Heart Palpitations: Tests and Treatment Options - Internal Medicine

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Heart palpitations can be a concerning symptom, especially when accompanied by a rapid heart rate, as you've described with your heart rate reaching 136 beats per minute. It's good to hear that you've already undergone some initial evaluations, including an electrocardiogram (ECG) and a chest X-ray, which were reported as normal. The prescription of a heart rhythm medication (likely a beta-blocker or similar) is a common first step in managing palpitations, particularly if they are associated with anxiety or increased heart rate.

Regarding your question about whether the heart rhythm medication could affect the results of your tests, it is important to note that certain medications can indeed influence heart rate and rhythm. For example, beta-blockers can help to lower heart rate and reduce the frequency of palpitations, which might make it more challenging to assess the underlying cause of your symptoms if you are on these medications at the time of testing. However, they are often necessary to manage symptoms effectively.

Since you have also mentioned that you had your thyroid function tested, it’s crucial to understand that hyperthyroidism can lead to symptoms such as palpitations and increased heart rate. If your thyroid tests came back normal, that rules out one of the common causes of your symptoms.
If your palpitations persist despite medication and your thyroid function is normal, there are several additional tests and evaluations that your healthcare provider may consider:
1. Holter Monitor: This is a portable ECG device that you wear for 24-48 hours. It continuously records your heart's rhythm and can help identify any irregularities that occur during your daily activities.

2. Event Monitor: Similar to a Holter monitor, but used for a longer period (up to 30 days). You activate it when you feel palpitations, which helps correlate symptoms with heart rhythm changes.

3. Echocardiogram: This ultrasound of the heart can assess the structure and function of your heart, checking for any underlying issues that might contribute to your symptoms.

4. Stress Test: This can help evaluate how your heart performs under physical stress and may reveal issues not seen at rest.

5. Electrophysiological Study (EPS): If your symptoms are severe and other tests are inconclusive, an EPS may be performed. This invasive test can help identify the source of abnormal heart rhythms.

6. Blood Tests: Besides thyroid function tests, other blood tests may be warranted to check for electrolyte imbalances, anemia, or other metabolic issues that could contribute to palpitations.

7. Lifestyle Factors: It’s also essential to consider lifestyle factors such as caffeine intake, alcohol consumption, stress levels, and sleep quality, as these can significantly impact heart rhythm.

In summary, while your current medication may influence heart rate and rhythm, it is essential to continue working with your healthcare provider to monitor your symptoms and consider further testing if necessary. If your palpitations continue or worsen, or if you experience additional symptoms such as chest pain, shortness of breath, or dizziness, seek medical attention promptly. Your healthcare provider can help determine the most appropriate next steps based on your specific situation and symptoms.