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Heart palpitations
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Heart palpitations

Hello, I am 28 years old and have been having heart palpitaions. I have been to my doctor and to the ER and they claim everything is fine. It gets really bad when I lay down at night. It usually keeps me up for at least 2 hours at night when they occur. It almost feels like my heart is beating so hard that it's choking me and it makes me cough. They come and go all the time for the last couple years. It's now getting to the point where it happens almost every night and now during the day also. Is there something I can do to prevent these. Please help!!
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74076_tn?1189759432
Hello,

Sorry to hear about your frustration.  Have you been to an electrophysiologist yet? Palpitations are the sensation of feeling your heart beat and can come from premature atrial or ventricular contractions, anxiety/depression, among other rarer causes.  The first step is usually an EKG and holter monitor to correlated the symptoms with possible arrhythmias. It is usually PAC/PVCs.

Assuming it is PAC/PVCs, it is common to have the sensation of a pause then a thump often associated with a cough.  These are worse at night because you are still and many people lay on their left side which brings the heart closer to your chest wall, making them easier to sense.

If a stress test, echo and other tests  your doctor may want to order are normal, there is rarely any signficant life threatening problems -- unfortunately they can be life altering depending on the symptoms.  If the symptoms are significant, the first step is a beta blocker.  If the bb doesn't decrease the sensation or symptoms, in some highly symptomatic people an antiarrhythmic medication like flecainide is tried.  This may reduce the frequency.

In rare circumstances, PVC ablations are done for monomorphic (originating from one site), frequent PVCs.  We do not do these procedures often but we do them in rare circumstances.

An electrophysiologist is often the best person to address these problems.  I hope this answers your questions.  Thanks for posting.
23 Comments
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Avatar_n_tn
hi, i have been having palpitations for about twenty years now. you should read skippybeat's comment on 5/8/06 for peace of mind instead of having anxiety about them for as long as i have - when i think of all the time i wasted worrying... i take 20 mg's of propranolol when mine get bad. i find it very helpful most of the time however, sometimes it takes two hours to work completely, so you could take a beta blocker maybe two hours before bed to ward them off if your doctor okay'd it. it's fine to take it "as needed" if all your tests are okay. also, you might consider not have any simple carbs at dinner - bread, pasta, sugar... many people post that this brings them on including me. veggies and fruit don't seem to be a problem. might as well try it and see if it helps. good luck!
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Avatar_n_tn
Hi momof2rugrats, despite I sympathize with your symptoms, I ask you and all the people around here with a normal certified heart to stop posting messages about palpitations. Did not you get the answers of DOCs are always the same? You are taking space out to whom really needs the help of a cardiologist. There are other places where you can write, such as the group PeoplewithPVCs http://health.groups.yahoo.com/group/PeoplewithPVCs/ where you will find interesting informations about palpitations.
And as a young DCM patient who has been waiting for months to write a message (and could not) I ask that a moderator could stop all those messages about palpitation. That CAN BE an issue. But was already LARGELY discussed.
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Avatar_n_tn
I can understand how frustrating it can be to see the repeating of such posts.  However the forum states 2 per every 6 months and if this is how they choose to use it is up to the person.

I have to say i posted re: palpitations and the dr. offered insight that was very helpful.. each post is different the answer may be the same but it gives the people suffering from palpitations some confort.

As for you not being able to get through i have found in the past if i wake up early at about 6 am or so i can get the post in.  And i am on the west coast.  So maybe that can help you get the questions you need answered.

Again i am not trying to minimize your frustration however i think palpitations are very scary. And the Drs. are very gracious in answering them and in a way that is simple to understand and are conforting.  The other thing is that the drs. will also give guidance on how to go about getting your palpitaions diagnosed pointing very scared people is the right direction.

Like i said i had heart palpitations.. and went in to the dr. and was told to ignor them.  That dr. did not to an ekg, event monitor, blood tests or anything.  Saying i was not high risk 30 yr old female not over wieght non smoker no history and that palps are common. Then I posted here dr. told me it is probably nothing but to set my mind at ease request a 24 hr monitor and ekg.  So i did.  they showed some premature beats (nothing big) and sinus tach.. which was a good thing however they did record the palpitation.. by that recording they could see they were not life threatening they did a series of blood work and found that i had borderline high cholesterol and i was only 30 excercise 4-5 times per week. I slept a lot better that night knowing the palps were not life threatening and have modified my diet to get the cholesterol down. The thing is if it was life threatening i would have never been equipt with the information for the test to ask for or the questions to ask had it not been for this forum.   So for that i am very greatful.  



