Ask a doctor on the topic of Internal medicine

to DRmed Ralf Berg Follow-up question

December 19, 2014 | 15,00 EUR | answered by Dr. med. Ralf Berg

Hello again,

this morning we wrote about "fear of myocarditis". How likely would endocarditis be, as I haven't had a fever this year. Last year I had an ultrasound, EKG, Holter monitor, and a normal blood test 8 weeks ago due to heart palpitations. I still experience heart palpitations sometimes, especially when I am stressed.

Best regards

Dr. med. Ralf Berg

Hello,

here is some good news again:

1. Heart palpitations and endocarditis are primarily not related.

2. Without fever and with a normal heart sono/echo finding, you also do not have endocarditis. With today's ultrasound machines, changes in the heart valves due to endocarditis can be directly observed.

3. Heart rhythm disturbances caused by premature beats = heart palpitations are common for all of us. It depends on 1. the extent of the palpitations, if there are only a few, it is harmless, and 2. where the extra beats originate and when they occur. This is a complicated issue and therefore the evaluation of a long-term ECG also takes time. However, if nothing is found and you are not advised to take antiarrhythmic medication afterwards, these are not threatening or pathological heart rhythm disturbances.

See it this way: Some people react to stress with temporarily high blood pressure or getting a red face and starting to sweat. On the other hand, you may experience a few ectopic heartbeats = some heart palpitations.

This is to be seen as a functional disorder and not as an organic failure.

In this sense, I wish you a stress-free and contemplative Christmas season.

Yours sincerely, Dr. R. C. Berg
(one can classify these, for example, using the Lown classification)