frequent heart palpitatons

April 3, 2007 8:59 PM

How many heart palpitations are enough to warrant a trip to the ER?

Every once in a while, maybe every few months, my heart will stutter a bit - pause for part of a second then beat quickly a few times as if "catching up".

This morning, it happened 4 or 5 times over the course of half an hour or so, then stopped. Now it has been happening off and on irregularly for about an hour. Once every 8 minutes or so (a guess).

Google says main causes for palpitations are stimulant use such as caffeine, anxiety, and diet.

I use caffeine to stay awake at work (anywhere from 200 to 1000mg a day depending) - I know this is horrible and am starting to cut back. Today I had 200mg.

I had social anxiety disorder a few years ago and took meds for it for 2 years, but have been off those for about 4 years. But lately I've been anxious (not anxiety attacks, just a general proccupation/worry about my future).

My diet is horrible.

The frequency of these palpitations is really worrying me, but I can not at all afford an unnecessary trip to the ER.

Should I go, or just try to change my habits, exercise, etc?

I'm leaning towards "sleep on it and go to a cheap clinic tomorrow if it continues".

posted by white light to Health & Fitness (21 answers total)

Response by poster: Clarification : google says palpitations in general are not a worry - but I assume this means the occasional one. My question is about whether these "clusters" of them are likely serious or not.
posted by white light at 9:06 PM on April 3, 2007

How old are you? Do coke or meth, anything like that? If the answers to these questions are "less than forty" and "no" then you're fine. Well, maybe not fine, but you're not going to die. You're stressed out and your lifestyle is unhealthy. You don't mention sleep, but I'm guessing that's a problem too. I'm not a doctor and I feel perfectly confident giving this advice.
posted by nanojath at 9:14 PM on April 3, 2007

Well, that pretty much covers the range of possible response.
posted by nanojath at 9:15 PM on April 3, 2007 [1 favorite]

Response by poster: I'm 24. I've never done any drugs besides pot (maybe 10 times), and yes, my sleep patterns are quite bad too (hence the caffeine).
posted by white light at 9:17 PM on April 3, 2007

Don't want to go to an ER?

Find the nearest Paramedic intern and say "Hey, wanna do a practice 12 lead on me?"

Then let them interpret the EKG strip. It might amuse the Paramedic and save you a trip to the ER. Unless, of course, the strip looks funky, in which case they might kidnap you and take you to the ER anyway.

Otherwise, your best bet might be an urgent care clinic. And try to improve the diet, mmay?
posted by drstein at 9:21 PM on April 3, 2007

Response by poster: based on this:

What I hate more is when a new checker opens up a line and says "next in line!" and the people at the END OF THE LINE jump over and basically cut in front of everyone that had been waiting longer.

I see that on occasion and when I said "Excuse me, he said "next in line" and you were at the end of the line" the offender stared ahead and basically ignored me.

People are just assholes.
posted by drstein at 1:50 PM on April 3

...I choose your judgement to trust most, and will go to a clinic tomorrow. And eat an apple.
posted by white light at 9:30 PM on April 3, 2007

Do you have health insurance? If so, your healthcare provider might have a toll-free number that you can call to speak to a registered nurse. They'll listen to your symptoms and then advise you.

I'm curious as to why your only two options are "hope it gets better and move on" or "go to the ER right now!"

Another option of course is to call and make an appointment with your doctor later and talk about the palpitations you've been having, and see how to best treat them.

And if you are feeling really nervous about it, or your spidey senses are telling you something's wrong, by all means, go to the ER!

Good luck.
posted by pazazygeek at 9:34 PM on April 3, 2007 [1 favorite]

nanojath's right, unless you happen to be one of those unlucky and rare folks born with an aberrant bit of cardiac conduction tissue or idiopathic hypertrophic subaortic stenosis. In which case, yes, palpitations are the only warning sign leading up to v-fib and sudden cardiac death, especially in young healthy people who don't do any coke or meth.

In which case nanojath, who is perfectly confident, is wrong, and you are perfectly dead.

The vast majority of palpitations wind up being benign.
posted by ikkyu2 at 9:37 PM on April 3, 2007

I have almost the same symptoms, although I was (am) having them a bit less frequently than you describe. I spoke with a cardiologist over the phone who was incredibly unconcerned. He said most palpitations of that kind are benign and won't do any harm, but that it might be a good idea to do an echo sometime in the next few months just to be sure it wasn't connected to mitral valve prolapse. Look up "premature ventricular contraction" and see if the symptoms match what you are experiencing- if they do, you almost certainly have nothing to worry about. Cardio also told me that magnesium supplements (chelated, not magnesium oxide) can help irregular heart beats in some people. Maybe try a supplement for a few weeks before making a clinic appointment?
posted by ohio at 10:17 PM on April 3, 2007

I am 2 years older than you and have had the exact same problem for years. In 2000 I had a Holter monitor for 24 hours... naturally my heart didn't stutter once during that time. Last May I took Sudafed and my heart got so bad I went to the ER. Everything turned out fine, but they put me on a beta blocker just in case. I did another Holter monitor, and once again my heart wouldn't "act up" during that time. The cardiologist is pretty convinced that nothing is wrong with me and the palpitations are benign... that some people are just more aware of their heartbeat than others. I hope this reassures you.

