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Heart Disease (Expert Forum)
Palpitations
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Palpitations
by Carrie41, Nov 21, 2006 12:00AM
History: Fourty-five year old female with no health problem except PVC's/PAC's/nsvt.
1. Can you tell me what is considered "frequent" and what is considered "occassional" palpitations. I get probably between four and ten feelings of dropped or skipped beats a day. They freak me out to no end. I think it seems like a lot but I have read that "frequent" means more than 30 an hour? Could you please clarify for my peace of mind?
2. I have been for two EP studies because a holter caught a short non-sustained run on v-tach. I have been told not to worry because I have a normal heart? True? Would they have been able to make my heart to go into v-tach if it could in the EP study?
3. If it is true that "everyone" gets palpitations then how come when I ask my sister or my friends if they feel anything weird in their hearts like skipping or fluttering they always say no?
4. I am on 20 mg celexa because of my anxiety about my heart. I think about it 24/7. I avoid social situations because I am afraid of having a panic attack about these things. The celexa just does not seem to take my obsessing about these things away. What would you suggest a person do about my constant anxiety/obsession about my heart. I have been told by numerous doctors and cardiologists that I am not going to drop dead but I am so sure these things are going to kill me. I obsess after having a bad bought of them and just can't stop thinking about them.
Doctor's Answer
by CCF-M.D.-MJM, Nov 21, 2006 12:00AM
Hello Carrie,
1. Can you tell me what is considered "frequent" and what is considered "occassional" palpitations. I get probably between four and ten feelings of dropped or skipped beats a day. They freak me out to no end. I think it seems like a lot but I have read that "frequent" means more than 30 an hour? Could you please clarify for my peace of mind?
Believe it or not, I have never read a defintion of what defines the frequency. It is more just looking at it and deciding how frequent they are.
2. I have been for two EP studies because a holter caught a short non-sustained run on v-tach. I have been told not to worry because I have a normal heart? True?
This is true.
Would they have been able to make my heart to go into v-tach if it could in the EP study?
That is hard to tell. We can make anyone go into ventricular fibrillation. Ventricular tachycardia can be more difficult. If you heart is normal and you have pvc's, pac's and nsvt, an EP study is not indicated.
3. If it is true that "everyone" gets palpitations then how come when I ask my sister or my friends if they feel anything weird in their hearts like skipping or fluttering they always say no?
Everyone has PVCs and PACs. Not everyone has palpitations. Remember that palpitations means that you can feel them. I will tell patients in clinic that they aren't cursed because they have PVC/PACs, they are cursed because they feel them.
4. I am on 20 mg celexa because of my anxiety about my heart. I think about it 24/7. I avoid social situations because I am afraid of having a panic attack about these things. The celexa just does not seem to take my obsessing about these things away. What would you suggest a person do about my constant anxiety/obsession about my heart. I have been told by numerous doctors and cardiologists that I am not going to drop dead but I am so sure these things are going to kill me. I obsess after having a bad bought of them and just can't stop thinking about them.
Honestly it sounds like your biggest problem is not your heart, it is your anxiety. It is very unlikely that these will go away. You need to ask yourself "what will it take to convince myself that these pvc/pac aren't going to kill me"....that is a question that only you can answer. It situations like yours, reassurance is the best we can do. Your risk of sudden death is the same as anyone else with a normal heart.
There are others on this forum with similar concerns. Hopefully they will post there thoughts.
I hope this helps. Good luck and thanks for posting.
1. Can you tell me what is considered "frequent" and what is considered "occassional" palpitations. I get probably between four and ten feelings of dropped or skipped beats a day. They freak me out to no end. I think it seems like a lot but I have read that "frequent" means more than 30 an hour? Could you please clarify for my peace of mind?
Believe it or not, I have never read a defintion of what defines the frequency. It is more just looking at it and deciding how frequent they are.
2. I have been for two EP studies because a holter caught a short non-sustained run on v-tach. I have been told not to worry because I have a normal heart? True?
This is true.
Would they have been able to make my heart to go into v-tach if it could in the EP study?
That is hard to tell. We can make anyone go into ventricular fibrillation. Ventricular tachycardia can be more difficult. If you heart is normal and you have pvc's, pac's and nsvt, an EP study is not indicated.
3. If it is true that "everyone" gets palpitations then how come when I ask my sister or my friends if they feel anything weird in their hearts like skipping or fluttering they always say no?
