Ask a doctor on the topic of Internal medicine

"Herz" translates to "heart" in English.

December 1, 2012 | 20,00 EUR | answered by Dr. med. Frauke Gehring

I occasionally have heart palpitations and flutters. My general practitioner says it's normal, but I have to mention that about a year ago I had it much worse. Now I only have it weekly, and a year ago there were a lot of things happening at once - moving to a new apartment, the death of my guinea pig. As a child, I often experienced sudden heart palpitations where I had to hold my breath and then it would go away suddenly. I have had numerous EKGs in the past years, and in 2007 I even had an echocardiogram, 24-hour blood pressure monitoring, blood tests, all without any findings. I have never had any heart issues, even the EKG two years ago was normal. I have been to the doctor often recently, and everything has been fine. I feel great, I can do anything, I never have dizziness, and I am very productive. My skin is always rosy, except for the fact that I have severe psychological problems, which I have had for a long time. I have always been mentally ill, a hypochondriac, and so on. I also have to take citalopram and see a psychologist. Yesterday, my heart was fluttering again after who knows how many days - a few flutters, normal beats, a few fast beats, and then it was over. Every time this happens, I am so scared that I might have something serious. What should I do?

Dr. med. Frauke Gehring

Good evening,

You have already realized: It is mainly a psychological problem that you seem unable to control with an antidepressant alone. That's why it's important to find out in the context of psychotherapy where this burdensome anxiety is coming from and actively address it.

Unfortunately, it is also not sensible to keep doing new examinations because surprisingly, with each new (good!) examination, the anxiety increases instead of decreasing! Unfortunately, you did not mention your age. As a precaution, you could still do a 24-hour ECG to make sure that it's just the usual extra heartbeats that we all have: A few hundred in 24 hours are completely normal!

However, you should then focus intensively on your psyche, maybe even consider with a psychiatrist whether you are still well adjusted to the Citalopram. Perhaps Cipralex or Venlafaxine would help better.

Best regards, Dr. F. Höllering, Specialist in Internal and General Medicine