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Heart feels weak, please please help
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Heart feels weak, please please help

Can someone tell me what these symptoms mean? Or could possibly be?
Heart palpitations for 2 weeks, each palpitation feels like a pinching sensation in my heart, fluttering heart feeling, and REALLY bad anxiety or sometimes I experience the odd palpitation, but manly just a CONSTANT fluttery feeling around my heart area,
This a all constant and hasn't stopped for 2 weeks straight and my heart constantly feels weakish
Had 3 ecgs, blood test, chest xray, seen countless doctors (they all said it doesn't sound serious)
But they still are not sure what it is? I'm so scared
16 year old female, never had anything like this before
(Also today I've been experiencing, like once or twice when I take a deep breathe a weird sensation in my throat, only lasts for 2 secs then goes (that was this morning now they're gone), also I figured out today that when I cough, or fake cough the discomfort worsens, like I can feel it more, it's not a pain just a discomfort around the area where I am experiencing these palpitations/flutters
going to see a peadiatricion in a week
This all started three months ago when I pulled a chest muscle, (which was a pain not a discomfort and it felt like it was in a different place) also could an ECG pick this up? What I've described? Because I had this when I was having an ECG and nothing showed up? Having heart discomfort/pain and it didnt even show anything
to add more detail, I do not feel any dizziness, lightheadedness or anything else, or heaviness in my chest as well
Just this discomfort, centered around my heart and every beat feels like a pinch, it's horrible
I can't really pinpoint where abouts, just all behind my left breast area
Right now I am feeling this weird heartbeat, like I get the odd one every few seconds that feels weird, like out of place and really shouldn't be beating like that, I guess that's called a palpitation?
I'm so scared and I feel so depressed all the time it's really getting me now
Avatar_dr_m_tn
Dear tasha721,

Palpitations or an increased awareness of your heart beat is one of the most common reasons people visit cardiologists. They can be very frightening and so it is natural for you to want to understand what they are, what is causing them, if anything bad might happen as a result of the palpitations, and also what treatment options are available.

So what does cause palpitations? First I would like to give you some background on our amazing heart and how it works. Our hearts have electrical networks that control the heart beat. After receiving an electrical impulse or signal, our pumping chambers (or ‘ventricles’) pump blood to our body and lungs. There are 2 major control centers that work together to send the electricity through the heart (called the ‘sino-atrial node’ and the ‘atrioventricular node’). The names are not as important as the concept that electrical activity is normally smooth and organized.

Palpitations occur when there is a change in electrical activity and pump function. If the heart beats too slow (less than 40 beats per minute, called ‘bradycardia’) patients can feel tired and sometimes dizzy. A slow heart rate can however be normal in really fit people. On the other hand, when the heart beats too fast (greater than 100 beats per minute, called ‘tachycardia’) patients can feel uncomfortable because of the rapid heart rate. Of course, a heart rate above 100 is normal with exertion or exercise so we only worry about fast heart rates that occur without warning, at rest, or faster than would be expected (even with exertion).

A skipped heart beat can be caused by electrical signals being fired outside of the hearts normal control centers. These are called PVC’s or ‘premature ventricular complexes/contractions. Instead of electrical signals flowing smoothly down the major control center ‘highway’ there is an extra signal from another area of the heart that causes the heart to beat out of time. These are very common and if they are not associated with other medical problems or changes in the strength or size of the heart, they’re usually nothing to worry about. PVC’s can be pesky and can lead to all sorts of symptoms include shortness of breath, a feeling of being butterflies, or even a sensation of being kicked from inside the chest. Your symptoms are most consistent with PVC’s but this can’t be confirmed without the results of your tests and a more complete medical history/examination.

Other types of palpitations can be more of a problem. The names become even more confusing but they generally describe whether the electrical problem is above the pumping chambers / ventricles (called ‘supraventricular’ – ‘supra’ means above) or within the pumping chambers (‘ventricular’). The symptoms associated with these kinds of palpitations may include; rapid onset palpitations without warning, sudden return to normal beat, rapid heart rate (>100bpm) without exercise, associated flushing/dizziness/chest discomfort, and relief with coughing or straining (as if you’re on the toilet). The ventricular type is uncommon in young people, particularly those without any family history of heart problems and a normal EKG and echo.

The starting point for you will be a full medical assessment to exclude an underlying reason for palpitations. Sometimes changes in our hearts electrical system reflect more general changes in our body and health. Tests might include electrolyte levels (including calcium and magnesium), complete blood count, thyroid function, and even a pregnancy test if relevant. An echocardiogram should be performed to check the strength of the heart and the valve function inside the heart. If you experience the palpitations many times a day a Holter monitor may be helpful. You should also complete a patient diary so that your doctors can match your symptoms with any changes in heart beat or rhythm. In addition to these tests it is also important to find out about any stress, anxiety, or depression, as all of these things can be associated with palpitations and can require expert treatment of their own for the palpitations to improve.

Warning symptoms that should always be reported to your doctor includes palpitations associated with collapse or near-collapse or palpitations that also cause significant chest discomfort / shortness of breath / sweating (not explained by exercise or heavy exertion). So far you haven’t had any warning symptoms so that’s great news.

In preparing for your pediatrician visit keep a diary of your palpitations over the next week. I wouldn’t recommend any longer than that because it can become a fixation that is not helpful. In your diary, write the time that the palpitation occurred, what you were doing at the time (i.e. resting, eating, exercising, studying), the duration of your symptoms, associated symptoms (shortness of breath, dizziness, chest pain, nausea), and anything that helped (i.e. deep breaths, lying down, rubbing the area, meditation) or made it worse (feeling anxious or stressed, exercising, changes in body position). Bring along copies of all of your previous tests and reports. To help our patients, doctors also need to know your medication list and also whether you have any recreational drug use (including smoking, alcohol, and other street drugs). Remember to write down your 5 top questions before the visit. Keep in mind the following question: What is it most important for you to leave the visit knowing? What is your biggest fear in relation to these symptoms? You will be surprised how much of a relief it can be to have your questions answered and to understand the next steps that need to be taken in managing your symptoms.

Take care and good luck.
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