What is it, palps, atrial fib????

[kellebelle]

I am a 43 year old female who is in good health.Since October I have been dealing with palps, they drive me crazy. I have had a holter, echocardiogram and tests came back normal other than pac's, sinus tach.The past couple of weeks have been horrible I will begin my episodes around 4:30 pm and they will last until bedtime. When they hit they will come every 2-3 minutes feels like my heart is jumping out of my chest very distrubing.

I saw my doctor on Monday and he drew blood again and ordered an event monitor. I wore it Friday events started at 5pm and I filled the monitor up by 9pm. I will be able to call it in Monday at 9am. I currently take a beta blocker, and also meds for panic attacks.My dad has atrial fib and that always concerns me that I am heading in that direction.I also have very low blood pressure 80/55.I also have Hashimoto's thyroiditis but the endo doc does not feel my numbers are abnormal, so I am not on thyroid medication.
Questions???  
Do you think it is atrial fib??? My heart rate does speed up a bit when these hit, but not much. Just seems to jump every few
minutes or so.

Would my low blood pressure cause the palps, I take 25 to 50 mg of atenlol per day. Only take 50 if they really get bad.

Is it anxiety or my heart?? With my dad's history I just wonder.
This is something new that I have never experienced in my years with panic disorder.

What tests do I need but haven't had????

I appreciate your time! Would love to hear from others who are bothered by these darn things.

Kelly

[Cleveland Clinic]

kellebelle,

thanks for the post.

1)Do you think it is atrial fib???

If it was not seen on the event monintor and holter, most likely not.

2) Would my low blood pressure cause the palps

Most likely not.

3) Is it anxiety or my heart??  

Both.  The symptoms are most likely from the palps which can cause anxiety. I would look into some relaxation and copin techniques to deal with your symptoms and your anxiety. If you look through the forum you can see what some others that have dealt with similar symptoms have used.

4) What tests do I need but haven't had????

I would work with your physician. It seems that most reasonable test have been ordered for palpitations.  

good luck

[craigie]

There is a website that deals with inflammatory diseases such as yours...www.rheumatic.org

[mrbh]

I can relate to what you are going through. Sinus tach and PVC's (in my case) completely rule my life and make things miserable.

Just for comparison, I take Inderal 20mg four times a day and Xanax for the panic. It doesn't help very much and the questions linger about the docs doing the proper tests, or perhaps missing something. That doubt becomes a heavy burden.

I agree with Hank that maybe this was something you were going to get sooner or later anyway. Not sure if one is destined for a-fib through family lines, but the need for follow up with your doctor is clear. Good Luck.

[Lamar1]

Kelly, I too have palpitations (sinus tachicardia and PVCs), and I too have Hashimoto's with thyroid values in the normal range! I have the antibodies but normal T3, T4 and TSH. The endocrinologist told me that since my thyroid is still performing well it can't cause the heart problems, but my aunt has Hashimoto's and also arrhythmia, so I just don't know what to make of it. Have you had Hashimoto's for a long time?

Good luck

Fran

[Mel22]

Add me to the list of people with heart palps and thyroid disorders (hypothyroid--taking Levoxyl).

[kellebelle]

Thanks to everyone who has replied. My doctor found Hashimoto's about 2 years ago...! I will be interested to see what my event monitor shows tomorrow.I will keep you posted.All of your input makes me relax and paints a more clear picture to me of what might be going on.....hope they can pin point it..! Guess its like finding a needle in the haystack!! Heart,thyroid,anxiety all the pieces seem to fit and effect each other. Pluto thanks for the website I will take a look. Kelly

[Lamar1]

Thanks Pluto and all. Many thyroid problems seem to be linked to palps, and it's hard for me to suspect that my Hashimoto's has nothing to do with it. However, in my case and Kelly's (if I understand correctly from her post), the thyroid is still working well so doctors don't think it can cause a heart problem. Hashimoto's is an autoimmune disease, so antibodies show up in the blood before the thyroid itself begins to malfunction. So what the endocrinologists say makes sens, still I've heard of people with Hashimoto's and arrhythmia...Trouble is, if my endocrinologist isn't convinced, he will never try to treat it...He knows best and is probably right, still I'm left with a doubt...