Everyone has PVCs and PACs. Not everyone has palpitations. Remember that palpitations means that you can feel them. I will tell patients in clinic that they aren't cursed because they have PVC/PACs, they are cursed because they feel them.
4. I am on 20 mg celexa because of my anxiety about my heart. I think about it 24/7. I avoid social situations because I am afraid of having a panic attack about these things. The celexa just does not seem to take my obsessing about these things away. What would you suggest a person do about my constant anxiety/obsession about my heart. I have been told by numerous doctors and cardiologists that I am not going to drop dead but I am so sure these things are going to kill me. I obsess after having a bad bought of them and just can't stop thinking about them.
Honestly it sounds like your biggest problem is not your heart, it is your anxiety. It is very unlikely that these will go away. You need to ask yourself "what will it take to convince myself that these pvc/pac aren't going to kill me"....that is a question that only you can answer. It situations like yours, reassurance is the best we can do. Your risk of sudden death is the same as anyone else with a normal heart.
There are others on this forum with similar concerns. Hopefully they will post there thoughts.
I hope this helps. Good luck and thanks for posting.
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I totally know where your coming from. I feel the exact same way! It is so hard dealing with these little buggers day after day with some days feeling hundreds and others feeling 1 or 2. It definatly is stressful. I am just getting myself back into exercising full time again cause my fears had me stopping it. I'm 23 and graduating from University this year, so I really need to get a grip on these things before going solo to who knows where after grad. I was just walking for about 50 mins and about 20mins into the walk I had about 10 nasty flips and strange sensations, thought I was a gonner for sure! But so far so good, still kicking. It is so hard to wrap your head around the fact that these things won't kill u? I am sure alot of us, including myself, can totally agree. Why can't we you ask? Who knows, probably because we have anxiety problems among other things. I hope you are feeling better soon and something besides exercise that I have been trying is cognitive behavioural therapy. (talking with a councellor) and it is helping me bit by bit. I wish you the best, hope to hear from you soon! :)
Nurse Kagome :)
I am a 55 year old woman with a history of PVCs. I too went through countless hours of anxiety over them. Here's my story in a nutshell, hopefully it will help you in some way.
Every since I was in my late 20's I've been feeling the occasionaly PVC. (a few a day) Then when I was in my 30ies, I had 3 episodes of almost constant PVCs (every 3rd beat). Each episode lasted about 2 weeks. They stopped on their own, no one seemed to be worried except me. Then about 3 years ago, I started getting runs of every 2nd beat was a PVC for hours or weeks at a time. I had all kinds of tests, and worried myself sick over them. I too obsessed like crazy, searched for the defination of "frequent", "occasional", etc. I hung onto to every bit of information I could find and tried to define my symptoms to those of other, trying to give myself hope. Anyhow this went on for a couple of years, even restricted my lifestyle to some degree. But one day, I decided that if there is nothing wrong with my heart, I have to get a hold of by obsessivness and try to live a normal life. I took "newborn" steps. I decided that for 1 hour I would not check my pulse and I would push all thoughts of pvcs and heart issues out of my thoughts if they happened. Even if I felt the pvcs in that hour I refused to allow them to get to me. This wasn't easy, but I took it an hour at a time. Just one or two hours one day, and then 2 or 4 hours the next time. Yes, I couldn't always do it, but I kept trying and eventually, I realized that I had forgotten to obsess about my heart for a few hours or half a day and eventually the times that I obsessed got fewer and fewer. Now I hardly ever get pvcs or if I do, I don't notice them anymore. Yes, there's time when I still get anxious, but you really have to train your mind to not think of them. Stop trying to get definitions of "frequent" etc. and just try one baby step at a time to not think about them. There was a time that I was having over 40,000 of them a day for weeks on end, and here I sit years later, writing about them now. Please stop obsessing, its the only thing that will help the anxiety in the long run.
Hope this helps.
Why would you be reluctant about therapy? Don't get me wrong; I'm a big fan of using the right medications for anxiety, but people who have therapy along with meds often do better than people who use only one or the other.
" I mean you would think that after 20 years of having them I would get over it, but I don't.
That IS the point of therapy. The PVCs will probably recur throughout your life, and therapy helps you deal with them so that if they show up when you don't have your meds on hand, you will not freak so badly. The idea is to learn, deep inside yourself, that these odd beats are not going to kill you. Learning takes practice.
Don't let the notion get to you that having therapy means you're some kind of nuts. You just need help for a specific problem here.
