What Causes Palpitations,fluttering And High Heart Rate?

Posted on Tue, 17 Jun 2014

Question: Hi-my name is XXXXXXX It'm 49 year old woman. In the past 6 months I have had an echocardiogram, ekgs, stress echo and halter monitor for 24 hours. Everything always comes back normal. But, for the past few weeks, almost every day, I have had palpitations and fluttering and my heart rate goes up to 120 or so for no reason. Is this a sign of something else? Are the doctors missing something? Does AFib show up on these tests?

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
May need more tests!

Detailed Answer:
Dear friend,
Welcome to Health Care Magic

It is reassuring to see a normal ECHO
TMT – Treadmill exercise ECG; may be with thallium isotope – may be necessary to evaluate ischemia (reduced blood flow / Coronary Artery Disease)
Blood tests for thyroid etc are also routinely done...

     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. If still elusive, Holter can be prolonged or event monitor may be needed. Holter records for days; Event monitor for weeks / Holter records continuously / Event monitor only at certain times .

If there are no clues and if the problem is still bothering to the extent of interfering with life style, one may need 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. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS. Though the test is the gold standard, it is INVASIVE and hence not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST.
     Many cases of palpitation are benign, especially when associated with normal ECHO and may not require treatment, If you also have 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 can suggest further based on his assessment of the situation.

Take care
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (17 hours later)

Thank you for your answer. 2 years ago I had another test done at the hospital where they injected XXXXXXX and I laid down and had a scan of the heart and lungs. Everything was clear. 0 calcium build up and my cholesterol is also good. I also suffer from Post Traumatic Stress and anxiety. I never had any dizziness, shortness of breath, blurred vision, etc. What do you think?

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
Investigate at your convenience

Detailed Answer:
Hi,

Normal calcium score is reassuring – the chance of Coronary Artery disease is minimal
Normal cholesterol is again reassuring – important risk factor for Coronary is not there
So also a normal scan…
It is not a disease of the blood vessels, valves or the walls

It is an issue of the nerves
The fact that you have no major symptoms and that the investigations are normal mean– the problem is benign.
Anxiety leads to fast rate – fast rate leads to Anxiety – a vicious cycle it is…

The need for further assessment and assistance is influenced by your symptoms

Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar