Heart stumbling during exercise


So-called extrasystoles are popularly referred to as heart stumbling. These are extra heart beats that occur outside of normal heart activity. The heart gets out of step, so to speak. This can be perceived as an uncomfortable palpitations. However, many people do not even notice extrasystoles.

Heart stumbling can occur more frequently during physical exertion, for example in the context of sporting activities.

The reasons

In most cases, palpitations are completely harmless. It also occurs relatively often in young people with healthy hearts. It is caused by a kind of short circuit in the complex conduction system of the heart. It is not clear exactly why extrasystoles occur in healthy people. However, there are triggers that trigger the occurrence of heart palpitations. These include sport, emotional stress, stress, fatigue, the consumption of luxury foods such as alcohol, nicotine or coffee and drug consumption.

In pre-existing heart diseases, extrasystoles also occur, both during exercise and independently of it. For example in patients with calcifications of the heart vessels (coronary artery disease). Extrasystoles can also occur in patients who have already had a heart attack. This is due to the fact that the scar tissue created by the infarct can disrupt the impulse conduction in the heart. Heart muscle diseases such as cardiomyopathies or myocarditis can also lead to heart stumbling.
Causes outside the heart can also cause palpitations. For example, an overactive thyroid or abnormalities in the body's electrolyte balance. Various medications can also trigger extrasystoles. Physical activity can increase the frequency of cardiac stumbling in these situations.

Find out all about the topic here: The palpitations.

Other accompanying symptoms

If heart stumbling occurs during exercise / exercise, further accompanying symptoms may be present. In particular, if several extrasystoles occur in a row, the stumbling of the heart can be uncomfortable. Sometimes this can lead to anxiety and anxiety. It can also lead to increased sweating. These are symptoms that are primarily of a psychological nature and can occur as a reaction to the unpleasant palpitations. In rare cases, persistent extrasystoles can lead to shortness of breath or dizziness.

The following topic may also be of interest to you: Dizziness and circulation

How do I know if this is dangerous?

If you have an occasional cardiac stumble under stress, there is usually no need to worry. Heart stumbling is very common among young people with healthy hearts. If heart stumbling occurs frequently, it can make sense to write an EKG to record the heart's action. Often, however, extrasystoles occur so rarely that they are not recorded during the duration of an EKG, namely about 10 seconds. In this case, a 24-hour ECG can be useful. But even during this period, something is not detected in all patients with occasional cardiac stumbling. However, a 24-hour ECG can provide initial indications of whether there are structural and functional disorders in the heart.

If the heart stumbling occurs mainly during sporting activity, it makes sense to carry out a so-called stress ECG. This means an EKG that is recorded during physical activity, usually during exercise on the bicycle ergometer. An ultrasound examination of the heart (echocardiography) can also be carried out. If necessary, a blood test is also carried out to check electrolytes and thyroid levels.

How dangerous is the palpitations? Find out more here.

The treatment

If cardiac stumbling in the sense of extrasystoles occurs in patients with healthy heart under stress / during exercise, this usually does not require any therapy. Exceptions are diseases that are the cause of the triggering of extrasystoles, such as an overactive thyroid. This usually has to be treated with medication. However, not so much because of the palpitations but rather because of other potentially serious symptoms. Even if deviations from the electrolyte balance in the blood are the cause, these may require treatment. Depending on which electrolytes are derailed, infusions, electrolyte substitutions or medication may be necessary here.

If structural heart disease is the cause of the heart stumbling, these must be treated specifically. In the presence of coronary heart disease (CHD), for example, the implantation of stents may be necessary to keep constricted coronary arteries sufficiently open. In addition, if you have coronary artery disease, certain medications must be taken permanently, for example fat reducers like simvastatin and blood thinners.

If heart stumbling occurs very frequently during exercise and causes symptoms, then - theoretically - taking beta blockers can be helpful. The disadvantage of beta blockers, however, is that they dampen the heart's action. This means that the heart rate can no longer increase sufficiently with greater physical exertion. This is counterproductive in certain sports. Therefore, the use of beta blockers should be carefully considered. In the case of troublesome heart palpitations, it is therefore advisable to try non-prescription products such as dietary supplements that contain potassium and / or magnesium. There are numerous different preparations available over the counter in pharmacies or drugstores. They can stabilize the stimulus threshold in the heart and thus lead to a reduction in cardiac stumbling. Tromcardin® should be mentioned here as an example.

If the drug therapy does not have a sufficient effect, a so-called catheter ablation can be considered in patients with severely symptomatic extrasystoles. With the help of a catheter, which is inserted through the inguinal vein, the place of origin of the extrasystoles in the heart is searched for and obliterated.

More information can be found here: The therapy of heart stumbling.

The duration

The duration / prognosis of cardiac stumbling depends on the triggering cause. For many patients it is completely harmless. The duration varies greatly. It can occur once - according to certain trigger factors - but it can also recur at irregular intervals.

In patients with structural heart disease, such as coronary artery disease or cardiomyopathies, the prognosis depends heavily on the underlying disease. In most cases, thanks to the current therapeutic possibilities, it is relatively good.

The course of the disease

The course of the disease in cardiac stumbling during exercise is very different. For some people it only occurs once, for example after a night of sleep or excessive coffee consumption. With others it occurs repeatedly, but hardly causes any discomfort while others find it very annoying.

In patients with pre-existing heart disease, the stumbling of the heart can recur and may also increase in intensity. It is therefore important for people with heart disease that they consult their doctor before engaging in sports. They can give advice on which sports are suitable and which may pose a risk.