ZocdocAnswersIs this just a heart palpitation?

Question

Is this just a heart palpitation?

Yesterday my heart pounded rapidly and slowly in an erratic way for about 10 seconds. It felt like it was going to stop beating, although I did not experience faintness or anything else. I have not had one since and that was the first time to my knowledge I've had something like that. My heart has skipped and elongated beats before, but nothing like that. I'm on an antipsychotic as well, and I am concerned it could be a side effect. I'm in my mid twenties and healthy for the most part otherwise(non smoker, average weight, healthy diet). In your opinion, should I get an EKG, or is there nothing to worry about?

Answer

I am sorry you experienced this scary episode. Heart palpitations are extremely common and typically represent a benign process. However, it is not possible to definitely determine the cause without a thorough in-person evaluation, and I recommend you discuss this further with your primary care physician. It is possible you experienced premature atrial or ventricular complexes, which are essentially early heart beats that originate outside the heart's normal conduction system. They are typically benign but can cause heart dysfunction if they become more frequent. It is also possible you experienced an arrhythmia, such as atrial fibrillation, atrial flutter, atrial tachycardia, or AV nodal reentrant tachycardia. These are sometimes experienced as discrete but short episodes of abnormal heart beat. If your heart beats rapidly enough during an arrhythmia, it may not be able to fill adequately, which can lead to lightheadedness, fainting, or, in rare cases, sudden death. You will need a thorough evaluation by your doctor to determine if this is a care. A typical evaluation consists of a thorough history, physical exam, and EKg. Depending on these results, you may need to undergo 24-hour EKG monitoring, exercise treadmill test, or echocardiogram (ultrasound of your heart). I recommend you discuss these possibilities further with your doctor.

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