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84483_tn?1289941537
Palpitations are real and scarey. The vast majority of visits to cardiologist are about palpitations, yes they are for the most benign but very troublesome.

They are serious heart issues out there that no doubt deserve and need to be discussed much more and for those that have these serious heart problems , i understand the way they feel about palpitations being the continuous story/thread of the day, but one must also realise what most are bothered by is what most will discuss and talk about.

There are other discussion boards out there that persons might do well and benefit from, but here is where the doctors answers our questions even though most of them same redundant, reassurance is always the best therapy for benign palpitations, even though its sames to be in constant need every so often. Good health and a peace of mind to all.
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Avatar_n_tn
I concur that palps are real, and very scary.  In my case, it's PVC's..

I thank God everyday that I do not suffer as many as some of you do (several thousand per day), but most will agree that even ONE felt PVC is too many.

I went through the normal routine after getting these.  I went to my Primary doctor, who after hearing what I was experiencing, referred me to get a Holter monitor.  The Holter only picked up one 'early beat' in the 24 hours.  Since I still had the referral, I made an actual appointment with the Cardio.  He had me do a stress/echo, which came back completely normal for heart structure.  They were also able to see what I was feeling, as I had them occur at the beginning of the procedure.  It was at that point that I had a name to my dreaded feeling...PVC's.  I was assured that they will not kill me, and that they will not lead to future problems.  They normally do not treat them unless they become very bothersome for the patient.  In a nutshell, I was told to ignore them, and live with them.

Fortunately for me, I get maybe between 15-30 per day of these things.  I certainly feel each and every one though.  I do wonder though, how many Doctors would not be so 'dismissive' of us if they actually felt these themselves.  I can certainly understand why they get that way, seeing as there is little to no real solid research as to what causes these things to happen.  Sure, they can suggest the usual things to 'lower' their frequency such as limiting your caffeine, alcohol, smoking, and stress.  But even that is not 100% proof of stopping the PVC's.  In my case, (and many others here I'm sure) where heart disease has been ruled out, yet we still have them, there HAS TO be a reason why they happen.  You don't just go from never having these one day, to the next day having few up to hundreds.

Modern medicene is wonderful, and has done great things for many people.  However in my case, personally, I feel that 21st century medicene has failed me.  We can spend millions of dollars of research to come up with literally hundreds of medicenes that line your local pharmacy to treat 'benign, non-lifethreatening' symptoms for colds such as stuffy nose, sore throat, and cough.  Yet there are hundreds (and thats just the ones on this board who knows how many for sure) who go through these awful PVC's each and every day, and we're constantly told that 'they are benign, and to ignore them'.  Sure, they wont kill us (just like a stuffy nose wont), but the psychological impacts, and quality of life impacts can be devastating.  That alone should warrant major comprehensive studies to determine WHY WHY WHY these things happen in people with no heart disease.

I'm extremely frustrated by this whole PVC thing....like others, I'm moving from scared to extremely angry about this.  I'm 31 yrs old, with three young kids.  I should not be worrying/dealing with this at my age....NOONE should, regardless of their age.  There HAS TO be a reason for these PVC's, and it's extremely upsetting that it's being taken so lightly by the medical community.

For me, I started taking daily 400 MG's of Magnesium Citrate supplements, and they do help alot.  I also have no caffeine at all, I dont smoke, or drink alcohol.  I am 6'2, 196 pounds, and I exercise on a tredmill at least 5 days per week for 30 minutes at a time.  See....I do all the things you are supposed to do, and I still have PVC's.....it just fuels my opinion even more that there is some common cause that is not found because proper research is not being done on PVC's.

Hang in there all,
--Mike
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Avatar_n_tn
A normal certified heart doesn't have electrical problems, benign or not. Palpitations are electrical problems. Misfires if you will. I have 20,000+ misfires per day, that's not normal!!!! ya, it probably won't kill me, but since no doctor or cardiologist can answer why they happen or how to get rid of them I think it's still worth asking about--medicine and research changes, don't you know.

If so many people get them, then heck yes when it happens to them, they want to know what to do about it.

