Palpitations: When to Worry About Your Heartbeat

Recently, I have been feeling my heartbeat?

Hello Doctor, thank you for taking the time to respond to my questions.
Recently, I've noticed that I often feel my heartbeat, although measurements taken with my Apple Watch show it to be normal, around 60-80 beats per minute.
I experienced a similar issue back in March of this year, and I had an ECG done at the hospital, which showed no abnormalities (though I have a right bundle branch block).
The doctor at that time suggested that I might be too anxious, but prescribed me Propranolol 10 mg, advising me to take one when I felt the symptoms.
I only took it once, and the symptoms disappeared.
Since the issue resolved a few days later, I didn't think much of it, but recently, the same situation has reoccurred.
I've taken the Propranolol a few times, and about ten minutes after taking it, the symptoms seem to subside.
After some time (ranging from a few hours to several hours), I feel the symptoms again.
Generally, my heart rate remains between 60-80 beats per minute during these episodes, but I still feel my heartbeat, especially when I’m relaxed; I tend not to notice it while working.
With three young children, I wonder if I might be overthinking things.
I kindly ask for your clarification on this matter.
Thank you once again.

Jerry, 30~39 year old female. Ask Date: 2020/08/23

Dr. Wu Xueming reply Cardiology

Many factors in daily life can contribute to this condition, such as emotions, stress, irregular sleep patterns, or excessive consumption of caffeinated beverages.
If this condition does not improve and becomes more frequent, it is advisable to visit a cardiology clinic for a 24-hour Holter monitor test.

Reply Date: 2020/08/23

More Info

It's understandable to feel concerned about your heart and the sensations you're experiencing. Palpitations, or the feeling of having a fast-beating, fluttering, or pounding heart, can be alarming, especially when they recur. Given your history of right-sided heart block and the previous episodes of palpitations, it's wise to pay attention to these symptoms.

Firstly, it's important to note that palpitations can be caused by a variety of factors. Stress and anxiety are common triggers, and they can lead to an increased awareness of your heartbeat, especially during moments of relaxation when your body is less distracted. The fact that your heart rate remains within the normal range of 60-80 beats per minute is reassuring, as this indicates that your heart is functioning properly in terms of rate.

You mentioned that you were prescribed Propranolol, a beta-blocker, which can help manage palpitations by reducing the heart's workload and calming the heart rate. It's not uncommon for individuals to experience palpitations intermittently, and sometimes they can be linked to lifestyle factors such as caffeine intake, lack of sleep, or even dehydration. Given that you have three children, it's possible that stress and fatigue could be contributing to your symptoms.

While your previous tests, including an electrocardiogram (ECG), showed no abnormalities, it's essential to continue monitoring your symptoms. If you find that the palpitations are becoming more frequent, or if you experience any additional symptoms such as chest pain, shortness of breath, dizziness, or fainting, you should seek medical attention promptly. These could be signs of a more serious condition that requires further evaluation.

In the meantime, consider implementing some lifestyle changes that may help reduce your symptoms. Regular exercise, a balanced diet, and adequate hydration can all contribute to heart health. Additionally, practicing stress-reduction techniques such as mindfulness, meditation, or yoga may help alleviate anxiety and reduce the occurrence of palpitations.

It's also beneficial to maintain a symptom diary. Note when the palpitations occur, their duration, and any associated activities or feelings. This information can be valuable for your healthcare provider in determining the underlying cause and appropriate treatment.

Lastly, if you continue to feel anxious about your heart health, don't hesitate to reach out to a healthcare professional for reassurance and guidance. They can provide you with the necessary support and may recommend further testing or adjustments to your treatment plan if needed.

In summary, while your symptoms may be related to anxiety and stress, it's crucial to remain vigilant and consult with your healthcare provider if your condition changes or worsens. Taking proactive steps towards managing your stress and maintaining a healthy lifestyle can significantly impact your overall well-being and heart health.

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