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Dr. Natasha
Dr. Natasha, Doctor
Category: Health
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Experience:  American Board Certified in Emergency Medicine and Ivy League trained
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Hello, I have a question about heart palpitations and flying.

Resolved Question:

Hello,

I have a question about heart palpitations and flying.

I’m a 32-year-old female, smoker, infrequent drinker. Normal height and weight. No ongoing medical issues and no family history of heart disease. I have struggled with panic and anxiety disorders, but both are controlled.

About two weeks ago, I began experiencing what feels like skipped heartbeats. Palpitations of this sort aren’t entirely new to me -- for most of my adult life, I’ve experienced skipped beats just before my period, but they’re very isolated and tend to go away once menstruation starts. I’ve also experienced skipped beats in conjunction with extreme periods of anxiety, but again: generally isolated, and they go away quickly.

These skipped beats, however, have been more sustained. At worst, they’ve come on at a rate of roughly 2-5 per minute and lasted for most of the day. At best, I’ll have only 20-30 per day. They don’t come with any other symptoms -- no shortness of breath, no chest pain, no fainting or even near fainting. Heart rate remains absolutely normal, and my blood pressure is great. At first, they made me anxious, which seemed to make them worse. I’ve stopped constantly panicking about them now, though, so they’re just kind of annoying.

I had a regular appointment with my psychiatrist several days after they began, so I chatted with her about it. She did a basic work-up and said that based on my heart rate, blood pressure and the steadiness of the rhythm surrounding the skipped beats, she suspected they were likely PVCs or PACs. Because my GP is located about an hour from where I live (and I’m in the process of finding one closer to home), she mentioned that I could go to urgent care to have an EKG and blood work. But she didn’t feel that it was a dire situation.

Unfortunately, immediately after that appointment, I came down with a terrible cold and only recovered earlier this week. I haven’t been to urgent care yet, primarily because the skipped beats calmed down quite a bit. But today, they’re back. Here’s the most interesting thing: I’ve discovered that the single best way to calm them down or make them stop completely is to spend 30 minutes on my stationary bike. The irregular beats seem to be worst first thing in the morning, but once I get on the bike, they usually disappear for most of the day. I’ll throw a few during the exercise (only if they were happening before I began exercising), but within 5 minutes of cooling down, they’ll disappear for up to 8 hours. If they reappear later, they’re definitely not constant. I’ve also found that avoiding gluten and most heavy carbs keeps the skipped beats at bay.

My question is this: I’m scheduled to get on an international flight tomorrow afternoon, and while I’m not panicking that I’m about to drop dead, I don’t want to be unsafe. I’ve scheduled a full work up with my GP for when I return. Will I be okay to fly tomorrow?

 I read that uncontrolled arrythmias can be a problem, but my psychiatrist mentioned that "uncontrolled" in this instance typically refers to situations like atrial fibrillation.

Thank you,
Lisa

P.S. I’ve also tried low doses of magnesium and Pedialyte under advice from aforementioned psychiatrist, which have seemed to help intermittently.
Submitted: 8 months ago.
Category: Health
Expert:  Dr. Natasha replied 8 months ago.
Hi
Thanks for your question.
Concerning arrhythmias are uncontrolled atrial fibrillation, ventricular tachycardia or supraventricular tachycardia.
Having the occasional PVC or PAC are not an issue, especially if you feel better with exercise.
If they are causing chest pain, dizziness, passing out or shortness of breath, then do not fly.
If they are not, then you can fly

hope that I provided you with excellent service.
Please leave positive feedback if I did
Use reply if you need clarification.
:-)
Dr. Natasha, Doctor
Category: Health
Satisfied Customers: 11668
Experience: American Board Certified in Emergency Medicine and Ivy League trained
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