Medical Edge Newspaper Column

Investigating An Overactive Heart

March 13, 2006
DEAR MAYO CLINIC:
My daughter, age 52, was recently diagnosed with hyperdynamic heart syndrome. She is unable to explain exactly what it is, though, and everything I find on the Internet is thick in medical terminology. Could you help us understand what this condition is, and what it may mean for my daughter's health?

ANSWER:
The reason why she can't explain it exactly, and why you've had trouble finding some clarity on the Internet, is that "hyperdynamic heart syndrome" is basically a nondescript condition or diagnosis covering a broad spectrum of possibilities.

To say that a heart is hyperdynamic means that it is overactive -- beating too hard, pumping too hard and circulating blood at too rapid a rate. The patient may feel palpitations, nervousness, excitement, edginess or shortness of breath. The whole system is revved up as if he or she has been running hard, yet the activity is internally generated.

Calling this overactivity a "syndrome," however, is like saying that fever is a syndrome -- it is merely a symptom, with a great many potential causes, ranging from the benign to the serious. Ideally, systematic evaluation can determine the underlying cause and lead to effective treatment.

The hyperdynamic heart could result from a bona fide physical condition such as anemia, elevated thyroid function or an abnormality in the heart itself. Alternatively, it may simply be a response to alcohol, stimulating drugs or excessive consumption of caffeine.

Sometimes, after doing a complete medical workup and an analysis of the patient's eating and drinking habits, doctors can find no specific reason for the hyperdynamic state. In such cases we prescribe beta-blockers, such as atenolol, propranolol or metoprolol, which are usually quite effective in calming the heart down and improving the patient's symptoms. If the specific cause is known, treatment is directed at it.

It's unusual for a 52-year-old to manifest a hyperdynamic heart; we see it much more frequently in younger adults. In any case, your daughter would do well not to concern herself with "hyperdynamic heart syndrome" per se, but to work with her doctors to get to the heart, so to speak, of the problem.

-- A. Jamil Tajik, M.D., Cardiovascular Diseases, Mayo Clinic, Scottsdale, Ariz.