Get outta here! Is it really considered "rare" to have four to ten a day? I feel like it is a lot. You know you read so much about "occasional" or "frequent" but it doesn't tell you how many that would mean. I guess I just look for a number (must be OCD or something)!
I can't believe it when I read this board and see that people have 40,000 of them. Do they actually feel the skips all day long? I would be a darn basket case if I had 40,000 of them. I have only had two today and feel strung out just thinking when the next one is coming. I don't know, maybe I will go the therapy route. I know that I will probably have them the rest of my life and have to find some way to deal with them. I envy people who have found out how to do it!
Anyways about the 40,000 skips, I don't have that. I have just read that some people do. And you are right - I think they are super strong as well to be able to put up with that. I couldn't stand it.
Myself, I get around maybe 5 - 10 skips or weird sensations a day which is more than enough for me!
I am still convinced that I am going to die from that amount!
The beta blocker atenolol 100mg daily in divided doses( usually before eating and at bedtime) has just about eliminated all my PVCs, I know the thinking is that betas usually decrease the sensation without decreasing the PVCs, but for me my pvcs are adrenaline driven at least most of the time that is probably why it helps to eliminate them. It has been nearly 5 years since my last prolonged epiosde, I still get a few every now and then but they don't scare me much anymore, just uncomfortable.. I know beta blockers don't work for everyone and I'm one of the lucky ones not to suffer any of the dreaded side effects of beta blockers, but for persons with life altering symptoms a beta blocker might be worth a try, my personal opinion only.
I think swallowing some pride and seeing a pyschologist can help, because I have had one session and it helped me a great deal.
Does anyone else think that the wearing the holter makes them MORE obsessive about the beats? I have been training myself for 22 years NOT to think about them, and now I have this blasted diary I must complete and give notations every time I have an "episode", including how long it lasted, what I was doing, etc. So I'm undoing all of my not-thinking-about-them....
Now im concerned about another symptom. I know i have gotten them in the past before but only here or there and only once or twice then disappeared. So i never paid much attention to it. but a couple of times recently i got about 3 or four of these sensations in a row. PLEASe tell me if this is what you are all feeling
I feel a sort of weird feeling in my chest. almost like gas. Feels like its the stomach. A spasm or contraction something cant explain it. Then there sometimes is a pause and then a hard heart beat after. They dont come too often and not everyday. i might go a few days without one then ill get like four in a row. and its a pretty profound feeling. I worry because I smoke ALOT. and im not very physically active. However im not over weight. My blood work is all normal. low blood pressure. etc. and there isnt any heart problems in my parents and they are 70 and older.
I just got a holter monitor test done. 24 hours. Is this enough to help reassure me that my heart is ok? Do need to get a 100 other tests after this to be sure? I dont have insurance right now and dont know if i can afford many more tests. Im still awaiting the results.
is it bad that im getting these so profoundly and being male? I notice most who complain are females. hormone related?
wmac
I guess it's all about coming to grips with these things, no matter how many we get.
Hi Tickertock!! The BB drastically decreases the frequency for me also, not just the sensation. Hope that continues.
Fran
Of course at first it freaked me out alot.. and I worried that my heart would just stop from them etc.. But one day I realized that I was starting to worry so much about dying, that I stopped living, and that was enough for me. Now I accept that I feel them occasionally, especially a few days before my time of month, that's when I feel them most. Regular excercise helps me more than anything.. If im having a time where I feel them alot (usually during high stress times such as my wedding or during my time of month), then I make sure to walk several laps around the track each day and they seem to go away more.
Good luck
10 pvcs per day is hardly any and no more than your average person youd pass on the street. In studies where they've put holters on a sample of the population 6% had more than 50 pvcs, 5% had more than 300, 4% had more than 500 and almost 3% had more than 1000 PVCs per day. These results are scientific fact and are published in reputable medical journals. A recent study of 625 people with normal hearts showed that 3.4% had nsvt during the 24hours of the study and 8.8% had couplets. Apologies if i already told you this in another post. I've written about this quite a few times in various threads on the forum as I find it very comforting. So just remember when you look at people around you that most of them are having more PVCs than you but dont know it. I have had 1786 and feel every single one of them as a horrible flip flop in throat and dropping sensation in chest. I literally didn't go longer then 2 minutes without PVCs for month..like torture. I think I'd rather have 10,000 per day and not feel them than have 200 per day and feel them.