Q. For the past four weeks, I have heart palpitations, shortness of breath, and fatigue. What to do?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by Dr. Hemalatha
This is a premium question & answer published on May 04, 2020 and last reviewed on: May 16, 2020

Hi doctor,

For the past four weeks, I have had terrible heart palpitations, shortness of breath, and bouts of fatigue. A thing I have started to notice is it seems to get much worse after eating anything with carbohydrates. After I eat, the symptoms ramp up in 30 minutes to one hour. I can exercise without any issues. I am 33 years old and this has never happened to me before. I went to the hospital one week ago who confirmed my heart was racing and temperature slightly up but standard blood tests came back normal and there was nothing on a chest x-ray. Where do I go from here? Will this stop? Many thanks.



Welcome to icliniq.com.

Fever causes a faster heart rate. Another reason, which is not uncommon in young people, is vagal atrial fibrillation. This is an irregular fast heartbeat that occurs in bouts after eating and during resting and spontaneously revert back.

What did your ECG show? Was it only sinus tachycardia or rhythm problem such as atrial fibrillation? Fever usually causes sinus tachycardia, which is a normal response to fever. When fever subsides, the heart rate slows down.

Sometimes it occurs due to gastrointestinal problems, in which eating leads to insulin gush, which lowers blood sugar and sensation like blackout, weakness, palpitations, and fatigue develop. Chances of this are very low.

Please send me the ECG strip so that I may diagnose your rhythm. Blood tests that might be helpful include CBC (complete blood count), U&E (urea and electrolytes), TSH (thyroid-stimulating hormone) and the ECG.

These are also some rare disorders that cause a sudden rise in heart rate, fever, shortness of breath, and very high blood pressure. This condition is called pheochromocytoma, but it is extremely rare.

Please tell me the other symptoms you develop along with fast heart rate feelings and fever. This along with the above tests will guide to reach a diagnosis.

If the above tests are normal, I will advise you to have Holter monitoring done for 24-48 hours to catch fast heart rhythm, if not caught on ECG.


Hi doctor,

I do not have an ECG strip to send but there were no irregular rhythms. I believe the complete blood count was normal, but not sure what else was looked at. I did have a high fever four weeks ago perhaps something is still lingering. Other symptoms are shortness of breath, and irritability or restlessness. When this began around four weeks ago, I did have what was thought to be a panic attack though this was thought to be from hyperventilation and has not happened since.



Welcome back to icliniq.com.

The panic attack lasts for a short time and may occur randomly. There may be a slight fever but no longer running or high fever. Chest infections cause abnormalities in CBC.

Hyperventilation does occur in a panic attack or sudden anxiety. It is good to know that the symptom did not occur since then.

If you still have tachycardia that are persistent, I would advise for CBC and TSH.

Wishing you good health. Take care.

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