Caffeine and Palpitations

My son, almost 15 year old athelete has had two occurances over the span of about 2.5 - 3 months, both during sporting events (pitching a school game on a hot/humid May day) and the other during an Ice Hockey practice, both occurances of where what he described as a "rapid heart beat", that didnt' come on suddenly, but he felt his legs get a bit heavy, then he felt his heart beating harder, a bit of dizziness...In both instances, he had consumed some caffeine prior to the events, during the baseball game he had about 1/2 gallon of ice tea, and just before (during the ride to practice) the hockey practice, had a 16oz cup of coffee. He is in great shape, is 5'10" and 165lbs. Lifts weights and trains pretty regularly.

These incidences don't in his words come on "suddenly" and stop "suddenly", but he notices it, get's a bit wary of it since it isn't too normal, sits, cools down, drinks some liquid and within about 5-10 minutes, is fine and back in the practice/game. He feels his heart beat sort of "idle" down during this cool down period, so it doesn't just "stop" and go back to normal.

His doctor checked him over, BP 129/66, heart sounded great. She sent him for an EKG which was fine as well.

He's pretty much always has a cup of (12oz) coffee before a hockey game, not every day though. He has removed this from his intake, and we'll see if it happens again. Just want to see if this seems logical, that these two events were "caffeine" induced?

[CCF-M.D.-MJM]

Macboys,

this is a very logical assumption.  Some people are more sensitive to caffeine and develop these sort of arrhythmias.  The key is the warm up.  If it starts slowly and progressively ramps up, this certainly is seen in people sensitive to caffeine.

He may notice this when he eats too much chocolate, drinks tea, soft drinks, and coffee.

If this keeps ocurring, a holter monitor (24 hour continous heart rate recording) or and event monitor (press a button to record heart rhythm during symptoms) is indicated.

This is the most likely, reason, however, there may be many more causes.  One key question: is there any family history of sudden death.  If there is, it may be prudent to check an echocardiogram to rule thinkening of the heart walls as seen with hypertrophic cardiomyopathy.  In the unlikely event that he actually passes out and loses consciousness, he would need urgent medical attention and a cardiology evaluation.

If you are concerned, don't be afraid to ask for a second opinion or to see a cardiologist.

I hope this helps.  Thanks for posting.

[Linda123]

Hi
Here I am again....:-)!!  Seems I can identify with virtually everyone that writes in - sorry!!  ...I have different sorts of arrythmias, I have had the click on and click off variety with rapid beat arrythmia, like 260 bpm, but I may also have had the sort of arrythmia you describe about your son. The thudding heart variety of palpitation happened to me when I had a shot with adrenaline in it, I can only describe it as a sort of wave that seems to come up from my feet and my heart gradually starts to speed up and thud hard making me feel most uncomfortable  - it maybe goes up to 160/180 bpms.  When this sort of palpitation happens I just sit quiet until it wears off which doesn't usually take too long.  It also happened to me twice in the space of 15 minutes a few months ago when waiting to see the doctor - I was anxious about the consultation.
Obviously your son hasn't had a shot of adrenaline to cause the thudding but he has had coffee and perhaps this could have caused the same sort of reaction??
Good luck anyway.

[MACBOYS]

Obviously, coffee has been removed from his routine. He simply fell into this on the long trips, didn't think about the impact caffeine could have honestly. There is no history of heart problems, sudden death etc.. in the family. Hypertension, yes, but nothing else. We will monitor from this point forward, but from what the ped has indicated, and for the most part, corroborrated here, it's seems like the caffeine boost contributed to these two incidents. Thanks for the support!

[mrw142]

I have an interesting problem that I have recently noticed.  I have woken up twice in the last couple months with a pounding heart.  When I checked my blood pressure on my home monitor, it was shockingly high, say 200/145 with a pulse of 100. This was as I woke up in the morning. The last time this occurred was a 6 weeks ago, and within about 15 minutes my blood pressure and pulse were down to normal levels, which are typically very good (115-125/65-75).  As I was having a nightmare at the time, I chalked it up to that.  I have checked my blood pressure a number of times during the day and when first waking since then with nothing abnormal, not a single check with a diastolic over 75 or a systolic over 130.  
This morning, I woke up again with a racing heartbeat.  (I do not remember my dream).  My blood pressure through the roof, heart pounding, my first reading 201/147! Pulse around 100.  That was an hour ago. My rate is now closer to normal, but still quite high for me: 147/95, pulse of 80.
I should note the following: I am a 40 year old male with no history of heart problems or any other health problems.  I have never noticed hypertension or high cholesterol (although my last check was 7 years ago--it was 165 at that time).  I do not know my family history, I was adopted.  My last check up was 2 years ago when I received an exam for life insurance (blood work and other regular checks--the doctor noted nothing unusual and gave me the most healthy rating for my age group).
I have a very stressful life lately: wife and 4 small children (oldest 7), we moved to a different state last year, my wife in her final weeks of pregnancy, have been out of regular work for one year, I recently started taking an online MBA program (a bit overloaded on courses), I teach multiple classes evenings at the local college, and I do part-time consulting work during the day for two corporations.  My combination of part-time jobs probably adds up to close to 70 hrs/week of very mentally stressful work.  My father was recently diagnosed with cancer, and that has added to my stress level.  I also have developed a bad habit of drinking large amounts of caffeine (which is why I posted under this topic area), such as a 44oz highly caffinated drinks like Mountain Dew or Coke.  However, this is typically earlier in the day, so when I awake, it's at least 14-16 hours after the caffeine.  I have been drinking caffeine about 5 days a week like this for 5 years.  Please help.

[fizzixgal]

Although this could be caused by stress/nightmares, it might be worth getting checked out as there are certain uncommon, usually benign tumors that can cause hypertensive surges by producing excess catecholamines (pheochromocytoma, glomus jugulare and others). The screening test for this would involve a 24 hour urine collection. I am not sure whether this would be more likely to happen in the mornings, but I have noticed that my own heart rate is always highest when I first wake up and my understanding is that catecholamine levels are naturally highest in the morning.

Other symptoms might include occasional or intermittent headaches, tremulousness, flushing.

Hope this helps...

Liz

[mrw142]

Fizzixgal:
Thanks so much for your response.  I have noticed more frequent urination and occasional difficulty evacuating my bladder (such as getting up sometimes a half-dozen times the hour after I go to bed to urinate).  However, I seldom have problems sleeping through the night--I don't often wake up to urinate.  Does this possibly signify a tumor?  This has been coming on for several years, pretty much throughout my 30s, I figured it was just a sign of an aging prostate. And if the tumor does exist that is emitting catechalomines to the level that is evidenced in my BP, am I at immediate risk for stroke when these levels are up?

[fizzixgal]

Well yes, a hypertensive crisis would put you at increased risk for hemorrhage at that time but I don't think the pressures you are measuring are *that* high unless you have some other problem like   an aneurysm that might predispose you to that. Really I wasn't trying to imply that you probably have such a tumor, it is just a possibility and rather remote. The increased frequency of urination could be many many things, including all that caffeine! I am btw not a doctor, just a fellow patient who does a lot of health-related research (someone called it "bibliotherapy"!), best to see your own doctor about this. The main thing is to get checked out for your peace of mind, and if it turns out you have labile hypertension to get it under control. If you are having panic attacks in your sleep, then that would be important to address too!

[mrw142]

Fizzixgal:
Thanks for the info!