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I've had 3 heart palpitations over 8 days - what could it be ?

Im 24, and since October 1st I've had 3 palpitations - where I can hear my heart rate rising and it reaches at least 120/130 bpm. I've had an ECG a month before for a routine - it showed up as normal. I've also had a oxygen test - came up as 99 percent. I have no idea what is going on. It just comes on and goes as soon as I reach home and lie down for a bit.
3 Responses
20748650 tn?1521032211
COMMUNITY LEADER
Whats your age?

Its a bit too slow for avnrt, but thats always a possibility, especially if you're young.

Could be atrial fibrillation with a rapid ventricular response, or atrial flutter with a lower ratio of conduction.

Also could just be pvcs with atach.

In short.. It could be well.. Anything. Sorry cant be more specific!

In any case routine ekgs are literally useless at diagnosing tachycardias.

What you need is to consult your primary doctor about it and request a cardiology referral.

The cardiologist will then order a holter monitor or an event monitor depending how frequently you have the issue.

If something shows up that needs to be taken care of then hell probably refer you to an electrophysiologist.. A heart rhythm specialist for an invasive ep study.

This invasive study, which involves us placing some diagnostic catheters inside your heart is really the only way to truly tell with 100% confidence what is going on.

As stated though to get to that point you first have to go through the usual channels where the evaluation of your pcm and the testing conducted by the cardiologist gives us an idea that something is up that warrants referral.
5 Comments
HI - Im 24. I dont have chest paints, it's just random palpitations and overwhelming feeling
My doctor has referred me to a 24 hr heart eval - although he think it's anxiety related.
Sounds great steenkash.. 24 hour monitoring (holter) is the way to go for this stuff.

As for the anxiety relation, i hear that very frequently from patients. Its kind of a pet peeve of mine, because doctors love to counsel patients on this because it releives any anxiety or worry they might have about the result.

On the other hand, personally if i was told that it would give me the impression my concerns were being 'shrugged off'

While its true that anxiety can be a major cause of tachycardia, nothing is certain until we're able to capture that rhythm on a monitor.

As for your peace of mind, you should actually HOPE that the monitor shows an ep abnormality.. Because an actual disease of your hearts electrical system is something we can fix.. With very low risk to you as a patient, and extremely high success rates.

Anxiety on the other hand is a lifetime of medications and therapy with a much lower prospect of ever getting any sort of permanent relief.

As for capturing the rhythm, this can be challenging because you have to actually be wearing the thing when you experience an episode. Good news is, if the holter doesnt catch an episode other options exist, such as a 2 week 'event monitor' and a 2 year implant (its an ekg recorder just smaller then the size of a bic lighter that they can put under your skin).

As a patient you have every right to request these other systems if the holter is unable to record the tachycardia, whats more i would encourage you to do so, and to pursue every avenue possible.. Just in case.

Thats not to say you shouldnt accept treatment for anxiety if thats what the doctor recommends, but you should definately make sure youre receiving a thorough evaluation.
Thank you very much ! Very informative They've also ordered TSH tests - let's see what it is. If it is atrial fibriliation - how treatable/manageable is it ?It's not life threatening is it?
Thank you very much ! Very informative They've also ordered TSH tests - let's see what it is. If it is atrial fibriliation - how treatable/manageable is it ?It's not life threatening is it?
20748650 tn?1521032211
COMMUNITY LEADER
I had written you a very long and detailed explanation.. Before my phone died and deleted all of it... I may redo it if i feel up to it later. For now ill summarize.

How manageable/treatable is it...

Well it IS manageable and treatable.

But that management and treatment is so complicated entire books,have been written about it. The procedure we're using now, pulmonary vein isolation, is actually fairly new.. And our last effort the MAZE procedure was a relative disaster.

Afib ablation is twice as dangerous as any other ablation performed for another arrhythmia and is only 70% effective, compared to 90%+ success rate seen in patients with other problems.

If the ablation fails twice the next course of action involves device implants, septal occluders, av nodal ablation with permanent pacemaker implantation

Even in an emergency we cant touch the thing without a preprocedural transesophageal echocardiogram. Whats more its often so stubborn that we need a mix of potent antiarrhythmics and electrical shock to break it.

Anything we do for it interventionally requires full anesthesia support and intubation.

Even cardiothoracic surgery is on the table for some patients.

Lifetime anticoagulation is a given as well.

Outpatient therapy involves selecting medicines with alot of contraindications, and constant follow up and adjustments and like the interventional procedures comes with mixed success at best.

The arrhythmia is associated with stroke, heart failure, hemodynamic instability and av nodal failure. So it had to be addressed.

But yeah, its dangerous and stubborn as can be.

Fortunately the field of cardiology is up to the challenge and they can and will get it under control. We know what we need to do and very few patients actually die from afib associated complications.

However if it turns out to be afib, ill be completely straightforward.. The rhythm is technically and logistically difficult, expensive and labor intensive to bring under control. The journey forward would be long.

2 Comments
To further put it into perspective a single afib ablation is likely to take 100% of an ep teams time and attention for an entire working day..
HI. Everything came back normal. Most likely cause is anxiety.
20748650 tn?1521032211
COMMUNITY LEADER
Glad you could get the tests and get a conclusive answer.. You were symptomatic while on monitor at all?
2 Comments
I was symptomatic whilst on the monitor, my heart rate went up to 100-120 a few times, but they said the rhythm was normal. Anxiety most likely.
Sounds like that is indeed the case steen.. Im sorry tou couldn't get an answer with an easier solution. On the bright side however your heart is perfectly healthy.
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