Sep 15, 2017

Interview Transcript

Announcer: Is it bad enough to go to the emergency room or isn't it? You're listening to ER or Not on The Scope.

Interviewer: All right. It's time for ER or Not. You get to play along and decide whether or not something that's happened is worth going to the emergency room or not. With Dr. Troy Madsen, he's an emergency room physician at University of Utah Health. Sitting around kind of minding your own business and all of a sudden you noticed like your heart's beating really fast, it's racing. ER or not?

Dr. Madsen: Yeah. Well, this is a good question because we see this quite often in the ER. And the medical term for it is palpitations when you just have that feeling like your heart's racing or maybe it's skipping a beat. So I'd say it kind of depends on the other symptoms you're having with it and how long this lasts.

If it's something that lasts for a few seconds, it goes away, you could probably just follow up with your doctor. But if it's something where it just will not go away, let's say you feel down and you feel your pulse and it's going really fast, if you're having other symptoms like you're light-headed, passing out, absolutely I'd get right into the ER.

Interviewer: All right. In the instance where you just see your doctor where if it's just for a quick moment, what could possibly be going on there?

Dr. Madsen: So one of the most common things we see when people say they have palpitations or they just have this feeling like it's skipping a beat or speeding up, we'll often see what are called premature ventricular complexes or PVC's. All that means is the lower part of the heart that squeezes the blood out, can beat a little bit early. Typically, it's not a problem.

If that happens, a lot of people have that especially when they exercise. If it's bothersome, a cardiologist can do an oblation where they find the spot that's causing that premature beat and get rid of it. But usually, it's not a serious thing where you need to rush right into the ER and get that diagnosed.

Interviewer: And it's usually something that just kind of happens once in a while?

Dr. Madsen: For some people, it happens more frequently. Others, may never even notice it when it's happening, you know. In some cases, people do feel it. They may notice it more when they exercise or they're walking, so it varies from person to person.

Interviewer: All right. And in the case of where you would go to the ER if it was continual and it lasted for a while, what could that be an indication of?

Dr. Madsen: Yes. So that could sometimes be an indication of more serious things. The most serious thing being ventricular tachycardia where your heart is just racing. And that can be a life-threatening thing. Some people may have heart conditions that set them up for that that make them more likely to have that happen. That's something where sometimes we even need to shock the heart to get it back into a normal rhythm.

Another thing we commonly see especially in older people is atrial fibrillation. Now, this is where the top of the heart, the atria, goes really, really fast. And in the bottom of the heart then senses some of those fast beats from the top and then conducts that at also a very fast rate. It also sometimes can be life-threatening because it will drop your blood pressure but in most cases, people come into the ER. Their blood pressure's okay. We can give them medications to slow their heart down or we can also, if we have to, give them a little bit of sedation and shock the heart back into a normal rhythm.

So if your heart's racing and it just lasts a short period of time, otherwise, you feel okay, I think you're okay just to see your doctor. If it's something that's going on for longer than a minute or two or it keeps coming back or you're having other symptoms with it, absolutely, you have reason to get to the ER.

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