Ep. 531 Your Heart’s Not Just Skipping Beats – The Shocking Truth About Palpitations in Women | Women's Cardiovascular Health with Dr. Sanjay Bhojraj
episode
Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+
1h 3m
2 speakers
4 chapters
transcribed 2 months ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What is the main topic discussed in this episode?
Welcome to Everyday Wellness Podcast. I'm your host, nurse practitioner, Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives. Today, I'm joined again by the amazing Dr. Sanjay, who is a board-certified interventional cardiologist turned functional medicine pioneer. Today, we spoke at length about the impact of palpitations, which are a common complaint of perimenopausal menopausal females, red flag symptoms that clue Dr. Sanjay into more concerning ideologies. the physiology of progesterone, estrogen, and testosterone as it pertains to heart arrhythmias and specific EKG changes that we can see in the perimenopause to menopause transition, wearable technology, differentials between benign versus more concerning arrhythmias, including atrial versus ventricular arrhythmias, as well as wrist stratification for atrial fibrillation, practical evaluations for uterine
getting a really strong history, initial testing to use with working up palpitations, imaging as well as potential sleep studies, the impact of treatment starting first with lifestyle and then medications, what impacts treatment decisions for specific types of palpitations, and last but not least, channelopathies and other genetic propensities for specific types of arrhythmias, including long QT, brigadas, WPW, and histories of sudden cardiac death, and the importance of genetic testing for these family histories. Again, a truly invaluable conversation, one I'm sure you will listen to more than once. Dr. Sanjay, so good to have you back on the podcast.
Cynthia, it's great to see you again and just connect with you. Such a great time. Last time, I hope we have as much fun and are as informative this time for your audience.
Well, I can tell you, as I was texting you over the weekend, there are a lot of requests to talk about palpitations, arrhythmias, which are commonplace for perimenopausal menopausal women. Let's start with palpitations. Obviously, you and I know there are things that are benign but annoying, and then there are things that are more concerning. Yeah. And it was purely coincidental when we were connecting that you mentioned this was an area of research that you studied during your training. So for listeners, truly serendipitous that Dr. Sanjay and I are going to have this conversation. Let's talk about palpitations. Let's unpack why they happen. Let's start with like the benign stuff all the way to the more concerning things that are out there.
Yeah, perfect. So and you kind of intuitively said a classification system that I don't know if I came up with, but that I'd often talk about with patients. If you can imagine a two by two kind of Punnett square or matrix on the top, I think of arrhythmias as either fast or slow and on the side, annoying or dangerous. Right now, these are the arrhythmias, not the patients. I'm not calling a patient annoying. Something that's not necessarily fatal or would not necessarily have consequences, but just you feel them and they just get you anxious and amped up.
What are palpitations and why are they common in perimenopausal and menopausal women?
And so with the framework of that matrix, we can really kind of fill out all the different types of arrhythmias and things. But before we even jump into that, let's talk about what a palpitation is, because a lot of people might not be aware. And your heart is like the thankless organ in your body. It beats 60, 80 times a minute. you know 60 minutes an hour 24 hours a day do the math i mean it is hundreds of thousands of times per day but you should never really be aware of it right you shouldn't have to think beat beat would be a big problem you'd never get anything accomplished during your day so we have this autonomous nervous system autonomic nervous system that drives our heart rate up and down but
every once in a while you will be aware or you can feel a heartbeat whether it's early whether there's a pause whether it just is kind of beating out of your chest and those are the sensations when you're more aware of the heart beating that people refer to as palpitations they can either be a single beat they can feel like a skipped beat they can feel like a you know my heart is about to jump out of my chest so a lot of different things fall under that that moniker of palpitation
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Chapters
4 chapters
1
What is the main topic discussed in this episode?
0:02–3:31
2
What are palpitations and why are they common in perimenopausal and menopausal women?
3:31–16:38
3
How do clinicians classify palpitations using the “fast/slow” and “annoying/dangerous” framework?
16:38–37:59
4
Which red flag symptoms should prompt urgent evaluation for arrhythmia?
37:59–1:03:11