Seeking Answers: Unexplained Rapid Heartbeat and Endless Doctor Visits

Please help me?

Hello, doctor.
Since December, I have occasionally experienced sudden heart palpitations, with my pulse rate ranging from 110 to 120 beats per minute.
This occurs about 2 to 3 times a day, lasting anywhere from 5 minutes to 2 hours.
When I am not experiencing these episodes, my heart rate is normal, around 80 to 90 beats per minute.
During this time, I have undergone numerous tests, and both pulmonology and cardiology specialists have been unable to identify any issues.
I have also noticed that well-known hospitals keep referring me back and forth (Taipei Medical University, National Taiwan University, and Mackay Memorial Hospital).
When I visit the pulmonology department, they refer me to cardiology, and when I go to cardiology, they send me back to pulmonology.
Eventually, I was advised to see a neurologist.
However, my symptoms have not improved, and I find myself constantly going to the hospital.
I have had four chest X-rays, numerous electrocardiograms, three 24-hour Holter monitors, one echocardiogram, and two abdominal ultrasounds (I have hepatitis B).
I have lost count of how many blood tests I have undergone, including tests for thyroid function, lipid levels, blood sugar, liver function, and kidney function.
Aside from slightly elevated blood pressure, everything else is normal.

Doctor, which other specialties can I consult? What additional tests have I not yet undergone? My initial symptom was rapid heart rate, and I still experience it.
I have been undergoing treatment for six months now, and my health insurance card has seen better days.
Every visit to the hospital has been for testing.
Besides testing, what other treatments can I pursue? Please help me and answer my questions.
It's not that I don't want to seek medical attention; it's just that after so many visits without resolution, I am reaching out for your advice.

P.S.
My height is 188 cm, and my weight is 110 kg.

jiàn tèlán, 20~29 year old female. Ask Date: 2003/06/02

Dr. Zhong Yuxun reply Cardiology

Dear Sir,
You have undergone numerous tests, all of which are normal, indicating that your condition is indeed normal.
It is not a matter of finding an issue, but rather how to explain your symptoms.
The accompanying information indicates that you have elevated blood pressure and are overweight (110 kg), both of which can lead to increased cardiac workload and result in a rapid heartbeat.
Additionally, a common clinical cause of sudden tachycardia is autonomic nervous system dysregulation, often seen in situations of anxiety, excessive stress, or insomnia.

I recommend starting with self-health management, focusing on weight control, increasing physical activity, maintaining a balanced diet, and ensuring adequate sleep.
Wishing you good health,
Dr.
Chung Yu-Hsuan
Director of Cardiology
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2003/06/02

More Info

It sounds like you have been through a challenging journey with your health, particularly regarding your unexplained rapid heartbeat and the numerous medical evaluations you've undergone. Your experience of having a heart rate that spikes to 110-120 beats per minute intermittently, while otherwise maintaining a normal resting heart rate, can be frustrating, especially when multiple specialists have not provided clear answers.

First, let's consider the potential causes of your symptoms. Rapid heartbeats, or tachycardia, can arise from various factors, including anxiety, stress, hormonal imbalances (such as thyroid issues), electrolyte imbalances, or even certain medications. Given that you have undergone extensive testing, including multiple echocardiograms, Holter monitors, and blood tests, it is essential to focus on the results of those tests and the symptoms you experience.

Since your heart rate is normal when not experiencing episodes, it may suggest that your condition could be related to situational triggers, such as stress or anxiety. Panic attacks can manifest as sudden episodes of rapid heartbeat, shortness of breath, and feelings of impending doom. If you have experienced significant stress or anxiety, it might be worthwhile to explore this aspect further with a mental health professional. Cognitive-behavioral therapy (CBT) and relaxation techniques can be beneficial in managing anxiety-related symptoms.

Another possibility is that your symptoms could be related to a condition known as paroxysmal supraventricular tachycardia (PSVT), which is characterized by episodes of rapid heart rate that can start and stop suddenly. If this has not been evaluated, you might want to discuss this with your cardiologist, as specific maneuvers or medications can help manage PSVT.

