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Extra heartbeat/anxiety
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Extra heartbeat/anxiety

I am a 33 year old female with no current medical conditions other than being overweight.  Within the past 5 months I have been having what the cardiologist describes an an extra heartbeat.  It's like a slight pause or hard heartbeat that lasts at most for 3 seconds.  I have had three EKG's, an echocardiogram, a stress test, worn a halter monitor, and had complete blood workup.  I do not smoke, drink, or consume much caffeine.  Everything has come out normal except the holter monitor noted a few extra heartbeats.  My primary physician and  the cardiologist believe that it is due to stress and anxiety.  I have been taking Buspar for 5 weeks.  I haven't been anxious prior to the extra heartbeat occuring, but it's still happening. I have always done some excessive worrying, but never really felt extremely anxious until I started feeling this.  I think about this happening most of the day. Even though I've actually seen 3 different doctors, I'm still concerned that something else is wrong.  I'm not sure what else to do, but I know that this is scary and is causing more stress and anxiety.  What do you suggest?  Is it really possible for stress to trigger this to happen?
Thanks.
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Sorry to hear about your premature beats.  

In reality, what you are going through is quite common.  Premature beats can be caused by caffine, theophylline (tea), and stress/anxiety among others.

The good news is that palpitations are NOT a sign of cardiac disease.  Given your normal EKG, echo, and stress test, you don't have anything to worry about from a cardiac perspective.  It is hard though.  Once you start to fixate on the premature beat, it becomes a problem of its own.  It is easy for us to say relax and don't worry about it, but you are the one having the symptoms.

Beta blockers can be used to decrease the strength of the hard beat after the pause, but beta blockers have their own problems.  They can make you tired and you have to take a pill every day.

My advice is to try not to focus on the symptoms and move on.  If you can't, consider a beta blocker under your doctors supervision.

Hope this helps.
17 Comments
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Avatar_n_tn
A few important points.
1. YES: stress can DEFINATELY cause missed heartbeats/ectopic heartbeats/other arrhythmias.
2. YES: stress can DEFINATELY cause missed heartbeats/ectopic heartbeats/other arrythmias!!!!!!!!!!!!!!!! SO REALLY DO YOUR BEST TO TRY NOT TO WORRY! Especially given that:
3. The vast majority of the general/wider population have missed/ectopic heartbeats like you do - they just don't notice and/or don't care/worry about it.
4. Your testing looks fine: I know it's cliched and corny-sounding, but CHILL OUT and enjoy your life and look after yourself. I've been where you are now, and I really wish that I had done as I advocate above cos it sure would have saved me from a whole world of worry and anxiety this last 10 years..... Only just starting to sort myself out now in this regard. Do yourself a favour and stop worrying now!

BM.
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Is Paxil safe for anxiety and stress with palpitations?
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Avatar_n_tn
Is Paxil safe for anxiety and stress with palpitations?
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Avatar_n_tn
Understeand your concern, and I know they can be uncomfortable if you can feel them.

If you read many of the posts in this forum you will find many people who are experiencing what you are. Ectopics are totally benign unless caused by heart disease, but since you don't have heart disease relax.  

I personally have lived a long time with ectopics.  They never killed me.  They can be annoying however.  My suggestion is that you focus and relax on other things.

I suggest that you loose weight and begin some exercising because that will give you the sense that things are OK and it will also reduce your stress anxiety.

I know exercise has always helped me when I've had ectopics.
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Avatar_n_tn
Hi there
Sorry to hear of your ectopics, they are horrible.  
Someone asked about paxil.  I am taking it and have found it to be most helpful, I feel heaps better, have much more confidence, and I have had no increase in palpitations as a result, infact I would say they have decreased quite a lot - which certainly proves that stress is a big trigger.  I avoided taking an anti-depressant for years because of the fear of it upsetting my heart but it looks as though my fear has been unwarranted.  I've been taking paxil for 6 months now with no ill effects at all.
Just my personal experience.
Good luck,
Best Wishes, Linda
p.s.  My cardiologist recommended paxil as being the least likely AD to upset the heart.
p.p.s.  I have had one side effect, just remembered - a little weight gain.
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Avatar_n_tn
There's a difference between ectopics and vt and other kinds of arrythmias.  

What would you suggest?  Fixate on them, worry about them, don't listen to your cardiologist, get all in a tither and spend thousands of dollars going to cardiologists who will simply tell him exactly what the last cardiologist said?