This forum's rules are two questions in a 6 month period. I've visited this board almost daily for one year and haven't been able to post, I'm frustrated just like you are. But I would never suggest to anyone here that they stop asking a question--any question, even if it's only important to them.

You caught me on a bad day. My mother and father both died in their 60's of sudden heart attacks (4 months apart infact). I think every question about the heart is important whether you think so or not. I might have BENIGN palpitations, but I still have concerns and worries and we're ALL human deserving of compassion and respect.
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Avatar_n_tn
I'm with Upbeat63 on this one. I too have periods of thousands of PVCs in a day. Fortunately for me, the episodes come and go. However, even in good times, I come here to read the posts and always read the posts about arrythmias. Why? Because even though they are benign, unless you have not had them,you don't know how bad they can make you feel. The accompanying anxiety is, at times, overwhelming. I don't personnally know anyone who has this same condition and by coming to this site, I know that I am not alone and there are many, many other people with the same problem. Knowing this gives me a little bit of comfort. I just wish that some drug company is following all these posts and someday will find a drug that can eliminate these terrifying yet benign events.
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Avatar_n_tn
Remember that one of the rule of this forum is:
"PLEASE do not repost a question already listed on the site "
http://www.medhelp.org/forums/cardio/TheRules.htm
Using the archive one can find tons of answers to palpitations'questions (that are all very similar). I know it very well because at 30 years old I am an expert, I have tons of PVCs, bigeminy,trigeminy and sometimes v-tach because of my familial cardiomyopahty. I had an ICD implanted 4 years ago. Because of Vtach. I know very well that PVCs are very bothering. I do everything is known by medicine. I also go to a psycotherapist. I take betablockers. I take xanax. I am always following a diet (because of my cardiomyopathy).
I respect all. But I wanted to be respected. I would not ask here things that were already and continously asked. There are other spaces to talk about PVCs. Again, I suggest you the yahoo group People with PVCs: there you will find suggestions and tips that here you never will have from a doc. Those are tips of people who suffer. Like us.



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Avatar_n_tn
Try to understand that this forum is for everyone and whatever question they ask regarding their heart is allowed.  Your comments are coming across rather rude unfortunately.  When people have heart palps, skips, pac's, pvc's or whatever you want to call them, they are VERY REAL and VERY FRIGHTENING.  This is especially so if a person has them for the 1st time or they've had them for long time and now the pattern is changing.  

Momof2rugrats has every right to ask, regardless of how much you think this issue has been discussed on the forum.  Her pattern of palps has changed and she's getting them more frequently which to me warrants a posting here!  People come here for insight from the doctors but also comfort and reassurance from others suffering as well.  I think you would agree that not every person will have the exact same cardiac history when posting too.  The doctors always answer respectfully, never insinuating that others stop asking this question either.

Please try to lighten up.  This forum is a wonderful, wonderful tool that has helped and will continue to help many people.  If you're frustrated because you haven't been able to post, keep trying.  It took me almost 6 months to get a question posted and I was very happy with the responses from doctor and all the other people kind enough to offer advice.  You are not the moderator for this forum so just grin and bear it.  You're obviously frustrated that you haven't been able to post but do not attack momof2rugrats or any other person posting here because of your own frustrations.  Not nice at all.  You suggest them going to other forums for help, well right back at you then.  It's so rude to ask that people not post a certain question because of your own opinion that it is an already discussed topic.  Too bad.  

Momof2rugrats, I understand how you're feeling.  I too suffer from these annoying little beasts but you're in good company.  Just for peace of mind, maybe get a 2nd opinion since they seem to come more frequently now.  I know mine always rear their ugly heads before and during my period.  Best of luck and don't let this other poster make you feel bad for asking your question!  

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21064_tn?1309312333
As the forum suggests, it is a place for anyone to ask a question relative to a cardiac concern.  About 25 years ago, when I first developed ectopics, I had similar anxiety to those of you dealing with them today.  I'm here to tell you that there are plenty of people here who are more than willing to share their experiences and calm your fears.  Benign, or not...sometimes piece of mind is the best medicine.  I imagine my internist, cardiologist and OB/GYN get tired of fielding the same questions, from patient to patient, but I've never felt that my "same old" question wasn't deserving of a time slot in a busy doctor's office.  Try and look at the forum the same way...I, for one, deveoped cardiomyopathy and was pretty terrified when I learned that chronic and very frequent pvcs were the cause.  Although they are almost always benign, they can provoke other problems in rare cases.

