Thanks for your concerns. By your clinical description, one could suspect indeed an arrhythmia
causing such symptoms; something that many physicians do not understand is that if the symptoms are sporadic, a Holter monitor
is only a 24 hour window of opportunity to catch an arrhythmia; if we dont it does not mean it doesn't exist. A more prolonged method of monitoring such as an event monitor, can be indicated, which can be worn for 3-4 weeks and increase the chances of detection. If nothing is seen after such period of monitoring, particularly if you document symptoms and the EKG/ST segment analysis is normal, then other causes, such as anxiety
, panic disorders, GI causes, etc could be pursued.
Dr Brenes-Salazar MD
Mayo Clinic MN