Question: I am a 39 year old male. I was having issues during exercise where it would feel like my heart skipped a beat and it took my breath away. This was very infrequent, maybe 5 times over 10 months exercising every other day. Saw cardiologist, had echo which was normal except for some slight webbing in pulmonary artery causing a tiny bit of increased flow that the Dr. said I have probably had my whole life. Also had stress test, went over my target heart rate which was 180 to 186. Dr. said I did well. I do believe I suffer from anxiety, as it runs in my family. I do notice from time to time that I will notice my heart beating faster (sometimes this is after eating) around 100 bpm, and then it appears out of rhythm, for example, two or three fast beats, a pause, then two slow beats, then back to fast. Its very odd but only happens when I get these palpitations, although not always with them. It almost seems I can control them with my breathing. This repeats over the course of a few minutes, then it takes my heart rate a bit to come down, which by this point I think my anxiety takes over and makes things worse. I mentioned I might have an irregular heartbeat to my Dr., so they are going to put me on a Holter monitor. My BP is a little high at around 130-140/90. No family history at all of any heart related issues. My Dr. mentioned he might put me on atenolol, but I am not sure I want to be on a beta blocker. From what I have read online these sound like ectopic beats, but I am looking for more clarification.

Hello Dr. XXXXXXX and thanks for your response. I didn't feel any rapid or irregular beats while wearing the monitor, so does this mean I should ask for another monitor? Also, can you elaborate on what you mean by dangerous rhythms, what is flute? How much magnesium do you normally suggest your patients take? Thanks again.