PALPITATION (Lat. palpitatio, from pal pitare, to throb, frequentative of palpare, to feel, move quickly). The term used to signify inor dinately forcible pulsations of the heart, so as to make themselves felt, and frequently to give rise to a most troublesome and disagreeable seri f,ation. It may be either functional or a symp tom of organic disease of the heart. 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 upward into the throat; and there is a sensation of oppression over the cardiac re gion, with hurried or even difficult respiration, and even nausea. In milder attacks there is sim ply a consciousness of sinking or fluttering of the heart.
Palpitation is due to many different causes. It is more common in women than in men, and is apt to occur especially at puberty, thc men strual periods, and the menopause. An amemic condition of the blood is a frequent cause. Pal
pitation is present in unstable states of the ner vous system, such as occur in neurasthenia, hysteria, worry, anxiety, and excitement. The excessive use of tea, coffee, alcohol, and tobacco predisposes to cardiac irregularities. Perhaps the most frequent cause is a flatulent and dis tended stomach. acting both reflexly and di rectly. Palpitation is a symptom of exophthal mic goitre. and lastly it is a concomitant of organic disease of the heart itself. Either hy pertrophy or degeneration of the cardiac muscle may produce it as well as affections of the valves.
The treatment of palpitation natnrally de pends on the causation. When the stomach is at fault, dietetic errors will need to be corrected. Tea, coffee, alcohol, and tobacco should he inter dicted, gime they not only affect the nerves. but hurt the digestion. Anaemia calls for iron, and neurotic conditions for sedatives such as the bromides, valerian, and camphor. When the cardiac muscle is diseased and palpitation is an expression of weakened power, digitalis, strych nine, and other cardiac stimulants must be given. During the paroxysms. relief may be had from the diffusible stimulants. as ammonia, in the form of the aromatic spirit.