Question
I just e-mailed my doctor about the feeling that my heart is flipping around in my chest. I feel like I have a heart problem. I had a 24-hour Holter monitor and they said it looks fine. But I think something is wrong. Should I see a cardiologist?
Answer
The feeling of your heart “flipping around” can be a little scary. However, some irregularities in the heart rhythm is the norm. Extra beats, called premature atrial or ventricular contractions, are seen on almost every 24-hour Holtor monitor study. Many people are not aware of these heart rhythm issues, some people (like you and I) feel them. They classically feel like a pause then a brief “flip/flop” in the chest or lower neck. If you had your symptoms during the 24-hour monitoring period, and all you had were these premature beats, then I am quite certain your doctor is correct.
The time to worry about your heart rhythm is when you have a structurally abnormal heart(your heart muscle is weak or too thick, or there is a significant heart valve problem), or you have fainting or lightheaded spells related to the heart, or you have episodes when your heart is beating too fast for several minutes or more at a time. These things should be evaluated by a cardiologist.
Some people continue to be symptomatic, despite reassurance from their doctor that the problem is benign. We do have medicines that can markedly decrease the frequency of these “extra beats”, but as you know, all medicines have potential problems and side effects. So a discussion of risk vs. benefit would be needed before starting one of these medications. If you are really wanting treatment for your heart rhythm issue, it is appropriate to see a cardiologist.