Sudden Fast Racing Pulse

[johnnyky]

Hi everyone, so I have a history of skipped beats and palpitations going back years. I'm 32 now, slender male, in basically good health. I have had many heart tests. I had a stress test 5 years ago which came back normal, an echocardiogram in 2011 that was normal and my most recent echo was in November of 2013 less than a year ago which was also normal. I had a CT scan in 2013 which was also normal. I have worn 48-hr holters in the past 5 years and they detected pvc's but they told me they were all benign. All the doctors have told me I have a structurally normal heart. About a year ago I started having gurgling sensation in my back when I would rise after laying down or laying back for a period of time. But I had the echo, and it came back normal, so that was that, but still having those symptoms. Doctors listen to me, and hear nothing. Of course I never have the skips or major symptoms when at the doctor's office.

I also have a history of my heart racing either at random times or with activity. The doctors told me some people are just more in tune with their bodies but I can't help noticing it. I have been taking Propranolol 10mg as needed for about a year for anxiety and racing pulse due to anxiety, it helps somewhat.

But for the last couple weeks I get these random bouts of very unpleasant sensation in my chest followed by my heart racing immensely in the span of a few seconds. Like I will be sitting or at rest and get up and it will just race. Usually I chew on a Xanax or Propranolol and that gets it under control somewhat but it's still scary.

Last week it happened I was sitting on the couch and I got up and my heart went from like 80bm to probably around 150bpm in a few seconds. I took a half Xanax and Propranolol and it helped a bit but ever since I've been having these unpredictable symptoms.

My question is, is this something new? I do have a history of anxiety, but sometimes this racing pulse comes out of nowhere, and of course my anxiety spirals out of control when it happens so it's like a chain reaction. Last week I went to the ER they did EKG on me but by then it had calmed down and they said it was normal. I saw my GP and she told me to start taking my 10mg Propranolol every day from now on and twice daily if needed. And she has prescribed me Lexapro, but I'm scared to take it.

I am trying not to rely too much on Xanax but it seems to be helping me more than anything else especially at night.
I've been on Propranolol daily for the last few days so why did I still get an episode last night? Would something have happened to my heart in the year since my last echo? Or is this just a rhythmic thing?

I was taking Lithium 900mg for four days but stopped it because it seemed to give me palpitations maybe it's not the reason but could it have caused these symptoms?

I'm just freaking out over it and hoping not to have another episode. I've had no fainting or dizzyness thank god, but the fast pulse is very scary. I'm seeing another cardiologist tomorrow maybe they can help me out. Is this just anxiety? Thats what my GP thought. Maybe I should just try the Lexapro.

[johnnyky]

So I saw the cardiologist. He said I have a structurally normal heart and am young so I have those in favor of me. Basically it's a rhythmic symptomatic thing rather than anything underlying.

He decided to take me off Propranolol and start me on 25mg Metoprolol twice a day. I'm going to see how I do on just 25mg though first. He said it's more selective for the heart and thinks I'll do great on it. So far, so good! No rapid pulse since taking it, no uncomfortable feelings in my chest, hardly any pvcs even!

So far it's working great. Maybe a more selective beta blocker was what I needed all along. I feel more energetic and better than I have in ages. Before, I'd feel jittery and scared of much activity and would get bad palpitation and pvcs with any activity. Since starting Metoprolol I feel great steady and calm.

I had already worn a holter monitor 3 years ago and they caught pvcs but everything was benign. The doc didn't say anything about a 30 day monitor. He sees me back in 3 months. For now I'm going to try and live my life. Has anyone else tried Metoprolol it's really helped me a lot it's made my heart feel normal for the fiirst time in ages. Propranolol was ok but it basically only helped my anxiety and not so much my pulse rate. This new one really seems to be slowing my heart and I love that! I'm feeling hopeful.

[tom_h]

A 30 day monitor is a simple 2 lead device about the size of a deck of playing cards; 2 wires.  I wore it while working out, running, and of course skating.  If I was not showering, it was on me. After a week, the daily electrode replacement becomes like brushing your teeth.  It recorded 3 episodes, and was absolutely instrumental in getting it diagnosed and fixed.  If you want to get whatever you have under control, sometimes you have to be slightly inconvenienced.

[achillea]

Lithium is rarely prescribed, and never(so far as I know) for heart rhythm issues.  Why were you given this medication?

[johnnyky]

Thanks for the helpful response. Lately I've been having these every few days mostly suddenly wiith acivity after sitting or laying down but I also notice I wake up with them too. My GP told me to start taking the Propranolol daily. And all the docs I've seen tell me there's nothing underlying wrong with my heart. I've cut out caffeine. I'd hate to have to wear a 30 day monitor I wore 48 hour ones and they were very bothersome.

What can I do short of any procedure to make these stop if in fact they are psvt? Will they go away on their own? How about upping my beta blocker or trying a different one?

Xanax does seem to help a lot. You say not to take the Lexapro and I'm still undecided but my GP thinks I need it. And separate from this issue, I do have severe anxiety at times.

I'm having a lot of anxiety over this I'm becoming consumed by wanting to prevent another episode at all costs. And I'm afraid to have sex because of fearing to trigger another one. Is sex safe if indeed I have psvt?

I just hope for now I can get by with some type of medication and see if that helps.

But I still got one last night a few hours after taking 10mg propranolol. Maybe it's just too low a dose or the wrong med.

I'm a fit healthy person and this is scaring me to death all the docs say nothing is wrong but anxiety. Maybe these will go away.

[tom_h]

A sudden racing pulse out of nowhere most likely has absolutely nothing to do with anxiety.  I agree that it can make you anxious once it starts.  It sounds like you are experiencing episodes of Supraventricular Tachycardia or SVT or as some refer to it, PSVT.  This cardiac anomaly is an electrical issue with your heart rather than a structural.  People in superb physical shape with robust hearts can develop this electrical problem.  Usually, Holter monitors will not catch it due its usually seldom occurrence.  EKG will typically not show anything either.  There is one type of SVT that may show an indicator in normal rhythm.  You best bet is to wear a long term, 30 day monitor.  It is worn continuously except for showering or bathing.  With it, you stand the best chance of capturing an event.  The monitor is usually set up to auto record an event, as well as having a manual button that you can press.

SVT is typically not a dangerous event, and many of us have had it nearly all of our lives.  I had it for 54 years.  Note the past tense.  There is a procedure that can be done to find the location of the problem and destroy it with a tiny and momentary blast of heat referred to as "cardiac ablation".  Beta blockers are often prescribed for SVT, but are seldom effective. Alprazolam aka. Xanax will do nothing for it either.  I would NOT take the Lexapro.  SSRI's like Lexapro are extremely hard to wean off of once you begin taking it.  Their withdrawal symptoms are very nasty.

What you MAY have has nothing to do with anxiety.  The problem is short sighted physicians can't look past the evidence that is before them, and if it looks normal, then the patient is suffering from anxiety.  Google SVT and see if it compares to your symptoms.

[johnnyky]

Another question I have is that is Propranolol the best bete blocker for racing sudden pulse or are there better ones I should ask about? I just want this NOT to happen again. It's getting to the point where I'm afraid to do any strenuous activity or sex because those seem to trigger it.