Heart Palpitations: When to Seek Further Medical Advice

My heart is racing, but the hospital says everything is fine?

Hello, I am 24 years old and have had issues with obesity and hypertension.
Since June of last year (2015), I have been seeing a cardiologist who diagnosed me with hypertension.
The doctor mentioned that my high blood pressure is purely due to obesity.
However, I occasionally experience palpitations (feeling my heart beating), usually as a strong vibration, but not very fast (below 100 beats per minute; typically around 60 beats per minute).
I mentioned this to my cardiologist during follow-up visits, but after undergoing an electrocardiogram, two echocardiograms, and a 24-hour Holter monitor, the doctor said there were no significant issues.
However, this symptom always appears when I lie down or after taking a shower (it also occurs occasionally at other times).
I try not to pay too much attention to it, but it is quite uncomfortable, especially recently (2016) when the frequency has increased, and my heart rate sometimes exceeds 100 beats per minute, accompanied by body heat and sweating.
Should I seek further medical attention? I am concerned that further tests may show nothing again.
What should I do? Is this a heart issue, or could it be related to autonomic nervous system dysfunction?

Lin, 20~29 year old female. Ask Date: 2016/02/13

Dr. He Dongjin reply Cardiology

Hello, it is likely caused by autonomic nervous system dysregulation.
It is recommended to use some simple medications for improvement, such as 0.5 mg Bisoprolol or Cardiolol.
Seasonal changes and weather may also have an impact.
There is no need to worry; everything should be fine.
Changhua Hospital cares about you.

Reply Date: 2016/02/13

More Info

Heart palpitations can be a concerning symptom, especially when they occur frequently or are accompanied by other symptoms such as sweating or a feeling of heat. Given your history of hypertension and being overweight, it is understandable that you are seeking further clarification on your condition.

First, it is important to understand what heart palpitations are. They are sensations that feel like your heart is pounding, fluttering, or beating irregularly. While they can be benign and caused by factors such as stress, anxiety, caffeine, or exercise, they can also indicate underlying heart conditions, especially if they are frequent or accompanied by other symptoms.

In your case, you have already undergone several tests, including electrocardiograms (ECGs), echocardiograms, and a 24-hour Holter monitor, which have not shown any significant abnormalities. This is reassuring, as it suggests that there may not be a structural heart problem or a serious arrhythmia. However, the fact that you experience palpitations frequently, especially when lying down or after bathing, and that they have increased in frequency, warrants further evaluation.

The symptoms you describe, such as increased heart rate (tachycardia), sweating, and a sensation of heat, could potentially be related to several factors:
1. Anxiety or Stress: Anxiety can lead to palpitations and may cause physical symptoms such as sweating and a feeling of warmth. If you are experiencing stress or anxiety, addressing these through relaxation techniques, therapy, or lifestyle changes may help alleviate your symptoms.

2. Autonomic Nervous System Dysregulation: The autonomic nervous system controls involuntary bodily functions, including heart rate. Dysregulation can lead to symptoms like palpitations, especially in response to certain triggers like lying down or after a hot shower.

3. Hormonal Changes: Hormonal fluctuations, such as those related to thyroid function or other endocrine issues, can also cause palpitations. It may be worth discussing with your doctor whether additional tests for thyroid function or other hormonal levels are appropriate.

4. Lifestyle Factors: Caffeine, nicotine, alcohol, and certain medications can contribute to palpitations. Reviewing your lifestyle and dietary habits with your healthcare provider may reveal potential triggers.

5. Obesity and Hypertension: Both conditions can put additional strain on the heart and may contribute to palpitations. Working on weight management through diet and exercise can be beneficial not only for your heart health but also for reducing palpitations.

Given that your symptoms have increased in frequency and intensity, it would be prudent to follow up with your healthcare provider. You might consider asking for a referral to a cardiologist who specializes in arrhythmias or a comprehensive evaluation of your autonomic nervous system. Additionally, keeping a diary of your palpitations, noting when they occur, their duration, and any associated symptoms, can provide valuable information for your healthcare provider.

In summary, while your previous tests have not indicated a serious heart condition, the increase in the frequency of your palpitations and associated symptoms warrants further investigation. It is always better to err on the side of caution, especially when it comes to your heart health. Seeking further medical advice is a reasonable step, and your healthcare provider can help determine the best course of action based on your symptoms and medical history.

Similar Q&A

Understanding Palpitations: When to Seek Further Medical Advice

Hello, Doctor. I apologize for the lengthy message and appreciate your understanding. Thank you. Last year, in December 2015, I suddenly felt some difficulty in breathing and a sense of weakness in my heart while sitting in a chair. After resting for a while, I felt better and di...

Dr. He Dongjin reply Cardiology
Hello, Yunwu. Your heart has been thoroughly checked and is fine, so there's no need to worry. What you're experiencing may resemble symptoms of autonomic nervous system dysfunction. Changhua Hospital is concerned about you.

Understanding Heart Palpitations: When to Seek Medical Help

Hello, Director Wu. I would like to ask about a concern I've been experiencing over the past week. I often feel like my heart skips a beat, and then suddenly beats very hard, causing significant palpitations. Whenever my heart beats strongly, my body also shakes a bit. I rea...

Dr. Wu Xueming reply Cardiology
Many factors in daily life can contribute to this condition, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages. It is recommended to adjust your lifestyle and engage in regular exercise. However, if symptoms persist, it is advisable ...

Understanding Heart Palpitations: When to Seek Medical Attention

Hello, doctor: I would like to ask you something. I have previously experienced symptoms of palpitations and chest tightness, and even chest pain during exercise. Last Saturday, when I went hiking with relatives, after just a short distance, I felt like my heart was about to jump...

Dr. Xiao Yongxun reply Internal Medicine
1. Palpitation refers to the sensation of an irregular heartbeat, rapid heart rate, occasional heart stoppage, or an irregular heartbeat experienced by the patient. Common causes include heart diseases, mental health disorders, physiological responses, medication reactions, or ot...

Understanding Palpitations: When to Seek Further Heart Health Evaluation

About 2.3 months ago, I experienced palpitations due to excessive coffee intake and went to the emergency room, after which I was referred to a cardiology outpatient clinic (where I was prescribed Cardizem 10 mg). Subsequent tests, including a chest X-ray and a 24-hour Holter mon...

Dr. Wu Xueming reply Cardiology
Due to your young age and lack of chronic diseases, your risk of developing heart disease is low. Many factors in daily life can contribute to this situation, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages. It is advisable to adju...