the Sudden Increase in Heart Palpitations: Causes and Concerns

Recently, there has been a significant increase in early onset of severe symptoms..?

Hello, Doctor.
I asked you a question in 2019.
Later, I consulted a cardiologist and underwent an echocardiogram and a 24-hour Holter monitor.
The echocardiogram showed no abnormalities and the structure was normal.
The Holter monitor recorded only five instances of premature beats.
After taking 5 mg of Concor and 10 mg of Cardiol, I gradually improved, even forgetting about the premature beats.
However, after catching a cold on February 18 of this year and taking cold medication, the episodes started to occur again, increasing day by day.
The highest frequency was on March 8, with at least 800 instances of palpitations in one day (taking Cardiol didn’t help much).
I experienced about 40 to 50 instances per hour, with fluctuations, mostly occurring in the evenings.
This time, the episodes also included a sensation of a pause followed by two beats and then another pause, which is quite alarming and bothersome.
I would like to ask why the episodes suddenly became more severe, especially since they mostly occur in the evenings? Can I take 10 mg of Cardiol if I feel uncomfortable? Does sexual activity also trigger severe premature beats?

kevin, 30~39 year old female. Ask Date: 2023/03/11

Dr. He Dongjin reply Cardiology

Hello, if you have a cold, taking cold medicine and engaging in sexual activity may increase the occurrence of premature beats.
This can make you feel uncomfortable but is not life-threatening.
You can take Heart Comfort 10 mg if you feel uncomfortable, and it's okay to take more when symptoms arise.
OK, Changhua Hospital cares about you.

Reply Date: 2023/03/11

More Info

Understanding the sudden increase in heart palpitations can be quite concerning, especially when it affects your daily life and well-being. Based on your description, it seems that you have a history of experiencing palpitations, which have recently intensified following a bout of illness and medication use. Let’s break down the potential causes and concerns regarding your symptoms.

Causes of Sudden Increase in Heart Palpitations
1. Underlying Heart Conditions: Although your previous tests, including echocardiograms and 24-hour Holter monitoring, showed no significant abnormalities, it’s essential to consider that heart conditions can sometimes be intermittent or may not present during testing. Early beats (premature atrial contractions or premature ventricular contractions) can occur in healthy individuals and may be exacerbated by stress or illness.

2. Medications: Certain medications, including over-the-counter cold medications, can contain stimulants that may increase heart rate and lead to palpitations. If you have started taking new medications or increased the dosage of existing ones, this could be a contributing factor.

3. Stress and Anxiety: Emotional stress and anxiety are well-known triggers for palpitations. The fact that your episodes occur more frequently in the evening may suggest a connection to daily stressors or relaxation after a busy day, which can lead to heightened awareness of bodily sensations.

4. Autonomic Nervous System Imbalance: The autonomic nervous system regulates heart rate and can be influenced by various factors, including stress, caffeine intake, and sleep patterns. An imbalance can lead to increased heart rate and palpitations.

5. Lifestyle Factors: Factors such as caffeine consumption, alcohol intake, lack of sleep, and dehydration can also contribute to palpitations. It’s important to evaluate your lifestyle and identify any changes that may correlate with the onset of your symptoms.

Concerns Regarding Your Symptoms
1. Frequency and Severity: The increase in the frequency of your palpitations, especially if they are accompanied by a sensation of "skipped beats" or "pounding," warrants further investigation. While occasional palpitations are common and often benign, a significant increase in frequency or severity should be evaluated by a healthcare professional.

2. Impact on Daily Life: If your palpitations are causing significant anxiety or impacting your quality of life, it’s crucial to address these concerns with your healthcare provider. They may consider additional testing or a referral to a specialist, such as a cardiologist or an electrophysiologist.

3. Medication Use: Regarding the use of your current medications (康心壓 and 心康樂), it’s essential to follow your physician's guidance. If you feel unwell or experience increased palpitations, consult your doctor before adjusting your medication regimen. Self-medicating can lead to unintended consequences.

4. Physical Activity: Engaging in sexual activity or other forms of physical exertion can indeed trigger palpitations in some individuals, particularly if there is underlying anxiety or if the body is under stress. It’s advisable to monitor how your body responds during these activities and discuss any concerns with your healthcare provider.

Recommendations
- Keep a Symptom Diary: Documenting when your palpitations occur, their duration, and any associated symptoms can help your healthcare provider identify patterns and potential triggers.

- Lifestyle Modifications: Consider reducing caffeine and alcohol intake, ensuring adequate hydration, and managing stress through relaxation techniques such as yoga or meditation.

- Follow-Up: If your symptoms persist or worsen, schedule a follow-up appointment with your healthcare provider to discuss your concerns and explore further diagnostic options.

In conclusion, while palpitations can be alarming, understanding their potential causes and addressing lifestyle factors can often lead to improvement. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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