Heart Palpitations and Fever: When to Seek Help

Fever, premature beats, and heart rate issues?

Hello, Doctor.
I have a bit of an arrhythmia issue and previously underwent a 24-hour Holter monitor test, which showed over 500 APCs.
The doctor said it was very mild and not a cause for concern.
However, today I feel slightly under the weather with mild fever, body aches, sore throat, cough, and abdominal pain.
Along with this, my heart rate has increased to about 90-100 beats per minute, and I frequently feel a skipped heartbeat, which makes me quite anxious.
I would like to ask you, since I had the 24-hour Holter monitor test two months ago, is it possible for the number of APCs to increase to several thousand in just two months? I also went to the emergency room because of the rapid heartbeat and discomfort.
The doctor performed an ECG and blood tests, which showed no issues.
A rapid test confirmed that I do not have COVID-19 or influenza, and I was sent home.
Is it possible that myocarditis was not detected? Could it develop into myocarditis in a few days? Currently, I still feel slightly warm but not feverish, and my heart rate remains in the 90s.
I am experiencing some muscle soreness and weakness, and I am really worried that myocarditis might not have been diagnosed.
Thank you, Doctor.
🙏

Xuan Xuan, 20~29 year old female. Ask Date: 2023/08/17

Dr. He Dongjin reply Cardiology

Hello, if someone is feeling unwell with fever, body aches, and sore throat, leading to an increased heart rate and frequency of arrhythmias, it is generally considered normal.
The likelihood of this developing into myocarditis is very low, akin to being struck by lightning.
Don't scare yourself; the symptoms do not resemble myocarditis at all.
Don't worry, Changhua Hospital cares about you.

Reply Date: 2023/08/17

More Info

When dealing with heart palpitations, especially in the context of a recent illness, it's essential to understand the interplay between various symptoms and underlying health conditions. Your concerns about experiencing palpitations alongside fever, body aches, and other symptoms are valid, particularly given your history of arrhythmia and recent health evaluations.

Firstly, it's important to recognize that palpitations can be influenced by several factors, including anxiety, fever, dehydration, and underlying heart conditions. In your case, the combination of a mild fever and other viral symptoms could be contributing to your increased heart rate and the sensation of skipped beats. Fever can elevate heart rate as the body works to fight off infection, and this can lead to feelings of palpitations or irregular heartbeats.

Regarding your previous 24-hour Holter monitor results showing a few hundred APCs (Atrial Premature Contractions), it's not uncommon for the frequency of these events to fluctuate over time. While your doctor indicated that the findings were mild and not a cause for concern, it's possible for the number of APCs to increase due to factors such as stress, illness, or changes in your physical condition. However, a significant increase in the frequency of these events would typically warrant further investigation.

Your recent visit to the emergency department, where tests showed no immediate issues, is reassuring. The fact that your ECG and blood tests returned normal results suggests that there is no acute cardiac event occurring at this moment. However, your ongoing symptoms, including a rapid heart rate and the sensation of skipped beats, can understandably cause anxiety, which can further exacerbate palpitations.

As for your concern about myocarditis (inflammation of the heart muscle), while it is a potential complication of viral infections, it is not something that can be definitively diagnosed without specific tests, such as an echocardiogram or MRI of the heart. If your symptoms persist or worsen, or if you develop new symptoms such as chest pain, severe shortness of breath, or fainting, it would be prudent to seek further evaluation from a cardiologist.

In the meantime, managing your anxiety and stress levels can be beneficial. Techniques such as deep breathing exercises, mindfulness, and gentle physical activity (as tolerated) can help alleviate some of the anxiety associated with palpitations. Staying hydrated and ensuring you get adequate rest is also crucial during your recovery from your current illness.

In summary, while your symptoms are concerning, the immediate tests you've undergone have not indicated a serious issue. However, if your symptoms persist or you have further concerns, do not hesitate to follow up with your healthcare provider for additional testing or a referral to a specialist. It's always better to err on the side of caution when it comes to heart health.

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