Heart Palpitations: When to Seek Further Testing

Q: Heart Palpitations: When to Seek Further Testing

Hello： If you are concerned about heart problems, you should first consult a cardiologist. <br>If it is confirmed that there are no heart issues, then you can return to the psychiatrist for follow-up. <br>Additionally, consider the possibility of hyperthyroidism.

Cardiac issues?

Hello, doctor.
In March, I experienced daily palpitations and went to the emergency room at two different hospitals.
I underwent blood tests, a CT scan, and an electrocardiogram, all of which showed no abnormalities.
Later, I was referred to a psychiatrist who diagnosed me with panic disorder.
After taking medication for two months, the doctor advised me to assess my condition and consider stopping the medication, as I felt I was recovering well.
Now, it has been almost two months since I stopped taking the medication, but recently I have been feeling that my heart rate is a bit fast (around 95 bpm) and sometimes I feel slightly short of breath.
Do I need to undergo another electrocardiogram?

Mi Ya, 30~39 year old female. Ask Date: 2016/08/04

Dr. Li Zhiyao reply Internal Medicine

Hello: If you are concerned about heart problems, you should first consult a cardiologist.
If it is confirmed that there are no heart issues, then you can return to the psychiatrist for follow-up.
Additionally, consider the possibility of hyperthyroidism.

Reply Date: 2016/08/04

More Info

Heart palpitations can be a concerning symptom, and your experience of feeling your heart racing, especially after a previous episode of daily palpitations, warrants careful consideration. While it is reassuring that your previous tests, including blood work, CT scans, and ECGs, did not reveal any abnormalities, it is important to understand that palpitations can arise from a variety of causes, both cardiac and non-cardiac.

Given your history, it is possible that your palpitations are related to anxiety or panic attacks, especially since you were referred to a psychiatrist and prescribed medication for panic disorder. Anxiety can lead to physical symptoms such as increased heart rate, shortness of breath, and a feeling of tightness in the chest. However, it is also crucial to rule out any underlying cardiac issues, particularly since you are experiencing a recurrence of symptoms after stopping your medication.

The heart rate you mentioned, around 95 beats per minute, is within the normal range for adults at rest, but if you are feeling that it is unusually fast for you, it could be worth investigating further. Shortness of breath, especially when combined with palpitations, can sometimes indicate a more serious condition, such as arrhythmias or heart disease, even if previous tests were normal.

In your case, it would be prudent to consider a few options:
1. Repeat ECG: Since you are experiencing new symptoms, a repeat ECG can help assess your heart's rhythm and rule out any arrhythmias that may not have been present during your previous evaluations.

2. Holter Monitor: This is a portable device that you wear for 24-48 hours to continuously monitor your heart's rhythm. It can capture any irregularities that might occur intermittently, which a standard ECG might miss.

3. Echocardiogram: An ultrasound of the heart can provide information about the heart's structure and function, helping to identify any potential issues that could be contributing to your symptoms.

4. Stress Testing: If there is concern about your heart's response to exertion, a stress test can evaluate how your heart performs under physical stress.

5. Consultation with a Cardiologist: Given your symptoms and history, it may be beneficial to see a cardiologist for a comprehensive evaluation. They can help determine whether further testing is necessary based on your current symptoms and medical history.

In summary, while your previous tests were normal, the recurrence of palpitations and associated symptoms like shortness of breath should not be ignored. It is advisable to follow up with your healthcare provider to discuss your symptoms and consider further testing to ensure your heart health is thoroughly evaluated. Remember, it is always better to err on the side of caution when it comes to your heart.

Similar Q&A

Understanding Palpitations: When to Seek Further Cardiac Evaluation

Hello Doctor, Since receiving my two vaccine doses six months ago, I have been experiencing intermittent palpitations and chest tightness. During this time, I visited a cardiologist and underwent a stress electrocardiogram, a 24-hour Holter monitor, and blood tests. The only fi...

Dr. He Dongjin reply Cardiology
Hello, it sounds like you might be experiencing symptoms of autonomic nervous system dysfunction, such as persistent anxiety related to stable angina pectoris at 50%. It would be advisable to undergo a self-funded cardiac CT scan to gain a clearer understanding. Changhua Hospital...

Understanding Increased Palpitations: When to Seek Medical Attention

Hello Doctor, three months ago I sought medical attention due to palpitations (feeling of strong heartbeats). I underwent a 24-hour Holter monitor test, and the doctor mentioned that I had over 1000 episodes in a day, but they were benign. Later, an echocardiogram revealed mild m...

Dr. Wu Xueming reply Cardiology
Many factors in daily life can contribute to this situation, such as emotions, stress, irregular sleep patterns, or excessive consumption of caffeinated beverages. It is advisable to adjust your lifestyle and engage in regular exercise. However, if symptoms persist, it is recomme...

Understanding Palpitations: When to Seek Further Heart Evaluations

Hello, doctor. When I was 14 and 15 years old, I suffered from anxiety and depression. Since then, whenever I consume coffee, chocolate, or feel emotionally distressed, I experience rapid heartbeat, a slight pressure in my chest, and headaches. I have previously undergone a 24-ho...

Dr. Li Han reply Cardiology
Hello, based on your description, you occasionally experience sensations of "rapid heartbeat," "a slight pressure in the chest," and "headaches," but these typically occur "when drinking coffee, consuming chocolate, or during times of emotional ...

Understanding Palpitations: When to Seek Further Heart Evaluation

Hello, I have been experiencing issues with palpitations, but I was previously diagnosed with anxiety disorder. Do I need to undergo further examinations?

Dr. He Dongjin reply Cardiology
Hello, anxiety disorders can lead to autonomic nervous system dysregulation, resulting in palpitations. You may start by taking the anxiety medication you were prescribed earlier. If there is no improvement, you can visit a cardiology clinic for further evaluation. Changhua Hospi...