Sudden Heart Palpitations and Chest Pain: What You Need to Know

The heartbeat suddenly skipped a beat?

Hello Doctor,
I had an echocardiogram, blood tests, and X-rays at the hospital last August, and currently, there are no major issues.
However, recently, after drinking water, my heart sometimes suddenly beats harder for a moment, and I often feel pain near my heart on the left side of my chest.
The pain feels like 2-3 different sensations, such as pressure, bruising, pulling, and sharpness.
The location varies but is mostly around the left side of my chest near the heart.
Sometimes, when the pain occurs, I feel inexplicably anxious and my heart rate accelerates suddenly.
When I visited the outpatient clinic, the doctor kept telling me that there are no issues with my heart itself and that these problems are due to external factors.
After hearing this, I could only respond with "thank you, I understand." However, when the symptoms occur, it is really uncomfortable, and I fear I might collapse.
My mood and physical state are in a constant state of alert.
The hospital prescribed me a medication for bradycardia, and I only take it when I feel very uncomfortable with a rapid heartbeat.

Doctor, given this situation, I am unsure if my heart is truly fine or if there is another underlying issue.
I kindly ask for your insight on this matter.
Thank you.

Zhang, 40~49 year old female. Ask Date: 2022/01/14

Dr. He Dongjin reply Cardiology

Hello, the attending physician stated during the on-site examination that there are no issues, so there should be no problems.
I haven't seen your diagnosis online, and it certainly cannot compare to that of the attending physician.
The symptoms are more consistent with discomfort caused by mitral valve prolapse.
It is advisable to discuss this further with your attending physician.
Take care from Changhua Hospital.

Reply Date: 2022/01/14

More Info

Understanding sudden heart palpitations and chest pain can be quite concerning, especially when accompanied by feelings of anxiety and discomfort. Based on your description, it seems that you have experienced a variety of symptoms, including sudden heart palpitations, chest pain, and feelings of anxiety, particularly after drinking water. While your previous medical evaluations, including echocardiograms, blood tests, and X-rays, indicated no significant heart issues, it is essential to consider several factors that could contribute to your current symptoms.

Possible Causes of Your Symptoms
1. Anxiety and Panic Attacks: Your symptoms of sudden heart palpitations and chest pain, especially when accompanied by feelings of fear or panic, may suggest anxiety or panic attacks. These episodes can cause physical symptoms that mimic heart problems, including rapid heartbeat, chest tightness, and discomfort. The body's fight-or-flight response can lead to increased heart rate and muscle tension, which may explain the sensations you are experiencing.

2. Gastroesophageal Reflux Disease (GERD): The timing of your symptoms after drinking water could indicate a gastrointestinal issue such as GERD. Acid reflux can cause chest pain and discomfort that may be mistaken for heart-related issues. The esophagus runs close to the heart, and irritation from stomach acid can lead to sensations of pressure or pain in the chest area.

3. Musculoskeletal Issues: Chest pain can also arise from musculoskeletal problems, such as muscle strain or costochondritis (inflammation of the cartilage connecting the ribs to the sternum). These conditions can cause localized pain that may feel sharp or aching and can be exacerbated by certain movements or positions.

4. Cardiac Considerations: Although your previous tests showed no significant heart issues, it is still essential to remain vigilant. Conditions like arrhythmias (irregular heartbeats) can sometimes present with palpitations and chest discomfort. If you experience these symptoms frequently or they worsen, further evaluation by a cardiologist may be warranted.

Recommendations for Management
1. Lifestyle Modifications: Consider making lifestyle changes that may help alleviate your symptoms. Regular physical activity, a balanced diet, and adequate hydration can improve overall cardiovascular health. Additionally, reducing caffeine and alcohol intake may help decrease palpitations.

2. Stress Management: Since anxiety appears to play a role in your symptoms, incorporating stress management techniques such as mindfulness, meditation, or yoga can be beneficial. These practices can help you manage anxiety and reduce the frequency and intensity of panic attacks.

3. Medication Adherence: You mentioned being prescribed medication for your heart rhythm. It is crucial to take this medication as directed, even if you do not feel symptoms at the moment. Consistent use can help stabilize your heart rate and reduce episodes of palpitations.

4. Follow-Up with Healthcare Providers: If your symptoms persist or worsen, it is essential to follow up with your healthcare provider. They may recommend additional tests, such as a Holter monitor (a portable device that records heart activity over 24 hours) to capture any irregularities in your heart rhythm during episodes of palpitations.

5. Emergency Situations: If you experience severe chest pain, shortness of breath, or other alarming symptoms, seek immediate medical attention. While your previous evaluations indicated no significant issues, it is always better to err on the side of caution.

Conclusion
In summary, while your previous evaluations suggest that your heart is functioning well, the symptoms you are experiencing could be related to anxiety, gastrointestinal issues, or musculoskeletal problems. It is essential to address these symptoms holistically, considering both physical and emotional health. Regular follow-ups with your healthcare provider will help ensure that any underlying issues are monitored and managed appropriately. Remember, you are not alone in this, and seeking help is a vital step toward feeling better.

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