[63F] Experiencing heart palpitations and right-sided abdominal pain

Patient Description

A 63-year-old female reports experiencing heart palpitations described as racing and fluttering, primarily in the evenings and when relaxing or lying down. These episodes have been occurring for several months and can last a few hours, accompanied by lightheadedness. Additionally, she has intermittent, stabbing abdominal pain on the right side, rated 3 out of 10 in severity, for about a month, with associated nausea. Bowel movements are described as floating and dark. She has been feeling more stressed or anxious lately. No fever, chills, chest pain, shortness of breath, or jaundice have been noted. The patient has a history of Celiac disease diagnosed five years ago and a family history of gallbladder disease. Current medications include Vagifem (10 mg twice per week), calcium (600 mg daily), multivitamins, and fish oil (600 mg daily). No known allergies or adverse reactions to medications have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Gallstones or Gallbladder Disease: The location and nature of your abdominal pain, along with your mother's history of a non-functioning gallbladder, suggest that gallstones or gallbladder disease could be a possibility. Gallstones can cause intermittent, crampy pain in the right upper part of your abdomen. The pain can come and go and may get worse after a meal. Changes in bowel movements and stool color may also occur.

    • Treatment usually involves a change in diet to avoid fatty foods that can trigger symptoms. In some cases, surgery may be required to remove the gallbladder.
  • Arrhythmia: This is a condition where the heart beats with an irregular or abnormal rhythm, which could explain your racing heart and fluttering sensations. Some types of arrhythmia can cause lightheadedness.

    • Treatment can range from lifestyle changes and medications to more invasive procedures like a pacemaker or defibrillator implantation, depending on the type and severity of the arrhythmia.
  • Anxiety Disorder: Anxiety can cause a variety of physical symptoms, including a racing heart and stomach pain. However, it's important to rule out physical causes first.

    • Treatment typically involves a combination of therapy, lifestyle changes, and medication.
  • Side Effects of Medication: Vagifem, which you are taking, can in rare cases cause palpitations as a side effect.

    • If this is the case, your doctor may adjust your dosage or switch you to a different medication.

Please note that this is not an exhaustive list and other conditions could also explain your symptoms.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to perform tests such as an ultrasound to check for gallstones, or an electrocardiogram (ECG) to evaluate your heart rhythm.
  2. Keep a symptom diary. Note when your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider in diagnosing your condition.
  3. Continue to follow a strict gluten-free diet to manage your Celiac disease.
  4. Stay hydrated and try to eat small, frequent meals instead of large meals to see if this helps with your abdominal pain.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Chest pain
  • Trouble breathing
  • Fainting

Remember, this advice is intended to be helpful and informative, but it's not a substitute for professional medical advice. You should always seek the advice of your doctor or other qualified health provider with any questions you may have regarding a medical condition.

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10 mo ago

People Also Ask


What are the common symptoms of gallbladder disease or gallstones?

Common symptoms of gallbladder disease or gallstones include intermittent, crampy pain in the right upper abdomen, especially after eating fatty foods, nausea, vomiting, and changes in stool color. Some people may also experience bloating and indigestion.


How can arrhythmia be diagnosed and treated?

Arrhythmia can be diagnosed using tests such as an electrocardiogram (ECG), Holter monitor, or event recorder. Treatment options vary depending on the type and severity of the arrhythmia and may include lifestyle changes, medications, or procedures like catheter ablation or the implantation of a pacemaker.


Can anxiety cause physical symptoms like heart palpitations and abdominal pain?

Yes, anxiety can cause a variety of physical symptoms, including heart palpitations, abdominal pain, nausea, and dizziness. These symptoms occur due to the body's 'fight or flight' response, which can be triggered by stress or anxiety.


What are the potential side effects of taking Vagifem?

Vagifem, a form of estrogen therapy, can have side effects such as headaches, breast tenderness, nausea, and in rare cases, heart palpitations. It's important to discuss any side effects with your doctor, who may adjust your dosage or suggest an alternative treatment.


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