Occasional Heart Palpitations: Causes and Concerns

Occasional heart palpitations?

Hello Doctor: I have mitral valve prolapse with regurgitation symptoms, and sometimes I experience slight palpitations.
My resting heart rate is generally a bit elevated (around the 90s).
I regularly engage in weight training and aerobic exercise; during weight training, I occasionally feel a strong heartbeat, but it is not uncomfortable.
The reason I am consulting you today is that while I was doing household chores in the evening, my heart suddenly started racing, with a heart rate of approximately 130-140 (I measured it immediately with my watch), lasting about 20-30 seconds.
During this time, I did not experience any dizziness, chest tightness, or chest pain.
I also attempted to measure my heart's electrical activity with the watch's ECG feature, but the data was quite erratic.
I wonder what might have caused this and if it could be related to my frequent anger throughout the day.
This situation has occurred several times in the past, with intervals ranging from a few months to several years.
I previously underwent an echocardiogram and a stress ECG, and the doctor indicated that there were no significant issues.
If there are no problems, why would my heart race like this? Should I undergo any further in-depth examinations? Thank you, Doctor, for taking the time to read my concerns, and I appreciate your guidance.
Thank you!

Yang Tingfang, 30~39 year old female. Ask Date: 2020/08/19

Dr. He Dongjin reply Cardiology

Hello, it sounds like your paroxysmal arrhythmia may be related to being angry throughout the day.
It is advisable to schedule a 24-hour Holter monitor test at a cardiology clinic for further evaluation.
Changhua Hospital cares about your well-being.

Reply Date: 2020/08/19

More Info

Understanding occasional heart palpitations can be a source of concern for many individuals, especially when they experience symptoms like rapid heart rates or irregular rhythms. In your case, with a history of mitral valve prolapse and regurgitation, it is understandable that you are attentive to any changes in your heart rhythm.
Palpitations are often described as the sensation of feeling your heart beating, fluttering, or pounding. They can occur in various situations and can be triggered by numerous factors. In your case, you mentioned experiencing palpitations during physical activities like weight training and also while doing household chores. This could be related to the increased physical exertion, which naturally raises your heart rate.
The heart rate you recorded (130-140 beats per minute) during your episode of palpitations is considered tachycardia, which can be a normal response to stress, anxiety, or physical activity. However, if these episodes occur frequently or are accompanied by concerning symptoms such as dizziness, chest pain, or shortness of breath, further evaluation may be warranted.

Several factors can contribute to palpitations, including:
1. Emotional Stress: As you mentioned, experiencing anger or stress throughout the day can lead to increased adrenaline levels, which can cause your heart to beat faster or irregularly.

2. Physical Activity: Engaging in vigorous exercise can lead to temporary increases in heart rate and may trigger palpitations, especially in individuals with underlying heart conditions.

3. Caffeine and Stimulants: Consumption of caffeine or other stimulants can also lead to palpitations. It is advisable to monitor your intake of caffeinated beverages and see if reducing them helps alleviate your symptoms.

4. Electrolyte Imbalances: Low levels of potassium, magnesium, or calcium can affect heart rhythm. Ensuring a balanced diet can help maintain proper electrolyte levels.

5. Hormonal Changes: Fluctuations in hormones, particularly during menstrual cycles or menopause, can also lead to palpitations.

Given your history of mitral valve prolapse, it is essential to keep monitoring your symptoms. While your previous echocardiograms and exercise stress tests indicated no significant issues, it is crucial to maintain open communication with your healthcare provider. If you experience palpitations that are new, more frequent, or associated with other symptoms, it may be beneficial to undergo further evaluation, such as a Holter monitor or an event monitor, which can provide a more comprehensive assessment of your heart rhythm over time.

In summary, while occasional palpitations can be benign, especially in the context of your known heart condition, it is essential to remain vigilant. Lifestyle modifications, such as managing stress, reducing caffeine intake, and maintaining a healthy diet, can be beneficial. If your symptoms persist or worsen, do not hesitate to seek further medical advice. Your health and peace of mind are paramount, and your healthcare provider can help guide you through any necessary evaluations or treatments.

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