The patient: “Lily,” a 41-year-old small business owner and mother of two.

Why she came to see me: Lily arrived at my office complaining of intermittent heart palpitations—a racing sensation, or “fluttering,” as she put it, that came on suddenly and persisted off and on for roughly seven to 10 days per month. Two weeks earlier, the palpitations had felt especially peculiar and, at her husband’s insistence, she’d gone to the ER. They’d performed an electrocardiogram (ECG) and a series of blood tests but eventually sent her home with the assurance that nothing was wrong.

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