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About Oregon daily emerald. (Eugene, Or.) 1920-2012 | View Entire Issue (May 13, 1977)
From the Doctor. Heart flutters due to stress, vices You talked about heart problems in Friday's EMERALD and said you’d discuss it further. Well — I wonder if you would discuss “heart palpitations,’’ too. I had a real heavy course load last year and a demanding job on top of everything else. I started getting "heart palpitations." They lasted a few months. (I had an EKG and they said I was O.K.). Then, I spent the winter in a cabin in the woods and had none at al — all winter. I was feeling great. Now, I’m back in school, doing volunteer work, and have a job too. Last week I started getting the heart palpitations again. Every now and then my heart will “flutter” or seem to try to jump out of my chest! (Average: about once or twice an hour). I'm worried about it and a little scared too. What should I do? Thanks for your help Dear Thanks: Let’s start with the definition. “Palpita tions” is a wonderful word, in fact an amaz ing word, because it sounds like it says something concrete and definite (“You've got palpitations; take two aspirin and move to Polynesia”), when it can actually mean a whole range of things from innocent to sig nificant to serious, depending on what the heart is doing and who it is doing it in. That's fine, what's so ambiguous about that, you say. Wed, it covers everything from a heart beating more strongly causing the person to notice it and because of gen eral nervousness, to become alarmed, to a heart adding a few early beats (atrial and ventricular premature beats), to a heart skipping beats either due to normal re flexes or to serious problems with the pacemaker areas, which occurs in some older folks, to sustained rapid beating which can be normal with fear, fever, or exertion, to intermittent very rapid regular beating or paroxysmal atrial tachycardia, which often occurs in young folks as well as old and by itself is rarely serious, to grossly irregular sustained rapid beating (atrial fibillation) caused by significant heart disease (usually rheumatic fever) in young people and often occurring without other serious heart disease in very old folks. The list goes on for several more pages. So what’s happening to you and why? Probably, you ai'i having premature beats, since (1) they often occur in young adults without heart disease, (2) the EKG will often be normal, and the heart will be negative, (3) the beat after the premature beat is a lot stronger than normal and the heart moved harder within the chest, giving a sensation of the heart “trying to jump out of my chest,” and (4) they went away when you were relaxed and came back when you were under stress. The sinus node in the heart generates brief electrical pulses that travel through the heart to make it beat 60 to 100 times a minute. Other places in the heart have the ability to generate pulses, but normally don’t because the sinus node generates one first and keeps the other areas sup pressed. However, when the heart is ex posed to certain chemicals, to certain nerve impulses, to certain toxins, or to a lack of oxygen, other areas can be so stimulated that they occasionally generate a pulse before the sinus node does. This pulse makes the heart beat prematurely, and the premature beat is followed by a pause until the sinus node picks up the rhythm again. During that pause the heart fills more fully with blood, and the muscle fibers are rested and well supplied. Con sequently, the next beat is a real strong one, causing a thump within the chest that can be easily felt. Now let’s take a normal college student in the mountains. Everything is relaxed, cigarettes and coffee to get those papers written are a thing of the past, adrenalin levels are at a minimum. Most of the stimuli to cause premature beats in the normal heart are gone, and so is the anxiety level that makes the student notice his or her funny beats and get scared about them. Now bring that same student to the Uni versity Law School, give him or her a mock trial to prepare for the next day and bar exams in two months, deprive him or her of sleep, add generous doses of nicotine, caffeine, and occasionally alcohol, then decongestants for his or her hay fever — the wonder is not that the heart has a pre mature beat once an hour, the wonder is how it avoids racing at 400 beats a minute. The body’s reaction to stress is to re lease epinephrine (adrenalin), an extremely potent cardiac beat accelerator and stimulant, into the blood stream. In addi tion, the heart has nerve endings on it which can release epinephrine directly into the heart tissue, under the control of cer tain parts of the brain which in addition to control of body functions, are related to emotions. Thus stress