Again thanks to everyone for your wonderful support. And Kelly, good luck on your event monitoring results!

[Lamar1]

Mel, what you say is very interesting. My endocrinologist says you don't get palps from hypothyroidism. If you don't mind, could you tell me if you too have Hashimoto's, and if so, did you start having palps before your thyroid became hypoactive?

Thanks so much

Fran - Italy

[sheryl1945]

Hi there...sorry to hear of your problems.  I too take xanax for panic/anxiety and it works well for me.  Not a cure, but a real help.  I'm just wondering if you need a stronger dosage.  I need to take two milligrams per day, and sometimes three.  Please discuss this with your physician.  Good luck.

[Lamar1]

Yes I'm from Italy! Sorry what is a TEE echo? I did have an echocardiogram plus 24 h holter. They told me no further tests would be required. I wonder if I should have an EP done. I'd prefer to go for ablation than to be on meds all my life, but if the cause of my tachicardia and PVCs was stress or the thyroid then it wouldn't be the right choice, what do you think? I have awful days, then I have days with no symptoms at all. I wonder what that means....

Thanks so much

[bigmick]

Pluto, Ericwithout, and others: re. latest cardio visit:
Dr Linker, James Cook Uni Hospital, Middlesbrough, NE England. 14/06/04.
Visit further to recent Holter 24hr monitor recording.
History: ectopy since mid-1980s, GERD since mid-80s, 5 parox. VMAF episodes in last 5 yrs - all commencing 3am-ish and self-terminating few hrs later. No meds in past or at present.

Latest Holter: 20 single PACs, few PVCs, 4 beat run of PVCs (not VT per se cos at HR of 80 or so not tachy - his words, not mine) This must be what is meant by a run of PVCs i.e. NOT fast enough to be VT per se. PVCs (as well as PACs - as one would expect with PACs) were coming from more than one focus (2 or 3 as far as he could ascertain) but this did not concern him in the slightest - despite my obvious anxiety about the same!).

He also had a detailed echo done (echo-while-u-wait!!) after my appt further to which he saw me again briefly for a few minutes. He said echo could not be any better - 75% EF, no valvular issues, normal chamber sizes and wall-thicknesses etc. 12-lead ECG was also A-OK.

My BP tends to run a little high at the 150-155 over 85-90 range, and he said he had seen many cases of adults my age where mildish hypertansion contributed greatly to slightly excessive ectopy: he wants me to try some mild BP med - he agreed with me that nifedipine would be a suitable one for me given my vagal-predominant tendencies early am brady and AF-wise (i.e. as opposed to a beta-blocker).

As regards ablation, he is not that keen on it at present ajudging it very much to be in its infancy - one could assume he meant in this country (the UK), but I kinda got the feeling he meant generally. When he referred to risks of ablation, I jumped in with stenosis, but he said no he meant tamponade in particular - 2 of his colleagues have had 3 cases of tamponade each in the last couple of years (out of how many ablations I'm afraid I don't know, but I'd hazard a guess at a couple of hundred instead of a couple of thousand given that ablations are far less popular (profitable?) here in the UK (National Health system) than in the US.

He talked with enthusiasm about a key-hole procedure whereby the atria are 'mini-mazed' using microwave energy through a 'wire' laid on the outside of the atria. He has a colleague in the UK who is having 80% success at first attempt (1 yr & no AF) and who is currently hopeful of getting the procedure down to a same day (in-and-out procedure) in the very near future. I'm afraid I can't remember the name of the doc concerned, but he was definately UK-based).

He doesn't feel I require any meds (never mind surgical intervention) at the present time and am unlikely to do so for some time yet if at all.

