Palpitations: When to Seek Help for Heart Concerns - Cardiology

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Dear Dr.
He,
In the past month, I have experienced noticeable premature beats, characterized by a distinct sensation of my chest vibrating.
This occurred about twice: once during sleep and another time while sitting and resting.
After these episodes, I did not experience significant discomfort.
Additionally, I occasionally feel a sensation similar to a "drop" in my chest, which has been happening more frequently, approximately 3 to 4 times a day.
I would like to ask Dr.
He:
Q1.
Is this sensation of "drop" in my chest a milder form of premature beats, or could it be related to another type of cardiac issue?
Q2.
If it is indeed a form of premature beats, even though the sensation of "drop" is less intense and occurs only 3 to 4 times a day, I am unaware of how many silent premature beats I may be experiencing.
Do you think it is necessary for me to seek medical evaluation to determine the frequency of both symptomatic and asymptomatic premature beats in a day? Is there a need for such an assessment?
Q3.
Although I have not experienced significant discomfort following these "drop" sensations, I find myself anxious about when they might occur again.
What advice or recommendations do you have for managing this situation?
Thank you, Dr.
He.

Axiang, 40~49 year old female. Ask Date: 2022/04/03

Dr. He Dongjin reply Cardiology


Hello, premature beats are not that serious and are not very important.
Currently, you are experiencing autonomic nervous system dysregulation due to this issue.
It is not related to other types of heart problems; the palpitations are caused by autonomic nervous system dysregulation.
There is no need for further extensive examinations.
Engaging in regular exercise, maintaining a normal routine, or consulting a psychiatrist for medication may be beneficial.
Take care from Changhua Hospital.

Reply Date: 2022/04/03

More Info


When experiencing palpitations, especially if they are accompanied by feelings of anxiety or discomfort, it is essential to understand the underlying causes and when to seek medical help. Based on your description, it seems you are experiencing episodes of palpitations, specifically premature beats, which can feel like a sudden jolt or fluttering sensation in the chest. Let's address your questions one by one.

Q1: Is the "falling sensation" in my chest a type of palpitation or something else?
The sensation you describe as a "falling feeling" can indeed be related to palpitations, particularly if it occurs alongside the awareness of your heart beating irregularly. This sensation is often associated with anxiety and can be exacerbated by stress or fatigue. It is not uncommon for individuals to experience a heightened awareness of their heartbeat during periods of anxiety, which can lead to feelings of panic or discomfort. However, it is crucial to differentiate between benign palpitations and those that may indicate a more serious underlying condition. If these sensations are frequent or accompanied by other symptoms such as chest pain, shortness of breath, or dizziness, it is advisable to seek medical evaluation.

Q2: Should I seek medical attention for my palpitations?
Given that you have experienced noticeable palpitations multiple times in a month, it would be prudent to consult a healthcare professional. While occasional palpitations are common and often benign, persistent or frequent episodes warrant further investigation. A healthcare provider may recommend an electrocardiogram (ECG) or a Holter monitor to assess your heart's rhythm over a more extended period. This can help determine the frequency of both symptomatic and asymptomatic premature beats, providing a clearer picture of your heart health. Understanding the nature of your palpitations can help alleviate anxiety and guide appropriate management.

Q3: How can I manage my anxiety regarding these palpitations?
Feeling anxious about the possibility of palpitations recurring is a common response. Here are some strategies to help manage your anxiety:
1. Education: Understanding that palpitations are often benign can help reduce fear. Many people experience them without any underlying heart disease.

2. Relaxation Techniques: Incorporate relaxation methods such as deep breathing exercises, meditation, or yoga into your daily routine. These practices can help reduce overall anxiety and improve your response to stress.

3. Lifestyle Modifications: Pay attention to factors that may trigger your palpitations, such as caffeine, alcohol, or high-stress situations. Reducing these triggers can help minimize episodes.

4. Regular Exercise: Engaging in regular physical activity can improve cardiovascular health and reduce anxiety levels. However, consult with your healthcare provider before starting any new exercise regimen, especially if you have concerns about your heart.

5. Seek Support: Talking to a friend, family member, or mental health professional about your experiences can provide emotional support and help you process your feelings.

In conclusion, while occasional palpitations are common and often harmless, your symptoms warrant a discussion with a healthcare provider to rule out any underlying issues. By addressing both the physical and emotional aspects of your experience, you can take proactive steps toward managing your health and reducing anxiety. Remember, it is always better to err on the side of caution when it comes to heart health.

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