Heart Palpitations

Q Every so often my pulse feels like it trips or skips a beat. Is this an arrhythmia? (47, teacher)

A. That "tripping" sensation may be an ectopic beat, which is common even in healthy people. However, symptoms alone cannot confirm an arrhythmia — an ECG is needed. If it is frequent or comes with dizziness, testing is recommended.

Q My ECG and blood tests are all normal, but I still get palpitations. It feels like nobody believes me. (36, office worker)

A. Normal tests do not mean "no symptoms" — they mean dangerous causes have been ruled out. Brief palpitations often do not appear during the moment of testing. At this stage the approach shifts from removing a cause to adjusting a repeating bodily response.

Q Is a Korean medicine clinic an appropriate place for palpitations? If it is a heart problem, surely herbal treatment cannot help? (41, homemaker)

A. Structural heart disease should be treated by cardiology first. But when tests are unremarkable, or when palpitations, insomnia and tension persist during treatment, Korean medicine can help. Deciding which case applies is the purpose of the first consultation.

Q Besides palpitations I am losing weight and my hands tremble. Should I check my thyroid or for anaemia? (34, office worker)

A. Yes, both should be checked. An overactive thyroid causes palpitations with weight loss, hand tremor and heat intolerance; anaemia causes palpitations with dizziness, fatigue and pallor. Both are confirmed relatively easily with blood tests.

Q What should I do the moment palpitations start? Is there anything that helps right then? (31, graduate student)

A. Slow, extended exhalation is the most immediate method. Breathe in for four seconds and out for six to eight, repeated for a few minutes, and the heart rate often settles. Alongside that, protecting your sleep is the key to reducing how often it returns.

Q The palpitations have made me afraid to exercise. Is it better to keep resting? (44, office worker)

A. If tests are normal, avoiding exercise actually works against you — regular aerobic activity lowers resting heart rate. However, if you have ever had palpitations, dizziness or chest pain during exercise, you must be tested first.

Q How do I tell whether palpitations can simply be ignored or are an emergency? (52, employee)

A. Seek care immediately if palpitations come with fainting or blacking out, chest pain, or severe shortness of breath. The same applies if a very fast or irregular pulse lasts several minutes or more, if it starts during exercise, or if you have a family history of heart disease.

Q I take diet supplements and energy drinks together. Could that be causing the palpitations? (28, job seeker)

A. It is quite likely. Energy drinks and diet supplements often contain overlapping stimulants, so the total intake is far higher than expected. If the palpitations began around the time you started them, stopping first and watching for change is the logical order.

Q I am on medication from cardiology. Can I take herbal medicine alongside it? (57, self-employed)

A. Combination is usually possible, but we need to know exactly what you are taking. Heart-rate lowering drugs, anticoagulants, thyroid medication and anti-anxiety drugs particularly need checking. Never reduce or stop your existing medication on your own.

Q How long until these palpitations improve? I worry I will have to live with them forever. (37, office worker)

A. It depends on the cause. Where a trigger such as caffeine or lack of sleep is clear, it often eases within a few weeks; where it is entangled with long-standing tension, expect two to three months. Most cases are manageable, and lifelong persistence is uncommon.

Q I never used to notice my heartbeat, but lately I can just hear it. Why am I suddenly aware of it? (39, office worker)

A. Your heart always beats, but the brain normally filters out the signal. Palpitations occur when the heart genuinely beats harder or faster, or when the brain becomes so sensitive that it stops filtering. Both are possible, so telling them apart is the first step.

Q I am fine during the day, but as soon as I lie down my heartbeat echoes into the pillow. Why is it worse lying down? (45, self-employed)

A. A quiet room and a lying posture both make palpitations easier to notice. Background noise disappears, and lying on your left side brings the heart closer to the chest wall so each beat transmits more easily. If it persists after changing position, or the pulse is irregular, testing is needed.

Q It only happens when I am stressed. Is my mind really making my heart race? (33, nurse)

A. Stress genuinely raises heart rate through the autonomic nervous system. It is a bodily response, not a matter of imagination. But if palpitations also occur outside stressful moments, or the pulse is irregular, do not explain everything by stress — it needs to be checked.

Q Do I have to give up coffee completely? I would like to keep my one morning cup. (38, designer)

A. You do not have to quit outright, but adjusting the total amount and the timing helps. Up to about 400mg of caffeine a day (three to four cups) is the usual guide; with palpitations, take less than that and avoid caffeine after early afternoon.

Q It is much worse the day after drinking, or after a big meal. Is that connected? (49, self-employed)

A. Yes. The day after drinking, dehydration and an unsettled autonomic system raise the heart rate; after overeating, blood flow shifts to digestion and the heart works harder. A blood-sugar drop after a load of sweet food can also trigger palpitations.

Q I live in Dong-gu, Incheon and work near Dongincheon. How often would I need to come in for palpitations? (40, employee)

A. We recommend acupuncture twice a week at first, adjusting the interval after three to four weeks. The first consultation takes about 30 to 40 minutes because of the detailed questioning. Dongjedang Korean Medicine Clinic is on Dongsan-ro in Dong-gu, Incheon, an easy trip from the Dongincheon area.

Q In what order do you assess palpitations at the clinic? What happens on the first day? (42, office worker)

A. The first consultation is about differentiation and assessment. We review when symptoms occur, the character of the pulse, and any existing test results, and if warning signs are present we recommend testing first. We then classify the body state, set the direction for acupuncture and herbal medicine, and review every three to four weeks.

Q Does acupuncture really reduce palpitations? You are hardly needling the heart itself. (50, office worker)

A. Acupuncture does not stimulate the heart directly; it works toward rebalancing the autonomic nervous system. Many patients whose palpitations are tied to tension and insomnia report a noticeable change. It is not, however, a treatment that corrects an arrhythmia itself.