Additionally, since you mentioned that you have undergone numerous tests, it might be worth considering whether you have had a thorough evaluation of your autonomic nervous system, which regulates heart rate and blood pressure. Conditions like dysautonomia can lead to symptoms similar to what you are experiencing.

In terms of further evaluations, you might consider asking for the following:
1. Thyroid Function Tests: To rule out hyperthyroidism, which can cause increased heart rate.

2. Electrolyte Panel: To check for imbalances that could affect heart rhythm.

3. Holter Monitor: If you haven't already, a longer-term Holter monitor (more than 24 hours) could capture your symptoms more effectively.

4. Tilt Table Test: This can help assess how your body responds to changes in position and may reveal issues with blood flow regulation.

If all tests continue to return normal and your symptoms persist, it may be beneficial to seek a second opinion from a different cardiologist or a specialist in electrophysiology, who focuses on heart rhythm disorders.
In the meantime, lifestyle modifications can also play a significant role in managing your symptoms. Regular exercise, a balanced diet, adequate hydration, and stress management techniques such as yoga or meditation can help improve your overall well-being and potentially reduce the frequency of your episodes.

Lastly, it’s essential to maintain open communication with your healthcare providers. Keep a detailed diary of your symptoms, including when they occur, their duration, and any potential triggers. This information can be invaluable for your doctors in diagnosing and managing your condition.

In conclusion, while it can be disheartening to feel like you are going in circles with your healthcare, persistence is key. Continue advocating for yourself, and don’t hesitate to seek out specialists who may offer fresh perspectives on your symptoms. Your health is paramount, and finding the right support is crucial in navigating this journey.

Similar Q&A

Understanding Unexplained Palpitations: Causes and Solutions

Hello doctor, about a month ago, one night I suddenly felt my heart racing and couldn't sleep (I had been smoking and it was almost 4 AM). I went to the emergency room where the doctor gave me a sedative so I could go home and sleep. The next day I felt fine and went about m...

Dr. He Dongjin reply Cardiology
Hello, please stop scaring yourself. You are experiencing anxiety, not a heart disease. You have undergone all necessary heart examinations, and everything is fine. The symptoms you are experiencing are due to panic attacks. You should visit a mental health specialist and conside...

Understanding Unexplained Rapid Heartbeat: Causes and Solutions

Last September, I had a simple health check-up, during which my pulse was only 84 beats per minute, and there was only one abnormal result: my cholesterol level was high at 228. However, over the past five months, my heart rate has been inexplicably increasing. I have a smoking h...

Dr. He Dongjin reply Cardiology
Hello, there is no danger to your life, so please don't be anxious. Your current concern about the heart rhythm issue is causing your heart rate to increase. Please continue to take your medication as prescribed and try not to measure your heart rate constantly, as this will...

Understanding Unexplained Tachycardia: When to Seek Medical Attention

Hello Doctor: About three years ago, I started experiencing unexplained episodes of tachycardia that occur irregularly. These episodes happen while I am awake; the first one occurred during exercise, but most of the time they occur while walking (without shortness of breath). My ...

Dr. Wu Xueming reply Cardiology
There are many causes of rapid heartbeat, such as emotions, stress, medications, and more. If this occurs frequently, it is recommended to undergo a thorough examination at a major hospital.

Understanding Rapid Heartbeat: When to Seek Further Medical Evaluation

A few months after being diagnosed last September, I discovered that I had a rapid heartbeat, and I also experienced severe insomnia after the diagnosis, which I had never encountered before. I underwent echocardiography and CT scans of the heart and lungs, but the cardiologist t...

Dr. Wu Xueming reply Cardiology
Many factors in daily life can contribute to this condition, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages. It is advisable to adjust your lifestyle and engage in regular exercise. However, if symptoms persist, it is recommended ...