Heart Disease Tests Question: What Tests are Needed to Diagnose an Arrhythmia?

I have been having a problem with a fast and skipping pulse. It comes out of nowhere, with seemingly no rhyme or reason, and it has lasted for up to seven hours. My blood pressure is lower than normal (100/65), and my pulse is 135.

A rapid and irregular heartbeat is, in fact, a common occurrence. It’s also a clinically significant one. You may have an arrhythmia, which is a potentially serious disturbance of your heart’s natural rhythm. It’s imperative that you see a doctor who can accurately assess the problem, because lower blood pressure and a rapid heart rate can negatively affect both your heart and your brain. An evaluation by a cardiologist would be ideal, but it’s also okay to begin with your primary care physician.

Testing should begin with a baseline electrocardiogram (EKG) and a Holter monitor evaluation. These are basic, noninvasive tests typically covered by insurance. If you’ve never had a Holter evaluation, you can think of it as a 24-hour EKG. You’ll be asked to wear several adhesive electrode pads on your chest, and wires will connect the pads to a small recorder worn on a belt or in a sling. At the same time, you will be asked to keep a diary of your activities and any symptoms you feel. Document your blood pressure periodically as well.

Your doctor will then analyze your heart’s rhythm to determine the specific type of problem you have. Appropriate treatment proceeds from there.

Some common underlying causes of arrhythmia include:

• Menopause, when hormone levels drop
• Sensitivity to caffeine
• Excess sugar intake, which causes fluctuations in insulin and adrenaline
• Alcohol
• Everyday stress
• Magnesium deficiency
• Mitral valve prolapse
• Any category of heart disease, including heart attack, hypertension, and angina

Arrhythmias also can occur as a natural part of aging or if there has been enlargement of the upper chambers of the heart. Medication may be necessary. But regardless of what the issue turns out to be, I recommend staying away from sugar, and cutting down on caffeine and alcohol. And, as always, watch your stress level.

Learn More From Dr. Sinatra

• Read more questions and answers about heart disease tests.
• Read more questions and answers on all topics.