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Pause in heartbeat - please help!
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Pause in heartbeat - please help!

I recently came off a 48 hr holter monitor for what I would describe as a pause in my heartbeat.  I usually get a run of these when I lie down or upon waking in the morning.  Sometimes they are accompanied by the sensation that my heart is pounding very hard.  My average heart rate is about 77 bpm and does not race during these episodes.  During the holter I had several of these pauses. I was certain they would show-up and I could finally get some resolution but I just got the results and the holter showed NOTHING - no pvc/pacs, no irregularity at all.  How could that be??  What could this be??  I can physically feel these and just to prove I'm not crazy I've had my husband feel them too.  I have had a very comprehensive cardiac work up for a 36 yr old in good physical health (numerous ekgs, echo, stress echo, chest x-rays, CT scan, blood work).  My heart is healthy and structurally normal and I realize I have a low cardiac risk but it's a bit unnerving when I feel these pauses and the cardiologist sees nothing.  How can it be that I feel these and the holter picks up nothing?  Any help you can offer would be greatly appreciated.  I just want to know what it is.
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61536_tn?1340701763
If you had the symptoms while on the Holter and the Holter showed nothing - be HAPPY - it's not your heart.

On a related note, I have reflux and often I get that sensation when it's acting up.  I do not have typical reflux symptoms, no burning.  I just get a little short of breath, a cold sensation in my lungs and throat, and that pausing sensation.
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Avatar_n_tn
I know exactly how you feel!! There are a couple of people on this forum with similar symptoms. I had my first palpitations at age 26. I'm now 35(female) and have recently been diagnosed with inappropriate sinus tachycardia. My resting heart rate is around 88, but can get to over a 100 with very little exertion. I contribute this solely to being out of shape. I'm almost 40lbs overweight, but have lost 16, so I'm working on it. Besides that, I'm healthy. For about 8 months, I have been getting these "paused" heartbeats.In addition I feel very lightheaded. I never faint. I call it swooning. the kicker is that I only feel these things when I am lying down. I hardly ever feel these things when I am up and around or sitting. I find this very weird. I have also had numerus test with all normal results. They have pulled the anxiety thing too. And I'm sorry, but I feel like I handle stress very well and don't have any more anxiety than the next person. I am now doing the 30 day heart monitor that my EP gave me, so I hope that this does catch some of these episodes. My GP suggested an ENT thinking that the positional lightheadedness could be from sinuses, even though I don't have any symptoms. I have no clue what could be causing this. NOW I have anxiety. I try not to think the worst,but sometimes it gets away from me. Anyway, keep us up to date. Maybe my heart monitor will let me know something. I'll let you know.
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154765_tn?1237251544
what do you mean when you feel a pause? Did you feel it when you had a 48 hour monitor?
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Avatar_n_tn
Yes, I felt several while I was on the monitor.  I usually get them a few minutes after lying down or upon waking in the morning - rarely during the day.  They feel random and all over the place - getting 1 or 2 in a row and then nothing for 50 beats or so.  Sometimes they keep me up all night and other times I don't notice them until morning but I have them everyday.
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Avatar_n_tn
The pause feels like a regular beat and then a pause for about a second and then a regular beat again.
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154765_tn?1237251544
I  understand why you are nervous I would call him and tell him you are feeling them alot. What did your cardologist say what he thinks these are?
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154765_tn?1237251544
do you get pain in the cheat or shortness of breath? how old are you?
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Avatar_n_tn
The first cardiologist dismissed my concerns and said I probably had some underlying anxiety issue.  I agree there is some anxiety but I believe it is caused by whatever is going on.  I'm the kind of person that needs a reason.  I find it hard to believe there's no explanation for what I'm feeling.

The second cardiologist who set-up the 48 hr monitor was called to an emergency the day the results came back and I saw the PA.  She told me that everything came back normal and not to worry - no real explanation.

I have had chest pain/pressure and a burning sensation on my left side.  It was quite severe for a while but has subsided.  I get an occasional pang here and there but does not seem to be heart related (had a stress echo for it).

I'm a 36 yr old female, fit and in good health.  This all started a year and a half ago with what I would call palpitations (strong heartbeat).  It progressed to the pauses or maybe the palpitations just made them more noticeable.  In the first year they came and went every few months - now I have them on a daily basis.
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187666_tn?1331176945
The PA may have said your results were "normal" even if a few PVC's were recorded. I don't know the percentage but so many people have occasional PVC's that the doctors consider it nothing out of the ordinary. Perhaps the heartbeat was still there but you just didn't feel it. My husband doesn't feel his heart beat at all. I can't imagine that. I feel mine almost all the time (not while driving or active); sometimes I even hear it thumping in  my ear, like now.
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154765_tn?1237251544
I know where you are coming from cardologist always think anxiety. Im getting a test done in june I have abnormalties on my ekg and they are saying they don't know if it is brugada syndrome it's a rare disaese (disease)  It's  life threating arrthymias and it's scary I already have a anxiety disorder but this doesn't help. You always want to know what is wrong. I seen a few cardologist and now Im dealing with a EP doctor in brighams woman hostipal in boston they are the best so ordered the test to see if I have this. I can't wait Do you live near boston?
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Avatar_n_tn
I live in Denver.  What is an EP?
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Avatar_n_tn
Thank you - I'll give that a try.
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Avatar_n_tn
When I feel the skip I am actually taking my pulse.  I can feel the skip by physically taking my pulse and can also sense it in my body - a pause like everything stops.  I read the posts of what other people describe as PVCs and PACs and the description is so close to what I feel.  The PA said they found no PVCs or PACs at all.  She requested the full transcript so she could look to see if there was anything on the monitor that wasn't reported.  I'm so frustrated because I thought the monitor would provide an answer.  Thank you for your responses - it helps to just talk about it and hear from others.
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Avatar_n_tn
I'm in Denver, Colorado.
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154765_tn?1237251544
the name is electrophysiologist. Ask your cardiologist if he can refer you to one of those.

