Heart Palpitations - When is it truly a medical problem?

I just want to know when heart palpitations becomes a medical issue and not just a psychological/psychosomatic one?

I've dealt with panic before, but throughout my late-30s to now (my late-40s), I've had the added issue of heart palpitations throughout the day almost every day. It comes with or without panic, as I've been able to manage my anxiety better these days.

Sorry if I have got your gender wrong but could it be the peri-menopause? I've had them after reaching that stage after never having had them before..Do you get hot flushes mainly at night? It most commonly between 45-55 yrs old but can be earlier.

I think the only way to know for sure is to get an EKG. Not sure if your primary care doc can do that or if you need to see a cardiologist.

Could the palpatations be due to medication? Getting an EKG would calm your anxiety about the palpatations. When I was younger I used to experience heart palpatations fairly regularly. It may have been due to stress.

I have DID (dissociative identity disorder) with male and nonbinary alters inside, in addition to my cigendered female body (born female at birth, and still go by female, her, hers, she, hir, they, and many other things). I'm okay with being mistaken for gender.

In fact, I loved how my real name (not revealed online here) is ambidextrous, and how the different spellings could mean female, male, or both. I've seen my name used in movies or television shows more and more today, so I'm totally okay with mistaken gender.

LOL

As far as my body is concerned, I used to get hot flashes between the ages of 42 and about 44. But then they lessened over time. I also got cold sometimes, too, which was probably a thyroid issue. When there are comorbid things going on such as perimenopause and thyroid issues and metabolic disorders (such as obesity and/or diabetes) going on all at the same time, your temperature may not meet the standard requisites for perimenopause or menopause. I chalk it up to the complexities of comorbidity (having multiple risk factors for multiple life-threatening risks such as heart disease and stroke).

In fact, women's changing hormones during perimenopause and menopause increase the risk for heart attack and stroke, according to some health websites. That is why I'm particularly concerned about increases in heart palpitations during my middle age.

Furthermore, more and more younger women are being overlooked for heart attacks when, in fact, researchers have shown an increase in heart attacks and heart-related diseases increasing among younger women in their 30s! This reveals a phenomenon that should be investigated - either with all the additives put into our foods that affect women, or with the lack of diagnostics happening for women. Most of all of the research done on food-based safety, vaccine safety, drug safety, and diagnostics for heart disease and other medical risk factors are done on healthy white males, as opposed to women of all statuses and minorities (by age, disability, race, cultural habits/behaviors, etc.). Thus, this could mean that women, including those who have different cultural practices than mainstream white Americans (such as eating different foods, working multiple working-class jobs, working swing-shift jobs, and living in apartments instead of houses with limited incomes) will differ in terms of their safety-based reactions to stimuli (foods, diagnostic tests, vaccines, drugs) than mainstream, middle- and upper-middle-class white males and the like. This puts women (who are considered minorities) as well as other non-gender-based minorities at risk for being under-diagnosed, misdiagnosed, and therefore mistreated in clinical settings.

I don't take any medication. My dissociative disorders have adverse reactions to psychotropic medications (most, not all), so my psychiatrists in the past have simply used more holistic means to help me, including my occasional (not frequent) use of melatonin, chamomile, and CALM for insomnia/sleep-wake disorders, for instance. I don't take vitamins like I should, so that could be the issue is my not getting enough vitamins. I also worry about the interaction with certain vitamins and supplements, so that is also why I'm hesitant. I try to get my vitamins through food, but I'm not eating the right foods (yet).

So, it's not medications. Besides, I've had this heart palpitation issue during times I wasn't taking any vitamins or over-the-counter supplements at all (which was a considerable amount of time), so I know it's not a reaction to anything I'm ingesting or digesting.

Good question though!

My doctors at the last VA I went to in a different state were referring me to see a cardiologist for things like stress tests, etc., especially for the orthostatic intolerance and possible POTS affiliated with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), for which I'm service-connected. But when I moved to the new VA, they just want to treat me generically with their women's clinic doctors. Initially, I was assigned to a PA, and I said I had too many complications that truly warrants a MD to treat me. So, after much protest, they finally switched me. But I'm still not getting the same referrals or treatment that I received at the VA in a different region/state. So I can't just request to see a cardiologist, despite my many attempts at discussing my issues. The doctors here all chalk it up to MST PTSD.

