Urgent care for arrhythmia? UPDATE - first post

[Kassia]

I've been experiencing arrhythmias for weeks now without realizing it.  I thought I was just stressed and my heart was pounding, but I put my hand on my chest last night and could feel the skipped beats and then the beats coming too close together.  I called my doctor's office this morning and they said I need to be seen but made an appointment for me to come in tomorrow.  I am uncomfortable but don't have any emergency symptoms.  Should I just wait until tomorrow or should I go to urgent care?  This is the same doctor's office that made an appt. for me last year for the following day when I had a medical emergency (total bowel obstruction).  

Should I just wait until tomorrow or would I be better off going to urgent care today?

 

UPDATE:  I saw the doctor and she picked up PVCs right away when she listened to my heart and then set up an EKG and saw them there, too.  She ordered some lab work and I'm getting a monitor tomorrow.  Does anyone know if I can run with the monitor on?  I'll have it on for 48 hours.  Maybe longer since 48 hours ends on Sunday?  

 

 

 

Edited November 29, 2018 by Kassia

[Lawana]

In my experience, urgent care centers don’t deal with heart issues. They would refer you on to the ER. Personally I would feel comfortable waiting for the next day appointment. 

[TechWife]

I don't think that urgent care is equipped to care for cardiac patients. If you showed up there, they would likely call 911 for you. Therefore, I recommend that you go straight to the ED.

I also think you need a new medical provider. Next day appointments are not appropriate for issues like this. If they were unable to get you in, they should have had a nurse talk to you (although many practitioners no longer have RN's or even LPN's anymore) who could either get you in to be seen right away or refer you to a specialist or the ED. The idea that they would put off evaluating a heart issue is alarming.

[gardenmom5]

it's good to get it checked out to be sure it's not serious (chances are good it's not).

be aware there are other things than can cause arrhythmias that drs have not been helpful with.   adreanals/cortisol.   thyroid.  low potassium.. . . at least, those are the things that will cause me to have arrhythmias and my drs did nothing, even after running an ekg. and another sent me for  US of my heart.  (we didn't find anything . . . . . )

[Moonhawk]

If it's been a constant never goes away thing, with no regular heart beat, then I'd go to ER. If the arrhythmia is happening regularly but not constant for at least 5 hours in a row, I'd probably be ok waiting for the appointment. Our ER experience for arrhythmia has been that, unless it was something they could see both immediately AND constantly on their tests, they won't do anything except say to get a cardiologist. The one time it was both immediate and constant DH was admitted.

They always say "get some rest and it should go away by itself. Relaxation is the best medicine for this". Which isn't helpful when you're panicking about heart issues, lol. 

Agree that if you can skip the GP and go straight to a cardiologist it can save you time and streamline the process. 

and is obvious from my post, I'm not licensed to give medical advice and am only speaking from our experience 😉

Edited November 28, 2018 by Moonhawk

[Kassia]

I did cut caffeine (but not chocolate!).  I don't drink or take meds.  I'll see the PCP tomorrow and then go to the cardiologist next I guess.  Ugh - it's been a rough year for me medically and I wonder if many of my issues are related.  

 

[Kassia]

3 minutes ago, texasmom33 said:

So dark chocolate can do it for me- my sensitivity tends to run along with hormone levels. Testosterone and progesterone levels can definitely impact it for some people, so don’t fear the worst. Hopefully it’s nothing, although I get how alarming it is. Nothing like laying there at night freaking out about your heart beat. 

 

Does it last all day long?  It's driving me crazy because it's so uncomfortable.  

Also, can I exercise tomorrow before my appt.?  I don't want to miss my workout if it's nothing but don't want to do anything risky.

[EKS]

If you lived here I'd suggest swinging by the fire department so that they could monitor your rhythm and tell you whether it was an emergency or not.  But I don't know what emergency services are like in your area. 

What you're describing sounds like my symptoms when I have atrial fibrillation, and that is something you want to get taken care of because the longer it goes on, the more likely it is to become permanent (the other issue is that it increases your risk of stroke).

[Terabith]

That's a good idea.  I know a lot of fire departments do that.  That's a really good.  

[Kebo]

Make sure you are getting enough fluids, food and sleep -- Dehydration, low blood sugar, and sleep deprivation can trigger or exacerbate palpitations.

