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What Causes Heart Palpitations With Normal EKG Report?
Question: Went to ER about heart palpitations since monday (4 days now) they did a EKG and it was normal (good) but I know something like AFIB would need to occur during this, Gave me a ECG and a nurse came in and said " you have afid already correct?" I said no and he said "sure looks like it" I was told when they hooked me up to ECG that I needed to notify someone if I was having a heart flutter (hence the male nurse who asked about AFIB) but when I left the main doctor said "oh no you are fine, your EKG was fine, blood tests normal" I sense something is wrong although I truly hope he was right and would LOVE it if he is. But am just left worried. I also have had severely rapid heartbeats in the morning when I wake up but that has not happened for over a month. But to be honest I have been worried about my heart since august when that started happening about once or twice a month. I just finished with a serious flu btw too! am still ending it now.
Brief Answer:
Need follow up
Detailed Answer:
Hi friend
Welcome to Health Care Magic
For accurate diagnosis and treatment, Irregular heartbeats need to be DOCUMENTED by ElectroCardioGram (EKG). Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly, one needs Holter or event monitor. Holter records for days; Event Monitor for weeks… Holter records continuously; Event Monitor only at certain times, activated.
ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots...
TMT – Treadmill exercise ECG (may be with thallium isotope) – is necessary to evaluate ischemia (reduced blood flow / Coronary Artery Disease)
If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. ( and treatment modalities - like thermal or radio-frequency ablation, which could be done during EPS). Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Thyroid / calcium, magnesium / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on - may be responsible.... /At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
Many cases of palpitation are benign, especially when associated with normal ECHO and may not require treatment.
If one also has symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up
The treating doctor alone could conclude better, based on the total clinical picture. Get an appointment with a cardiologist / and follow it up.
Good luck
God bless you
Need follow up
Detailed Answer:
Hi friend
Welcome to Health Care Magic
For accurate diagnosis and treatment, Irregular heartbeats need to be DOCUMENTED by ElectroCardioGram (EKG). Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly, one needs Holter or event monitor. Holter records for days; Event Monitor for weeks… Holter records continuously; Event Monitor only at certain times, activated.
ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots...
TMT – Treadmill exercise ECG (may be with thallium isotope) – is necessary to evaluate ischemia (reduced blood flow / Coronary Artery Disease)
If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. ( and treatment modalities - like thermal or radio-frequency ablation, which could be done during EPS). Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Thyroid / calcium, magnesium / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on - may be responsible.... /At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
Many cases of palpitation are benign, especially when associated with normal ECHO and may not require treatment.
If one also has symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up
The treating doctor alone could conclude better, based on the total clinical picture. Get an appointment with a cardiologist / and follow it up.
Good luck
God bless you
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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