I am a 41 year old woman. For 2 months I have been suffering from palpitations at rest, reaching up to 103 beats per minute, I did an echocardiogram and electrocardiogram: all negative. I have always led a healthy life, even going to the gym. I wonder; these fast beats, so annoying, indicate that sooner or later (and maybe not so much later) you will suffer from a heart disease? My cardiologist told me not to use beta blockers, while the doctor who gave me the echocardiogram said I could. What should I do? I am very anxious, I am afraid that something will happen to me.
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Massimo Mapelli, Disompense Unit, Clinical and Rehabilitation Cardiology, Card. Monzino IRCCS, Milan.
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Last year the New England Journal of Medicine, the most prestigious medical journal in the world, published a clinical study in which a large number of people (419,297, all without a known heart disease) were subjected to monitoring through a special Smartwatch, a new generation watch, with many functions in able, among other things, to record an electrocardiographic trace in a similar way to what we do every day, but only for a few seconds, in our clinics.
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Controls with special Smartwatches
The presence of significant arrhythmias in these people was extremely low; significant cardiac rhythm abnormalities were recorded in only 0.52% of the subjects analyzed. From a medical point of view, these data make the use of massive monitoring and screening programs in people who do not have signs or symptoms truly compatible with heart disease, such as atrial fibrillation or other more or less arrhythmias, unjustifiable (if not completely futile). malignant.
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Reassuring study
It can be said that this study has reassured about the presence (or rather the absence) of heart patients in the population and has therefore, more generally, led to greater optimism. This brings us back to his case. The presence of a completely normal electrocardiogram and echocardiogram, as yours are according to what you are referring to in your letter, allows us to reassure you about the nature of the troublesome episodes: they are most likely benign, without characteristics of a possible evolution into a heart disease and perhaps linked simply to an anxious state typical of her character, always according to what she tells us.
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Distinguish anxieties from clinical suspicions
However, numbers and percentages are double-edged weapons when compared to a single patient, and she herself could answer me, if you read the aforementioned study, that 2,161 subjects were found in which clinically relevant arrhythmias were found. As you understand, the right way to distinguish between patient anxiety and clinical suspicion must always be found. And not simple; but knowing that in probabilistic terms there is nothing wrong with his heart can be of great comfort.
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Non-invasive tests
Discuss with your family doctor or cardiologist the opportunity to undergo some additional non-invasive tests (electrocardiographic monitoring or exercise tests), but in the meantime you are exercising your most difficult muscle to train: optimism. So continue with your healthy lifestyle (as soon as possible, go back to the gym regularly), try to take mild doses of beta blocker (for purely symptomatic purposes) and consider yourself absolutely healthy, at least until proven otherwise.
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October 6, 2020 (change October 6, 2020 | 09:58)
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