My fellow veteran sisters with MST experiences like me have all complained about that particular women's clinic and the overall VA, which oversees care for our entire state (it's a small state). We are all psychopathologized, so whilst it is important to ask our physicians about the most appropriate course of action, it is very challenging when our physicians don't take our requests seriously and instead pathologize most women when their husbands in this state get better care for similar heart-related symptoms (despite them being of similar age and rank). I don't live in a very friendly state or attend a very friendly VA system here.

I'm therefore left to fend for myself, ask online, research for myself online, and do what most of us women have to do in order to take charge of my own health. Sadly, we have to spend money outside of the VA to get the care we should be getting within the VA. It's there way of discriminating against women veterans without outright discriminating against us - especially those of us with MST-related PTSD on our military jackets.

I have a benign heart palpitation problem. I went through the diagnostic process I guess 4 years ago. I was experiencing palpitation episodes that would last several hours at a time. Cardiologist did the holter monitor and confirmed the issue. He also did an upper GI series to rule out GERD which can also feel like palpitations — no GERD. The good news is that there is nothing structurally wrong with my heart. I remember telling the cardiologist, “So, you are saying it’s all in my head?” And he replied, “Absolutely not. You are having heart palpitations; they are not, however, caused by anything particularly wrong with your heart and that is good news.”

In my case, they are benign PVCs caused by adrenaline and also my asthma medications. I’m a musician with a major symphony chorus, and I noticed the issue was particularly prominent while rehearsing. My cardiologist explained they see this issue with athletes because of the adrenaline response, and in my case like other musicians who have to perform on a high level. Add to it the asthma meds which have palpitations as a side effect and there you have it. Oh, and I was peri menopausal at the time it all started which is common timing. (FYI: anxiety can cause similar responses; it wasn’t my issue at the time though.) Thyroid issues can also be in the mix, but the palpitations are still benign, meaning they aren’t themselves harmful.

It is a completely benign nuisance basically for me. He said it will come and go for me probably forever. I have a beta-blocker I take when it kicks in. I can go months where I need to take it daily, and then it just goes away for a while. It kicked in recently but isn’t terribly bothersome so I’m monitoring to decide if I need to restart the beta-blocker again but it is not bothering me much.

All that to say that most palpitations are benign nuisances, so while you wait to be evaluated try not to stress too much about it which, coincidentally, will exacerbate the palpitations.

@ArtleyWilkins - Thank you for your response. I'm hoping mine is benign. I had labs ordered at the VA, so I went this morning to get my thyroid and some other issues checked out. I hope I'm not dealing with anything serious. It helps to know that there is a non-threatening explanation to these palpitations.

Let us know how your doing when you get the test results. My guess (based on some experience) is that you'll be fine!

My test results was for an abnormal thyroid test #1, so test #2 is for thyroid primarily. I haven't been checked out at all for cardiovascular at the VA, but I do get a free checkup by a Medicare provider. The problem in Idaho is that many doctors are refusing to take Medicare, as they claim they don't get paid enough. So, the freebies I should be getting from Medicare, which I pay for, isn't even available in my area of Idaho. It really sucks. And, although the VA is free to me, they won't approve of things that Medicare claims I should be checked out for. This is cray cray!

Medicare for all would never work if the docs and hospitals boycott and go all private for the rich and upper middle classes only. The VA turning into Medicare or private ways wouldn't work because of similar reasons, or possible funding issues that shut down the already scarce VA hospitals that remain. So, unless I inherit a fortune, I am at the beck and call of politics, unfortunately. This isn't laziness; poverty isn't laziness; disability isn't laziness; but rather the system of individualist culture sucks! And many are paying for it with their lives at stake!

Hey @SprinkL3 I started the beginnings of perimenopause when I was 41. No docs believed me and relied on hormone levels which are not necessary proof to determine early menopause. You can look up the symptoms but heart palps, higher blood pressure, major insomnia( you either continue to have it or it literally ramps up big time out of the blue) Many women have a hard time with the gyn especially if the doc is a man. I dropped mine like a hot potato when he downplayed what I was feeling and gave me an invasive uterine biopsy which is assumed to be necessary but research says you treat the symptoms of peri as actually peri once you are past 40.