Re: Irregular Heart Beat

Posted By CCF Cardio MD-SGM on January 22, 1998 at 23:43:34:

In Reply to: Irregular Heart Beat posted by Jim on January 12, 1998 at 01:33:04:







: I have been plagued over several months with these beats.  They started minor, and have become extremely painful.  I now have continuos pressure in the chest, 6-12 skipped beats per minute, dizziness, numbess, and on occasion, shooting pains throughout my back and chest.  I also have Hashimotos Hypothyroidism.  Every doctor i have seen has told me there is nothing wrong.  But yet my symptoms continue to worsen.  I have spells of near passing out now.  I also am awakened at night with a "surging" feeling in my chest.  Prior to all my symptoms i had only noticed that at night while lying down all of my muscles would twitch rapidly from my calf to my bicep in no particular order.  I was checked out and told to start an exercise program.  I did this..and that's when the irregular beats began to occur.  I have in the past few weeks have had two pauses of at least three seconds.  I feel i am worsening, but yet the cardiologists and doctors tell me to go home...that nothing is wrong.  I know there is something wrong...and i am desperate for help before it is too late.  Any thoughts as to what i may have would be appreciated.  I only hope you can help.  Thank you so very much.  



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Dear Jim,
As you may have read in the numerous other questions on the subject of palpitations or premature beats, this is generally a benign condition, treated with reassurance and only rarely with medications.  To review, palpitations arise from either the upper(atria) or lower(ventricles) chambers of the heart, and cause a premature beat  that is followed by a pause, and then a forceful beat that is sometimes sensed by affected individuals.  The fact is that almost everyone has some degree of premature contractions, usually atrial in origin, but most people do not notice these harmless irregularities in their heart's rhythm.  In the absence of structural heart disease (prior heart attack, congestive heart failure, cardiomyopathy, or valve disease, for example)  premature beats from either the atria or the ventricles are benign.  One way to evaluate highly symptomatic palpitations such as those you have noticed, is to perform a Holter monitor test to assure that these are intermittent, not sustained, in nature, and to help pinpoint the origin of the premature beat.  An echocardiogram to rule out the structural heart disease I mentioned is also a consideration.   In the absence of concerning results from these tests (and from what I can gather, your caridologist doesn't seem worried about this), then one should be reassured, and would be wise to avoid stimulants such as caffeine or cigarettes, as well as alcohol, which tend to exaccerbate premature beats.  Rarely, consideration is given to treatment with beta-blocking medications to possibly reduce the incidence of premature beats.  However, beta-blockers have occasional side-effects such as fatigue, impotence, and rarely depression that must be weighed against their marginal therapeutic benefit in this instance.
In your question, you describe continuous chest pressure, dizziness, numbness, a surging in your chest, and note a feeling of desperation. I want to make another recommendation that you might consider...
The constellation of symptoms that you've noted often points to non-heart-related illnesses such as anxiety disorder, panic disorder, and variants of depression.  I think it may be very important, now that you've received a clean cardiac bill of health from a physician, to think about arranging an evaluation with a mental health professional.  I hope this suggestion will  be helpful.
Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your physician.