Palpitations: Causes, Symptoms, and Treatment Options - Cardiology

More Info

---

Palpitations can be a concerning symptom, especially when they persist over a long period. Your experience of feeling palpitations for three years, particularly after an episode of dizziness, is noteworthy. While your heart has been evaluated through various tests such as ECGs, echocardiograms, and stress tests, and no significant issues have been found, it’s understandable that you still feel uneasy about the ongoing symptoms.


Understanding Palpitations
Palpitations are often described as the sensation of feeling your heart beating, which can be perceived as a fluttering, pounding, or irregular heartbeat. They can occur in isolation or be associated with other symptoms such as dizziness, shortness of breath, or chest pain. In your case, the absence of chest pain or significant discomfort is reassuring, but the persistent nature of your palpitations warrants further exploration.


Possible Causes
1. Physiological Factors: Given that you are a long-term athlete, your resting heart rate of 46-50 beats per minute is considered bradycardic (lower than normal). Athletes often have lower resting heart rates due to increased cardiovascular efficiency. However, a heart rate dropping to 42 beats per minute could be concerning if it is accompanied by symptoms like dizziness or fatigue.

2. Electrolyte Imbalances: Intense physical activity can lead to imbalances in electrolytes such as potassium, magnesium, and calcium, which can affect heart rhythm.

3. Autonomic Nervous System: The autonomic nervous system regulates heart rate and can be influenced by stress, anxiety, or even certain medications. Dysregulation can lead to palpitations.

4. Hormonal Factors: Conditions such as hyperthyroidism can lead to increased heart rate and palpitations. It may be worthwhile to have your thyroid function tested if this hasn’t been done.

5. Caffeine and Stimulants: High caffeine intake or the use of stimulants can lead to palpitations. Assess your diet and lifestyle for potential triggers.

6. Anxiety and Stress: Psychological factors can also manifest physically. Anxiety can lead to heightened awareness of heartbeats and may contribute to the sensation of palpitations.


Treatment Options
1. Lifestyle Modifications: Reducing caffeine intake, managing stress through relaxation techniques (like yoga or meditation), and ensuring adequate hydration and nutrition can help mitigate symptoms.

2. Monitoring: Keeping a diary of your palpitations, noting when they occur, their duration, and any associated activities or feelings can provide valuable information for your healthcare provider.

3. Medication: If palpitations are linked to anxiety or stress, medications such as beta-blockers may be prescribed to help manage symptoms. However, this should be discussed with your healthcare provider.

4. Further Evaluation: If symptoms persist, consider asking your doctor about a Holter monitor, which records heart activity over 24-48 hours, or an event monitor for longer-term monitoring. This can help capture episodes of palpitations and provide more insight into their cause.

5. Referral to a Specialist: If your symptoms continue to be bothersome, a referral to a cardiologist or an electrophysiologist may be beneficial. They can provide a more in-depth evaluation and discuss potential interventions.


Conclusion
While your heart appears structurally normal based on the tests performed, ongoing palpitations can be frustrating and concerning. It’s essential to continue working closely with your healthcare provider to explore all potential causes and treatment options. Remember, understanding your body and its responses is key to managing symptoms effectively. If you ever feel that your symptoms worsen or if you experience new symptoms, do not hesitate to seek immediate medical attention.