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Heart Disease  (Expert Forum)
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Many Types of Heart Palpitations
Answered by
Cleveland Clinic -
Cleveland - OH
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MedHelp Member's Question

Many Types of Heart Palpitations

by Pete-Man, Jun 07, 2005 12:00AM
Hello,



I am a 44 year old male.  I am not overweight and am in good shape and exercise regularly.  I have a 3+ year history of increasing palpitations with no known cause.  Other health conditions include raynauds.



I am currently finishing wearing an event monitor and it is catching all sorts of different kinds of palpitations.  So far, this is what the monitor reports say:  sinus bradycardia, PAC's, atrial couplets, atrial triplets, atrial runs, wide complex tachycardia, PVC's, accelerated junctional rhythm PAC's, ventricular bigeminy, ventricular couplet, accelerated ventricular rhythm.  I am on Toprol due to prior diagnosis of sinus and supraventricular tachycardia so the Toprol may well account for the bradycardia but I am sure it is not responsible for these other arrythmias because they started before I ever began Toprol.



My doctor is concerned because the monitor showed I had sinus bradycardia in the 30's which skipped to an atrial couplet and a run of triplets.  He has scheduled a stress test for me.  Questions I have:



1.  Why is my doctor concerned about the bradycardia skipping to the atrial couplet and run of triplets?  Am I going to drop over dead?

2.  How is it possible that I could have all these different types of palpitations going on in the same heart?  What types of disorders could cause such a thing?

3.  I have no problem exercising vigorously and so I think the stress test will come out fine.  Assuming it is okay, what other tests should I consider?

4.  Can anxiety cause all these types of palpitations?



Thank you so much...





Doctor's Answer

by Cleveland Clinic, Jun 07, 2005 12:00AM
Pete,



thanks for the post.



1. Why is my doctor concerned about the bradycardia skipping to the atrial couplet and run of triplets? Am I going to drop over dead?



No. He is concerned because you have various arrythmias and wants to rule out coronary blockages as a cause. Sinus bradycardia in itself is not something to be concerned about unless it were causing symptoms.





2. How is it possible that I could have all these different types of palpitations going on in the same heart? What types of disorders could cause such a thing?



It is extremely common. Odds are the rest of your work up will be normal.



3. I have no problem exercising vigorously and so I think the stress test will come out fine. Assuming it is okay, what other tests should I consider?



Other than an echo, none.



4. Can anxiety cause all these types of palpitations?



They can be a factor, and in some the most significant symptom. If your anxiety is driving your life, or you have a hard time keeping focused on important stuff, you should seek help in dealing with it.



good luck
Member Comments (26)

by Neon, Jun 07, 2005 12:00AM
Can I ask (this is important as I'm trying to compile information which may help me move closer to the possible cause of these annoying, harmless beats): if you breathe mostly through your mouth, can you post 'MOUTH', or if through the nose, post 'NOSE'. If you are always struggling for air (as an annoying habit), post 'AIR HUNGER'.



Thanks.



I'll get back to you.

by wmac, Jun 07, 2005 12:00AM
To: pete man
Hello, I too have several different arrythmias as well. You said that you have wide complex tachycardia do you me ventricular tachycardia? I have Pac, pvcs, supraventricular tachycardia and ventricular tachycardia as well as accelerated idioventricular rhythm. So I can totally relate to your problem. I have had several monitors in fact I just had my loop recorder taken out two weeks ago. I have had a ep study in January. They gave me a 90% chance of being fixed but lucky me they didnt fix me. (hahha) They couldnt induce my vt. I was pretty bummed but they say its not life threating, but try to convince me of that when it happens.I am not on any meds, when I did try the toprol xl I started out with very small doses and did them for three days and thats when I had the worse run of vt yet so that is why they did the ep study. They say I have good strong healthy heart with a ef of 70 so that is why they are not worried. I wish you luck.

wmac

by bama jane, Jun 07, 2005 12:00AM
To: Pete man
Pete,

I have multiple arrhythmias as well, and as in your case no one knows why.  I have had them for 5 years and have been told by numerous doc's that while they are no fun to live with they should not kill me.  They just came out of nowhere. Before that I had never felt one in my whole life. I am 54 now.   I know it is hard to believe that one heart with no known disease can do all this.  I have figured out some of my triggers: bending over,indigestion, and definitely stress. I get them every day at different levels. I sometimes get short of breath and sometimes not. I think it has to do with the type of arrhythmia at the time. Also for me Pepsi is a a thing of the past. No caffeine at all. Even when I do everything right I can still get some really uncomfortable days or nights. The point in telling you all this is that some times it makes me feel better knowing other people that have the same thing are still here and it hasn't progressed into something worse. I hope knowing that I have had all these different arrthythmias and am still here helps you.

by Pete-Man, Jun 07, 2005 12:00AM
Thanks Doc.  And thanks Wmac and Bama Jane.



