Three Years of Heart Palpitations Dismissed as Anxiety

In November 2021, Gemma stood in line at a neighborhood pharmacy. She was twenty-six years old. Without warning, her heart rate spiked from 70 to 172 beats per minute. Her vision narrowed at the edges.

Sweat broke out across her forehead. Her knees buckled. She grabbed a display rack to avoid hitting the floor.

Later that day she was sitting in an urgent care clinic. The attending clinician recorded a resting heart rate of 88 beats per minute and a blood pressure reading of 120/78. An electrocardiogram trace showed normal sinus rhythm. It was unremarkable.

"You have a demanding job and a lot on your plate," the clinician told her. "Your body is holding onto stress in ways you might not consciously register." She received a leaflet about breath control before she went home.

Over three years, Gemma experienced recurring episodes where her heart raced suddenly. These spikes came with lightheadedness and presyncope. Profound fatigue followed every episode.

Every time she sought medical care, doctors pointed back to her mental health.

The Language of Hypervigilance

After she requested her medical notes under data protection regulations in late 2024, Gemma discovered that clinicians persistently framed her symptoms as psychological even though she attended sixteen consultations across two clinics and one hospital emergency department.

In January 2022, a primary care doctor recorded this: Patient presents with ongoing palpitations. Clear physical exam. Suspect underlying generalized anxiety disorder.

Seven months later, in August 2022, another episode left her unable to stand. A different practitioner wrote: *Reassured patient. Disclosed mild work stress. Encouraged sleep hygiene and reduction of caffeine intake.

Health anxiety contributing to symptom hyperfixation.

Although the medical notes remained polite, they became reductive when doctors suggested her panic attacks were nocturnal even after Gemma explained that her heart raced while she was reading or brushing her teeth.

Doctors treated a heart beating at nearly three times its resting rate as evidence of psychological vulnerability.

Doctors relied on snapshot diagnostics. An ECG in a room, recorded after an episode passes, will show normal sinus rhythm for intermittent cardiac events. Clinicians defaulted to anxiety.

Three Years in Logbooks

In June 2022, Gemma bought a pulse oximeter and a heart rate recorder. She began keeping a structured logbook inside a notebook. Over twenty-four months, she filled two notebooks with handwritten entries. She tracked variables for every episode: date, peak heart rate, and activity.

• October 2022, morning: Peak HR 168 bpm. Sitting at table drinking water.
• February 2023, evening: Peak HR 175 bpm. Folding laundry. Felt lightheaded, sat on floor.
• August 2023, late morning: Peak HR 162 bpm. Walking to the bathroom upon waking.

When she brought the logbooks to four separate appointments, doctors ignored the records because they preferred to review her blood test results, which kept coming back normal for thyroid function, electrolytes, and anemia markers. Doctors took clean bloodwork as proof that nothing structural was wrong.

By early 2024, Gemma stopped using the word "heart" around her family. Clinicians at sixteen appointments told her that her body was misinterpreting normal stress. She began doubting her own pulse.

Forty-Eight Hours on Paper

After Gemma moved to a new town in June 2024, she met a covering primary care doctor who skipped the summary tab on the screen so that she could look inside the notebook which Gemma carried.

The doctor flipped through pages of numbers. She compared the sudden onset spikes against the recorded activities. An abrupt leap from 65 to 170 bpm while sitting motionless did not match the typical gradual curve of a panic response.

In July 2024, Gemma received a continuous ambulatory Holter monitor. The device recorded every heartbeat across two full days of her normal routine, unlike the ECGs she received in the past. During the second morning, Gemma was typing an email when her chest fluttered. She pressed the button on the device.

It was mid-morning.

A cardiologist analyzed the trace two weeks later. The mid-morning recording was unambiguous. It showed a sudden, paroxysmal run of rapid cardiac rhythm, distinct from normal sinus tachycardia driven by adrenaline. The trace captured an electrical abnormality on paper.

It had been happening unmonitored for three years.

The cardiologist's written assessment was brief: Ambulatory monitoring demonstrates clear evidence of paroxysmal arrhythmia, explaining the patient's long-standing symptoms of palpitations and presyncope. Not attributable to anxiety.

The Morning After

Her formal diagnosis was confirmed in late August 2024. A cardiologist prescribed a daily medication designed to control the heart's electrical signaling and regulate her resting rhythm. The sudden spikes in heart rate stopped within four weeks of starting treatment.

Nobody apologized. There was no confrontation with the clinicians who spent three years attributing her symptoms to work stress. Administrators updated her medical records, overwriting suspected health anxiety with specific cardiac coding.

In November 2024, three years after her first urgent care visit, Gemma stood in her kitchen making coffee. She watched the kettle boil. Her heart rate remained at 64 beats per minute. She picked up her cup and walked to her desk.

She opened her laptop for work. The two notebooks sit inside the top drawer next to her keyboard, packed with handwritten numbers.

Questions people ask

Why did Gemma’s ECGs not detect her heart rhythm problem?

Her earlier ECGs were recorded after the episodes had passed and showed normal sinus rhythm. The intermittent abnormal rhythm appeared only when a Holter monitor recorded every heartbeat for two days.

How did doctors determine that Gemma’s palpitations were not caused by anxiety?

Gemma’s logbooks showed abrupt heart-rate jumps while she was sitting or doing ordinary activities. A new doctor recognized that this pattern did not match the gradual increase expected with a panic response, and ambulatory monitoring confirmed a paroxysmal arrhythmia.

What happened after Gemma was diagnosed with a paroxysmal arrhythmia?

A cardiologist prescribed daily medication to control the heart’s electrical signaling and regulate her rhythm. The sudden heart-rate spikes stopped within four weeks, and her medical record was updated with cardiac coding instead of suspected health anxiety.