skippin' beats

  Dear whoever...
         I am a very healthy 22 year old...I bike about 10 miles a week and
  exercize regularly...however, for about a year now I have been haveing
  some type of irregularity in the beating of my heart.  I will sometimes
  go days w/out it then all of a sudden out of nowhere something feels as if
  it punches me in the middle of my chest.  It last maybe 2 seconds.
  I have recently as well been losing the feeling in my left arm.
  sometimes I wake up and my hands will be asleep...and my
  pinky fingers are always cold..almost numb.
  I have had a stress test done and they found nothing unusual.  I know that
   sodas and caffine definetly trigger it...and I know lack of sleep does as
  well.  Does anyone have any ideas on how to stop this? Or at least hold it
  at bay? thanks...
    

[CCF Cardio MD - MTR]

Dear Ed, thank you for your question.  You complain of a common problem,
palpitations, which many people write into this forum about.  In fact, on 5/8,
you are the third person to write in about this topic.  Palpitations are caused
by premature beats from the atria and ventricles which are usually benign. Common
causes of palpitations include tobacco, caffeine, alcohol, and stress. Eliminating
these provoking causes can often dramatically reduce the frequency of palpitations.
If you read the response I did to Stuart's questions on PVC's on this same date
(5/8/98), you'll find more information and a reference from a medical journal
about a good review article on palpitations which you may find helpful.  Given
that you're 22, healthy, and had a negative stress test, I suspect that your
palpitations are benign and are not indicative of any underlying cardiac disorder.
Medications like beta-blockers can be used to suppress palpitations (after other
reversible causes have been ruled out) but they have side effects which include
decreased exercise tolerance and impotence.  Thus, I suggest that you eliminate
the aforementioned causes of palpitations and see what happens.  If nothing changes,
then you should see your physician again.  I hope you find this information useful.
Information provided in the heart forum is for general purposes only.  Specific
diagnoses and therapies can only be provided by your physician.