Heart palpitations
September 4, 2010 | 10,00 EUR | answered by Dr. med. Olaf Stephan
I have been experiencing noticeable heart palpitations for about 3 weeks. I feel as though my heart pauses briefly and then resumes pumping regularly. There are no chest pains or difficulty breathing associated with this. I had a similar problem about 5-6 years ago, and underwent an ECG (stress test) and a Holter monitor, but no specific diagnosis was made. It eventually resolved on its own. I am relatively slim, weighing 68.0 kg and standing 1.88 m tall. I am a patient with Crohn's disease and have been taking corticosteroid medications for the past six months, currently at a dosage of 5 mg per day. I am a businessman and my job can be occasionally stressful, but I believe I can handle stress well. Could there be something pressing on my heart, such as fluid or something from the intestines? I am at a loss for what to do.
Dear inquirer,
There are a variety of different heart rhythm disorders, which may either be noticed by the patient or remain unnoticed. The spectrum ranges from harmless palpitations (where only the subjective feeling of the heartbeat exists) to harmless individual extra beats (extrasystoles) to complex and dangerous rhythm disorders. Unfortunately, a remote diagnosis is not possible here, you would need to conduct a 24-hour Holter monitor ECG to identify the type of heart rhythm disorder. Without knowledge of the ECG, everything remains speculative. The Holter monitor ECG can be performed by a general practitioner or a cardiologist. If necessary, an exercise stress test on a bicycle should also be conducted to see if the rhythm disturbances disappear under stress or are provoked by the stress, the latter would clearly be considered pathological. It could also be possible that your symptoms are stress-related, or a potassium or magnesium deficiency, which could be conceivable within the context of your underlying condition (Crohn's disease), can lead to heart rhythm disturbances. In this case, further investigations (laboratory tests) would be appropriate. It seems unlikely that fluid is putting pressure on the heart, and this would manifest through other symptoms as well. Heart rhythm disorders are not a direct side effect of corticosteroid therapy. Therefore, it is advisable for you to consult your general practitioner or a cardiologist for a definitive evaluation.
Kind regards,
O. Stephan.
