Arrhythmia: When to Seek Medical Attention for Heart Issues

Arrhythmia?

Earlier this year, I had an echocardiogram, and the doctor mentioned that I have mild mitral valve prolapse.
I regularly play basketball and have a high level of physical activity (though I don't wear a fitness tracker during exercise, so I'm unsure of my heart rate while exercising).
When I'm not exercising, my pulse is around 55-62 bpm, and my blood pressure is 60/90 mmHg.
My resting heart rate is also about 55-62 bpm.
Since the end of last year, my pulse has been somewhat unstable, fluctuating between high and low; sometimes it suddenly spikes to over 100 bpm (while sitting or sleeping), and at other times it drops to the thirties or forties (while awake).
This occurs about two to three times a day on average, and I currently don't feel particularly unwell.
I would like to know if this situation requires medical attention.
Thank you!

Niming, 20~29 year old female. Ask Date: 2020/03/04

Dr. He Dongjin reply Cardiology

Hello, if you have no discomfort, you may observe for now.
If you are still concerned, it would be advisable to visit a cardiology clinic for further examination.
Changhua Hospital cares about you.

Reply Date: 2020/03/04

More Info

When it comes to understanding arrhythmias and knowing when to seek medical attention for heart issues, it's crucial to recognize the signs and symptoms that may indicate a more serious underlying condition. Based on your description, you have experienced fluctuations in your heart rate, with episodes of bradycardia (low heart rate) and tachycardia (high heart rate). Additionally, you mentioned having a mild mitral valve prolapse diagnosed during an echocardiogram earlier this year.

Mitral valve prolapse (MVP) is a common condition where the valve between the heart's left atrium and left ventricle doesn't close properly. While many individuals with MVP experience no symptoms or complications, some may develop arrhythmias, particularly if there is associated mitral regurgitation or if the prolapse is more severe. Your regular physical activity is beneficial for cardiovascular health, but the irregularities in your heart rate warrant further attention.

When to Seek Medical Attention
1. Symptoms of Arrhythmia: If you experience palpitations (a feeling of your heart racing or fluttering), dizziness, lightheadedness, fainting, or chest pain, these could be signs of a significant arrhythmia. Although you mentioned not feeling particularly unwell, the episodes of your heart rate dropping to the 30s or rising above 100 while at rest are concerning.

2. Persistent Bradycardia: A resting heart rate of 55-62 beats per minute can be normal for well-conditioned athletes; however, if you are experiencing episodes of bradycardia (heart rate below 60 beats per minute) that are symptomatic, such as causing dizziness or fainting, this should be evaluated by a healthcare provider.

3. Tachycardia Episodes: Sudden increases in heart rate, especially if they occur while at rest, can indicate an underlying issue that may require further investigation. If you find your heart racing unexpectedly, it’s essential to consult a physician.

4. Associated Symptoms: If you experience any new symptoms such as shortness of breath, excessive fatigue, or swelling in your legs, these could indicate heart failure or other cardiovascular issues, necessitating immediate medical evaluation.

Recommendations
- Monitoring: Keep a log of your heart rate fluctuations, noting the circumstances surrounding each episode (e.g., activity level, stress, hydration status). This information can be invaluable for your healthcare provider.

- Lifestyle Adjustments: Continue with regular exercise, as it can help improve cardiovascular health. However, ensure you stay hydrated and manage stress, as both can influence heart rate.

- Follow-Up: Given your history of MVP and the current symptoms, it would be prudent to schedule a follow-up appointment with a cardiologist. They may recommend further testing, such as a Holter monitor to assess your heart rhythm over 24 hours or an event monitor for longer-term monitoring.

- Education: Learn about the signs of serious arrhythmias and when to seek emergency care. If you ever feel faint, have severe chest pain, or experience prolonged palpitations, do not hesitate to seek immediate medical attention.

In conclusion, while your current symptoms may not seem alarming, the irregularities in your heart rate and the presence of mitral valve prolapse warrant a thorough evaluation. Regular check-ups and open communication with your healthcare provider are essential in managing your heart health effectively.

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