Symptoms of an Abnormal Heart Rhythm

It is important to understand that you can have a dangerous heart rhythm and have absolutely no warning symptoms. The two most common cardiac problems which are often without warning symptoms are atrial fibrillation which can cause a stroke and cardiomyopathy (weak heart muscle) which can cause sudden cardiac death. At the other end of the spectrum you may have severe symptoms such as frequent heart palpitations (irregular flip flopping sensation inside your chest) and have no risk of a stroke or sudden death. The most concerning symptom is passing out (also called syncope) or nearly passing out (called presyncope). These types of warning symptoms (syncope, presyncope) should not be ignored and require immediate evaluation.  

 

If you think you may have an abnormal heart rhythm the best option is to make an appointment with one of our heart rhythm specialists (called electrophysiologists). With a few noninvasive office based tests we can quickly determine whether your situation is dangerous or not. The good news is that all heart rhythm problems, including dangerous life threatening problems, if you give us a chance to promptly make a diagnosis, can be treated effectively thus preventing a bad outcome.

 

The bottom line is that you should not delay in making an appointment because we may find that your heart is completely normal and thus provide reassurance relieving you of your concern and worry. On the other hand, because all heart rhythm problems are treatable, we may be able to perform a minimally invasive procedure such as an ablation to relieve you of your symptoms or institute therapy that prevents a disabling stroke or protects you from sudden death.

Palpitations

 

The feeling that your heart is pounding in your chest in a very noticeable and erratic pattern can be very disturbing and can ruin your concentration. The key to making a diagnosis is recording your heart rhythm when you experience your palpitations. We have many noninvasive and minimally invasive options available to record your rhythm. We may find that you simply have occasional skipped heart beats from the top chambers of the heart (premature atrial contractions = “PACs”) which are not harmful and do not require treatment. We may find that you have frequent skipped beats from the bottom chambers of your heart (premature ventricular contractions = “PVCs”) which can if frequent enough weaken your heart muscle. The good news is that with PVCs we can give you medications or perform an ablation to eliminate these skips and thus prevent your heart muscle from getting weak. The most concerning cause for an erratic heart beat is atrial fibrillation which is a chaotic rhythm from the top chambers of your heart. Immediate detection of this rhythm is important because it can cause a stroke. See the section on atrial fibrillation for more details.

 

Sustained Rapid Heart Action

 

In contrast to the sensation of an erratic irregular heart beat described above you may have the sensation that your heart goes from normal (60-100 beats per minute at rest) to very fast (>170 beats per minute) and regular in the blink of an eye even while at rest. This may cause you to become breathless and dizzy. This is usually due to a regular fast rhythm coming from the top of the heart (paroxysmal supraventricular tachycardia = “PSVT”). The good news is that this rhythm can be treated with medications or completely cured with a minimally invasive ablation procedure. Once a diagnosis is made using a heart monitor one of our electrophysiologists can discuss your treatment options.

 

Syncope

 

Syncope means passing out or blacking out. This can result in a serious injury such as a broken hip or a concussion if you hit your head. If it occurs while driving it could result in a motor vehicle accident. Any episode of syncope requires immediate medical attention to make sure that it is not a warning sign of a life threatening heart rhythm disorder. Depending on the results of noninvasive office based testing our heart rhythm doctors can then recommend the best option to make a definitive diagnosis. This might include wearing an external monitor, having a tiny monitor called an implantable loop recorder (ILR) injected under your skin which takes only thirty seconds using a syringe, or you may need a direct inspection of the electrical system of your heart which is called an electrophysiology study (EPS). Once a diagnosis is established we can provide a treatment which greatly reduces or eliminates recurrent syncope