Heart Racing

I first experienced PVCs when I was 16, and I have had migraines all my life.  I wore a Holter and was told that they were benign (I only had/have one every now and then).  I am 26 now, and 4 months ago I woke up and my heart was pounding- and beating faster than normal.  I don't know if it was stress, but it scared me because my father was diagnosed with an arrythmia (and extremely high blood pressure) which may or may not have been caused by smoking/drinking/extra weight.  I had an Echo and another Holter- Echo was normal, and Holter showed "more skipped beats than normal" 4-5 an hour and 2 single PVCs.  After about 4 days I felt completely normal for 4-5 months.  Then, 4 days ago- I woke up from a restless sleep (having had a headache all day) and my heart was beating really fast.  I would guess it was over 150bpm (and maybe a little higher).  It took about 10 minutes to calm down- then I was cold and shakey (shaky).  The rest of the day I felt "off" and my resting heart rate was slightly high (normally it is in the low 50s and it was in the high 60s-70s- maybe worry?) I went to the doctor and he said- event monitor but, I couldn't pick it up until this week.  The next morning the same thing happened- taking about 15 minutes to stop.  It hasn't happened again- but, again I felt "off" for 4 days.  Anyway, when this happens- I can't sleep and I feel really depressed and worried- and then it disappears.  I am in fairly good shape (I used to be a ballet dancer) and my blood pressure is normally normal (a little high at the doctor's office- nerves, I guess?).  Thanks for your input!

[Cleveland Clinic]

Heart Racing, You are on the right track.

The event monitor will be able to track what rhythm you have when you have your symptoms. Given the fast heart rate this could be any number of rhythms including atrial fibrillation, flutter, atrial tachycardia or AVNRT. The key is to catch the rhythm on the monitor and then treatments options would be defined.

The symptoms people get from rhythm problems are variable. Im sorry to hear yours are so severe.

good luck

[EricaM.]

I also just wanted to mention that I had my thyroid checked as well- and it was normal.

[Linda123]

Dear Erica
I don't think you're having panic attacks, I think you're probably having episodes of SVT, scarey but not life threatening and I understand that an ablation can sort out most of these kind of arrythmias if necessary.  I think heart rhythm problems are far too often put down to panic attacks.
Good luck.
Best Wishes

[sheryl1945]

Erica...sounds like anxiety to me, but it's imperative that you have your doctor check you out first.  Hankstar - you are so wise and kind to help people here!  I get lots of pvc's/pac's but have finally learned to simply accept them, after a LONG talk with a cardiologist.  Anxiety can raise havoc with one's heartbeat.  I suffer from panic attacks.  Nobody ever died from a panic attack but it is fear personified!  Horrible thing to go through.  I see a psychiatrist regularly and she's helping me a lot.  Erica, good luck...keep us posted.

[EricaM.]

Thanks for the comments, guys.  I have been worrying about this a lot- so, I guess it could very well be anxiety.  It seems to happen after about 4-5 hours of sleep- in the early morning hours, (a very lonely time- which probably makes it worse).  Does anyone know if this is consistant with SVT?  The fact that it always happens at the same time?  And in the case of anxiety...wouldn't my heart rate "speed up" after I woke up as opposed to before I woke?  It feels like it is already going fast when I open my eyes.  Can anxiety speed up your heart rate in your sleep?  And- do people who are diagnosed with periodic SVT have a normal life expectancy?  Thanks, you guys make me feel so much better.

Erica

[fpd3hm]

Based upon my own experience, I believe this is panic-related. I have had episodes where I awake with my heart rate slightly elevated, and then it increases when I begin to panic AND I have had episodes where I awake with my heart rate already at 150bpm or more.  Repeated trips to the doctor, including late night ER visits, have revealed nothing remarkable.  Still, the attacks persist, especially when I am under stress during the day.

I suggest you refer to The Anxiety and Phobia Workbook (Bourne, Third Edition).  There, you will see the very first case study in chapter one describes a person with symptoms remarkably similar to yours.  Also, The Anxiety Book also details these so-called "nocturnal panic attacks" and states that most attacks awake the victim from a deep sleep, usually between one and four in the morning, without warning, e.g., a nightmare, or other provocation.

I think you will notice that with deep abdominal breathing upon awaking, your symptoms will subside.  It's trickier than it sounds, especially when you're freaking out due to your symptoms.  But it works like magic.

Also, exercise, stretch, meditate, eat right, and, above all, try not to go to bed worried about your next attack.  This is a virtual guarantee that you will have one.

Good luck.

