Hard Heart Beat at Night

[jparsonage]

For the past 6 months or so, I have been experiencing chest tightness, pain, and a hard beating heart at night, and occasionally during the day.  It starts particularly when I am laying down, and it isn't relieved by getting up.  During this time, I also experience episodes where my heart's rhythm goes out of whack, and it feels like my heart flutters, stops, and then flutters again.  I went to the emergency room in December because my heart rate was 120bpm, I was having chest pain, and the abnormal rhythm was occuring and it worried me.  I was sent home because by the time I got in to see the doctor, the symptoms had subsided and they had nothing to assess (approx. 6 hours later).  The doctor told me that likely the "fluttering" sensation I was feeling was premature ventricular contractions, and that they can be normal.  My GP also passed them off, suggesting that it's normal and I shouldn't worry.

A little background on me, I suppose.  I eat very healthy, and I drink a lot of water.  I don't have any caffeinated products after about 3pm.  I don't exercise as much as I should, but when I do exercise it is always in the morning, long before these problems start.  I'm not on any medications.  I don't suffer from anxiety attacks.  These problems come along seemingly unprovoked when I go to bed, and cause me to lay awake in bed until around 3am or so (I go to bed between 10-11pm).  I really don't know what I can do, and I'm not sure that this is "normal".

Any ideas?

  

[gtojohnny]

Hypertrophic Cardiomyopathy is sometimes referred to as an enlarged heart. I have HCM and experience some of the same symptoms you are describing. You should have a full workup from a cardiologist. However, in order for you to have HCM of the hereditary nature, one of you parents would have to carry the gene as well.

[Cleveland Clinic]

You age doesn't make me concerned about coronary artery disease.  You could, however, have an arrythmia causing your symptoms.  If you are having PVC's you should ahve them worked up because it is uncommon for someone like you to have them.  You should see a cardiologist and wear a Holter monitor to get an idea of what your PVC burden is.  Given that this is giving you lots of symptoms, I would suggest, at least intially, going on some beta blocker to try to suppress this.  If that doesn't work well, depending on where these PVC's come from, you could have an ablation procedure.  You cardiologist should be able to guide you through this process.  He may however send you to see an electrophysiologist right away.  

[jparsonage]

OK, more info (Sorry!)

I don't smoke or drink excessively (I drink maybe one or two alcoholic drinks every month).  I have a family history of heart disease, a Great Aunt who died 1 1/2 years ago from a heart attack due to an enlarged heart (she was obese as well).  The rest of my family history I'm a little vague about as we don't keep in touch with any of our family.  

The pain is a little left of center, and radiates into my back/shoulder.  It is sharp and throbbing.  I will often get a headache during or afterwards, I'm not sure why.  I don't experience shortness of breath per se, it's more difficulty breathing due to the feeling like someone is pushing on my chest.  I think this is finally it!

[jparsonage]

I should also add that I'm 23 years old, and otherwise healthy.