Heart palpitations—the feeling that your heart is skipping a beat, fluttering, or beating too hard or too fast—can be a symptom of arrhythmia. Because these episodes often pass before the patient reaches the clinic, doctors use longer rhythm recordings: Holter monitors, home telemetry, or a small recorder implanted under the skin.
An episode lasts a few minutes, then everything returns to normal, and an EKG performed a few days later is normal. This is precisely when longer heart monitoring helps catch what a few-minute office examination will not show.
A symptom that is easy to brush off
Arrhythmia is—as explained by the American National Heart, Lung, and Blood Institute (NHLBI)—a disorder of the heart rate or rhythm: the heart can beat too fast, too slow, or irregularly (NHLBI: what is arrhythmia). Among the possible symptoms, the institute lists heart palpitations, as well as dizziness and fainting, fatigue, shortness of breath, or chest pain.
Not every “skipped beat” means disease. The NHLBI notes that an occasional feeling of a missed heartbeat is completely normal. The goal is to distinguish harmless episodes from arrhythmia that requires treatment—and that cannot be done by guesswork.
The trap is simple. The episode happens in the evening at home, at work, or on the road, and the patient arrives for an appointment a few days later when the heart is already beating normally. Hence the phrase: “I went to the doctor and nothing came up.” Sound familiar? Patient notes help the doctor in such cases: when the episode occurred, how long it lasted, what preceded it, and whether it was accompanied by other symptoms.
Tests that monitor longer than a few minutes
According to the NHLBI, the most common test in diagnosing arrhythmia is the electrocardiogram (EKG). When symptoms occur infrequently, a longer recording may be needed. A Holter monitor records the heart rhythm during normal daily activities, while an implantable loop recorder—a small device placed under the skin—can stay in place longer than a Holter and transmit data to the clinic. The institute states that it helps clarify palpitations or fainting spells, especially infrequent ones (NHLBI on arrhythmia diagnosis).
The same NHLBI material lists blood tests, including potassium and thyroid hormone levels, as well as an EKG performed during exercise, because some rhythm disorders only appear under exertion.
In cardiological practice, echocardiography, or an ultrasound of the heart, is also used as a complement, allowing for an assessment of the heart’s structure and valve function. The choice of tests depends on how often and under what circumstances the symptoms occur—this is decided by the doctor after talking with the patient.
Some of these procedures do not require a hospital stay. At the Maspeth Clinic, rhythm disorder diagnostics include Holter monitoring, home telemetry, stress testing, 2D echocardiograms, and fainting diagnostics, with the implantable loop recorder being placed right on-site at the clinic.
When not to wait for an appointment
Heart palpitations accompanied by heart attack symptoms—pain, pressure, or discomfort in the chest, shortness of breath, weakness, or the feeling that you are about to faint—constitute an emergency. The CDC recommends calling 911 immediately in such cases (CDC on heart attack symptoms). Emergency help is also required for loss of consciousness, especially if the person does not recover quickly or if the fainting is accompanied by chest pain or palpitations (MedlinePlus on fainting).
In other cases of recurring palpitations, you neither need to dismiss them nor obsess over them. A sensible step is a consultation during which the doctor will decide whether and what kind of rhythm monitoring is needed.
Describing symptoms
In diagnosing arrhythmias, the medical history is particularly important: the doctor needs to know if the heart is “fluttering,” “pounding,” or “stopping,” how long it lasts, and what helps. Such nuances are easier to convey in the language you think in than in a hurried translation at the office.
Cardiological rhythm disorder diagnostics at the Maspeth Clinic are performed by Dr. Adam S. Budzikowski, MD, PhD, FHRS—a cardiologist and electrophysiologist. A description of the tests can be found on the page on heart diagnostics and treatment at the Maspeth Clinic, and the full range of the doctor’s services is on his cardiologist profile in the PolishPages directory. An appointment can be scheduled by phone: 929-252-9330.
This article is for informational purposes only—it is general information, not medical advice, and does not replace a doctor’s visit. Consult a physician for individual health concerns.
