Hello doctor, I am a 25-year-old woman and 21 weeks pregnant. I have always noticed some irregular things with my heart but none have ever been detected on a monitor. However, it is much worse since becoming pregnant. I have noticed after eating any food, drinking caffeine, or feeling anxious my heart flutters and I feel dizzy and short of breath. Sometimes, I get a sudden wave of extreme fatigue. I am concerned I have atrial fibrillation or some other heart rhythm problem that my doctors are not finding. This triggers my anxiety and makes the symptoms worse. How would I know if it is just anxiety that seems to come at certain times, or if it is a problem with my heart? I have had a few EKGs and one 24 hour Holter monitor but did not experience symptoms during the tests.
Hello. All these symptoms may just indicate anxiety. However, we should make some attempt to rule out arrhythmias. Now, your symptoms which occurs including fluttering and dizziness can occur with anxiety or caffeine. Caffeine itself can produce palpitations and various symptoms. So overall, I would keep anxiety as the first possibility. But, whenever you get symptoms, you should try to feel pulse for pulse rate in one minute if possible for you. Or else if you have electronic BP apparatus then it may show your pulse rate. So it may indicate the possibility of atrial fibrillation. Next, ectopics are quite a common arrhythmia in the young patient, and it can be there in you. May get aggravated by pregnancy. It can give you the feeling of a skipped beat. Now, we should confirm it objectively. So the best way other than Holter is, you order Alivecor Kardia monitor, which is a mobile-based system, which is portable and you can attach yourself at home and it will record your rhythm and can be analyzed. Alternatively, various watches are available which can record your pulse rate throughout the day and we can at least analyze the heart to consider the possibility of atrial fibrillation. Overall, it does not appear anything serious to me at the moment. I guess you must have had an echo done, right?