He definately ackowledges and accepts the tie-up between digestive woes and AF for many lone VMAFrs, although the mechanisms involved in the same remain a bit elusive. I commented that digestive maladies can push one's vagal drive too high thus precipitating shortened AERP and VMAF and he also said he thought along similar lines. He commented that I was indeed strongly vagal given the nature and timing of my episodes to date.

He also commented that he felt my generalised anxiety disorder (diagnosed many years ago) likely did not help things at all. He said he saw many middle-aged AFrs (lone) who whilst having broadly similar AF in terms of HR etc. (whilst in AF and whilst being Holter monitored) could be nonetheless split into two groups - those who were highly symptomatic and those who did not even know they were in AF. He cited one of his middle-aged male patients who only just recently found out he had AF whilst having a routine medical who peddled up a notoriously long and steep local hill (Sutton Bank) whilst in AF with HR of 150-180 and did not feel symptomatic at all!

All in all an appointment with a really decent bloke and very good cardio/EP (IMHO at any rate) at a first class cardiological hospital facility. He told me to lose a couple of stone (current height 6’4” and weight 17.3 stones), and get out of his office and go for a run!!

Cheers for now,

Mike F.

[pandora9048]

hi,
Xanax is good for panic and anxiety, but really does nothing for palpitations.  I read that on a website.  Don't remember where.
Pan

[drottdee]

mike,I too have pvcs and gastro troubles with anxiety. I learned from here that I was having gastro problems,actually it was eric that suggested that i have a GI workup. Anyhow i take nexium for the gerd,but I cannot take any beta blockers due to low normal bp and heartrate.My pressure was so low on beta blockers that I was near passing out a work. I have been taken off all meds including celexa for the anxiety. And GUESS WHAT, I feel like a new woman,the pvs are annoying and I still take nexium but i am finally getting back to my regular activities.which includes soccer or football as you may call it.I attribute the vigourous exercise to helping me to cope,another thing that I learned from this forum. so lets all cheer for bechem and england in the euro cup and relax and hope that all is well.

cheers back at ya

[Dr. Erik]

Glad to hear that you have made some progress in assessing what is going on. I think that controlling your mild hypertension will go a long way toward suppressing your ectopy. Pluto takes a combination of two Hypertension drugs. I can't remeber the two but it may be worth a try as he is controling his ectopy through this combination. One of the drugs may even have ant-arrhythmic properties. Good luck and please keep us all posted.

Erik

[Mieke]

Hi everyone

Just wondering if anyone can tell me what it means when you can hear your heartbeat in your ears?  I suffer with frequent PVC's and MVP with reg (mild) and there are times when my heartbeat is pounding in my ears, I don't need to take my pulse I can count it out just by hearing it!  Does it mean High blood pressure?  Haven't had mine checked for a while but it is usually normal.

[Lamar1]

Guys, do you think palpitations could be triggered by a gastric cause even without digestion problems? My digestion is great but I do notice I often have tach and more PVCs after eating...

Thanks so much in advance for any feedback

[Rocko1]

Hi there! Well I too had the problem of increasing pvc's after meals. However in my case it was only.... after the evening meal. At the time back in February, I had borderline high blood pressure. It was app 145/95. Well I got really scared due to the palps and immediately began eating correctly and cut out ALL of my wine. 2 to 3 or 4 glasses an evening. Then in March i began taking 1000 mg of omega 3 and 250 mg of Mag oxide a day. Well interestingly my blood pressure went down to 120 over 80(approximately) and my pvc's in the evening drastically(not totally): subsided. I hardly ever have one now in the evening but I do notice maybe on good days 2 or 3 and bad days maybe 10 or so. Hopefully they will continue to subside to nothing. I dont know if it was loweting bp, the fish oil and mag or both but something has dropped them to this level now from about 100 to 200 in the evening. Incedentaly, I had holter testing and an echo which both came back "normal". thnx, Rocky

[Lamar1]

I loved your post, Rocky! It shows sometimes PVCs can get better even without meds like b-blockers. BTW, 1 cardiologist told me PVCs usually improve with age, another said they usually don't.......Somehow I hope I'll get better without having to go on meds starting at such a young age - 33.