and emotions can cause premature beats and other kinds of heart rhythm irregularities. Nicotine and caffeine are also effective producers of cardiac stimulation and premature beats. Alcohol acts as a toxin and can cause the same problem, and decongestants are re lated to epinephrine. Space and time don’t permit a full dis cussion of aH of the other possibilities other than premature beats. From what you tell me, I think the most likely diagnosis is oc casional premature beats and that this does not indicate any real heart disease or problem that will get any worse in the fu ture. In essence, you should relax, elimi nate cigarettes, caffeine, alcohol, cold pills, and decongestants and stop worrying. Most likely, this will eliminate the problem. If it does not, come in for a further evalua tion. Terry Copperman, M.D. Copyright 1977 tnerqv Plan could slow exoaus to suouros City dwellers rewarded for reduced consumption NEW YORK (AP) — If logic had anything to do with it, New York City would benefit from Pres. Carter's energy proposals. The city's brownstone and high-rise buildings are hard to beat as potential energy savers. It has enough buses, subways and trains to move millions of people to their jobs, enough for most to avoid the higher gasoline prices that are the centerpiece of Carter’s energy strategy. Most importantly, the feeling among city officials is that Carter s program should place the overall costs of city living on a more equal and attractive footing with its surrounding suburbs. This is mainly because suburbs would bear the brunt of Carter’s deter mination to make auto travel more expensive. And a study by a coalition of Northeast legislative leaders says that the proposed gas tax rebate formula would heavily favor New Yorkers and other Northeaster ners, producing a possible net federal revenue gain here of about $140 million. The reason is that the North east has 23 per cent of the nation's population and thus would get back 23 per cent of the proposed rebate. But the region uses only 19.5 per cent of the nation’s gasoline, resisting in a net profit to taxpayers, especially those in cities, who don’t drive cars much. All this has some New Yorkers expressing hope that a new na tional energy-saving lifestyle will cause the young and affluent to think a bit harder before leaving for the suburbs. But recent talks with energy experts, economists, city home owners, cab drivers and others show there may be enough nega tive impact in the Carter plan to offset its touted pluses for cen tralized cities like New York. Negative items such as this: The Carter energy package leaves largely untouched the high cost of foreign oil which, along with high local utility taxes, are the main culprits behind New York’s high electricity and heating costs. And this: There are no new proposals to reverse the ef the city's energy-saving mass transit system, which has suf fered a steady decline in rider ship for more than two decades "The Carter approach is to beat people over the head for driving cars, without providing any alter native,” says Dr. Barry Com moner, an energy expert with Brooklyn roots. Studies show that the average New Yorker uses slightly over half tie amount of energy the av erage American uses to travel, run his utilities, and heat and cool his home. Yet the New Yorker’s saving ways are rewarded with some of the highest energy prices in the nation, almost sure to rise under Carter’s plan. According to the Edison Elec tric Institute, average New York households use less than half the electricity other Americans use. But their average annual electric bill is about $300, roughly the same as the national average, meaning the cost per kilowatt of electricity in New York is more than twice as high as the national average. Carter’s plans by themselves won’t touch off vast lifestyle changes in New York as might be true in a sprawling city such as Los Angeles which relies almost entirely on cars. But a number of existing trends and behavior pattei is that have affected New York for years could either be hastened or slowed. Among the possible effects are: • The trend of people and jobs moving from New York City to the suburbs will likely continue, but rising suburban energy costs re sulting from the Carter program may become a factor in slowing the exodus. • Carter’s program for the first time offers some hope of ample reserves of heating fuel for the city. But according to Lou Verach, a city researcher who is studying the program's effects, Carter’s plan to lift import ceilings on li quefied natural gas (LNG) could worsen the city's dependence on Middle East fuel, and ultimately higher prices. • Perhaps the most striking immediate impact of the Carter program will be on New York’s 11,000 cabdrivers. 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