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What Causes Heart Fluttering With Normal ECG And Stress Tests?
Question: Hello,
A few months back I started having some heart flutters. I went to the doctor and the ekg was normal and then they did a echocardiogram and stress test and everything came back normal. No structural problems with the heart, valves etc. and I didn't have any flutters while I was at the doctors. All was good. My cardiologist said my heart flutters must be harmless pvcs or pacs etc. These tests were done 6 weeks ago. In the past week I seem to be getting flutters again. Let me add that this past week I had to go for a cancer screening and I figured the flutters were related to anxiety towards the impending cancer tests. Well my cancer tests came back negative, I'm perfectly fine. But the the flutters haven't disappeared. They're still here. So I'm freaking out a little. Should I calm down about these because of the cardiac tests I had just a few weeks ago? Or is it possible that the cardiologist missed something. I have been diagnosed with generalized anxiety disorder and I'm wondering if it is normal for these flutters to be hitting me even though my cancer tests came back negative. Could it be residual effects of the stress of the cancer scare? Or could my cardiologist have missed something? I'm planning to go back to the doctor on Wednesday but I'd love some answers about this now. Thanks so much!
A few months back I started having some heart flutters. I went to the doctor and the ekg was normal and then they did a echocardiogram and stress test and everything came back normal. No structural problems with the heart, valves etc. and I didn't have any flutters while I was at the doctors. All was good. My cardiologist said my heart flutters must be harmless pvcs or pacs etc. These tests were done 6 weeks ago. In the past week I seem to be getting flutters again. Let me add that this past week I had to go for a cancer screening and I figured the flutters were related to anxiety towards the impending cancer tests. Well my cancer tests came back negative, I'm perfectly fine. But the the flutters haven't disappeared. They're still here. So I'm freaking out a little. Should I calm down about these because of the cardiac tests I had just a few weeks ago? Or is it possible that the cardiologist missed something. I have been diagnosed with generalized anxiety disorder and I'm wondering if it is normal for these flutters to be hitting me even though my cancer tests came back negative. Could it be residual effects of the stress of the cancer scare? Or could my cardiologist have missed something? I'm planning to go back to the doctor on Wednesday but I'd love some answers about this now. Thanks so much!
Brief Answer:
Ambulatory moitoring / beta blockers - help
Detailed Answer:
Dear friend,
Welcome to Health Care Magic
You are right! Anxiety may be the most likely underlying cause.
The tests so far have practically excluded diseases of the valves and wall (Echo) and arteries (Stress test / blood supply). There could be problem of the nerves of the heart – conduction system, which needs a separate battery of tests…
Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly or precipitated by a specific activity like exercise, one needs Holter or event monitor. Holter records for days; Event monitor for weeks / Holter records continuously / Event monitor only at certain times .
Your palpitation is most likely to be benign – being associated with normal ECHO and stress test; it may not require treatment. If you also have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need further urgent work up
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / electrolytes / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on - may be responsible.... /At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk / Hence it is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS.
You may benefit from Beta-blockers ( like Metoprolol), first line medicine for most people.
It will benefit both anxiety and missed beats.
Your doctor will give proper prescription and follow up
Take care
God bless
Ambulatory moitoring / beta blockers - help
Detailed Answer:
Dear friend,
Welcome to Health Care Magic
You are right! Anxiety may be the most likely underlying cause.
The tests so far have practically excluded diseases of the valves and wall (Echo) and arteries (Stress test / blood supply). There could be problem of the nerves of the heart – conduction system, which needs a separate battery of tests…
Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly or precipitated by a specific activity like exercise, one needs Holter or event monitor. Holter records for days; Event monitor for weeks / Holter records continuously / Event monitor only at certain times .
Your palpitation is most likely to be benign – being associated with normal ECHO and stress test; it may not require treatment. If you also have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need further urgent work up
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / electrolytes / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on - may be responsible.... /At times, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
If there are no clues and if the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk / Hence it is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS.
You may benefit from Beta-blockers ( like Metoprolol), first line medicine for most people.
It will benefit both anxiety and missed beats.
Your doctor will give proper prescription and follow up
Take care
God bless
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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