[Rocko1]

I had noticed them perdiodically in times past. One here or there over week long periods although at the time I didnt know what they were!!! What concerned me was the sudden onset of mine right out of the blue at age 49. Unfortunately all I have read is that they tend to increase with age. However this probably wouldnt be universal especially if an underlying cause is there... besides being alive!!*S*.. ps... I have always been extremely active and athletic and I wonder if there might be an association(just a dumb guess) between a little extra wear and tear on the heart and their occurence.

[Lamar1]

Maybe what that cardiologist meant was that PVCs might become less symptomatic with age? Don't know, but I hope he was right! He was an expert who replied to a question asked on a forum similar to this.

[Lamar1]

That's wonderful news! Since they are basically benign and we're going to have regular checkups anyway, who cares to be aware of them?? Symptoms and quality of life are the main issues...

[wingtip]

I had palps from age 24 on, and it developed into cronic afib by 35.  I have to say its gets a lot easier once they are cronic because you can stop worrying.  I went on a thinner, and started to test my limits and found that the palps can be ignored once you realize they won't kill you.

The only time I have focused on them in the past five years is when my cardiologist told me I had a blockage in the left main,  but once the doctor proved that wrong with a angiogram, they went "away" again.

[pitterpat]

This year I have started fibrilating. At first they told me it was anxiety. But when I went on Atkins last month with all it's associated Splenda sweeteners, I started fib every night after dessert. I read online that Splenda seems to cause tachycardia in many people. Finally it wouldn't self correct so I went to the hospital and was kept overnight as I went in and out of afib with heartrate over 200. They put me on aspirin and Atenenol and Dr. Weil's site suggested Coenzyme Q10, L Carnatine and Hawthorn to improve the hearts pumping ability. But I still fib a little after a busy or stressful day, usually after dinner. I understand it is fairly common to get afib, but its not as benign as they used to think due to the blood pooling in the heart as it quivers instead of pumping which is sited in 15% of stroke victims as the cause of stroke. Ergo the thinners. I'm scared. My husband is too.

[arcee]

In these posts I have read of several people who have had irregular heart for many years.  Well -- how about 40 yrs in my case.  I recall vividly the "jumps" that seemed to go up into my throat when I was speaking on the phone in a new and stressful job at about age 31.  And I had had some instances earlier than that.  In more recent years -- last 10 or 12 -- the episodes have become more common.  They sometimes last an hour or so -- and sometimes last a few days.   The reason I have just sought out this Forum is I am experiencing an episode of about 10 days now in which they seem to be sticking around for most of the time.

I take special note of the references to digestion, etc., being related.   I am much convinced of this.   Years ago, I recall a medical drama on TV in which a middle aged man passed out between his hospital room's bathroom and his bed.  After the younger doctor had floundered around wondering what had occured (thinking first of stroke), the wise senior doctor informed him that this type of situation was not terribly uncommon, explaining that men sometimes faint after going to the bathroom.

I think of that story since I have often gone days with no irregular heart only to come into another bout with it immediately after a bowel movement.   Also, in cases where I have the urination urge, if I delay it -- especially if I am just waking -- my heart will begin to jump.

Another item from this Forum that grabbed my interest was the mention of vagus connection.   Unfortunately, I am afraid that the vast percentage of people know nothing of the vagus nerve and its crucial relationship to much of our innards.  

And how about one's diaphragm?   I have read that a dislodging of the diaphragm's position can cause very scary symptoms, including some that act like heart problems.

So  --  what am I doing?   Am taking Atenolol anyway for mild hypertension and increasing dosage for correction of the arrhythmia.   Had somewhat sleepless nite last nite due to the problem so took 25 mg just before breakfast.  Within an hour or so, my heart had normalized.    That lasted about 3 or 4 hours before some abnormal beats crept in.  As I type this, the problem is not too bad ---  mid afternoon.   I will take another 25 mg this evening to hopefully get a good sleep.

