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Q. My EKG reading shows sinus arrythmia. Kindly advise.

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Jun 16, 2020 and last reviewed on: Jul 10, 2020

Hello doctor,

I went to urgent care today because I had bad heart palpitations while taking a walk, along with some cuest discomfort. I have heart palpitations quite frequently but these felt different. They were a but thump behind my sternum, several times in a row. The EKG reading from urgent care says “sinus arryhtmia”. I have had many EKGs done before but it has never said that. Is this of concern?



Welcome to

Your ECG is fine and sinus arrhythmia is normal phenomenon, where heart range varies with respiration. It may not be evident always or depends on sensitivity of machine, and also it is more pronounced, detectable when one is breathing heavily or rapidly. So it is not a matter of worry at all.

Next thing, were you also having palpitations when ECG was taken or subsided by that time? Because considering symptoms of palpitations and chest discomfort, its important to rule out possibility of cardiac arrhythmias like PSVT/ paroxysmal atrial fibrillation, which are intermittent and ECG would be absolutely normal at other time. So normal ECG does not rule out possibility of arrhythmia.

So you should either have holter monitoring (24 hour ECG monitoring, but it would detect arrhythmia only if it happened during this 24 hour period) or you can buy simple single lead ECG devices, which would help to monitor your rhythm whenever you are symptomatic. So, basically we need an ECG rhythm during symptoms so as to reliably rule out possibility of cardiac arrhythmia. In a nutshell, your ECG is fine and may need further steps. I would also like to know why are you eliquis, Prednisone. And thyroid problems may cause arrhythmia like atrial fibrillation, so TSH should be monitored.

Hi doctor,

Thank you for your answer. No, I was not having palpitations when the ECG was taken, but I was having some left sided pain. I have a mitral valve prolapse with mild regurgitation, but the palpitations I felt today were completely different from what I am used to. I am taking Eliquis because I had a blood clot in my left jugular vein. The Prednisone is for Sjogrens.



Welcome back to

So you are at a risk of cardiac arrhythmia. In that case, normal ECG would not rule out cardiac arrhythmia and some chest heaviness may persists for few hours following arrhythmia. So you should have some sort of rhythm monitor, best would be home based ECG monitors which I mentioned above, by which you can get your rhythm checked at any moment. You should get an echo appointment if it is more than one to 2 years for last echo. Besides MVP, pulmonary hypertension would be another parameter to be looked at during echo.

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