Go to a good cardiologist.  Get the tests necessary to rule out any heart disease or abnormalities.  If things appear normal on the ECG.  Then take it for what its worth.  That's what he did, and the good doctor told him to not worry about it.

The fact is that I'm speaking from experience.  When I first got PAC's I fixated on them terribly!  There were time I would have one every few seconds when I would fixate on them.  They nearly ruined my life.  I then decided that the way to beat this is to simply concentrate on other things and to live as normally as possible.  It's the same theory in overcoming any paranoia.  You start taking steps that cause you to face your fears, and pretty soon you aren't afraid of them anymore.  I never had one ectopic beat that caused me to be short of breath.  Indeed I would run 3 to 4 miles with 2 to 3 ectopics a minute and be as fresh as a daisy when I got done.  If his arrythmia was causing shortness of breath I would say further investigation was a must, and continue to search it out to find a suitable answer.  

You obviously have a different arrythmia and different symptoms.  It's illogical to compare your situation with someone who is having a few irregular beats a day. Also long QT syndrome is an entirely different matter and can indeed be fatal.  By the way I eventually got AFIB, so I know what it feels like to have my heart jumping all over the place.  But having AFIB was totally different than having PAC's!  No comparison.  With AFIB I felt an energy drain I never felt with PAC's.

When I developed a more serious arrythmia I sought aggressive treatment, and after two med failures I had an ablation which was a success.  Which is what I would encourage anyone to do.  But not for a few PAC's or PVC's, which I still get from time to time.

The bottom line was that if you read the posts of people on this forum you will find that most will say the same thing.  Generally everyone says you learn to cope and live with them.  The more you fixate on them, the worse they get.  

It won't be easy, but what other option is there?
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Avatar_n_tn
Hi there... I was just wondering... did your cardio ep seem to think that the childhood fever resulting in the valve problems "could" have been the reason for the beat irregularites? Just wondering... best wishes to you...
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Avatar_n_tn
Thank you so much for the time you spent to respond. and i wish you the very best of luck.... I know what you mean by certain docs just kind of writing you off... My pvc's started out of the blue. however in hindsight i think i did have them periodically for a long time and didnt know what they were. They have become much less frequent as of late. btw im 49 yrs old and have been very athletic all my life... Like you .. it is hard to accept a lot of the answers we get when something just doesnt feel... right in our bodies. In my case I "think" high blood pressure stress, a little too much wine at times, probably led to the increased freqency. After controlling all of these factors they have become much less frequent. And after an ekg, echo, holter which all came back as normal, I am going to have to accept the fact that im ok. I certainly hope so.. My best regards and best wishes and health to you.. from a fellow athlete.
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Avatar_n_tn
RELAX???  What?  I have seen psychiatrists and psychologists trying to learn relaxation, have tried several programs of combating panic/anxiety disorder as well.  There is no way I or anyone who suffers the kind of pvc's I have can relax.  Some of us are unfortunate and can feel these devilish beats and some are fortunate and never know they have them.  Of course I had to be in the category that does feel them.  I am not alone either.  I have talked to several who have done similar programs to no success and they are as frustrated as I am.

I wish it was as simple as relaxing.

When I am not bothered with arrythmias of afib and pvc's, no problems.