I always think of comparing the pvc questions (for the umpteenth time) to that of a person who suffers from chronic headaches.  They've got to have the same fears of their "benign" conditions. But for a small percentage of cases, headaches can produce similar anxiety and frustration.

This is a place to learn, make friends, vent and share open dialogues and experiences....Hence, a "forum."

Let's all remember that all questions have a place.

connie
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Avatar_n_tn
Giorg,

Go back and read it again..."PLEASE do not repost a question already listed on the site or post responses saying you are still waiting. We realize if your question has not been answered that you are still awaiting your response."  

This means do not repost your own same question because the doctor has not answered it yet.  Read this in the context of the whole paragraph and that's what it means.  

Well said Connie.  Love the comparison to a headache!  Have a good one (:

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Avatar_f_tn
I agree that one reason that there are so many questions about palps is because in most cases the answer we get - even though we may have debilitating, extremely frightening symptoms - is that they are nothing to worry about.  It is sort of like having severe, blinding headaches and going to the doctor to be told there is nothing wrong, maybe they are in your mind.  If the doctor could diagnose me with something treatable, something concrete instead of just saying "yep, you have palps, but we don't know why and are pretty sure it won't kill you" it would almost allay my fears more.  It's like an ax is sitting over your head and you're wondering if the palps will get worse, maybe the doctors are wrong, etc.  That is probably why so many people seek reassurance on this issue and I don't blame them a bit (though, thank God (!), my palps are SO much better than they have been in 2 years right now.  Hope it continues!)
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Avatar_n_tn
Actually, it's more reassuring than "we're pretty sure it won't kill you". There was a study done that my cardiologist told me about that showed no increased mortality risk in patients with pvc's with otherwise normal hearts. Plus look at all the postings of people who have several thousands per day for years and are still here to talk about it. I am extremely grateful for all of the postings here on pvc's. Were it not for this site I would be anxiety ridden and miserable, living a limited life, instead of just trying to accept that they won't hurt me and going about my everyday business. It's not easy with three kids and since no one I know has this problem, I look to this site for support. Today I drove an hour on the expressway with bigeminy the whole way and the entire time I was reminding myself of the reassuring postings I have read. I'm sorry for the man's problems who complained of pvc's postings but we all need support and fear is fear, no matter how serious the problem.
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Avatar_n_tn
I suggest you do some more reading.  I have researched this extensively (part of my work) and what you are suggesting is wrong and misleading.
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84483_tn?1289941537
I for certain can't absolutely say that PVCs are DEFINITELY BENIGN is all cases, but for the very vast majority of sufferers I would definitely say their prognosis points in a very benign direction, being a sufferer off and on for over 20 years, plus all the others that have been around for "years" complaining of them, I would argue that most studies done regarding them have shown that they pose no increased of sudden death in those with the criteria for what meets a "normal heart" or even those with mild insignificant heart disease or structural abnormalities, just my 2 cents worth.This is my personal opinion and understanding only , I'm not a doctor, just a heartfelt sufferer though I rarely ever have them anymore.
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Avatar_n_tn
Could all of these cardiologists of people posting be lying or that uninformed? Perhaps sudden death could occur, but as my electrophysiologist says "you have more of a chance dying in a car crash". good enough for me. there are no guarantees in life.
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Avatar_n_tn
I know from your previous posts that it is not worth my time pointing you toward the studies.  People come to this forum for support.  It only takes one ill-informed person to suggest that what someone is suffering from increases their mortality and it obliterates the reassuring opinions of 10 cardiologists.  What you are providing is not what people come here for, and unless you are qualified in this field you should be careful of what conclusions you draw from the studies you read. Most studies look at mortality in the setting of some other condition. I recall in a previous post you questioned the frequency of ectopics in the general population and you refered to a study which you misinterpreted.  I did not correct you at the time as the post had reached its limit.  Do you understand statistics and sample sizes? Do you know how to interpret statistical results?  So you know what makes a valid statistical study? I can assure you that most people get ectopics.  Most studies take a population sample over a short period of time and hope that the sample size is large enough to capture what would they would find had they sampled over a much longer period in the general population. Do you think that if most people with normal hearts get ectopics that they all have higher mortality? No, because the statistical implication here is that those with the ectopics set the norm as we know it.  

