Latest news with #palpitations
Medscape
07-07-2025
- Health
- Medscape
Palpitations: A 12-Lead EKG Doesn't Tell the Full Story
This transcript has been edited for clarity. Palpitations are one of the most common complaints when seen in the clinic, but a normal 12-lead EKG does not tell the full story. It captures just a few seconds. Your patient might still be having intermittent arrhythmias, like atrial fibrillation, premature ventricular contractions, or short runs of ventricular tachycardia, that simply do not show up during the visit. What do we do? We start with a detailed history. Ask about when it happens, how long it lasts, what brings it on, and whether it comes with dizziness, chest pain, or near syncope. The pattern matters: regular vs irregular, brief or sustained, activity related or at rest. Then we monitor. A 24- to 48-hHolter is fine if symptoms are frequent. If they're rarer, think longer-term options like a 14-day patch monitor or even an event recorder. For concerning symptoms, an implantable loop recorder is still on the table. Next, we stratify risk. If symptoms happen with exertion or there is a history of heart disease,you want to refer to cardiology. Those patients need imaging and further workup. The bottom line is that a normal EKG does not rule out a real rhythm problem. If something feels off, trust your gut and dig deeper.
Daily Mail
29-06-2025
- Health
- Daily Mail
I suffer with random heart palpitations but the ECG came back normal... so what could it be? DR ELLIE answers
I have had heart palpitations on and off for some time. I've had an ECG but this didn't reveal anything abnormal. Do I need treatment? Dr Ellie responds: Palpitations involve the heart racing or beating abnormally. Some people may notice a thumping or feel an irregular heartbeat.
Daily Mail
19-06-2025
- Health
- Daily Mail
Emma Willis details her 'scary' surgery after doctors found 'bizarre' hole in her heart during check-up
Emma Willis has opened up about undergoing heart surgery earlier this year, calling the procedure 'pretty scary'. The much-loved presenter, 49, took a trip to the doctors in January after experiencing an increasing number of heart palpitations. Following a scan, Emily was shocked to hear she'd been living with an undiagnosed hole in her heart for her entire life 'which she had no about'. She had keyhole surgery to fill the hole in March at London's Royal Brompton Hospital, only making the news public a few weeks later in an Instagram post. Now, Emma has opened up about the surgery during an appearance on Heart Breakfast. Speaking with Amanda Holden, 54, and Jamie Theakston, 54, The Voice host said: 'That is pretty scary (hearing about the heart issue). 'You find these things that are happening in your body that you didn't know about. It was really bizarre. 'I found out in January and by March I was in on the table and having a little device fitted to fill a hole that I never knew excited. I've had it my whole life and just had no idea.' She added: 'I always had palpitations, but kind of fitting with what was happening in my life. So, if I was a bit stressed or if I'd had a night. I kind of always had them. 'But for the last couple of years, I've been having them more and more and they got to a point where it was quite a lot. I also have high cholesterol, which is why I was referred to a cardiologist. 'So, it wasn't even for that, and when I got there the doctor said, "actually, it's okay, but there is something going on with your heart and I want to check it out!"' Emma was then asked about the device she had fitted, to which she replied: 'It's a soft metal device, basically. 'It kind of looks a bit like this strange covering on these leads (in the studio), and they stretch it really flat and put it in a cannula. 'They then go through your groin, straight into your heart and it pops out of one side of the hole, and then they put it through the other and it seals the gap. The tissue then grows around it for three to six months and it seals.' Sharing some promising news, Emma revealed that since she underwent surgery the palpitations have eased - though she admitted they may never stop completely. Emma had candidly opened up about the aftermath of the procedure last month, saying she had been left 'really anxious and nervous' in the weeks following surgery. The 49-year-old told The Sun: 'It's a bit of a head scramble when you find out something like that, that you've had something there your whole life, and you had no idea about it. 