HOWEVER, see a doctor anyways.
posted by IndigoRain at 10:24 PM on April 3, 2007

Oh, one other thing - cut back on the caffeine slowly. And it's okay to still have some once in a while. When I first cut back, even though I did so slowly, I was getting really nasty headaches, even after a month. The cardiologist said it was probably caffeine withdrawal and to go ahead and have some once in a while. I've gone from 2-3 glasses of pop a day to 2-3 glasses a week.
posted by IndigoRain at 10:27 PM on April 3, 2007

I'm in the same boat as IndigoRain - when I've worn a holter heart monitor I have a day of completely smooth sailing, and then later that week I'll be trying to go to bed, heart flopping like a fish out of water. Doctors say not to worry about it. Quite unnerving.

I've found it for me it is generally stress-related. Make an appointment with your family doctor, and in the meantime get some exercise.
posted by anthill at 10:49 PM on April 3, 2007

Cut back on the caffeine, and check into mitral valve prolapse to see if it corresponds to you your symptoms.
posted by Manjusri at 11:13 PM on April 3, 2007

Talk to your doctor about it. Call him tomorrow and say you have a question you would like to ask. He'll tell you whether or not to come in or be worried. I sometimes experience the same thing (I think). You may have a heart murmer.
posted by xammerboy at 11:16 PM on April 3, 2007

The same symptoms happened to me frequently in college around exam time. It was always associated with an increased intake of caffiene, increased stress, and limited sleep. I went to the student health center once because they were occuring every 30-60 seconds over the course of a few hours. The doctors hooked me up to an EKG. They could see the palpatations on the screen, but it was determined that they were stress and stimulant related. The treatment was essentially, "take a long walk, listen to some music, read a novel, and reduce your caffiene intake."

Totally non-medical (IANAD) side note: I found that one drink helped reduce my stress level enough that my heart settled down. I have no idea if this was a good idea medically, as substituting one chemical for another is of questionable value, but it helped on those nights where I couldn't sleep because my heart was trying to wriggle its way out of my chest.
posted by idlyadam at 11:19 PM on April 3, 2007

Are you very sure that the heart palpitations are not your panic attacks coming back?
posted by divabat at 2:35 AM on April 4, 2007

This is not what Emergency Rooms are for. Make an appointment with a primary care doctor, an internist preferably, and get checked out -- for peace of mind if nothing else.
posted by drpynchon at 8:38 AM on April 4, 2007

I occasionally experience the exact same thing you describe. My palpitations come and go depending on how much I weigh, how stressed I am, the amount of caffeine I drink, and my menstrual cycle (they're more prevalent right before and during the week of my period).

I know they are scary. They used to keep me awake at night wondering if my heart was just going to stop completely. But I went to my primary care doc and he did an ECG and I wore a holter monitor for 24 hours. I apparently have a slight sinus arrhythmia (you can read more about these here and here). Three different doctors (my primary care doc, my endocrinologist, and my gynecologist) all assure me that I'm fine and the palpitations are just something I'll have to live with.

My advice is to go to a doctor and ask for a holter monitor for 24-48 hours. This will tell them if there's anything wrong at all with your heart - having to do with the palpitations or not. It's kind of a hassle to keep up with it for one or two whole days, but your peace of mind is totally worth it. Oh, and do keep your caffeine intake limited, that does help. And you might try eating a little healthier and start taking a quality multivitamin if you're not already.
posted by susiepie at 10:14 AM on April 4, 2007

"...I choose your judgement to trust most, and will go to a clinic tomorrow. And eat an apple."

Why thank you! I think....

Hey, sometimes even minor changes in your diet can have a profound effect. Simple things like reducing the amount of sodium that you eat every day can help lower your blood pressure.
posted by drstein at 11:42 AM on April 4, 2007

I'm not a doc but I do have these palpitations sometimes, and have had them the same ways you have.

Are you having any other symptoms? Dizziness? Nausea? Stuff like that...if your ONLY symptom is the palpitations, it's probably nothing important. I'd make an appointment with primary care just in case (which is what I did under the same circumstances.)

Now, if OTHER symptoms are popping up, a little more urgency would indeed be appropriate.
posted by konolia at 12:44 PM on April 4, 2007

unless you happen to be one of those unlucky and rare folks born with an aberrant bit of cardiac conduction tissue or idiopathic hypertrophic subaortic stenosis

ikkyou2, is this what causes SVT? I had bouts of palpatations for years which grew increasingly longer and more painful. One sure way to gets lots of attention in the emergency room is to walk in and announce you are having an SVT. After one extremely protracted and painful episode (small town hospital, deep snow, took the doc 45 mins to get to the hospital, etc.), I had cardiac ablation and am now considered cured. The surgeon explained it as having "an extra nerve" on my heart.

My point is here that my story started out pretty much like this one...short bouts of palpatations becoming stronger, longer and harder to stop over about 15 years. Decongestants, caffeine, stress, and being really tired were all triggering factors to an episode but not really the cause. Sometimes I was sitting on the couch doing nothing at all.
posted by rcavett at 7:45 PM on April 5, 2007