Heart Palpitations: Causes, Symptoms, and When to Seek Help

Cardiac issues

Hello Doctor: My heart often suddenly beats violently, with a heart rate exceeding 200 beats per minute.
It feels like my heart is about to burst with pain, and I also experience some mucus secretion in my throat.
When it stops, my heart may suddenly stop beating for several seconds to over ten seconds, then it beats forcefully twice before returning to normal.
After the intense heartbeat stops, I feel weakness in my limbs, dizziness, pale complexion, and my hands and feet are cold and clammy, making me feel close to fainting.
Sometimes this happens several times a month, while other times only a few times a year.
It can occur during intense exercise, in a calm state, while climbing stairs, sitting down, or standing up...
the specific triggers for these symptoms are unclear.
I believe it might be congenital, as I have experienced this since I can remember, and it often affects my studies and work, leading to frequent absences, which is very distressing.
It has become more severe as I grow older, possibly due to a lack of exercise as I have aged.
In the past two years, the episodes have become increasingly painful and unbearable.
I have not undergone any examinations, so I am eager to understand the cause.
Should I go to the hospital for an examination? I am about to enlist in the military and wonder if this will have any impact.
Would it be sufficient to have this checked during the military physical examination? Additionally, if the examination is conducted while my heart is in a normal rhythm, will it still be able to detect anything?

Huang, 20~29 year old female. Ask Date: 2011/11/24

Dr. He Dongjin reply Cardiology

Hello, please visit a medical center and consult a cardiologist specializing in arrhythmias.
It is highly possible that you may have an arrhythmia, which could exempt you from military service.
However, there are many types of arrhythmias, and further outpatient examinations are necessary for a definitive diagnosis.
Changhua Hospital cares about your health.

Reply Date: 2011/11/24

More Info

Understanding heart palpitations is crucial, especially when they manifest as intense episodes that can significantly impact your daily life. Based on your description, it sounds like you are experiencing episodes of tachycardia, where your heart rate exceeds 200 beats per minute, accompanied by discomfort and other symptoms such as dizziness, weakness, and a sensation of impending faintness. These symptoms can be alarming and warrant further investigation.

Causes of Heart Palpitations
Heart palpitations can arise from various causes, which can be broadly categorized into physiological and pathological factors:
1. Physiological Causes:
- Stress and Anxiety: Emotional stress can trigger the release of adrenaline, leading to increased heart rate.

- Caffeine and Stimulants: Consumption of caffeine, nicotine, or certain medications can lead to palpitations.

- Exercise: Intense physical activity can cause temporary increases in heart rate.

2. Pathological Causes:
- Arrhythmias: Conditions like atrial fibrillation or supraventricular tachycardia can cause episodes of rapid heart rate.

- Structural Heart Issues: Conditions such as hypertrophic cardiomyopathy or valvular heart disease can lead to palpitations.

- Electrolyte Imbalances: Abnormal levels of potassium, magnesium, or calcium can affect heart rhythm.

Symptoms to Monitor
In addition to the rapid heartbeat, you mentioned experiencing:
- Chest Pain: This can be concerning, especially if it feels like pressure or tightness.

- Throat Discomfort: The sensation of mucus production could be related to anxiety or a response to stress.

- Dizziness and Weakness: These symptoms suggest that your body may not be receiving adequate blood flow during these episodes.

When to Seek Help
Given the severity and frequency of your symptoms, it is advisable to seek medical attention. Here are some guidelines on when to consult a healthcare provider:
- Frequent Episodes: If you experience palpitations multiple times a month or if they are worsening.

- Associated Symptoms: If palpitations are accompanied by chest pain, shortness of breath, or fainting.

- Impact on Daily Life: If your symptoms interfere with your ability to work, study, or engage in daily activities.

Diagnostic Tests
To understand the underlying cause of your palpitations, a healthcare provider may recommend several tests:
- Electrocardiogram (ECG): This test records the electrical activity of your heart and can identify arrhythmias.

- Holter Monitor: A portable ECG device worn for 24-48 hours to capture heart activity during normal daily activities.

- Echocardiogram: An ultrasound of the heart to assess its structure and function.

- Stress Testing: This can help evaluate how your heart responds to exertion.

Preparing for Medical Evaluation
When you visit a healthcare provider, it’s helpful to provide a detailed history of your symptoms, including:
- The frequency and duration of episodes.

- Any triggers you’ve noticed (e.g., exercise, stress).

- Associated symptoms (e.g., dizziness, chest pain).

- Your lifestyle habits (e.g., caffeine intake, exercise routine).

Military Considerations
Regarding your upcoming military service, it’s essential to disclose your symptoms during the pre-enlistment medical evaluation. The military may have specific requirements regarding cardiovascular health, and they can provide guidance on whether your condition may affect your service.

Conclusion
In summary, while occasional heart palpitations can be benign, the nature and severity of your symptoms suggest that a thorough evaluation is warranted. Seeking medical advice will help determine the underlying cause and appropriate management strategies. Early intervention can lead to better outcomes and improved quality of life.

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