Palpitations: Causes, Symptoms, and When to Seek Help - Cardiology

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Palpitations can be a concerning symptom, especially when accompanied by feelings of anxiety or other physical sensations. Based on your description, it seems that you have already taken significant steps to investigate the underlying causes of your palpitations, including visits to both cardiology and psychosomatic medicine specialists. Here’s a comprehensive overview of palpitations, their potential causes, and when you should seek further help.


Understanding Palpitations
Palpitations are the sensation of feeling your heart beating, which can feel like fluttering, pounding, or racing. They can occur in various situations, often triggered by stress, anxiety, caffeine, or even certain medications. In your case, the palpitations seem to be linked to anxiety, especially given the context of your symptoms and the improvement you’ve noticed with the medication prescribed by your psychiatrist.


Causes of Palpitations
1. Anxiety and Stress: Emotional stress and anxiety can lead to increased adrenaline levels, which can cause your heart to beat faster. This is often accompanied by other symptoms such as tightness in the throat, difficulty swallowing, and tingling in the extremities, which you have described.

2. Cardiac Issues: While your tests (ECG, echocardiogram) have returned normal, you mentioned a mild mitral valve prolapse. This condition is generally benign but can sometimes be associated with palpitations. It’s important to monitor this with your healthcare provider.

3. Autonomic Nervous System Dysfunction: The autonomic nervous system regulates involuntary bodily functions, including heart rate. Dysregulation can lead to symptoms like palpitations, especially during times of stress.

4. Lifestyle Factors: Caffeine, nicotine, alcohol, and certain medications can contribute to palpitations. It’s worth considering your intake of these substances.

5. Hormonal Changes: Fluctuations in hormones, such as during menstruation or menopause, can also lead to palpitations.


Symptoms to Monitor
You mentioned experiencing heart rates of 140-150 beats per minute during episodes of palpitations. While this can be alarming, it’s essential to consider the context. If these episodes are brief and resolve with rest and medication, they may not be immediately dangerous. However, you should be vigilant for any of the following concerning symptoms:
- Chest pain or discomfort
- Shortness of breath
- Dizziness or lightheadedness
- Fainting or near-fainting episodes
If you experience any of these symptoms, it is crucial to seek immediate medical attention.


When to Seek Further Help
Given that your heart tests have been normal, it may be beneficial to focus on managing anxiety and stress, which seem to be significant contributors to your symptoms. However, if you continue to experience episodes of rapid heart rate or if your symptoms worsen, further evaluation may be warranted. This could include:
- Holter Monitor: A portable device that records your heart’s activity over 24-48 hours to capture any irregularities that may not appear during a standard ECG.

- Stress Testing: This can help evaluate how your heart performs under physical stress.

- Electrophysiological Study: In some cases, this may be recommended to assess the electrical activity of your heart more closely.


Conclusion
It’s great to hear that you have found some relief with the medication prescribed by your psychiatrist. Continue to communicate openly with your healthcare providers about your symptoms and any changes you notice. Managing anxiety through therapy, lifestyle changes, and possibly medication can significantly improve your quality of life and help reduce the frequency and intensity of palpitations. Always prioritize your health and don’t hesitate to seek help if you feel your symptoms are becoming unmanageable.