Ask a doctor on the topic of Internal medicine

Heart palpitations

April 30, 2015 | 15,00 EUR | answered by Dr. med. Frauke Gehring

Dear Sir or Madam,

I have the following problem. Since the summer of 2013, I have occasionally experienced heart palpitations. At the beginning, it was always just a more pronounced beat or a feeling of fluttering. I then went to the cardiologist and after a long-term ECG, stress ECG, and echocardiogram, nothing unusual was found. During a routine check-up in January 2015, another ECG was done (very short, about 10 seconds) and again, nothing abnormal was detected.

I have not had any palpitations since January 2015. However, at the end of last month, I suddenly felt my heart fluttering out of rhythm for several beats while standing. The same thing happened two days later, but I had no other symptoms, no dizziness, no shortness of breath, etc. Two days later, while lying on my side, it happened again until I sat up.
This month, the same thing happened again. A few days ago, I felt my heart flutter for a few seconds (about 1-2 beats) while standing, and now the same thing happened today. While standing, it felt longer this time, about 15 seconds, and when it didn't improve after 3 beats, I became nervous and it only went away after I walked a few meters.

I unfortunately have a lot of fear of death in general. Now, these palpitations are increasing this fear even more. I don't have a problem with the palpitations in general, but I am afraid that they won't stop one day and I will collapse, and then it will be too late.

Now to my questions:

How do you assess the situation? I am in my mid-20s, currently not doing any sports but used to do a lot in the past.

1) Could these be serious heart rhythm disturbances or atrial fibrillation, if all tests have been negative so far, although they were already 2.5 years ago? However, I did not have any palpitations when I had the long-term ECG.

2) Should I see a doctor in general, today, or this week, or is it enough to wait until next month?

3) Should I just do more sports and stop worrying? What can I do to stop the palpitations, was walking a good idea? Cold water, coughing?

Best regards.

Dr. med. Frauke Gehring

Good evening,

Such feelings do not indicate a serious heart rhythm disorder, especially since congenital defects have been ruled out.
1. this is not to be expected at your age. A resting ECG could possibly reassure you, as it rules out atrial fibrillation.

2. If you do not have any circulatory problems, it is sufficient to wait for a month.

3. I would wait for the ECG just to be on the safe side. If it is good, sports and relaxation exercises would be helpful. Other tricks do not help against palpitations, only against a racing heart, which you do not have.

All the best!

Sincerely, Dr. Höllering