[PeterPan]

1 hour ago, EKS said:

What you're describing sounds like my symptoms when I have atrial fibrillation,

Yup, what the op is describing sounds like what my MIL had with a-fib. I'm totally flabbergasted you're not in the emergency room right now. It's easily treatable and they can stop it immediately with an injection. They'll put you on meds, maybe run some tests, and you'll go back to your happy life.

I'm pretty non-interventionist, and I'd go to the emergency room if you're having bothersome symptoms. It's upping your risk of stroke, etc. and it's hard on your heart. I would go in. Women tend NOT to take care of themselves with heart problems because they have this impression of what it should be like or they're too busy taking care of everyone else. If it's doing it, go in.

[Kassia]

3 minutes ago, Kebo said:

Make sure you are getting enough fluids, food and sleep -- Dehydration, low blood sugar, and sleep deprivation can trigger or exacerbate palpitations.

 

I never sleep.  I have chronic insomnia and my carpal tunnel syndrome has gotten very bad and it keeps me up in pain much of the night.  😞  

I drink plenty and food is not an issue.  😛

[Kassia]

11 minutes ago, PeterPan said:

Yup, what the op is describing sounds like what my MIL had with a-fib. I'm totally flabbergasted you're not in the emergency room right now. It's easily treatable and they can stop it immediately with an injection. They'll put you on meds, maybe run some tests, and you'll go back to your happy life.

I'm pretty non-interventionist, and I'd go to the emergency room if you're having bothersome symptoms. It's upping your risk of stroke, etc. and it's hard on your heart. I would go in. Women tend NOT to take care of themselves with heart problems because they have this impression of what it should be like or they're too busy taking care of everyone else. If it's doing it, go in.

 

I think my mother had a-fib, too.  I remember her having the monitor and some kind of procedure.  My doctor said only to go to the ER if I started having chest pains, trouble breathing, etc.  I don't have any pain - I'm just uncomfortable because it feels weird.  But it's been going on for a long time now.  

ETA: and it feels worse when I think about it because it makes me anxious, which makes my chest tighten and my heart beat faster

Edited November 29, 2018 by Kassia

[Lawana]

The duration of symptoms is why I would be comfortable waiting for a next day appointment. I have sat in the ER many many times with my mother and MIL for heart issues, including a complete heart block with Mom. If my symptoms were as OP described, I would not go to the ER. YMMV and all that. 

I also wouldn’t touch the exercise question with a ten foot pole lol. Not a doctor, don’t play one on TV, and all that. 

[sassenach]

8 minutes ago, PeterPan said:

Yup, what the op is describing sounds like what my MIL had with a-fib. I'm totally flabbergasted you're not in the emergency room right now. It's easily treatable and they can stop it immediately with an injection. They'll put you on meds, maybe run some tests, and you'll go back to your happy life.

I'm pretty non-interventionist, and I'd go to the emergency room if you're having bothersome symptoms. It's upping your risk of stroke, etc. and it's hard on your heart. I would go in. Women tend NOT to take care of themselves with heart problems because they have this impression of what it should be like or they're too busy taking care of everyone else. If it's doing it, go in.

That’s not how my afib treatment went. I went into my gp. She referred me for an EKG and 24hr holter. From there she sent me to the cardiologist. He sent me to get an ablation. Probably at least 6-8 weeks in all. No meds in the interim (but mine wasn’t constant). I still get premature beats here and there and have to be careful with triggers. 

[Shoeless]

So many things could cause what you are describing. Anything from anemia to thryoid to anxiety to a benign heart murmur to a-fib to...?

I would forget the workout until you are seen by someone. Also no caffeine, dark chocolate, anything that will raise your heart rate.  

I'd expect and EKG and labwork, plus a referral to a cardiologist for a cardiac ultrasound and/or a holter monitor. I had episodes of tachycardia that was related to an undiagnosed thyroid condition and anemia. It was really damn scary. 

How often are the skipped beats? You say it's been happening all day.  Do you mean you have no normal heartbeats, just these skipped ones all day?  Or do you mean you'll have normal beats most of the time and then once in awhile you have a skipped beat, and that pattern has been happening all day?  Is your heart following the typical "lub-dub, lub-dub, lub-dub" beating pattern at all before the skipped beats, or is the pattern something else entirely?  When you say you are uncomfortable, is it because this is causing you anxiety or because it is causing physical discomfort, (pain, pressure, shortness of breath, dizziness, weakness, mental confusion)?  That's not to discount if it's anxiety that is making you uncomfortable.  