I very much appreciate your response doc!  You helped ease my mind some but what concerns me is that these palpitations are gradually getting more frequent over time.  Two years ago I could go two days without feeling anything - now I am doing good if I go four hours without something flopping around in there!  People who don't have these palpitations don't know how lucky they have it.  Once you have them you feel like you are living on the "edge" of life.  I guess we are all always only a heartbeat away from death but when you have palpitations you just realize this more than anyone else.



I saw a cardiologist today and he said that the one palpitation that my regular doctor is most concerned about could even be a short run of V-tac but he cannot tell for sure.  Eeeeeeks!  I always thought v-tac was BAD BAD BAD.  But he did not seem too concerned about it.  So, yes Wmac - I MAY have had v-tac also!



A question for Wmac, Bama Jane, and anyone else who wants to answer:



Have your palpitations gotten more frequent with passing time?



Thanks Everyone.  Take Care...      :^)

by wmac, Jun 07, 2005 12:00AM
To: Peteman
I just dont get any of if. Just when I think I have it all figured out boom here they are again. I do not drink caffine at all or eat chocolate, No msg. Tonight out of the blue they are here with everything I do I bend boom, I sit boom, I relax boom I just dont get it. They are the booms that hurt. Im afraid to move at times. And yes it seems that they have gotten worse over time. I have had palpitations since I was 19 but up untill six years ago not much then the last three years have been the worst. I sometimes cant function I get depressed and all I want to do is cry at times. I am 41 now I have gone to counselors to and that really hasnt helped much either. I feel very crippled at times. Help

wmac

by cam4, Jun 08, 2005 12:00AM
To: Everyone/pete
i think all of us at one time or another have felt the same way about our pvc's. I myself will go long periods of time and feeel nothing and them they hit... I have found that hormones play a big role, so I just expect to feel bad around those times of the month. I try my hardest not to eat certain things.. including MSG. I went to Applebees last night and asked about MSG in thier food and found out that EVERYTHING they cook (according to manager of this particular restaurant) is cooked with some type of MSG with the exception of the salads!! I am blown away because I should have put that together with why I always feel bad when I eat out at places like that. I thought MSG was pretty much oin chinese food and I aske for it to be cooked without it. I did get my food prepared last night without MSG. EVEn the veggies had to be special prepared with no seasongings. AMAZING!!!

I hope that things get better for you Pete.. just remember, before you had this bad spot things were ok.. know that that time will come again.. It feels like that the skips will never end.. but.. they usually do,,

good luck

cam

by wmac, Jun 08, 2005 12:00AM
To: Cam4
Yes I agree with you that hormones play a big role! But its funny none of the docs will admitt that. I find that about a week before my monthly my heart will go nuts. I have been talking with a gyno about this and we are considering a hysterectomy not only because of that but due to other problems, but im just concerned either A it will help with the heart or B it will make it worse. I can live with the monthly thing forever but I can cope with the heart thing on a daily basis. So im kinda stuck and I have to decide by tomorrow what im going to do. In the medical book however it does say one of the symptoms of pms is cardiac palpitations and when you read under premenoupause it also say palpitations and tacycardia. So go figure. Im just really getting to the point I cant deal with any of these heart palps or tachy.

wmac

by Pete-Man, Jun 08, 2005 12:00AM
To: How Many Palp's Do You Get?
Hi,



Thanks everyone for your input.  Here is another question for any of you who get various types of palpitations.



NOT counting individual PVC's or PAC's, how many events do you get in a day?  By an "event", I mean something that is an abnormal heart beat or string of beats separated by a relatively longer time of no symptoms.  So an event could be a couple seconds of SVT or an event could be 5 minutes of bigeminy or 45 minutes of SVT.  I know this is hard to answer but please take a stab at it.  On a typical day I will get probably 3 to 6 of these "events."  



Thanks....

by Momto3, Jun 08, 2005 12:00AM
To: wmac and Pete-Man
Wmac,



Although I value and respect the opinions and treatment options presented by male doctors, I have found that a female cardio is really helpful.  She really, really gets the whole hormone thing!!  Hope you are have a great day!



Pete,



Can't say how many events I had prior to my ablations, but I can tell you that I had NSVT a LOT, to the tune of 24% of my daily heartbeats.  Holter recorded 22,000 ectopics, lots of peculiar stuff.  Good luck to you!  I know frustating those extra beats are, boy do I!!

by Jeff-67, Jun 08, 2005 12:00AM
To: wmac
I tried Toprol once. It was so bad. Probably 8 hours after the first tablet (probably around the time the blood