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.
Detailed Answer
Most palpitations are not dangerous, but if any of the following apply, go to a medical facility immediately rather than waiting.
- Palpitations with fainting or your vision going black
- Chest pain occurring at the same time
- Breathlessness severe enough that speaking is difficult
- A very fast or irregular pulse lasting more than a few minutes
- Sudden-onset, sudden-ending episodes that recur while at rest
- Palpitations or dizziness that appear during exercise
- A family member who died suddenly at a young age or had heart disease
An ECG is the basic test. If episodes are intermittent and never appear in the clinic, a 24-hour Holter monitor records the rhythm at the moment symptoms occur. Echocardiography or an exercise stress test may be added. When we see these signs at the clinic, we ask patients to have cardiology testing first and decide about Korean medicine treatment only after reviewing the results.
Korean Medicine Clinic Perspective
Korean medicine treatment is strongest for palpitations that keep recurring despite unremarkable tests, or for the discomfort that lingers alongside treatment of a known cause. Keeping the order of diagnosis first, treatment second is what is safest for the patient.
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