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What does a palpitation feel like
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What does a palpitation feel like


  Can someone or someone(s) please describe the feeling they get when they think they are having a palpitation?
  Recently, I had an episode of syncope followed by a week or so of general dizziness and some chest pain.  The long story of all the cardio work I had done was that it was a 'vaso-vagal' response.  A stress echocardiogram revealed a healthy heart.  I was counseled to change my diet and do more cardio work (not just weightlifting).  The chest pain was ruled to be costochondritis.  
  Needless to say,  I have a lot of anxiety about the whole affair,  including what I think are palpitations.  They occur every once in a while, especially when I am particularly worried about my health.  Also, while I am exercising, sometimes I will feel a 'hard' beat.  Is this dangerous?  
  The doctors have prescribed Xanax to relieve the anxiety and are suggesting I try a longer term therapy with Paxil.  Does anyone have any similar experiences?
  
  Thanks,
  Tommy
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Dear Tommy, thank you for your question.  If you had a normal stress echocardiogram, then you do have a normal heart.   Palpitations are caused by premature beats of the ventricles or the atria of the heart and are perceived to be "skipped" beats since a brief pause in the cardiac cycle occurs after a premature beat.  Premature beats are also perceived to be "hard" beats because the strength of the ventricular contraction is greater with a premature beat compared to a normal beat.  Common precipitants to premature beats include alcohol, tobacco, caffeine, stress, and anxiety.   Thus, these precipitants should be avoided if at all possible.  Treatment of anxiety is commonly used for patients with premature beats and appears to help limit the severity and frequency of the premature beats.  Premature beats / palpitations are not dangerous to you since you have a normal heart - as your stress echo demonstrated.  This problem is a nuisance to you however, so you may have to develop coping strategies for the long term.  Medications known as beta blockers can be used to suppress premature beats but these medications have numerous side effects that limit their use.  
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.
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.





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