Heart Palpitations: Causes and When to Seek Help

A sudden thump in the chest?

Dear Dr.
He,
Hello.
In the past two weeks, I have experienced a noticeable sensation of a "thump" in my chest, occurring approximately four times.
This happens while I am in a stationary position (standing, sitting, or lying down) and not during physical activity.
I would like to ask Dr.
He the following questions:
1.
Based on the description above, considering my recent noticeable "thump" in the chest, in your opinion, is it more likely to be a cardiac premature contraction or a muscle spasm in the chest? Which possibility is greater?
2.
Recently, I have occasionally experienced bloating and pain in my stomach, along with oral inflammation (mouth sores).
Could these gastrointestinal issues and oral inflammation trigger the occurrence of cardiac premature contractions?
3.
Does aging also play a role as a potential factor in triggering cardiac premature contractions?
4.
After experiencing the noticeable "thump" in my chest, I feel a slight sensation of "palpitations and chest tightness," but there is no significant discomfort.
In this situation, should I seek immediate medical evaluation or continue to monitor my condition? Which approach would be better?
Thank you, Dr.
He.

A-Xiang, 30~39 year old female. Ask Date: 2021/09/11

Dr. He Dongjin reply Cardiology

Hello, it sounds like there is a higher likelihood of premature ventricular contractions (PVCs).
Any discomfort, including stomach pain or mouth ulcers, could potentially trigger the occurrence of PVCs.
As age increases, the likelihood of experiencing PVCs may also rise.
If you feel a sudden pause in your chest without any significant discomfort, it is advisable to monitor the situation.
Changhua Hospital cares about your well-being.

Reply Date: 2021/09/11

More Info

Understanding heart palpitations can be quite concerning, especially when they manifest as a noticeable "thump" or "pause" in the chest. Based on your description, it seems you are experiencing these sensations intermittently, which can be attributed to various factors. Let's address your questions one by one.

1. Heart Palpitations vs. Muscle Spasms: The sensation you describe as a "thump" in your chest could indeed be related to premature heartbeats, commonly known as premature ventricular contractions (PVCs) or premature atrial contractions (PACs). These are generally benign and can occur in healthy individuals. On the other hand, muscle spasms in the chest wall can also create similar sensations. Given that you are experiencing this while at rest, it leans more towards heart palpitations rather than muscle spasms, but a definitive diagnosis would require further evaluation, such as an electrocardiogram (ECG).

2. Gastrointestinal Issues and Heart Palpitations: Your recent gastrointestinal symptoms, such as bloating and stomach pain, along with oral inflammation, can indeed contribute to heart palpitations. Conditions like gastroesophageal reflux disease (GERD) can irritate the vagus nerve, which is closely associated with heart rate regulation. This irritation can lead to sensations of palpitations. Additionally, discomfort from gastrointestinal issues can cause anxiety, which may further exacerbate the perception of palpitations.

3. Age as a Factor: As we age, the heart's electrical system can undergo changes, making older adults more susceptible to arrhythmias, including palpitations. Factors such as increased blood pressure, changes in heart structure, and the presence of other health conditions can contribute to this. Therefore, age can indeed be a contributing factor to the occurrence of heart palpitations.

4. When to Seek Medical Attention: Given that you experience a sensation of "heart fluttering" followed by mild feelings of anxiety and chest tightness, it is essential to monitor these symptoms closely. If these episodes become more frequent, are accompanied by significant chest pain, shortness of breath, dizziness, or fainting, you should seek medical attention immediately. However, if the sensations remain infrequent and do not escalate in severity, you may consider a period of observation while maintaining a healthy lifestyle, including stress management, regular exercise, and a balanced diet.

In conclusion, while occasional heart palpitations can be benign, it is crucial to remain vigilant, especially with accompanying symptoms. If you have concerns or if the symptoms persist, I recommend consulting a healthcare provider for a thorough evaluation, which may include an ECG, blood tests, and possibly a Holter monitor to assess your heart's rhythm over a more extended period. This will help rule out any underlying conditions and provide peace of mind. Remember, maintaining a healthy lifestyle and managing stress can significantly impact heart health and overall well-being.

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