Thanks to all for the good info on this Forum.

[PMarlene]

You know, I was put on tenormin years ago and I told my cardio that all it did was slow my heart rate down so I felt the pac and pvcs more.  I don't think the beta blockers do much for these.  I was on Quinidex for 23 years and was very well maintained.  I felt great.  They quit making it and I was put on Rhythmal.  I had bad proarrythmia attacks and bronchial spasms so am now on 50 mg twice a day of Tambocor. That is a small dosage. So far, so good.  I have a few skips but they seem to be managable.  Thanks to everyone for posting these comments.  You can't imagine how they help.

[Mieke]

Hi Pluto

I posted on this thread on 15th June asking a question to anyone, no one commented and as I read your posts frequently and you seem to know lots about our heart problems I wondered if you had any idea or similar experience as to why I can hear my heart beating?  It may sound silly but it really bothers me,especially when trying to sleep. Thanks

[Mieke]

Thanks Pluto for responding to my question.  Its nice to know you are not alone with these problems be they small and of not much significance or major ones.  We all worry about our hearts when they are not functioning as they should and its such a comfort to be able to discuss with others these issues which don't always warrant taking up a question with the doctors.
Thanks once again for your time and all the best to you.

[shano]

I hope someone reads this posting and responds.  I am writing in reference to my mother who is 74 year old has had a pacemaker/ difibulator for the last 4 years.  Before she had this she had what she calls "fluttering", which I dont know if this is palpitations or not.  After the difibulator she hasnt had any fluttering until about 6 months ago.  Her pcp put her on atibiotics for an ulcer.  The antibiotics made her very ill.  She has gone off of them.  She had a stress test and ekg and echo gram.  No signs of anything. The cardiologist wanted her to come in for a heart cath to check for blockage.  The Friday before the test her difibulator went off and knocked her to the floor.  She went to the hopital after that and had the heart cath done.  Nothing was found.  They increased her amiodarone from 200mg to 400mg a day and also increased her sythroid from 25 to 50.  She still had the fluttering so they thought it might be her stomach.  She had edoscope, colonoscopy nothing was found.  She has symptom like it is her stomach but with  fluttering.  She does take Xanax and it does calm her down a bit. Nothing shows up on any test. No doctors can find what is wrong with her. She just knows something is not right.  Now she is so depressed she does not eat or sleep.  Does anyone out there relate at all.Thanks

[akitalady]

At last I have found some other sufferers.I am having a terrible time with palps at the moment. My Doc says that they are ectopic heartbeats and are not dangerous but it is easier said than done to ignore the problem.Mine started really bad in FEb this year. I went to the ER and was given beta blockers, which I have been taking since.
They worked reasonably well up to last Wednesday when I woke up with a racing heartbeat and the beats were very irregular.I felt hot and very strange, almost as if I might faint.
Panic then set in, as I was alone in the house.
Same thing happened Thursday twice and again Saturday.Always when I wake up !
My Doc phoned me and said that I must increase my dose of the beat blockers but my blood pressure is already not that good 100/71 so I dont want to make it worse.
I have had atrial fibrillation in the past and been sent to hospital for them to monitor it.
I am starting the menopause, according to one specialist I see and I have breast swelling that is so severe,it is a stabbing sharp pain and feels like terrible pressure.
I suffer from a lupus kind of illness, which I think is at the root of the problem but they are not tying everything together
I am in therapy for dealing with my illness but I am not over stressed at the moment, as life is good when I am not plagued with palpitations !!
I'm interested to hear from anyone having the same problems.Particularly the fast heart rate but whether you also have missed beats with it.Any treatments that have worked for you would be good to know but I take coumadin daily to prevent clots, so I may be limited on what I can take and also HRT of any kind is not allowed for me  aagghh!!
Best wishes & peace to you all