[Momto3]

I am so glad you were able to post your question.  I know you have been trying for awhile :) As for the anxiety debate, I believe that anxiety can trigger (or add to, it you will) any underlying health concerns. It's probably the whole chicken and the egg thing. I was diagnosed in my early 20's with MVP/MR and have had episodes of pvc's for years. They seemed to come and go with relatively no obvious provocation. I took a beta blocker on and off for 10+ years and eventually it seemed to aggravate the pvcs so I went off of it (with Dr's approval). A couple of years later, the pvc's returned BIG TIME! Still benign even with incredible frequency....I do not have clinical anxiety attacks, but do have an "anxious" personality (seems to go hand-in-hand with a lot of MVP folks!) I know that sometimes absolutely nothing can bring on an "attack" of arrythmia...I think it best to follow up with the cardio and see what he has to say. The symptoms (regardless of their origin) are very real and you will feel better after you have been checked by a doctor. The event monitor will probably give you some relief in that you can record what you feel, when you feel it...Take care.

[ElIng]

I just experienced this "racing heart" for the first time in months, yesterday afternoon while walking. With me, it hasn't happened in my sleep (knock on wood!) that I'm aware of. It always happens in the afternoons. This time I coughed (that stops them for me most of the times)and it stopped but came back, I went through at least 10 episodes of a very fast heart rate (over 150bpm) that I can feel the pounding almost in my throat. Each episode lasted a few minutes or more, it took a few hours to get my heart rate to normal. I have a slight mitral valve prolapse and am going to a cardio in Perth next Thursday for more evaluation. I have had the 24 hour monitor which showed simple sinus tachycardia of around 110 bpm and there were quite frequent both atrial and ventricular ectopic beats. And also 3 episodes of a more rapid tachycardia of approx. 150 bpm where there were small visible P waves consisitent with paroxysmal atrial tachycardia. (I still don't even know what that all means!)
I had this fast racing happen a few months ago which landed me in the ER out of total fear, my rate was 180+bpm and it lasted for 2 hours! That was scary!

[sheryl1945]

Heart rate can definitely increase even DURING sleep!  I've had that happen to me many times.  You can be awakened by heart palpitations.  Scary, but harmless.  Good luck.

[nikl]

I often get the chills and shakes after an anxiety attack although I have a lot more symptoms like racing heart or palps, dizziness and stomach upset.  I seem to have more palps when stomach is upset or emotionally upset and like an earlier post I also cough when I get these and it helps unless I'm having a bad run of them. No test showed any heart problems.  I noticed they increased when last year I had a very bad stomach flu and the palps just seem to come and go now.

[skiking]

Hey Erica - - - First off snort a big gagger of coke with a big cup of coffee and chase it with coca-cola and a bunch of candy when you wake up. If that doesn't freak your heart into normal rythme shoot up a healthy dose of smack. If that doesn't work see your doctor. JUST JOKING. No, really though. I am 28 years old and have a congenital heart problem that has kept life more than interesting at times. When I was diagnosed the docs told my parents I probably would not live past five. I have been through numerous surgeries and procedures and have lived with a St. Judes valve and some other hardware for 20 years. Anyhow, I know what you are going through and how scary your heart pounding out of your chest can be. All my life I have been way more active and healthy than the docs could imagine and since high school there is only one year that I did not ski more than 100+ days (and that was cuz of work, I know pretty lame excuse). So NO JOKE there I was, I thought I was gonna die. It was a beautiful spring day in the wasatch, skies were blue with a fresh blanket of waist deep Utah powder. First run, fresh tracks, loving life until half way down I stopped cuz my heart was beating out of my chest. Laying in the snow looking at the clear blue sky, wondering if I was going to die, wondering if it was the four hits of acid I ate before leaving the house that was making my heart race. After 15-20 minutes my pump skipped to normal pace and the rest of the day was one of the skiest pow days ever, EPIC. For the next 5 or so years of my life I would experience the same thing once every month or so. Basically I would work my heart into a frenzy. I told my docs about it and they really didn't do anything except gave me this dumb little machine to record the event. I never captured the episode on the recorder,however, a few years ago I was kayaking with a friend and exerted myself enough to put my heart into panic. Two hours later I was in the ER where they clocked my heart at 300 beats per minute. At that point I was circling the drain so they had to cardio-vert me while I was awake (that was one of the most crazy experiences ever).  They kept me in the hospital for a week  on telematry til they could get me into the cath lab to fix me up. They did a radio frequency ablasion with a catheter that has changed my life for the better, YAHOO.  Anyhow, is what I am trying to get at is there is no need to be scared, that tends to complicate things. And there is alot that science, technology, and doctors can do for you. Also, adrenaline kicks in before we wake up, to get us going. It may just take a little bit of medicine to get you straightened out. I would say see a doc, if you haven't allready, and most of all don't worry. I wish you the best and good luck. If you have any questions or need help with anything feel free to email me at ***@****
peace and love to everybody. free the plant.