If in doubt, head to the ER.  They will at least assess you and decide whether you really need to be there, (something acute and emergent that requires immediate treatment), vs something that is chronic and will need managed treatment.  

[PeterPan]

41 minutes ago, Kassia said:

 

I think my mother had a-fib, too.  I remember her having the monitor and some kind of procedure.  My doctor said only to go to the ER if I started having chest pains, trouble breathing, etc.  I don't have any pain - I'm just uncomfortable because it feels weird.  But it's been going on for a long time now.  

ETA: and it feels worse when I think about it because it makes me anxious, which makes my chest tighten and my heart beat faster

Ok, I'm going to say this again. Your doctor is being a MALE DONKEY. That is why women get under-treated for serious heart problems, because docs say stuff like that and blow off what women are saying. Your heart should not be racing, feeling like it's pounding, working hard, like you just ran a race, or being irregular. If it's doing uncomfortable stuff, GO IN. They will do an injection and stop it on the spot. My MIL was like oh my lands why did I live like this and not realize they could have stopped it?

Also, I'm trying to remember. I think my MIL saw a heart doctor. Now I can't remember. She passed (of unrelated things, grief) a year later. But it may not have been her GP but a heart doc who handled it. I can't remember now. 

If you're uncomfortable, I would go in. I don't know that my MIL ever got to pain. I mean she literally hosted Christmas was 30 people and was like hang on I'm going out to the ambulance now so they can run my heart for a bit. 

[PeterPan]

38 minutes ago, sassenach said:

No meds in the interim (but mine wasn’t constant).

My MIL was older, having it frequently (multiple times a day), and it was putting her at risk of a stroke. They offered her meds same day she finally went to the emergency room. She dithered and I was like ok, your choice, but what are you going to say when you end up back there and tell the doc hey I refused your meds because I was scared they would poison my body with toxins? So she made the choice and took the meds. 

[Kassia]

26 minutes ago, MissLemon said:

So many things could cause what you are describing. Anything from anemia to thryoid to anxiety to a benign heart murmur to a-fib to...?

I would forget the workout until you are seen by someone. Also no caffeine, dark chocolate, anything that will raise your heart rate.  

I'd expect and EKG and labwork, plus a referral to a cardiologist for a cardiac ultrasound and/or a holter monitor. I had episodes of tachycardia that was related to an undiagnosed thyroid condition and anemia. It was really damn scary. 

How often are the skipped beats? You say it's been happening all day.  Do you mean you have no normal heartbeats, just these skipped ones all day?  Or do you mean you'll have normal beats most of the time and then once in awhile you have a skipped beat, and that pattern has been happening all day?  Is your heart following the typical "lub-dub, lub-dub, lub-dub" beating pattern at all before the skipped beats, or is the pattern something else entirely?  When you say you are uncomfortable, is it because this is causing you anxiety or because it is causing physical discomfort, (pain, pressure, shortness of breath, dizziness, weakness, mental confusion)?  That's not to discount if it's anxiety that is making you uncomfortable.  

If in doubt, head to the ER.  They will at least assess you and decide whether you really need to be there, (something acute and emergent that requires immediate treatment), vs something that is chronic and will need managed treatment.  

 

I think I have mostly normal heartbeats but my heart is beating faster than usual, then it will skip a beat and make up for it with two close together.  So maybe (if this makes sense)...  thump..thump..thump......thumpthump..      As far as the discomfort, I don't know how to explain it, but there are none of the symptoms you described.  It's more like I'm always hyperfocused on it because it feels off and it makes me anxious so I get that anxious feeling in my chest.  I don't feel nauseated but the irregularity makes me feel weird in a way that's close to it.  

 

Skipping a workout is hard for me.  I'm a compulsive exerciser.  😞  But I don't want to die for a workout either.  I had a dear friend who had Marfan syndrome and she dropped dead while walking fast to our sons' track meet.  

[Kassia]

6 minutes ago, PeterPan said:

My MIL was older, having it frequently (multiple times a day), and it was putting her at risk of a stroke. They offered her meds same day she finally went to the emergency room. She dithered and I was like ok, your choice, but what are you going to say when you end up back there and tell the doc hey I refused your meds because I was scared they would poison my body with toxins? So she made the choice and took the meds. 

 

I forgot to mention earlier that my mother did have a mild stroke or maybe a series of ministrokes several years ago when she was still relatively  young.  I should tell my doctor that tomorrow.