'I'm a brilliant overthinker, and my mind will go in every possible direction and scenario, so going into something like surgery, I really got myself at it, I get really anxious and nervous.' Speaking about her recovery, the 49-year-old continued: 'It's been a smooth recovery, it's been much more of a psychological adjustment, because you don't have a wound that you can see. The healing is all internal and you can't feel it. 'It's getting your head around the fact that your heart has to learn how to work in a different way to how it's worked for nearly half a century.' Luckily for Emma, her husband Matt, 41, has been by her side throughout the whole experience and she noted that the Busted star has 'coached her through breath work and wellness'. She made her return to television for the first time since the surgery last month, featuring in the BBC series Change Your Mind, Change Your Life. The four-part series, which is thought to have been filmed before her surgery, sees Matt and Emma navigate life's challenges together. Their decision to appear on the show came after the Busted star opened up about his own issues with addiction, which Emma had spoken about in her own interviews. Ahead of the BBC series' release last month, Emma said: 'Therapy has played a huge role in both of our lives, not just individually but as a couple too. 'It's given us the tools to understand ourselves and each other better, and we know firsthand how powerful that can be. 'With this documentary series we'll hear from incredible experts and see what really happens in the therapy room, to help break down the stigma and start conversations. 'Asking for help is never a weakness; it's one of the bravest things you can do.' Change Your Mind, Change Your Life, released on BBC and BBC iPlayer last month.
Medscape
23-05-2025
- Health
- Medscape
ECG Challenge: Palpitation Episodes in a COPD Patient
A 70-year-old man presents with a chronic obstructive pulmonary disease (COPD) exacerbation. He reports shortness of breath and palpitations. He has no known heart disease but has experienced palpitations in the past that were short-lived and did not require therapy. Figure 1. Courtesy of Philip J. Podrid, MD. The correct diagnosis is atrial fibrillation with Ashman's phenomenon (Figure 2). Figure 2. Courtesy of Philip J. Podrid, MD. Discussion The rhythm is irregularly irregular, with no organized P waves. The average rate is 174 beats/min. The QRS complex duration (0.08 sec) and morphology are normal. There are only three supraventricular rhythms that are irregularly irregular: Sinus arrhythmia (one P wave morphology and stable PR interval) Multifocal atrial rhythm (also called wandering atrial pacemaker) with a rate < 100 beats/min and multifocal atrial tachycardia with a rate > 100 beats/min (≥ 3 different P wave morphologies and PR intervals without any predominant P wave morphology) Atrial fibrillation in which there are no organized P waves Therefore, this is atrial fibrillation. Noted are several QRS complexes that have an increased duration (0.12 sec) with a right bundle branch block (RBBB) morphology with an RSR' morphology in lead V1 (←) and a broad terminal S wave in lead V5 (→). These complexes are not runs of NSVT, because they have a typical RBBB morphology and their intervals are also irregular. They are not the result of rate-related aberration, because there are other RR intervals as short or even shorter than these aberrated QRS complexes that are not associated with aberration. However, preceding the aberrated complexes is a long (┌┐)-short RR interval (└┘). This is the Ashman's phenomenon which is not caused by an abnormality in His-Purkinje conduction but rather by normal rate-related changes in His-Purkinje refractoriness or time for repolarization. When the heart rate is slow (long RR interval), His-Purkinje refractoriness or time for repolarization prolongs whereas when the heart rate is fast (short RR interval), His-Purkinje refractoriness or time for repolarization shortens. This change in refractoriness or repolarization with heart rate is what causes the QT interval to change with heart rate, ie the QT interval is shorter at a faster heart rate and longer with a slower heart rate. When there is an abrupt change in heart rate from slow (long RR interval) to fast (short RR interval), His-Purkinje refractoriness does not adapt or change immediately and hence one or several QRS complexes are conducted with aberration. Most commonly the aberration is an RBBB, likely because the refractoriness of the right bundle is slightly longer than that of the left bundle.
