I am sorry you are experiencing such troubling symptoms. I'm glad you have already scheduled a doctor
's appointment, as well, as it will be critical for you to undergo an in-person evaluation to determine the cause of your symptoms.
Heart palpitations have many causes. As you mentioned, your heart can beat more rapidly during periods of anxiety, fever, and pain. You may also be sensing premature atrial or ventricular complexes, which are essentially early heart beats initiated outside the heart's normal conduction system. These are common and are often benign, although they can cause dysfunction of your heart muscle if they are persistent and frequent. Additionally, an arrhythmia can cause palpitations. Although these are less common in someone your age, they can certainly still occur. Common examples include atrial fibrillation, atrial flutter, and AV nodal reentrant tachycardia. It will be important for you to discuss these possibilities with your doctor to determine if there is any specific concern for an arrhythmia.
Generally, an evaluation to rule out arrhythmias consists of a thorough history and physical exam as well as an EKG
. If this is unrevealing, you may need to undergo 24-hour EKG monitoring, exercise treadmill test, or echocardiogram (ultrasound of your heart). I urge you to consult your doctor to determine if any of these other tests are indicated.