The Philippine Heart Association (PHA) advised going beyond counting heartbeats and focusing also on the regularity of the pulse to detect potential cardiac arrhythmias that could lead to life-threatening complications.

In an online forum, PHA treasurer and electrophysiologist Dr. Luigi Segundo clarified that while arrhythmia is a general term for various heart rhythm disorders, identifying the specific nature of the irregularity is crucial for preventing strokes and heart failure.

“Ang cardiac arrhythmia, umbrella term ‘yan. Maraming mga sakit na magdudulot ng arrhythmia,” he said.

“Pwedeng siya ang primary na sakit, meaning, pinanganak talaga na may arrhythmia, o kaya naman complication ng heart attack,” he added.

Silent threat of AFib

Among the various types of arrhythmias, Atrial Fibrillation (AFib) remains the most common sustained condition.

Unlike a heart attack, which presents with sudden, acute pain, AFib can be “compatible with life,” meaning a patient might feel normal while their heart rhythm is dangerously irregular.

“Ang atrial fibrillation po, irregular na pintig ng puso. Maaaring hindi siya agad nakakamatay, pero karamihan kasi dito, masyadong mabilis,” he said.

“At ang puso, parang elastiko, nai-stretch … maaaring may risk na magkaroon ng heart failure later on.”

He warned that the most morbid complication of AFib is the formation of blood clots, which can travel to the brain and cause a stroke, or to the lungs, resulting in a pulmonary embolism.

Consumer gadgets

With the proliferation of smartwatches, pulse oximeters and digital blood pressure monitors, many Filipinos are now self-monitoring their heart rates. While these are not classified as official medical devices in the Philippines, Segundo noted they are highly effective for screening.

“Sa Pilipinas, hindi siya considered na regulated medical device, but it is something that can help the doctors and patients screen for diseases,” he said, noting that these gadgets often have over 90 percent sensitivity.

To ensure accuracy, he advised users to ensure a proper “fit” of the wearable and to use it consistently to build a reliable data set.

However, he emphasized that a formal diagnosis must still come from a physician via an electrocardiogram (ECG).

Pulse versus heartbeat

The experts also clarified the technical difference between a heartbeat and a pulse. While a heartbeat refers to the actual contraction of the heart muscle, the pulse is the transmission of that flow through the arteries.

“In theory, pwedeng pareho. Pero kung mahina ang puso o may bara sa mga pulsohan, baka hindi eksakto ang bilang,” Segundo noted.

For practical screening, the radial pulse, which is located at the base of the thumb on the wrist, is the most recommended site for self-checking using the index and middle fingers.

Slow versus irregular

Addressing common concerns about slow heart rates (bradycardia), Segundo clarified that a rate below the standard 60 to 100 beats per minute (BPM) is not always a cause for alarm, especially among athletes.

“Kung magaling ang puso, hindi na kailangan masyadong maraming tibok para maka-deliver ng dugo. Ang ibang atleta, pwedeng mas mabagal sa 60 or 55,” he said.

He stressed that a slow heart rate is generally only a concern if accompanied by symptoms such as dizziness, fainting or shortness of breath.

Conversely, a “skipped heartbeat” or palpitations, defined as any awareness of one’s own heartbeat, requires a medical checkup if it occurs without a trigger like exercise, caffeine or stress.

“Hindi lahat ng irregular na pintig ay delikado, pero hangga’t hindi niyo ipinapa-check sa doktor, hindi niyo makukuha ang peace of mind,” he said. (PNA)