Bad Palpitations And Pregnancy

[Sue143]

Hi! I'm 37 years old and in good health. I don't drink, smoke, or have any caffiene except for rarely chocolate. Weight 104 lbs., BP 110/60. Six 6 yrs ago when I was 7 mnths pg got first episode of tach. It lasted 12 hours. HR 120. Heart echo normal except for mild regurg from (I think) one of the ventricles. Told it was minor and nothing to worry about. Had 2 more episodes of tach didn't last long, but started getting palp. all the time. Skips beats, hard beats, etc. Seemed minor with a few strong ones. Had treadmill stress test and full run of blood work incl. thyroid. Blood work came back normal. During stress test had a few palp. and the Dr. said he was surprised that I could feel them because most people wouldn't. Stress test normal. Wondering if because of the tach the first time lasting so long, if it could have made my heart more sensitive so that I'm more aware of palp., or could it weaken it?
Afterwards always had palp. with occasional short bursts of tach. Some were strong enough to make me stop in my tracks. Noticed that I would have more if tired or the 2 wks prior to my period. Even upper body movement can trigger them. Dr. says sinus rythum is ok.
2nd pg, first 3 mnths were the worst. Palp. constantly with short bursts of tach.  I found out was slightly anemic. One night I had them almost non-stop. When I got up in the mornings heart would pound hard and heart rate would be around 100 just walking after getting up. Wore a Holter monitor for a few days and my cardio said my palp. were bad enough for medication if I wasn't pg. Rest of pg went fine with normal palp.
I started to get bad palp. yr.ago. Face got hot and flushed and got shaky afterwards. I got such a bad one that everything started to get dark and face got really hot.  Dr. said it was from a drop in BP and everything was fine. Had another echo, Event monitor and blood work. All tests came back ok, still have mild regurg and palpitations ok. Still said nothing to worry about. A couple wks later I got palpitations every 10 mins. all day. Dr. prescribed Toprol XL and said to take if I had a bad day. So far haven't taken them. I don't get bad ones too often, but I had one a couple of weeks ago that felt like my heart was being squeezed, it got really tight, felt like it stopped beating. Only lasted a few seconds but Wanting to have another baby and my cardio said he's not worried at all, that my heart is healthy and fine. I just worry about these bad palpitations since they've never been evaluated. I don't know how bad they really are. I'm afraid of having them more often for the first months and maybe even have them get worse, or not stopping on their own. My husband is actually afraid of me dying. Do you think another pg is ok? What causes these bad ones to happen? I worry about them even if I didn't get pg again.

Any and all answers will be greatly appreciated!
Sue

[CCF-M.D.-KE]

Dear Sue,

I am not sure what type of rhythm is causing your palpitations. The descriptions you give suggest that you have a structurally normal heart.  If these palpitations are short bursts supraventricular tachycardia (SVT), they are more of a nuisance than a significant threat to your health. If the palpitations are premature ventricular contractions (PVCs), it remains likely that they pose no significant threat. I would ask your  doctor what type of rhythm disturbance you have, he/she does not seem to be very concerned. They are probably correct the palpitations may not represent anything very serious.

Medical therapy with toprol XL is a good idea. However, if you have SVT you may be a candidate for  radiofrequency ablation, which is procedure to eliminate the rhythm disturbance. Before further discussing possible therapeutic modalities  the  rhythm disturbance is needed.
Sorry I could not be more specific, without the actual rhythm disturbance I am only able to  give a generalized answer. I hope this helps your situation. You should also avoid caffeine, alcohol, tobacco and stimulants such as those found in decongestants.


Thanks for your question,


CCF-MD-KE

[matty_boston]

Hi Sue,

I am sorry to hear about your bad palpitations. I, too, am experiencing what you are, and I like you, am a young healthy person (35yr old). Mine are usually noticable at night while in bed and usually can cause problems right before I go to sleep (I wake up with a startled feeling). I have had experiences with some doctors that assume just because you are young, there is no problem with your heart. My suggestion to you is to keep stressing that these palpitations are bothersome to you and you need more answers (if possible).

I have been getting palpiations on and off for about 5 yrs, and like you, I haven't found the causes of them. Some possibilities include: lack of sleep, stress, alcohol, caffiene, sugar, exercise (or lack of?).

The problem I have found is when I get them, I get stressed out, which causes them to become worse. I know you probably heard this 100x by now (and its easier said than done), but try to relax and remember what the dr told you regarding these palpitations as being ok. From what I read, alot of palpitations are benign.

Hope this helps and good luck!

[CLM]

Alice, what was the outcome of seeing Dr. Natalie?  Did you do an ablation or meds?  I am curious, since you can count me in, ladies, as a young (37) mom with loads of pvcs (I even get fun little runs of VT!  Whoopie!)  Anyway, even with the VT, I have had all the tests run and have seen an EP but am told it is benign in my case due to a healthy heart and no family history of anyone dropping dead (ha ha).  I suppose I must not have any other markers either because no one is suggesting mandatory ablation or anything.  But after the two weeks I have just had, with thousands daily and couplets regularly, I am thinking that ablation sounds mighty nice.  I have decided that if the "obsession" over these darn pvcs gets too out of hand, it will be worth the risk of the procedure.  They are willing to ablate for "benign pvcs" because I really do get a lot and they seem to be monomorphic (and they do appear in more complex forms, like couplets and short vt).  Often they won't consider ablation for "just" pvcs, even zillions.  (That will likely change as techniques are perfected.)  I look forward to hearing from everyone.

[briane]

Does any one have pain with there palpitations?  What have you been told about this?  I have pvcs and pacs and recently had a spell where my heart fluttered off and on all night and it caused some pain and tightening. I had a normal heart cath last february, about a year and a half ago I had a holter monitor and echocardiogram and about 2 years ago I had a stress test.  The only thing I was ever told is that I had pvcs and pacs and that none of the tests showed anything to worry about.  Thanks to whoever may have some info.

[Sue143]

I have on few occasions had one beat of the palpitations actually hurt. My cardiologist said it was ok and nothing to worry about. Mine didn't hurt alot. You should be sure to ask your Dr. about yours just to be safe. I still have to find out what kind of palpitations I have, so I don't know what kind mine are yet. Let me know what you find out.

Sue

[Sue143]

I just found out that I have SVT so I may be a candidate for an ablation. I'm really interested in hearing about it from someone whose been through it. I'm nervous just thinking about it. I've read about it and it says you're awake but sedated and it takes 2-4 hrs. What about recovery? Since you have kids you understand there's little time for rest with a 3 and 5 yr old. The Cleveland Clinic isn't too far away so I'm thinking about it. Any info you could give is really appreciated. Thanks!