[I'mallheart]

Hello i am a 27 male...i was at the ER last friday for fast heart rate 140..they took ekg...normal...gave me a betta blocker that helped...i am still havig wierd feelings missed or skipped beat, blood preasure not too bad..they are checking my thyroid also..i see Doc Thursday...is there any tests i should have done..this is scary.i feel for all of you, and feel blessed not to have it as bad as some in this forum
GOD BLESS YOU ALL AND HEAL YOU AND ME!!!!

[lauren1717]

Hi Everyone
I'm just responding because many of your symptoms seem very similar to mine. When I was about eight my mother noticed my heart would be going fast for seemingly no reason at all- I don't remember this at all because I was so young. I was referred to a cardiologist which after numerous scans, ECG's and a Holter discovered no structural heart damage or SVT, VT etc. The racing heart was just put down to the fact that I was an anxious kid and my body was too receptive to adrenalin. Shortly after this, I noticed at night time that I would begin to feel sick and shaky and my heartrate would begin to noticeably increase to about 100-130 beats per minute. This happened about once every couple of months only ever at night until I was about 13 and then they stopped. At times I would feel as though I would have an attack ( I would begin to feel nauseous and shaky- I don't think my heart rate was increased) but it would go away after awhile. Last month however, I had an attack again which lasted many hours- my heart rate was varying between 100-130, I was shaky and so nauseous I vomitted. I went to the doctor who said it was just anxiety and not SVT or VT etc because my heart rate was varying and I become nauseous first before my heart rate increases. However, I am still very concerned that I may have been misdiagnosed. I am living in constant fear of having another attack. Anyone else experienced something similar? Do you think I could have SVT or VT?

[EricaM.]

Does anyone know exactly what a "skipped beat" is?  Can you have more of them when you are tired?  Are they very dangerous?

Erica

[Momto3]

I always referred to my pvcs as "skipped" beats. But, the doctor explained that they are actually "extra" (ectopic) beats. She said that the ventricle beats prior to when it is supposed to, and then there is a pause, and then the beat that is supposed to occur. I know the heartbeat sound is lub-dub, lub-dub, lub-dub...I think in the case of pvcs it would be more like lub-dub-dub, lub-dub-dub (depending on how many in a row). I do find that being tired can "wake them up". Did you get your event monitor?

[sheryl1945]

Hi Erica..."skipped" heartbeats are VERY common and no, they are not dangerous.  As for when you're tired, YES, they seem to come on more frequently then.  I often get them when I'm tired.  Just ignore them (easier said than done).  Good luck.

[IronCatfish72]

Up until a few years ago ... I had had very occasional (maybe once every couple of years) instances of waking up at night with a pounding heartbeat ... they were scary, but always gone by morning.  Then, in 2000 I expoerienced chest pain, which my doctor diagnosed as chestwall (not heart-related) after giving me an EKG ... in 2001, I had another instance where I woke up with chest pain and a racing heartbeat, but that was again gone by morning.  Then in 2002, I had it again, and went to the ER, where they gave me EKG, chest x-ray, etc. and said I was fine.  Now, ever since mid- to late-July of this year, I've had periods of racing heart and some chest pain that last for 3-5 days at a time (although only bad enough to keep me up for the first couple of days of it) ... I'm in the middle of one of those periods, after having about a week of feeling fine.  I've been seen by my regular doctor, and by an ER ... blood tests, EKG, chest x-ray, blood pressure, pulse, etc. checked out as normal (70-90 BPM), and they said to cut out the coffee, but that I was fine.  I have very low cholesterol, and my blood pressure's always been normal. In fact, my doctor told me that at my age (31) I'm at a very low risk for heart trouble.  Could these symprtoms all be anxiety-related (I do worry A LOT about these issues ... I always think I have some very bad disease)? Could the chest pain and palpitations be related?

And finally, what should I ask my doctor when I see him next Monday (I'm going to ask about a Holter monitor and stress test).

Thank you very much. I find this site informative and reassuring.

[sheryl1945]

Hi Iron...YES, anxiety can play a major role in heart symptoms.  I've had anxiety problems for years and my heart goes way too fast, so I was put on tenormin which slows it down beautifully to a more comfortable rate.  Skipped beats can also be a sign of anxiety.  Check things out with your doctor, of course.  Good luck.

