A single strong thump in the chest lasting a few seconds with the pulse briefly touching 130 is most often a premature beat (ectopic) followed by a compensatory pause, or a short burst of sinus tachycardia - it is not necessarily SVT. True SVT usually starts abruptly, stays at 150-220 per minute steadily for minutes to hours, and stops as suddenly. A 5 second episode is unlikely to be SVT, but the only way to confirm is to catch it on a recording. Please get a resting ECG, 2D echo, and importantly a 24-48 hour Holter monitor; if the episodes are infrequent, a longer patch monitor or even a smartwatch single-lead ECG taken during the thump helps me a lot. Also check haemoglobin,
TSH (
thyroid), serum
electrolytes and
vitamin D, since anaemia and thyroid problems commonly cause palpitations. In the meantime cut down chai/coffee, energy drinks, nicotine, alcohol and OTC stimulants, sleep 7-8 hours, stay well hydrated and manage anxiety with slow breathing - fear itself raises adrenaline and gives you more thumps. Do go to an emergency department if you ever get palpitations along with chest pain, breathlessness, fainting or near-fainting, or if a fast heartbeat lasts more than a few minutes. I can review your ECG and Holter with you on a Practo consult or at Synergy Multispeciality Hospital, Miraj.