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Diuretics, also called water pills, are medications used to treat hypertension, swelling due to fluid accumulation, glaucoma and congestive heart failure. They promote the removal of water and salt from the body through urine. Heart palpitations or cardiac arrhythmias refer to irregular heart beats that can occur as flutters in the chest or rapid thumps. Some diuretics may cause heart palpitations 1.
Diuretics are classified based on how they work and affect the body. There are five types: loop diuretics, thiazide diuretics, potassium-sparing diuretics, carbonic anhydrase inhibitors and osmotic diuretics. Thiazide and loop diuretics are associated with heart palpitations or cardiac arrhythmias. Examples of thiazide diretics are chlorothiazide and hydrochlorothiazide. Furosemide and torsemide are examples of loop diuretics.
Action and Therapeutic Effects
Loop diuretics like furosemide act by promoting the removal of salt and water at the loop of Henle, located in the kidneys. Thiazide diuretics do the same thing in the distal tubules of the kidneys. The two medications lower the volume of blood in the body and therefore decrease blood pressure in hypertension. Their action also reduces the size of swelling in the body.
There are different types of salts or electrolytes in the body. Some are sodium, potassium and calcium. The desired effect of thiazide and loop diuretics is to remove sodium and water from the body. They also affect other salts in the body, which can lead to negative outcomes. Potassium is an electrolyte that is needed for the proper functioning of the heart. Loop and thiazide diuretics cause low levels of potassium or hypokalemia in the body, which causes cardiac arrhythmias or heart palpitations 1.
Cardiac arrhythmias or heart palpitations may be felt as the heart beating too fast, too slow or irregularly. They may be harmless or cause serious medical problems. When the heart beats weakly, there is a tendency for blood to accumulate in the heart. This can lead to the formation of blood clots, which can travel through the blood stream and block blood supply to various organs. The outcome of this type of situation may be fatal. Other problems associated with heart palpitations are cardiogenic shock, heart failure and cardiac death. Being aware of heart palpitations associated with diuretic medications is important, so that if they do occur, a person can seek medical attention.
Heart palpitations due to diuretic medications like thiazides and loop diuretics can be prevented by taking potassium supplements. Potassium-sparing diuretics like spinorolactone, eplerenonere and triamterene remove salt and water from the body without lowering its potassium content. This type of diuretic can be prescribed in place of or in conjunction with other diuretics to prevent low potassium levels and cardiac arrhythmias 1.
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