[IronCatfish72]

So, should I ask him to put me on a Holter (sp?) monitor and give me a stress test? Any other tests I can ask for to help rule out serrious problems?

Thanks again!!!

[LynnSB]

I'm on an event monitor .. I am having more skipped beats than ever my my life, yet I am told this is not an emergency. I fill up the event monitor ( it stores five "events"  at a time) and while I'm sending it in via phone, my heart is beating irregularly. I'm just beside myself.  I am having PACs, PVCs and runs of very quick PACS -- 4 to 15 or so rapid fire beats. Does anyone know what this is? PAT? I was told it was not PSVT . It is sinus tachycardia but what is the significance of SALVOS OF VERY FAST BEATS that start and stop like this, suddenly.. i am so depressed about all this i can hardly take much more . i also feel systemically horrible.,

[Linda123]

Just an article for thought:-

DETROIT, March 9, 1997 --
Sinai Hospital reports a non-life threatening, but often debilitating, recurrent rapid heart rhythm produces symptoms easily confused with "panic attacks" -- a misdiagnosis made twice as frequently in women. Recognition and appropriate treatment of the cardiac disorder can eliminate panic-like symptoms in 90% of cases.
These new findings are being reported in the March 10, 1997
issue of the American Medical Association journal Archives of
Internal Medicine by a Wayne State University School of medicine research team, whose senior member is Michael H. Lehmann, M.D., Clinical Associate Professor of Medicine and Director of the Arrhythmia Center at Sinai Hospital, Detroit MI. The lead author of the article is Timothy J. Lessmeier, M.D., currently at the Heart Institute of Spokane, Spokane, WA.
The researchers studied 107 patients (median age 40 years; 55% women) referred for electrophysiologic testing, a special heart catheterization procedure for rhythm problems. This test proved that the patients suffered from paroxysmal supraventricular tachycardia (PSVT) -- a recurrent, non-life threatening heart rhythm disorder (typically 150-250 beats per minute) that often stops on its own after several seconds to minutes.
At the time of physician contact, however, the diagnosis of
PSVT was made in only 48 (45%) of patients. Among the 59 initially unrecognized cases of PSVT, a median of 3.3 years
elapsed until the proper diagnosis was made. Prior to that time, symptoms in 32 (54%) of these unrecognized cases of PSVT were attributed (by non-psychiatric physicians) to "panic," "anxiety" or "stress" -- a diagnostic error made twice as frequently in women vs. men. In fact, 12% of patients with unrecognized PSVT sought the care of a mental health professional because of their symptoms.
The potential for symptom overlap between PSVT and panic attack was striking. Of the 107 patients studied, two thirds had a PSVT episode frequency and symptom profile that met American Psychiatric Association criteria for Panic Disorder.
Following the electrophysiology test, PSVT was treated either
by another catheterization-like procedure designed to completely eliminate the abnormality called "radiofrequency ablation," or by medication aimed at suppressing recurrences.
After a median 20 month follow-up period, 86% of patients were cured of their symptoms -- including 91% of those whose symptoms were attributed to "panic," "anxiety" or "stress."

The fleeting nature and relative infrequency of PSVT episodes likely contributed to such initial misdiagnoses. Even the
traditional portable 24-hour electrocardiogram recorder succeeded in catching a PSVT episode in only 9% (6 of 64)patients having this test.
  
Far more effective, the researchers found, were "event monitors" which detected PSVT in 47% (8 of 17) patients so tested. An event monitor is a lightweight electrocardiogram recording device that is typically worn (like a beeper or wrist watch) over a 1-2 week period, and activated by the patient whenever he or she has palpitations or other symptoms.

Also potentially helpful is a subtle suggestive marker of a tendency toward PSVT, called a "delta wave," which
sometimes may be evident on a standard electrocardiogram.
However, this diagnostically valuable clue was not initially recognized in over one third of the patients with this telltale electrocardiographic sign.
he study's findings should help physicians to avoid overlooking PSVT -- a curable heart rhythm disorder -- as the basis for recurrent "panic"-like symptoms, especially in women.
Research is now needed to define the proportion of patients with panic attacks actually suffering from PSVT.
  

[another housewife]

I am 26 yrs old and have experienced heart racing episodes since I was about 19 and pregnant with my first child.  I have had it at least once with every child I had and with my last one I had it 5 times, and am having it now that I'm not pregnant.  I went to the cardiologist when I was pregnant and they gave me an electrocardiogram and blood work and he said everything was fine.  Are they able to tell about all those things mentioned above, like the svt and psvt?  Thenk you for any camments.