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From anxiety attacks to palpitations, what you need to know about keeping your heart healthy

Ahead of Heart Rhythm Week which starts on Monday, experts answer some of your most common concerns. Abi Jackson and Nel Staveley report

When it comes to our hearts, what we 'feel' isn't always the best indicator of what's going on below the surface.

For instance, when we're given a sudden fright, it can sometimes feel as though our pounding heart is going to leap out of your chest - but it won't.

On the other hand, symptoms that seem quite mild might actually be a sign of an arrhythmia (abnormal heart rhythm) that needs to be checked by the experts.And that's why, if you have any concerns about your heart or pulse, it's always best to talk them through with your doctor.

If they too are concerned, usually a first step is to refer you for an electrocardiogram (ECG); machines can give a far more thorough picture of what's going on.

As Queen Rania of Jordan found out, there are often relatively straightforward treatments for many conditions. In 2010, she underwent a medical procedure in New York to correct an irregular heartbeat. And stars like Sir Elton John have also had to seek treatment - in 1999 he had a pacemaker fitted after he was also found to have an irregular heartbeat. Panic attacks are very common, too, thought the symptoms can be terrifying.

Last year, while appearing on Strictly Come Dancing, chef Gregg Wallace revealed severe anxiety left him with a pain in his chest and feeling breathless. He sought professional help to manage his fears.

In the meantime, Trudie Lobban, founder and CEO of Arrhythmia Alliance (, and Christopher Allen, senior cardiac nurse at British Heart Foundation (, answer some common queries ...

Q. Sometimes, particularly when I lie down at night, I get palpitations for no reason and it's worrying me.

"Palpitations are a feeling that your heart seems to be beating faster than normal, and some people describe it as skipping a beat or fluttering. Lots of people say they are only really aware of the symptoms when lying in bed and, in most cases, although frightening, palpitations are not dangerous and may be due to anxiety," says Lobban. "However, it's still important to have the possibility of any underlying heart condition ruled out, so you should make an appointment to see your GP and request an ECG for this purpose."

Allen adds: "Many factors, including stress and anxiety, can trigger palpitations. Not smoking, and cutting down on alcohol and caffeine, can help to reduce them."

Q. My teenage daughter is suffering with panic attacks and says she's terrified her heart is going to stop.

"Panic attacks can be very distressing, and even lead some people to attend A&E, feeling as though they're having a heart attack, especially the first time it happens," says Allen. "It's important to try and get to the root cause of these attacks to try and prevent them occurring more frequently, sometimes with medications and counselling support. Also, be reassured that a panic attack will not cause a cardiac arrest in an otherwise healthy person."

Lobban adds that she can "totally understand your daughter's concern".

"The physical symptoms are frightening and often accompanied by feelings of sheer terror and bewilderment," she explains, "but you must reassure her that a racing heartbeat and shortness of breath will not cause a heart attack.

"Panic attacks can be a combination of physical and psychological reasons. The saying 'it is good to talk' can be very apt and talking therapy, in the form of cognitive behaviour therapy [CBT], has proven long-term benefits for a panic disorder."

Q. I've really got into the gym and fitness lately, but I've noticed that when I'm really pushing myself, my heart beat becomes a little irregular, should I get it checked?

"Exercising in the gym will obviously increase your adrenaline. These palpitations associated with exercise are not usually dangerous unless, of course, an underlying heart condition exists," says Lobban.

"The only way to be reassured, so you can happily continue your fitness regime, is to ask your doctor for an ECG to help rule out any problem."

Allen adds: "When you physically exert yourself, it's normal for your heart to beat much faster than at rest - but it should always be regular. You should definitely make an appointment to see your GP; they can check your pulse and arrange for you to have an electrocardiogram (ECG) to check the electrical activity in your heart.

"They might also want you to wear a small, portable ECG monitor for 24-hours or more, to see if your heart rhythm changes at all through the day."

Q. My uncle died from a sudden cardiac arrest. I've read this can be a faulty heart rhythm that may run in families, should I be concerned and can I get tested?

"Sudden Cardiac Arrest [SCA] is unpredictable and can happen to anyone, anytime, anywhere," says Lobban. "One of the risk factors is a family history and in your family, sadly, it was your uncle. There are inherited conditions that can cause SCA, which is why it is essential that any close or relatively close family members should always be offered an ECG, from which an electrophysiologist would be able to detect any underlying characteristics that could indicate a person may be at risk of cardiac arrest."

Allen agrees that testing is important: "In any family where someone has died following a sudden cardiac arrest, usually the coroner will recommend all first-degree relatives are referred for genetic testing - this means the parents, siblings and children of that person. Before you are offered genetic testing, your parent (the sibling of your uncle) will need to be tested first. If their result is positive, you will then be offered testing.

"However, if their result is negative, you won't need testing because they can't pass down a faulty gene that they don't have," he adds.

"Contrary to popular belief, faulty genes do not 'skip generations'."

Two per cent of the population in Northern Ireland suffer from atrial fibrillation which equates to 29,041 people, according to the latest figures from Northern Ireland, Chest, Heart and Stroke Association.

About heart rhythms

  • Your heart has a natural pacemaker called the sinus node, which sends electrical impulses through special fibres in the heart muscle to stimulate it to beat. These electrical impulses usually keep it in a regular ‘sinus’ rhythm. Your heart will normally beat between 60 and 100 times a minute when you are resting
  • At one time or another, most people have felt their heart race or skip a beat
  • An arrhythmia is a change in the rhythm of the heart. The heart rate can become abnormally rapid, slow and/or irregular. Most arrhythmias are harmless, but some can be serious
  • You may not notice any symptoms of an arrhythmia. If you do have any, they will depend on the type of arrhythmia you have and how severe it is. Symptoms may include:
  • Palpitations or a fluttering in your chest
  • Dizziness
  •  Fainting or collapsing
  •  Breathlessness
  •  Chest pain
  • For more information visit

How the stars cope...

Celebrities who suffer from atrial fibrillation (AF):

Barry Manilow: “I felt my heart skip a beat,” he told CBS News. “I didn’t pay much attention to it. And then it went blump-bla-bla-blump. And it got crazier and crazier, I felt like there was a fish flopping around in my chest”

Vice President Joe Biden: Doctors diagnosed the Vice President had AF saying the condition was related to sleep apnea, which is a common cause. He was instructed to exercise more and drink less coffee

Roger Moore: “People should know their pulse as they would their weight,” he told the Express in 2009. “If I had been checking my pulse, I would have realised my heartbeat was slow and sought help”

President George W Bush: While on a jog at Camp David in 1991, then-President George W Bush was stricken with shortness of breath, chest tightness and fatigue. The elder President Bush, who was 66 at the time, had developed AF due to hyperthyroidism, according to the New York Times. Bush’s heartbeat was regulated through medications given over two days. His doctors decided against treating him with electrical cardioversion, news reports said. He later made a public-service announcement warning people about the dangers of AF

Elton John: Sir Elton had a pacemaker fitted to regulate his heartbeat which allowed him to return to the stage within two months. He became a celebrity backer of the Arrhythmia Alliance, a British charity

Miley Cyrus: “The type of tachycardia I have isn’t dangerous,” wrote Cyrus, now 22. “It won’t hurt me, but it does bother me. My heart rate increases a lot just from going up the stairs”

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