Early morning Palpitations & abnormal rhythm

To: Everyone
Hi,  I am 'new on the block'.  

I found myself in emergency at the end of March this year.  I had awakened with rapid heart palpitations, pain in my back and left arm.  

At the hospital an ECG was done, as well as an x-ray and an enzyme blood test.  All were normal and I returned home later in the day.  However I was given a date for a treadmill test and a prescription for 81 mg. enteric coated aspirin.  The treadmill test showed a 'glitch' and the cardiologist requested a Holter monitor test, an echogram and a nuclear stress test.  

The nuclear stress test indicated that I had a 'small zone of angina', but the cardiologist did not prescribe anything and discontinued the aspirin therapy.  I also have a heart murmur (mitral valve prolapse).  The 'regurgitation' was apparently within normal limits.  I have to have the nuclear test done again next year and will see the cardiologist again at that time.  (I dislike the nuclear stress test as the stress is chemically induced and the pain resembles heart attack symptoms.  I wonder if this test itself is hard on the heart).

What concerns me is that I still sometimes awaken from sleep in the early hours with rapid palpitations.  I am prone to panic attacks and I have a hard time deciding whether the palpitations are due to panic or due to the mitral valve prolapse.  I have from time to time felt that I was going to pass out, but never actually have done so.  This I have read can also be due to panic.

Seems to me that I read somewhere that early morning palpitations can be due to mitral valve murmurs.

Was wondering if anyone else has experienced a similar thing.  I would greatly appreciate any advice  as I am  confused by what is a 'real'  problem and what isn't.  As all the tests are essentially negative and the cardiologist doesn't seem concerned, so I have to assume that part of this is of nervous origin.  Help please?  :)

Sincerely, Christine

[RNRita]

Hi, Christine.  MVP within normal limits shouldn't cause much in the way of symptoms.  Also, I think the parameters have changed there anyway.  They told me I had MVP many years ago and then, a few years later, told me that I didn't have it.  Go figure.  Waking up with palpitations is classic anxiety and panic.  I am NOT saying that this is definitely what is causing yours as I am not a doctor, but I have had this myself and so has my 36 year old healthy as a horse hubby!  Waking up with tachycardia is no fun, but in my house, it happens a lot.  If you have been worked up and your cardiologist doesn't seem concerned, I think you are okay.  If you ever take your pulse and your HR is over 150, I would tell him again!

[mabebesc]

Hi,
I agree with Rita that waking up with tachycardia has been linked to anxiety. Are you sure you still have MVP?  Like Rita,  I was told back in the 70's that I had MVP only to find out in the 90's that the guidelines have changed and I don't have it anymore.
I don't know if this will be helpful but when you wake up with your fast rate,  just try to take slow deep breaths and don't get scared.  The fast rate is not going to hurt you and will slow down as you relax. I know this easier said than done but it's worth a try.
This past Monday I had an ablation done and when I woke up on the morning of the ablation, my heart was racing because I was so scared.  I just get deep breathing slowly and then my rate slowed down eventually.
Betty

[ChrisEva]

Thanks so much, Betty!  It helps so much to know that others have had the same problems.   I also feel a good part of this problem is anxiety.

I am an only child and I grew up with an alcoholic father.  I was constantly scared of him when he was drinking.  (He was a wonderful dad when sober.)  My Mum used to take it all in stride, but I was always terrified that something awful would happen when he was shouting and raging.  I think a lot of my anxiety problems stem from that unhappy upbringing.  I just cannot deal with stress very well.

That being said, when I saw the cardio. on the 15th, he told me that the 'regurgitation' of the MVP was within normal limits.  I took this to mean that it wasn't serious enough to be a problem at present.  He didn't prescribe any medication, but wanted me to come back next year for another nuclear stress test. (they did discover a small area causing angina).

Betty, thanks for the tips.  I shall try to remember to take deep breaths.  I also drink a cup of warm milk which seems to help.  

I note you mentioned the morning of your ablation your heart was racing.  - I hear you!  I absolutely HATE medical tests!  As a matter of fact, the early morning after the threadmill test I awoke with rapid palpitations.  I sometimes think the tests are more stressful than the problems!  LOL!

Christine

[ChrisEva]

Thank you too, Rita!  

It is comforting to know that so many others have had these same symptoms.  At least I won't panic when it happens next.  I do agree with the diagnosis that it probably is anxiety.  As you will see in my reply to Betty, I had plenty of stress growing up as an only child and with an alcoholic father.  

The heart tests were done at our University of Sherbooke hospital which by reputation is one of the best hospitals in Canada, so I trust that they know what they are talking about.  

Thanks again for the comfort and I will definitely do the 'deep breathing' like both you and Betty suggest.



Christine