Experiencing Heart Palpitations After Pulmonary Embolism
A 26-year-old female, weighing 100 pounds and standing at 5'2", experienced a pulmonary embolism (PE) along with cerebral venous thrombosis in late May 2025. She has low levels of protein S but does not have any autoimmune disorders. She is currently being treated with Xarelto at a daily dose of 20mg. Following the occurrence of blood clots, she encountered no significant complications aside from minor visual disturbances, and her cardiac health was deemed stable. However, last weekend she began to experience the same heart palpitations and chest discomfort that she had during her PE episode. After visiting the emergency room, her heart rate was measured at a slightly elevated rate of 110. A CT scan did not reveal any evidence of clots, and the ECG indicated the presence of an extra heartbeat. The physician reassured her that there was no cause for concern and suggested undergoing a 24-hour Holter monitor test, although she has yet to complete it. Blood tests, including troponin, D-dimer, CBC, sodium, potassium, and creatinine, all yielded normal results. Prior to her PE, she did not suffer from heart palpitations or chest pain. She denies any anxiety issues and abstains from caffeine, smoking, and alcohol. She wonders if her current symptoms could be linked to the PE. Currently, she continues to experience heart palpitations and chest pain, which occasionally disrupt her sleep. In addition to the Holter monitor, she is considering whether it is advisable to consult a cardiologist for further evaluation. Thank you for your guidance in advance!
Answers (1)
7/30/2025, 6:20:44 PM
OpenHealth AI
It's understandable to be concerned about heart palpitations and chest discomfort, especially following a significant event like a pulmonary embolism (PE). While these symptoms can be alarming, it's important to approach them with a clear view of your health status. Given your recent tests and the reassurance from your physician, here’s a breakdown of your situation and some actionable steps.
Main Points:
- Your current symptoms of heart palpitations and chest discomfort may not indicate a serious problem, especially since tests have ruled out critical issues.
- It's wise to continue with the recommended monitoring (like the Holter monitor) to gain more insight into your heart's rhythm.
- Consulting a cardiologist could provide you with additional reassurance and evaluation, especially since you're experiencing ongoing symptoms.
Explanation:
Heart palpitations can occur for various reasons, including your body adjusting to the aftermath of a PE, stress responses from your recent health events, or benign conditions like extrasystoles (extra heartbeats), which were noted in your ECG. Since your heart health has been assessed, and tests haven’t identified new problems, it’s likely that your symptoms are more related to your recovery process and possibly benign in nature.
Next Steps:
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Complete the Holter Monitor Test: This is crucial as it will provide detailed information about your heart's rhythm over 24 hours. Make sure to follow through with this test, as it might pinpoint the cause of your palpitations.
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Monitor Symptoms: Keep a record of your palpitations, noting when they occur, their duration, and any associated activities (for example, physical exertion or stress). This diary can provide valuable information for your doctors.
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Consult a Cardiologist: If your symptoms persist or worsen after completing the Holter test, scheduling an appointment with a cardiologist may be beneficial. They can provide specialized insights and possibly conduct further evaluations if needed.
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Manage Stress and Rest: Given that your symptoms can disrupt your sleep, focus on relaxation techniques such as deep breathing, meditation, or gentle yoga before bed to help alleviate anxiety and promote quality sleep.
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Follow-up on Symptoms: If you encounter new symptoms, such as increased pain, shortness of breath, or if palpitations become more frequent, seek medical attention promptly to ensure a thorough evaluation.
Your experience and feelings are valid, and taking proactive actions will help you feel more in control. Don't hesitate to reach out with any further questions or concerns!
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