 

[PeterPan]

Do you have someone who can go with you? Sometimes medical stuff gets overwhelming, with options, and it's nice to have an extra set of ears to run things by afterward and see if you're remembering things the same way. 

Be safe!

[Kassia]

2 minutes ago, PeterPan said:

Do you have someone who can go with you? Sometimes medical stuff gets overwhelming, with options, and it's nice to have an extra set of ears to run things by afterward and see if you're remembering things the same way. 

Be safe!

 

Thanks so much for your support.  🙂   DH could go with me but I'll be fine on my own for this.  Plus the doctor puts everything in my patient portal electronically so I can go back and review it and send her a message if I have any questions.

 

 

3 minutes ago, kand said:

Obviously I have no idea if what you are experiencing is something worrisome or not, but if it helps put you at ease (which in turn does tend to reduce irregular beats), I spent almost a year having PVCs at a rate of thousands a day, and two different cardiologists did not feel that was enough to warrant doing anything about (it would have required an ablation). It was uncomfortable as all heck though. It’s a fairly common peri-menopause symptom. The cure for me was getting pregnant 😂. 

 

 

LOL, I'm definitely not getting pregnant!  I'm 51 and in menopause but I do have low thyroid issues.  Thanks for sharing your experience.  🙂  

[Shoeless]

1 hour ago, Kassia said:

 

I think I have mostly normal heartbeats but my heart is beating faster than usual, then it will skip a beat and make up for it with two close together.  So maybe (if this makes sense)...  thump..thump..thump......thumpthump..      As far as the discomfort, I don't know how to explain it, but there are none of the symptoms you described.  It's more like I'm always hyperfocused on it because it feels off and it makes me anxious so I get that anxious feeling in my chest.  I don't feel nauseated but the irregularity makes me feel weird in a way that's close to it.  

 

 

It makes sense.  I get those from time to time as well, from a combo of thyroid issues and anemia. And yes, the feeling is very weird when it happens!  I noticed that you said in another post that you have low-thyroid issues.  Obviously, I am not a doctor so my opinion should not replace that of a skilled doctor, blah blah blah.  But it may be that your thyroid needs another look-see or you need a thyroid medication adjustment.  

[rdj2027]

I had those issues and it at east it got much much better after my vitamin D deficiency was dealt with.  Obviously it could have been something else but 2 years later I very rarely have those symptoms anymore, usually  only when I am overly stressed.

[Kassia]

6 hours ago, MissLemon said:

It makes sense.  I get those from time to time as well, from a combo of thyroid issues and anemia. And yes, the feeling is very weird when it happens!  I noticed that you said in another post that you have low-thyroid issues.  Obviously, I am not a doctor so my opinion should not replace that of a skilled doctor, blah blah blah.  But it may be that your thyroid needs another look-see or you need a thyroid medication adjustment.  

 

This is all so confusing.  So, who do I see - endocrinologist or cardiologist?  

It's been such a rough year.  I've always been incredibly healthy with no medical issues and then this year I've just been slammed with problems.  My mother and grandmother were hypochondriacs and I don't want to be like them.  

[wintermom]

All the best with your appointment. I've been going through similar heart beat sensations, and just spent 2 weeks with a holter monitor. My symptoms were so infrequent that I wanted to ensure I captured something on the monitor.  I must say that putting the issue "under the microscope" has made me more anxious and aware, and perhaps that's not a good thing. On the other hand, it's probably best to take note of heart-related items just in case there is something serious going on. 

[Kassia]

1 hour ago, texasmom33 said:

I would still start with the cardiologist to make sure it is nothing that requires immediate treatment. They can then give you the green light and then I'd move forward with the endocrinologist. 

Not to rain on your parade, but I've had a much harder time finding a decent endocrinologist than good cardiologist. In fact (I have thyroid lesions) I have been going to my ENT for my thyroid monitoring for the last 3 years after the endocrinologist disasters. So if you have a good ENT by any chance, start there for the thyroid (if you don't already have an endcrinologist you like.). But I would still prioritize getting in for the arrhythmia. 

And as I side note- I hadn't thought about it, but like @rdj2027, I also have low Vit D that requires constant supplement. I'm now wondering if when mine comes back if it's when I forget to take my supplements for a couple of weeks. Hmmm.....

 

I have a tough time finding any good doctors!  It's so frustrating to spend so much time and money on lousy medical care/advice.  I don't have an endocrinologist or cardiologist yet.  