Good Luck
I hope I helped you
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Avatar_n_tn
Ireneo is right. Some doctors will tell you when the ectopics show up on a holter and some just say that everything is normal if nothing but a few of those things show up. They are so common.

The chest pressure and burning kind of sounds like acid reflux. Have you tried any meds for that?

Another thing it could be is gallbladder. The only way to truly know if it is gallbladder is with a HIDA test. An ultrasound just won't show the whole picture. I know this from experience. I went through 5 years of trying to find out what my burning/stabbing/stinging left-sided chest pain was from. At one point my cardiologist told me it was some minor coronary artery spasms out of desperation for an explanation. (And yes, I went through the whole anxiety-**** explanation from the doctors.) However the calcium channel blockers did no good! He finally ordered a HIDA test after numerous ultrasounds said I was fine and like magic the answer was discovered. It took 5 YEARS!

Good Luck. Try not to fret too much over it.
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Avatar_n_tn
I just saw what you wrote to Ireneo about no PACs or PVCs. When I was having my gallbladder issues, I sometimes thought I was having those beats when I was not. It was a gastro issue from GERDS and my bad gallbladder. However at other times I was having the palps. They have been documented. Check into gastro problems. ??? You might find an answer there.
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154765_tn?1237251544
sounds like dmil241 is in the right track call a gastro I agree.
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154765_tn?1237251544
I can't spell the word  Ill get the word it's long but they spealize in the elecrtcity of her heart they know alot about arrythmias. Is denvers in massachusetts?
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Avatar_n_tn
Don't be afraid, that just makes it worse ;)  I'm 23, I am healthy, active, and eat well, and I have had a PVC arrhythmia for almost 3 years now.  My heart skips, or pauses for a second, or sometimes feels like it pounds.  I was totally unaware of this until a doctor noticed and told me to have it checked out.  Which FREAKED me out of course! I was sure something was seriously wrong, and the stress only made it worse. But after numerous tests and bills nothing was found and the doctors only shrugged and said i'd live. Since then it's been a battle of trying to just get used to it and not stress about it.  It does still bother me when it skips or pauses like crazy, but other than that it doesn't effect me, it just feels weird. I usually only notice it when i'm not doing anything, especially when i'm going to sleep.  It sometimes keeps me from falling alseep right away because I can feel it.  Alot of people have arrhythmias and they're usually benign and can eventually just clear up.  But yes they are weird and scary.  Just learn to relax, don't take stimulants like caffeine, and exercise, all that helps.  DO get it checked out, just to be safe, but most likely it's nothing to be scared about.  You'll be ok.
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Avatar_n_tn
I just got off the 24 hr holter monitor.the results were PAC'C and paused heart beats,sometimes of 2 seconds or just a little longer.i am seeing an Electrocardiophysiologist,on the 12 th of this month.to see if i am a canidate for a pace maker .or medication change.but leaning towards a pace maker.i am 62 and scared .it happens to me quite frequently mostly when resting,makes me shore of breath and very aware it is happening.i have been on heart medication for many years for PAC'S .also 7 years ago i had a bad case of atrial fibrilation was hospitalized for 4 dayd and put on Digoxin Diavan and Sotolol.can some one please explain ?paused heart beats to me i am scared & confused..thank you all.and lots of luck to everyone..thanks ..Snookie.
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Avatar_m_tn
It sounds to me like it's Sinus Arrhythmia which is completely normal and has to do with your breathing. When breathing and just before exhale, you can feel a sensation or a thump feeling followed by a pause as you exhale. All your heart is doing is slowing down as you are exhales and then speeing up when inhaling. That pause feeling is nothing more then your heart slowing down. Very normal response. More then likely you're now starting to notice it.
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Avatar_m_tn
im 19 yrs old and having paused heartbeats and fast pounding. i went to the dr today and he said that i was fine and it was PVC or PAC or something like that and that im fine and im just very stressed out right now (which i really am my bf got into some trouble i just got a promotion at work which has a lot of responsibilities and im moving out and also trying to pay all my bills on time it may not seem like alot but im not used to all that)and all i need to do is calm down and live my life normally. But i cant, i keep thinking that he is wrong and that my heart is gonna stop beating and i give myself anxiety attacks and i cant help it. please help me calm down. i dont want to die from this! im only 19!
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Avatar_m_tn
It might have to do with your stomach??? look up Hiatus hernia.
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