lid for 15 minutes. Drink the infusion twice - for example, in the morning and in the evening. If your heart beats strongly, you can drink the entire dose at once.

Herbal treatment can be diversified with medicinal plants such as mint, lemon balm, hawthorn berries, cornflower flowers, spring adonis, rose hips, and oat sprouts. In case of a severe attack of pain, you should immediately consult a doctor.

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Homeopathy

Severe attacks of palpitations can often be cured with homeopathic remedies. They are prescribed based not only on the patient's complaints and sensations, but also on his constitutional features.

For cardiovascular disorders, the most common homeopathic medicines are:

• Ignatia 6, 12, 30 – will help with neurological tachycardia, difficulty breathing, coronary pain. Stress overloads are considered a special indication.
• Platinum 6, 12, 30 – prescribed for cardiac and hysterical neurosis.
• Spigelia 3, 3, 6 – used for strong heartbeat of psychogenic nature, with stabbing or aching heart pain.
• Actea racemosa x3, 3, 6 – will help if tachycardia is associated with hormonal changes in the body.
• Cactus x3, 3 – prescribed for anxiety, frequent intense heartbeat, squeezing pain behind the breastbone.
• Arnica x3, 3, 6 – can be used for cardiac disorders associated with excessive physical activity.
• Pulsatilla x3, 3, 6 – especially recommended for women during periods of hormonal imbalances, menstrual cycle disorders, and also for hypotension.
• Camphor monobromate x3.3 – is suitable for use in depressive disorders and hypotension.
• Veratrum album x3.3 – recommended for eliminating tachycardia at the initial stage of a hypotensive attack, as well as with sticky cold sweating.

If the probable causes of a strong heartbeat include disorders of the autonomic nervous system, then Acidum phosphoricum, Magnesia phosphorica or Kalium phosphoricum are added to the above-mentioned drugs.

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Surgical treatment

The help of a surgeon to eliminate a strong heartbeat is required only in extreme cases, when the cause of the pathology is obvious and cannot be cured by medication.

The patient undergoes a full range of necessary diagnostic tests, after which the doctor can choose the most appropriate method of surgical care:

• Mechanical, laser, cryogenic, chemical or electrical interruption of conduction pathways and zones associated with impaired automatism. Cardiac access is achieved through a therapeutic or diagnostic catheter: first, the pathological zone is identified, after which destruction is performed.

Today, the most convenient method of destruction is the radiofrequency ablation method: this procedure allows you to act on several zones at once, which improves the prognosis for the patient.

• The installation of a pacemaker (cardioverter-defibrillator or pacemaker) is performed through open-heart surgery. The problematic areas of the conduction apparatus are removed, and the likelihood of developing an attack of palpitations is reduced to a minimum.

The need for surgery can be discussed in the following cases:

• if ventricular fibrillation was detected (even if only one);
• if persistent attacks of tachycardia are observed that do not respond to medication therapy;
• if organic heart disorders are detected (valvular defects, structural anomalies, etc.);
• if the patient has strict contraindications or intolerance to drug therapy;
• if attacks of strong heartbeat in children interfere with the normal development of the body.

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