Ms. Zhou, 50, has been flustered from time to time in the past 3 months.
I have been to the clinic, I have had an EKG, I have been to the hospital and I have an EKG. I have done five or six electrocardiograms before and after, but every time I do an electrocardiogram, the result is nothing and everything is normal.
The electrocardiogram was normal, and the doctor did not prescribe any medicine to Ms. Zhou, but told her that it was anxiety, tension, menopause and so on. Ms. Zhou also went to see a Chinese medicine practitioner, and took 20 sub-decoctions for 3 weeks, but there was no effect.
By chance, Ms. Zhou saw my popular science and then found me.
I ask: Do you still feel flustered every time you do an electrocardiogram?
Ms. Zhou: Sometimes yes, sometimes not.
I asked: Did you feel flustered just a few seconds after doing the electrocardiogram?
Ms. Zhou: Not really. Every time I do an electrocardiogram, my palpitation disappears.
I asked: under what circumstances do you feel flustered, how long does it take to get flustered each time, and does it have anything to do with it?
Ms. Zhou: There is no regularity. Sometimes it is just a few times, sometimes several minutes. The most obvious thing is that you cannot sleep well.
I ask: Have you ever done a holter?
Ms. Zhou: What do you mean?
I said: Is it a Holter, a 24-hour ECG?
Ms. Zhou: No, never heard of it.
I said: Then let’s do a Holter monitor, which can record heartbeats every minute and every second for 24 hours. If you have a heart attack when you are wearing a Holter today, then we can find the cause of the heart attack, and then we know how to treat it.
Ms. Zhou: 24 hours, still have to be hospitalized?
I said: No need to be hospitalized, this electrocardiogram is about the size of a mobile phone, it can be put in a pocket, sent back to the hospital after 24 hours, and analyzed on a computer to give a diagnosis .
Afterwards, Ms. Zhou took a Holter monitor.
Two days later, Ms. Zhou came for a follow-up visit with a dynamic ECG report. The dynamic ECG report indicated that the heart rhythm was stable, and premature heart beats were visible, with a total of 1780 premature heart beats in 24 hours.
I asked: Did you feel flustered when you took this dynamic electrocardiogram?
Ms. Zhou: I’m flustered.
I asked: What time is it?
Ms. Zhou: It’s about 5 in the morning. When I wake up, I feel very flustered.
I looked at the electrocardiogram at around 5 o’clock, which is the time when there are more premature heart beats. This is right, which shows that the reason for Ms. Zhou’s palpitation is the premature beat of the heart.
So what causes premature beats?
During the last consultation, I learned that Ms. Zhou had no discomfort after exercising and exercising, so premature beats caused by myocardial ischemia were ruled out. Ms. Zhou has done a color ultrasound of the heart before, which is also normal, so it is ruled out that the heart structure diseases such as heart enlargement, heart failure, valvular disease, and cardiomyopathy are caused.
Ms. Zhou’s family has been unhappy for the past six months, and her mood is also not good. In addition, she can’t find the reason after being flustered, so she does not sleep well. These mixed together, will lead to premature beats, premature beats aggravated, there will be the performance of palpitation.
The patient is then treated for arrhythmia and premature beats. He instructed the patient not to worry, there are not many premature beats, and there is no other heart disease, pay attention to ensure sleep, and feel better.
One week later, Ms. Zhou returned to the clinic and felt that her palpitation had improved significantly.
3 weeks later, Ms. Zhou returned to the clinic and felt that she did not feel flustered, so she re-examined the dynamic electrocardiogram, and the result showed that there was no premature heart beat.
Ms. Zhou then stopped her premature beat drugs. It is recommended to continue to maintain a good attitude, insist on proper exercise, and ensure enough sleep. Don’t worry too much.
Is the palpitation caused by premature beats?
Of course not, premature beats are just one cause of panic.
Heart palpitation is a common manifestation. First of all, we must think of arrhythmia, that is, there is a problem with the heartbeat, such as fast heartbeat, slow heartbeat, and disordered heartbeat. Common arrhythmias: sinus tachycardia, sinus bradycardia, atrial tachycardia, supraventricular tachycardia, atrial fibrillation, atrial flutter, ventricular tachycardia, conduction block, premature heart beat and so on.
We don’t know how to treat until we find the cause of the panic.
There is also a possibility that Ms. Zhou was wearing a dynamic ECG, and palpitation occurred 24 hours after wearing the ECG, but the dynamic ECG showed normal, no arrhythmia, no premature beats. What to do with this panic?
If we have enough evidence, like doing a Holter monitor, and the symptoms of palpitation also occur, then palpitation caused by heart disease can indeed be ruled out. At this time, it can be considered that the palpitation caused by menopause, autonomic dysfunction and other reasons, and then symptomatic treatment can be done.
In short, palpitation is a common manifestation, and most of us may have experienced palpitation, such as when we are nervous, excited, or exercising. Panic is normal, don’t be nervous.
If it is palpitation without any incentive, especially repeated palpitation, then it is still recommended to see a doctor, it is best to wear a 24-hour dynamic electrocardiogram, also called holter, to find out if it is It’s not a heart problem, that’s how to treat it!