[29F] Experiencing heart palpitations with dizziness and fatigue

Patient Description

A 29-year-old female reports experiencing heart palpitations described as skipped beats for the past 6 months. These palpitations occur a couple of days each month, lasting for 4 hours or more, and are noted both at rest and during her menstrual cycle. The patient also experiences moderate dizziness, particularly when transitioning from lying to standing or when bending over, along with fatigue. She reports no change in frequency or intensity of palpitations during exercise, and her heart rate remains at 64 bpm with a blood pressure of 106/76 mmHg during episodes. The patient has been experiencing stress and anxiety, which may be contributing factors. There have been no changes in caffeine intake, medications, or lifestyle that coincide with the onset of symptoms.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  1. Premature Ventricular Contractions (PVCs): These are extra heartbeats that begin in one of the heart's two lower pumping chambers (ventricles). They can cause a feeling of a skipped heartbeat or palpitations. PVCs are common and often occur in healthy individuals. They can be more noticeable at rest and during times of hormonal changes, such as your menstrual cycle.

    • Typical Testing and Treatment: A doctor might recommend an electrocardiogram (ECG) or a Holter monitor to track your heart rhythm over time. If PVCs are benign, they may not require treatment, but lifestyle changes or medications can be considered if they are bothersome.

  2. Hormonal Fluctuations: Changes in hormone levels during your menstrual cycle can affect your heart rhythm and cause palpitations. This is a common experience for many women.

    • Typical Testing and Treatment: Keeping a symptom diary can help correlate symptoms with your menstrual cycle. If symptoms are severe, a healthcare provider might suggest hormonal treatments.

  3. Orthostatic Hypotension: This condition involves a drop in blood pressure when you stand up, which can cause dizziness. It might be related to dehydration, prolonged bed rest, or certain medications.

    • Typical Testing and Treatment: A doctor might perform a tilt table test or recommend increasing fluid and salt intake. Compression stockings and medications can also be considered.

What you can do

  1. Lifestyle Adjustments: Try to reduce stress through relaxation techniques such as deep breathing, yoga, or meditation. Limiting caffeine and alcohol can also help reduce palpitations.

  2. Stay Hydrated: Ensure you are drinking enough fluids, especially if you notice dizziness when standing up. This can help maintain your blood pressure.

  3. Symptom Tracking: Use MDandMe to journal your symptoms, track your menstrual cycle, and note any potential triggers. This information can be valuable for your healthcare provider.

  4. Gradual Movements: When changing positions, do so slowly to help your body adjust and reduce dizziness.

What you should look out for

  • Seek Medical Attention If:
    • You experience chest pain, severe shortness of breath, or fainting.
    • Your symptoms worsen or become more frequent.
    • You notice any new symptoms that concern you.

Remember, while these suggestions can be helpful, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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1 mo ago

People Also Ask

What are heart palpitations and are they dangerous?

Heart palpitations are sensations of a fast-beating, fluttering, or pounding heart. They are often harmless and can be caused by stress, anxiety, caffeine, or hormonal changes. However, if they are accompanied by chest pain, fainting, or severe shortness of breath, medical attention should be sought.

How can hormonal changes during the menstrual cycle affect heart rhythm?

Hormonal changes during the menstrual cycle can affect the autonomic nervous system and lead to palpitations. Estrogen and progesterone fluctuations can influence heart rhythm, making palpitations more noticeable during certain times of the cycle.

What is orthostatic hypotension and how can it be managed?

Orthostatic hypotension is a condition where blood pressure drops significantly when standing up, causing dizziness or lightheadedness. It can be managed by staying hydrated, increasing salt intake, wearing compression stockings, and moving slowly when changing positions.

How can stress and anxiety contribute to heart palpitations?

Stress and anxiety can trigger the release of stress hormones like adrenaline, which can increase heart rate and lead to palpitations. Managing stress through relaxation techniques, exercise, and adequate sleep can help reduce these symptoms.

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