I have to supplement with Vitamin D, too.  

[J-rap]

Because it's already been going on for quite some time, I think I'd be comfortable in waiting.  (I guess the appointment is today though, by now!)  I wouldn't exercise.  From my understanding, if the total number of beats turns out to be the same, it is not as critical.  So, if you skip beats but then make them up with beats that are closer together, that is better than skipping beats but not making them up.  That is what I've been told by a cardiologist, anyway.

[PeterPan]

On the vitamin D, are you taking it with K2? NOW Vitamin K-2 100 mcg,100 Veg Capsules  I take 200mcg a day in addition to my 10k IU vit D. 

I think the style of the doctor matters more than the label. I just started back on thyroid meds after years of being off them. I just went with some random guy who had an opening (heck, after 16 years of no docs I had to start somewhere) and the guy is actually really nice and listens and collaborates with me. And honestly, he's so random I think other people don't like him, because he's a little hairbrained, but it's working for me. I'm on naturethroid, happy as a lark, losing weight, more energy, all good. And the guy doesn't do things ideally (only runs TSH to save money, blah blah), but you know I just self-advocate and push a bit and say hey but this and this and he listens. 

So I think if I had a swanky opinionated doc who didn't listen and who was stuck on synthroid I wouldn't be as far as I am with my hairbrained guy who actually does listen. Also though, I'm not so sure they're gonna want to start thyroid meds till you get the heart thing figured out. You're being seen today, right? just ask. Maybe then run the labs on the thyroid while they're working up everything else. You can have that discussion. They watch your heart with thyroid meds and go slowly, so it will matter. I think it's just a conversation you'll have an you can work out a sequence and get both and get back to feeling like you want. :)

I hope your appt goes well!

[Kassia]

22 minutes ago, PeterPan said:

On the vitamin D, are you taking it with K2? NOW Vitamin K-2 100 mcg,100 Veg Capsules  I take 200mcg a day in addition to my 10k IU vit D. 

 

 

I have not been taking Vitamin D with K2 but I will.  Thank you for the recommendation! 

[Kassia]

I saw the doctor and she picked up PVCs right away when she listened to my heart and then set up an EKG and saw them there, too.  She ordered some lab work and I'm getting a monitor tomorrow.  

[prairiewindmomma]

18 minutes ago, Kassia said:

I saw the doctor and she picked up PVCs right away when she listened to my heart and then set up an EKG and saw them there, too.  She ordered some lab work and I'm getting a monitor tomorrow.  

Glad this is being taken care of! Hope you get helpful info off of the monitor.

[stephanier.1765]

I don't know about the running but please take care of yourself. And please update us again when you get your results.

[displace]

They should tell you about the monitor and exercise.  If you’re sweating it may distort the readings, and the physical act of running may cause artifacts.  It depends on the monitor they use.  PVCs are normal, but a large amount is not necessarily.  GL and I hope all is well.

[Catwoman]

1 hour ago, Kassia said:

I saw the doctor and she picked up PVCs right away when she listened to my heart and then set up an EKG and saw them there, too.  She ordered some lab work and I'm getting a monitor tomorrow.  

 

I just saw this thread — I’m glad you saw the doctor and I hope everything turns out ok.

Can you ask around and see if you can get a recommendation for a good cardiologist? You’ll probably get referred to one anyway, but even if your regular doctor thinks she can take care of this, I would still insist on getting a second opinion from a cardiologist, just to be sure you’re getting the best possible advice and treatment.

Praying that this is just a minor and easily correctable issue.

[J-rap]

That's really interesting about the PVCs.  From what I've read, they're much more common than we think.  I'm glad you're getting it checked out.

[Kassia]

Thanks everyone!  I will update once I get the results from the monitor.  My doctor said it could be up to a week after I return it because the cardiologist has to read it and give her the results.  

Thanks again for the support.  It means a lot to me.  🙂

[sassenach]

I would ask them about the running. My guess is that until they know the nature of your arrhythmia, they’re going to want you to keep it low key. 

[Forget-Me-Not]

On 11/28/2018 at 5:46 PM, Kassia said:

 

I never sleep.  I have chronic insomnia and my carpal tunnel syndrome has gotten very bad and it keeps me up in pain much of the night.  😞  

I drink plenty and food is not an issue.  😛

 

Lack of sleep can cause cardiac issues. You need to mention that to your doc. It could be an underlying cause.