I have heart palpitations—What should I do? Part II of II

By Lenny Organ • May 12, 2025 • Tags:Heart, Healthy,

If you are experiencing heart palpitations:


  1. Stay Calm:
  • Try to remain calm and avoid panicking.
  • Sit or lie down in a comfortable position.
  • Practice deep breathing exercises: Inhale slowly and deeply through your nose, hold for a few seconds, and then exhale slowly through your mouth. 
  1. Identify and Avoid Triggers:
  • If you suspect that caffeine, alcohol, nicotine, or stress may be triggering your palpitations, avoid these substances for the next hour or so.
  1. Monitor Your Symptoms:
  • Pay attention to the duration and frequency of your palpitations.
  • Note any accompanying symptoms, such as chest pain, shortness of breath, dizziness, or fainting. 
  1. Consult a Doctor:
  • Seek immediate medical attention if:
  • Your palpitations are frequent, severe, or prolonged.
  • You experience chest pain, shortness of breath, dizziness, fainting, or lightheadedness. 
  • You have a history of heart disease.
  • Your palpitations occur after a recent heart attack or surgery.

Your doctor may:

  • Conduct a physical examination.
  • Review your medical history and medications.
  • Order diagnostic tests, such as an electrocardiogram (ECG), echocardiogram, or Holter monitor, to determine the cause of your palpitations. 
  • Refer you to a cardiologist for further evaluation and treatment.


Holter Monitoring for Heart Palpitations


A Holter monitor is a valuable tool for diagnosing the cause of heart palpitations. Here's what you need to know: 

  • What it is: A Holter monitor is a small, portable device that continuously records your heart's electrical activity over a period of 24 hours to 14 days. 
  • How it works: Electrodes are placed on your chest to detect your heart's electrical signals, which are then recorded by the monitor. 
  • Benefits:
  • Convenience: The monitor is small and portable, allowing you to wear it during your normal daily activities. 
  • Comprehensive Monitoring: It provides continuous monitoring of your heart rhythm, capturing episodes of palpitations that may not occur during a short ECG test. 
  • Improved Diagnosis: Holter monitoring can help identify the type of arrhythmia causing your palpitations and guide treatment decisions. 


If your doctor recommends a Holter monitor, they will provide you with specific instructions on how to wear and use the device.

Echocardiogram: A Window into Your Heart


An echocardiogram, often referred to as an "echo," is a non-invasive imaging test that uses sound waves (ultrasound) to create moving pictures of your heart. It's a painless and safe procedure that provides valuable information about the structure and function of your heart. 


What an Echocardiogram Can Show:

  • Heart Size and Shape: Evaluates the size and shape of the heart's chambers. 
  • Heart Wall Thickness and Motion: Assesses the thickness and strength of the heart muscle. 
  • Heart Valve Function: Examines how well the heart valves are opening and closing. 
  • Blood Flow: Evaluates the flow of blood through the heart chambers and valves. 
  • Fluid Around the Heart: Detects any fluid accumulation around the heart (pericardial effusion). 


Types of Echocardiograms:

  • Transthoracic Echocardiogram (TTE): The most common type, performed by placing a transducer (probe) on the chest wall. 
  • Transesophageal Echocardiogram (TEE): Involves passing a small probe through the esophagus (the tube that connects the mouth to the stomach) for more detailed images. 
  • Stress Echocardiogram: Combines an echocardiogram with exercise or medication to assess the heart's function under stress. 


When an Echocardiogram May Be Recommended:

  • To diagnose heart conditions: Such as heart valve disease, coronary artery disease, heart failure, and cardiomyopathy. 
  • To monitor the effectiveness of heart treatments: Such as medications or surgeries.
  • To evaluate the severity of heart damage after a heart attack. 
  • To investigate symptoms: Such as chest pain, shortness of breath, or heart palpitations. 

 

Stress Echocardiogram: A Test of Your Heart's Strength Under Stress


A stress echocardiogram is a specialized type of echocardiogram that evaluates how well your heart functions under stress. 

  • How it Works:
  • Resting Echo: First, a standard echocardiogram is performed while you are at rest. 
  • Stress Induction: You will then undergo stress induction, which can be achieved in two ways:
  • Exercise Stress Test: You will exercise on a treadmill or stationary bike, gradually increasing the intensity until you reach your target heart rate. 
  • Pharmacological Stress Test: If you cannot exercise, a medication (such as dobutamine) will be administered intravenously to simulate the effects of exercise on your heart. 

 

  • Stress Echo: Once you reach your target heart rate or the peak of the medication's effect, another echocardiogram is performed. 
  • What it Evaluates:
  • Heart Function Under Stress: The stress echocardiogram assesses how well your heart pumps blood when it's working harder. 
  • Blood Flow to the Heart Muscle: It helps determine if there are any blockages in the coronary arteries that restrict blood flow to the heart muscle during exercise. 
  • When it's Used:
  • To Diagnose Coronary Artery Disease: If you have symptoms such as chest pain, shortness of breath, or dizziness. 
  • To Evaluate the Effectiveness of Treatment: After a heart attack or heart surgery.
  • To Assess Heart Function Before Major Surgery: To determine if your heart is strong enough to withstand the stress of surgery.