Why don't you try posting your views in thee form of a question in this forum and see what response you get? It would not be ethical for the doctors not to acknowledge your views if they were in fact correct.
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Avatar_n_tn
I have just read everyone's comments about the Heart Palp's. I respect everyone's view's about this subject, and the postings. I have to agree with someone that has had these palp's appear out of no where. I had them once in a great while before, but about six months ago, they started happeniong more frequently. I have been to the Doc's and have had most of the test done. Everything has checked out normal, but the anxiety is changing the way I live. I also have chronic chest and back pain. It is scarry to have the palps when you try and rest, that's when I have them. Perhap's it is not the same with other doc's, but I feel some just treat the symptoms. I understand why everyone comes to this forum, any change in your health that effects your heart is frighting. I joined this because I am scaired. I am only 30 and in good shape, good diet, etc.. But I want to be around for my family with out having to worry that I won't wake up some morning. Maybe, a seperate forum should be opened for those of us with these mystery palps and accompaning symptoms. I really do understand the concern and frustrations with health and needing to post questions, but we should all be here for the support.
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84483_tn?1289941537
Without pinpointing any particular study or studies, they say "experience is the greatest of all schools that even the fools will learn", in no way am intending to insult you or anyone else,just referring to what the the majority of medical community has come to a general concensus regarding PVCs in the last 25-30 years regarding what was once thought about PVCs, but up to about 25-30 years ago PVCs were regarded as a harbinger of SCD or worse things to come.

Proarrhytmic drugs were given to those with PVCs only to result in detrimental consequences even though the PVCs were greatly suppressed, those in which the the PVCs were not suppressed the mortality was significantly lower from what I remember. The age of holter monitoring showed that a great percentage of the population suffered or had PVCs, while a great percentage of the population maybe obese or overweight, I don't necessarily draw the same conclusion with PVCs, most cases of being obese is brought on by self destruction and over indulgence, I myself am about 30 lbs overweight simply by over indulgence, PVCs are for the part way beyond our control and even the healthiest children have them, so they are considered a natural normal occurence.

Years of experience have taught doctors that for most part PVCs are a normal occurence in otherwise healthy individuals, though an aggravating , distressing and somtimes life altering nuisance to those who are aware of them, they in themselves do not impact your overall lifespan or longevity, but they way a person reacts to them can have negative consequences.

I just want to add that I once felt just the way you do regarding PVCs and fully understand where you are coming from. I too looked at all the negative studies which I must say far outweighed the positive ones, but when you look at them objectively and not just as a sufferer you will begin understand that those those studies don't reflect the general heart healthy population. Of course from following your ordeal, I can't comment that my personal opinion should apply to your case , it very well may not , but I wish you the very best. I can say that you come across as a very intelligent person who simply has some very logical questions for what really can't be explained.

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Avatar_n_tn
What an interesting and beautiful thread. I guess it shows that the frequency of PVCs questions is linked to the vast number of people who get them, versus the number of people who, oh, I don't know, get an aortic anuerysm?

But none of our suffering should be minimized, benign or life-threatening. That's to everyone.

Studies are argued by the researchers and the readers alike, I'm glad it's been so healthy, and vigorously done so here too.

I did notice the last four questions were of different topics, but if they don't relate to you, it doesn't mean they aren't helpful to all the posters here.

I hope I've helped some people along my journey, because I have received a lot of help here. Keep reading, posting and asking questions everyone. We all make a difference.

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Avatar_n_tn
Shame on you for posting that thread.  People are on this forum frightened to death by their pac's and pvc's.  You are just spouting off studies completely disregarding the fact that many people are extrememly anxious when it comes to these heart palps.  

Why don't you leave it their doctors to decide what is benign and what is not.  I am sure they have the credentials to prove it, do you?  Please do not try to frighten other people again like that.  It is really unkind and many people will read what you wrote and become very upset and anxious about their palps even though they have had good cardio work-ups and been told by their doctors they are fine.

You keep talking about risk factors and making comparisons.  It is obvious you have done reading, I am not doubting that at all.  But don't scare everyone just to show off or make a point.  These are good people who are scared and have capable doctors taking care of them.  You very well may have undone a lot of reassurance that people gain from this forum on this subject.  Please don't do it again.  Thank-you, I am not trying to be rude to you all either.  Have a good evening.
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A related discussion, WHY WHY WHY? was started.
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