Heart Palpitations: When to Seek Medical Attention - Cardiology

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Heart palpitations can be concerning, especially when accompanied by symptoms such as shortness of breath and chest pain. Your description of experiencing a resting heart rate exceeding 110 beats per minute, particularly following episodes of palpitations, warrants careful consideration.
Palpitations are often described as a feeling of having a fast-beating, fluttering, or pounding heart. They can be triggered by various factors, including stress, anxiety, caffeine, nicotine, or certain medications. However, when palpitations occur frequently and are associated with other symptoms like chest pain or difficulty breathing, it is essential to evaluate the underlying causes.

In your case, the combination of elevated heart rate (tachycardia), palpitations, and accompanying symptoms such as shortness of breath and chest pain could indicate several potential issues. These might include:
1. Arrhythmias: Abnormal heart rhythms can lead to palpitations and may sometimes cause symptoms like chest pain or shortness of breath. Conditions such as atrial fibrillation, atrial flutter, or other types of tachycardia could be responsible.

2. Cardiac Ischemia: Given your history of chest tightness and the results from previous myocardial perfusion scans indicating ischemia, there is a possibility that your heart is not receiving adequate blood flow, especially during episodes of increased heart rate.

3. Anxiety or Panic Attacks: Psychological factors can also manifest physically, leading to palpitations, increased heart rate, and sensations of chest tightness or difficulty breathing.

4. Electrolyte Imbalances: Imbalances in potassium, magnesium, or calcium levels can affect heart rhythm and lead to palpitations.

5. Thyroid Issues: Hyperthyroidism can cause an increased heart rate and palpitations, along with other symptoms like weight loss, heat intolerance, and anxiety.

Given these possibilities, it is crucial to seek medical attention, especially since your symptoms have become more frequent and are affecting your quality of life. A healthcare provider will likely recommend several diagnostic tests to determine the cause of your symptoms, including:
- Electrocardiogram (ECG): This test records the electrical activity of your heart and can help identify arrhythmias or other heart conditions.

- Holter Monitor: A portable ECG device worn for 24-48 hours to capture heart activity over time, especially during episodes of palpitations.

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

- Blood Tests: To check for electrolyte levels, thyroid function, and other potential contributing factors.

In summary, while palpitations can sometimes be benign, the combination of your symptoms suggests that further evaluation is warranted. It is advisable to consult with a healthcare professional who can perform a thorough assessment and guide you on the appropriate next steps. Early diagnosis and management can help prevent potential complications and improve your overall well-being.