Worsening Palpitations: When to Seek Medical Attention

Palpitations are becoming increasingly noticeable?

Hello Doctor, I have been experiencing palpitations since middle school, but they were not severe; I could just feel my heart beating, so I didn't pay much attention to it.
However, as I have gotten older, the symptoms of palpitations have changed and become more uncomfortable.
Now, I can feel my heart beating very strongly, and it can last for 1 to 2 hours.
During this time, I experience some shortness of breath and discomfort in my heart, which makes it difficult for me to concentrate on work.
Previously, other doctors suggested that I wear a 24-hour Holter monitor, but they mentioned that the effectiveness of the test might not be significant.
Since I am currently working abroad and plan to return to Taiwan in January next year, I am unsure if I should take leave to have the examination done in Taiwan.
Thank you.

Miss Wang, 20~29 year old female. Ask Date: 2016/04/22

Dr. Li Han reply Cardiology

Hello Ms.
Wang, regarding your inquiry, "I have experienced palpitations since junior high school, but they were not severe; I could only feel my heart beating...
Now I can feel my heart beating very strongly, and it lasts for 1 to 2 hours.
During this time, I experience some shortness of breath and discomfort in my heart, which prevents me from concentrating on my work." Generally speaking, palpitations are a subjective symptom.
Objectively, they may be related to arrhythmias, but they may also be unrelated.
However, more details about your symptoms are needed for better assessment.
Since your symptoms can last for 1-2 hours, in Taiwan, where hospitals are readily available, there should be a good chance of obtaining an electrocardiogram in a timely manner.
If you still have concerns, it would be advisable to consult a cardiologist in person after returning to Taiwan.
The Changhua Hospital of the Ministry of Health and Welfare is here to support you.

Reply Date: 2016/04/22

More Info

Palpitations, or the sensation of feeling your heart beating, can be a common experience, especially in younger individuals. However, as you have noted, the nature and intensity of these palpitations can change over time, and it is essential to take them seriously, especially when they become more pronounced or uncomfortable. Given your description of experiencing palpitations that last for 1 to 2 hours, accompanied by shortness of breath and discomfort, it is crucial to evaluate these symptoms further.

Understanding Palpitations
Palpitations can be caused by a variety of factors, including anxiety, stress, caffeine intake, hormonal changes, or underlying medical conditions such as arrhythmias, heart disease, or thyroid disorders. While occasional palpitations are often benign, persistent or worsening symptoms warrant a thorough investigation to rule out any serious underlying issues.

When to Seek Medical Attention
You should seek medical attention if you experience any of the following alongside your palpitations:
1. Prolonged Duration: If your palpitations last longer than a few minutes or occur frequently.

2. Associated Symptoms: If you experience chest pain, dizziness, fainting, or severe shortness of breath.

3. Change in Pattern: If the nature of your palpitations changes, becoming more intense or frequent.

4. Impact on Daily Life: If your symptoms interfere with your ability to work or perform daily activities.

Given that you have been experiencing these symptoms for an extended period and they have worsened, it is advisable to consult a healthcare professional.

Diagnostic Considerations
The recommendation for a 24-hour Holter monitor is a common approach to assess heart rhythm abnormalities. While some may feel that the effectiveness of this test is limited, it can still provide valuable information about your heart's electrical activity during your daily routine. If your symptoms are frequent, this test can help determine if there are any arrhythmias or other issues that need to be addressed.

Planning Your Return to Taiwan
Since you are currently working abroad and plan to return to Taiwan in January, it would be wise to consider scheduling a medical evaluation upon your return. If your symptoms are significantly impacting your quality of life, you may want to discuss the possibility of taking a medical leave to address your health concerns sooner.

Conclusion
In summary, while palpitations can be benign, the changes you are experiencing warrant further evaluation. It is essential to consult with a healthcare provider who can perform a comprehensive assessment, including a physical examination, a detailed history of your symptoms, and possibly further testing such as an electrocardiogram (ECG) or echocardiogram. Your health is paramount, and addressing these symptoms proactively can help ensure that any underlying conditions are managed effectively.
If you feel that your symptoms are severe or worsening, do not hesitate to seek immediate medical attention, even while abroad. Your well-being should always come first, and it is better to err on the side of caution when it comes to heart health.

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