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Heart Palpitations and Chest Pain

Richard H. Hongo

Richard H. Hongo, M.D., FACC

Sutter Pacific Medical Foundation

Mills-Peninsula Medical Center

California Pacific Medical Center

Question:

I've had an eating disorder for 10 years. One of the main problems that seem to continue is heart palpitations, which I've had daily for three months. Tests (Holter, ECHO, EKG) show that I have palpitations, but no other problems. I also have chest pains

Answer:

Palpitations are a very common problem and, generally speaking, they are usually more of an annoyance than a danger. The time it does raise concern is when there is some underlying heart disease.

The normal EKGs and ECHO that you have had are good indicators that your heart is healthy. The chest pains do have to be addressed because it can be an early sign of narrowing in the arteries of your heart. You should make sure you see your doctor regarding the chest pains. Depending on your age and other health issues, your doctor may want you to have a treadmill stress test. Typically, if you are making an appointment for chest pain, the doctor's office will make it a priority to get you in sooner. If the chest pains are suddenly getting more intense, or you are having an episode that is not going away, then I would recommend calling your doctor right away or consider going to the ER.

It sounds like they caught your palpitations on the 24-hour Holter monitor. Since the findings did not seem to alarm your doctor, it was probably something safe like premature atrial complexes (PACs) or premature ventricular complexes (PVCs). These are extra beats that come from a spot in the heart that has become irritated, and this spot decides from time to time to beat out of sequence. Again, with an otherwise healthy heart, these extra beats are almost always harmless. That is not to say, however, that palpitations are not a problem.

Palpitations can be very symptomatic and be very disruptive to normal daily life. There are treatments for palpitations that include dietary changes and medications that your doctor can recommend for you. In some extreme cases, when palpitations are very debilitating and do not respond to medications, catheter ablation procedures can be performed by a cardiac electrophysiologist to eliminate the irritated spot in the heart.

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