Fiona Xie’s scary fast heartbeat (heart palpitations): What it means and when to worry

Crazy Rich Asians star Fiona Xie recently reminded her followers of the importance of regular health screenings and early intervention, something she now understands firsthand. In May, the 43-year-old actress took to Instagram to share her own health scare, posting a photo of electrodes attached to her chest during a medical check-up.

“When your heart stages a rebellion, the universe sends you a care package disguised as medical appointments,” she wrote. “From rogue palpitations to full-body forensics—tinnitus investigations, ski-damaged knee confessions, blood work that revealed more than I bargained for.”

Xie went on to reflect on how witnessing loved ones battle serious illnesses underscored the urgency of staying proactive. “Having gone through some health scares with my cousin and super close friends with cancers and some battling strange autoimmune diseases, it’s imperative to have regular medical checks,” she explained, adding a heartfelt reminder to her 406,000 followers: “Sometimes breaking down is just breaking open to care you forgot you deserved.”

While her experience was unsettling, Xie called it a “blessing in disguise.” She expressed gratitude to the healthcare professionals at Thomson Medical, describing the ordeal as “hypochondriac pain turned into the most thorough love letter my body has ever received.”

So, what exactly are heart palpitations—and when should you worry?

According to Dr. Pipin Kojodjojo, an electrophysiologist at Mount Elizabeth Novena Hospital, heart palpitations refer to sensations of irregular or rapid heartbeats that may feel like fluttering, pounding, or skipped beats.

“Imagine someone suddenly jumping out and startling you—that rush, the feeling of your heart racing, is a palpitation,” he explains. “These can be triggered by normal reactions to emotional or physical stimuli like fear or excitement, but they can also signal an underlying abnormality in heart rhythm.”

While palpitations are often harmless, they can occasionally point to more serious issues. Here’s what you need to know:

Are there any misconceptions or myths about heart palpitations that you frequently encounter?

A common misconception is that experiencing heart palpitations is simply a part of the ageing process. This is not true. Palpitations can affect individuals of all ages including infants, children, adolescents, and adults. Age alone is not a determining factor, and the presence of palpitations should not be dismissed based solely on someone’s stage of life.

How can someone differentiate between harmless palpitations and symptoms that need urgent medical attention?

It is essential to distinguish between palpitations that are benign and those that may indicate a more serious underlying condition. Concerning symptoms include chest pain or tightness, significant shortness of breath, dizziness, fainting, or palpitations that persist for more than a few minutes or occur repeatedly without a clear trigger. 

People with a personal history of heart disease, or with a first-degree relative who has died suddenly or unexpectedly, should be especially cautious. 

If any of these signs are present, it is advisable to consult a healthcare provider or go to the emergency room without delay.

What diagnostic tests are typically recommended when someone experiences frequent or severe palpitations?

To investigate the cause of frequent or severe palpitations, doctors typically begin with an electrocardiogram (ECG), which measures the heart’s electrical activity and rhythm. 

A Holter monitor, a portable device worn over 24 to 48 hours, can capture irregularities that don’t appear during a short ECG. An echocardiogram offers detailed images of the heart’s structure and function, helping to detect structural problems. 

Blood tests may also be ordered to identify contributing issues such as anaemia, electrolyte imbalances, or thyroid disorders.

How are heart palpitations treated, especially when they’re caused by an underlying health issue?

Treatment for palpitations depends largely on their root cause. If an arrhythmia (abnormal heart rhythm) is diagnosed, medications may be prescribed to help regulate the heartbeat. In cases that do not respond well to medication, procedures such as catheter ablation may be considered. 

This minimally invasive technique targets and disables the heart tissue responsible for the abnormal rhythm. If palpitations are due to an underlying medical condition—such as hyperthyroidism or anaemia—treating that condition often resolves the symptoms. In many cases, lifestyle changes also play a key role, including reducing stress, limiting caffeine and alcohol, and ensuring adequate rest.

Are there lifestyle changes or preventive measures people can take to reduce the occurrence of palpitations?

Yes, several lifestyle adjustments can help reduce the frequency and intensity of palpitations. These include maintaining a balanced diet that’s low in stimulants like caffeine and sugar, engaging in regular physical activity, and practicing stress-reduction techniques such as mindfulness, meditation, or yoga. 

Staying well-hydrated, limiting alcohol intake, and prioritising sufficient sleep are also important. Finally, it’s always wise to consult a healthcare provider about your symptoms to confirm that the palpitations are not a sign of a more serious condition.