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Palpitations present as a sensation of rapid or irregular heartbeats. Though they are often benign, they still raise concerns about underlying cardiac issues. Many patients present at a Naturopathic medical office with this complaint. The most frequent causes of these mysterious episodic palpitations is histamine intolerance or mast cell disorder, candida and mycotoxin exposure, and undiagnosed Dysautonomias. A comprehensive cardiology assessment of palpitations can provide either an accurate and treatable diagnosis or provide assurance that the health of the heart is not affected by the unknown current trigger.

The initial evaluation may be completed by a primary care physician or a cardiologist. A detailed patient history will gather information on the onset, frequency, duration, and associated symptoms that may help identify potential triggers. Lifestyle Factors will be explored such as caffeine intake, stress levels, and substance use aids in uncovering lifestyle-related contributors. A physical examination which includes blood pressure measurement, evaluation of heart sounds, and assessment of peripheral pulses, can provide valuable insights. A neurological examination is crucial to help identify potential neurological causes, such as autonomic dysfunction often seen with mold exposure, Lyme disease, and other chronic autoimmune disorders such as Small Fiber Neuropathy.

Diagnostic Testing can include the Electrocardiogram (ECG) which records the heart’s electrical activity, aiding in the detection of arrhythmias or abnormal rhythms. An extended ECG such as a Holter Monitor provides monitoring over 24-48 hours to capture intermittent abnormalities that may be missed in a standard ECG. A Stress Test may be recommended to evaluate heart function during physical exertion which helps identify exercise-induced arrhythmias.

Advanced Imaging such Echocardiography or a Cardiac MRI can provide detailed images of the heart’s structure and function, aiding in the identification of structural abnormalities.

Laboratory tests for anemia, electrolyte imbalances, and thyroid dysfunction helps rule out non-cardiac causes of palpitations.

In conclusion, a systematic approach encompassing patient history, physical examination, diagnostic testing, advanced imaging, and laboratory assessments is pivotal in the cardiology evaluation of palpitations. Early and accurate diagnosis allows for tailored interventions, ensuring optimal cardiac health. In the absence of any identifiable physical or electrical dysfunction, testing to determine root causes such as mold toxin exposure, Lyme disease, Bartonella, and histamine disorders should be undertaken by your Naturopathic physician.