Palpitations, rapid heart rate

[Nicole__0__0]

Posted by Nicole on May 26, 1999 at 09:54:26
I have been having random palpitations and a recurrent rapid heart rate for a few years now.  Recently, my doctor decided to check for MVP.  My echo came out clear and showed no signs of MVP.  He also ran an EKG and had me use a 2-week event monitor.  What he discovered were harmless (as he described them) PACs and an occasional rapid heart rate.  He instructed me not to worry, and indicated that if it bothered me, he could put me on beta blockers, but that it wasn't necessary.  He is now following up by checking my TSH level every six weeks, because it seems to be climbing.  He originally thought my thyroid could be causing the palpitations, but from everything I've read it seems that palpitations are a symptom of hyperthyroidism and I believe with an elevated TSH level I am being checked for hypothyroidism.  Anyway, my question has to do with my palpitations which are still occuring.  The skipped beats I feel do not worry me so much as the rapid heart rate.  Some nights, for no apparent reason, my heart will begin beating rapidly and feel like it's pounding in my chest.  I've checked my pulse during these episodes and it's always upwards of 95 - normally, I'm at 75 or so.  The episodes can last anywhere from 15 minutes to a couple hours and frighten me!  There is a long history of heart disease in my family, so I'm just wondering if there are any other tests I should have done or if my doctor has covered all the bases he should with the ECG, EKG, and event monitor.  Could my potential hypothyroidism be causing any of this?  Any advice would be helpful.  Thank you.

Posted by CCF CARDIO MD - MTR on May 26, 1999 at 14:31:35
Dear Nicole, thank you for your question.  Generally, hyperthyroidism causes rapid heart rhythms, not hypothyroidism.  If your TSH is indeed elevated, then that is a sign of hypothyroidism.  Thus, I don't think any thyroid abnormality is present here.  You have already had all the appropriate tests done to investigate the palpitations, however, the rapid heart rhythms may be something new.  Thus, I think you should contact your physician to discuss the current problem.  PAC's are a benign problem that won't harm you and do not portend a bad prognosis.  Common precipitants of PAC's that should be avoided include alcohol, tobacco, and caffeine.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Posted by Nicole on May 26, 1999 at 15:56:55
Thank you for your quick response!  My doctor is aware of the rapid heart rate episodes and assured me he saw nothing irregular in the ECG, EKG, and event monitor.  He did detect a slight heart murmur, which was why he ordered the ECG for MVP.  Could these rapid heart rate episodes (they probably occur every other week or so) be in any way dangerous, or would the EKG have picked up any abnormalities in my heart rhythm?  I am only 26 years old, and, as far as I'm concerned, in good health (i.e., I feel fine!) I don't feel the need to challenge my doctor, but wonder if I should do more to look into this.  Horror stories about young people dropping from ARVD or other similar disorders freak me out, to say the least!  

Posted by CCF CARDIO MD - MTR on May 26, 1999 at 22:18:08
Dear Nicole, I don't think you have structural heart disease and I doubt that you have a serious ventricular arrhythmia.  The tests that have been done have already ruled out those possibilities.  Therefore, you should speak with your physician regarding the rapid heart rhythm because I can only speculate in this forum.  You need more definitive answers.  Good luck!

Posted by Gabriel on May 27, 1999 at 23:25:05
I am writing regarding a condition that sounds very much like that of Nicole's. About six years or so, I was diagnosed as having arrhythmia and was prescribed beta-blockers.  Unfortunately, I found them to be quite debilitating and stopped taking them.  I seemed to be doing okay without them until I had a panic attack after a particularly pronounced onset of PAC's coupled with a very fast and faint heart beat.  I was put through a battery of tests including a 24 hour heart monitor, EKG, and tilt table test and was told that my arrhythmia was minor and that if I wanted to I could go on beta-blockers but didn't have to.  I elected not to take them but recently I have had more frequent PAC's which are making me change my opposition to the aforementioned medication.  I also have had several episodes in the middle of the night where I've felt as though I can't breathe and attempt to wake up but can't seem to be able to.  Frankly, these episodes are quite terrifying as it feels as if I don't wake up I'll die. Now, I'm wondering: are these episodes merely sleep apnia (apnea) or could they be related to my arrhythmia?  In other words, could my heart actually be stopping momentarily when I feel this (it really feels as if that is actually what's happening).  In fact, when the doctor looked at the results of the 24 hour heart monitor I believe he mentioned that there was a long gap between two beats.  Also, recently I have experienced a numbness and slight pain on my left arm as well as very slight tingling reminiscent to that experienced when a limb begins to wake up after having been asleep.  Could that be related to a heart problem? My heart muscle, I was told, is doing great except for a very slight murmur.  It's my electrical system that's out of whack apparently.  Thus, could the numbness in my left arm and sleep disturbances be related to a fibrilating heart?  Keep in mind that I am 25, in reasonably good physical shape, but by nature a very anxious person (drink loads of caffeine).  I appreciate any and all advice.

Posted by cindy wexler on May 28, 1999 at 23:11:53
i have had heart palputations for two to three week now, i do have mvp
i also get ventricular tackacardia. my dr. advised e to drink orange
juice and take potassium is this true

Posted by CCF CARDIO MD - CRC on June 08, 1999 at 09:24:58
A low potassium can be a cause of some heart arrhythmias.  Orange juice does have potassium in it.  
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician
can provide specific diagnoses and therapies. Please feel free to write back with additional questions. Good luck.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire
online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your cardiac problem.