Glenn
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Avatar_n_tn
Did I undestand you correctly to say that you had had multiple echos of your heart and they didn't catch your valve problem?  I have multiple arrhythmias and there does not seem to be a structural problem. I get some of them every day. Mostly from the top of my heart. I have had all the tests, as well as an ep study. Study was only able to induce sinus tach. It is difficult to ignore. Movement like bending over, lieing on my left side,reaching above my head and at times it will start when exercising, also eating or drinking can cause  these misbeats.   I have pat, sinus tach, wandering pace maker, junctional and accelerated junctional rhythms.  Also pac's pvc's, and multiples of both. Lieing down to sleep is also difficult because I have to keep sitting up to stop the irregular beats. I have tried ignoring them but at times the extra beats will send it into racing.  With all that you have to deal with, what helps you the most to cope with your arrhythmias?  That is why I come to this site when my heart is really at it's worst.  I find good ideas from people that have similar problems and the answers to their questions from the doctors has helped me.
Thank you
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Avatar_n_tn
Thank you so much for taking the time to answer my questions.   You are a very compassionate person.  It always helps to hear how others deal with this.  I wish  you good luck and good health.
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Avatar_n_tn
Hello everyone, this is the first time in this forum. I have found great comfort in knowing that I am not alone with this problem. I too have been to multiple doctors who really don't seem too concerned. I have had all the usual tests which come back showing nothing but I still just cannot let this go. I was on Lopressor for a while which made me feel worse and my doctor is suggesting maybe a different beta blocker. Many people have suggested that we just relax. I would love to but it seems I just don't know how. Are there any relaxation techniques that have worked for any of you? I am very open to suggestions because this is starting to rule my life.
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Hi, I'm a 38 year old female and today I went through my first stress test and echo .I have been experiencing my heart feeling like it is bouncing around or a flip-flop feeling.I'm always out of breath and I don't excercise like I should I'm not overweight but I have been under alot of stress lately with a sick daughter .My family has alot of heart problems (mom, grandma, uncles , aunts and my daughter has  a pacemaker) when I did my stress test my heart rate started out around 98 bpm and within 1 minute on the treadmill it went to 140 to 150bpm they asked me if I was nervous . I told them this is the problem I can't do anything without feeling like i just ran a mile. No I  didn't think i was nervous. Actually I felt pretty comfortable because I know all these people from when my daughter got her pacemaker.They are really really nice people.Well by the 4- 5 -and finally the 6th  minute my heart rate was in the hi 180's she really acted concerned about this and it took a long time to come down close to the low 100's is this normal ? She couldn't tell me anything and I wont find anything out until next week. UGH! If anyone can give me an idea ?? The guy that did my echo acted like everything there looked ok. He also asked me if I was nervous. because of the heart rate. which I wasn't. But now I am now by the way they all acted. so if anyone knows anything about this sort of thing I would really appreciate the info. thanks
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I'm glad to see what I've been experiencing is much more common than I thought. My PVCs, as they were diagnosed by a PA during a ekg who advised they were common and not a big deal but considering its my heart it is a big deal to me, vary in their severity. I've had a stress test, heart scan, and cholesterol dropped from 249 a year ago to most recently 158 through big changes in my diet. My GP keeps suggesting that my "flutters and thumps" are all in my head, which distresses me as he is also a cardiologist. I've been experiencing them since I was seventeen (I'm thirty-five now), or at least that was the first time I recognized them and the first time I went to the ER for a "acute anxiety attack". Mine are less frequent than many of those who post, and seem to increase when I'm fatigued or stressed. Like many, it seems that they are more frequent when I focus on them, but sometimes it is difficult to not focus on them. Often they trigger anxiety attacks, I've been prescibed both Xanax and Ativan (for sleep) to settle what my GP terms my "high strung personality". The little ones don't bother me as much, especially when I lay off the caffeine, but the big thumps still freak me out. I've tried everything to reduce them from magnesium, fish oil, potassium, folic acid, and daily (81mg) aspirin. but there is no rhyme or reason as to their occurance with me. Even though my job is not stressful, in fact it is boring if anything, when I am on vacation they seem to disappear or at least they are not very noticeable. I'm not looking for help per se, as reading all these posts have helped me a bit, but just wanted to throw my two cents out. I apologize if I just rambled on and on. Also, I experience very brief chest pains, lasting maybe a sec or two, and maybe I'm getting panicy here but as you get older you start to pay attention to things you never did, like aches and pains, especially when people your own age, or slightly older, get treated for or die of heart disease (Darryl Kile and Michael Tata come to recent mind). These chest pains are not a daily occurance, and do not occur after physical activity. Is this something to worry about? I'm sure some are stress/anxiety related, but I've had a few while browsing the 'net while my feet were up on a table. I'm 5'8" 205, need to lose a few, but a stocky build, so I'm wondering if I'm putting pressure on my chest by sitting like this. Whew. Any comments or suggestions would be appreciated. Other than grammar and composition suggestions.
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Do any of you that have the extra beat have GRED or stomach problems? I have and I was just wondering as I have the same problem with the extra beat and it scares me so bad I throw myself into a panic and I am really at my ropes end. What do I do to stop thinking about it and get on with my life as it is causing problems at home. Any suggestions would help.
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I think this website has some information you may find useful. Click on the "Search" button at the top of the page. Type in GERD as your search term. When the results appear, look for --

PVCs and silent acid reflux or GERD (The Heart Forum)

Hope you'll find what you're looking for.

NHS
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