Heart skips, tachycardia, pinching & other sensations.

[MFoot]

I am a 28 year old male suffering with arrhythmia problems. I've had a 24 hour monitor, ECG, blood test, scan and stress test and the cardiologist has told me I have nothing to worry about and to relax, however I am finding this difficult for the following reasons:

Just under a decade ago I had a couple of instances of (some kind of) tachycardia whilst exerting myself and having drank some alcohol (It felt like a flip-flopping in my chest, like a bird fluttering and lasted for a minute or two before slowly dropping). Around this time I experienced my first heart skips and am now used to these and understand they are a nuisance but benign. Doctors blamed the racing heart rate (180-200bpm) on alcohol, then a fever, then when it happened at the gym, on exertion. But after testing my heart told me it was fine and I shouldn't worry about it.

For 5 years I had no symptoms, then 2 years ago these problems started again, more frequently with no clear cause:

Skips - I'm used to these, everyone gets them, though I sometimes get them in runs and unless I change position it doesn't feel like it will stop but I'm assured this is fine so try not to worry about it. I do find they're worse when I'm more tense and paying attention to them and happen more frequently when in stressful situations or if I have alcohol (rarely) but not exclusively.

Racing heart - This has only happened half a dozen times but it very scary. It occurs mainly during walking/exertion. I get a sudden pinching sensation in my chest, a bit like a skip but stronger, then my heart rate accelerates suddenly. This happened when walking following a run and I was wearing a heartrate sensor which reported a jump from 130-190 staying at 190 for 2-3 minutes before slowly falling. After these attacks my heartrate seems sensitive and rises easily. Occasionally however I have woken in the night with a racing heart around 130-150bpm though I believe this was due to alcohol in on instance and stress in the other.

Pinching - This is probably what worries me the most, this almost exclusively happens out of the blue when I'm walking. I get a sudden sensation like a punch or lasso yanked around my chest. It feels different to a skipped beat as I'm not aware of a pause or thump. It's almost painful but only lasts a split second but it stops me in my tracks. I think this is the sensation that sometimes precedes the tachycardia but not always. Doctors have never caught this on a monitor, nor the extremely high heart rate, they only perform ECG's afterwards. They caught a skip on it once and told me that was harmless. My heart is structurally fine, my heart rate is naturally high (around 85-90, 75 if I'm very relaxed), I apparently don't need beta blockers and am in no danger of dropping dead.

Flutters - occasionally I get a fluttering sensation and my heart rate jumps up for a few seconds. Then goes back to normal.

The problem is how do they know for sure nothing sinister is going on if they never recorded the more severe episodes. Also, even if this is just anxiety (I have had panic attacks and acknowledge some anxiety) the effect on my life has been pretty devastating. I've analysed every aspect of my life from diet, sleep, stress levels, down to how fast I'm walking! I eat well, I get 6-7 hours sleep, I'm healthy! The result is that I have lost all passion and energy in my life! I've stopped exercising, I've lost a relationship, I don't like visiting places anymore for fear of having one of these episodes. It's actually debilitating and serious and I partly believe that the episodes of arrhythmia are the cause not the symptom! but everyone just thinks I'm being anxious and it's in my head. Can someone please shed some light on this issue as I can't face going back to the doctors again!

[MichelleP_3811]

I am sorry to hear you are still having problems.  I understand where you are coming from.  I have the same issue as you with the tachycardia after I have had a night of drinking.  I think at least in my case there is a dehydration issue going on.  I wonder if your indigestion had a lot to do with what happened.  I would say if you sense a bout of the extra beats coming on then do what you can to shake them loose.  Coughing sometimes works for me.  Take an antacid if it happened right after you ate.  You might even try actually doing something that gets your heart rate up.  This can sometimes knock them out for me.  But if you can try and get the stuck signal jarred loose you may be able to sleep a bit better.

I have had a number of heart rhythm issues in my life from svt, to ectopic beats to some inappropriate sinus tachycardia among some other health issues not related to the heart and what I have found is for the most part doctors do less fixing then they do managing.  It is not that they don't want to fix us it is just that sometimes there really isn't a good fix available.  I had one heart issue that was easy to fix so to speak with an ablation but to do it they had to damage my heart.  The type of svt I had was such that the damage was small but anytime they have to damage something to essentially stop something from happening it can lead to other issues.  This is why doctors shy away from doing ablations for the extra beats (pvcs and pacs) unless a person is having a lot of difficulty functioning or passing out from them. Because in the process of trying to isolate the cells in the heart causing the extra beats other more troubling issues can arise.  It is a bit like playing russian roulette with your heart.  You fix one problem only to create another and wind up chasing your tail trying to fix issues.  
The reality is every cell in your heart has the ability to conduct an electrical signal.  This is actually mother natures safety net for the heart in case something goes wrong another part of the heart can take over and keep the heart beating.  But why the cells get active when they don't need to is the big mystery but the point is going in to fix the spots causing the extra beats can be risky.  For some it is a success but I have read that there is a good chance that the issue will come back and the risk of creating a bigger issue is not one EPs like to take.  

That said, I do think that the medical community does their patients a disservice by calling the condition normal.  It may be normal for everyone on the planet to have an ectopic beat at some point in their life but I do not believe that everyone will have bouts of them in the hundreds and thousands a day.  That is not normal and to tell a patient that it is leads a patient to question their own sanity.  What really needs to be expressed instead is educating those with an uncommon amount of ectopic beats that they are not a threat to the health of your heart even in the long run.  The fact is your heart can beat quite oddly and even speed up to rates you are getting from time to time and not be affected one bit by it all.  The heart is a very strong muscle that can handle a lot and still keep on working.  This is why cardiologists are rather nonchalant about the heart maladies that scare us to death.  But I think telling the patient that they do indeed have a problem but fixing it is too risky especially if it comes and goes would go a lot farther to help a patient deal with the issue then telling them that it is all in their head.  Once we can come to grips with the fact that we aren't going to die from what is going on then it really does come down to us learning how to not let what is going on run our lives.  The fact is that you do have some heart issues that are not normal.  But those heart issues are really more annoying than anything else but there is nothing wrong with going and getting a second opinion anyways.  If it gives you some peace of mind it can't hurt.    Take care.  I do hope you feel better soon.

[MFoot]

Almost a year on from my initial post and I've gone  9 months without an episode, until recently. Instead of the pinches and inappropriate tachycardia I've been having panic attacks in some social situations. Aside from these I've felt generally less stressed so thought another course of CBT might be helpful focusing on these panic attacks (where my heart rate can shoot up to 160+ from 70 resting)

My GP informed me at this point I have 3 choices: Citalopram to stop me being anxious, Propranolol to control my heart rate, or CBT. I chose the latter because I feel those pills could make things worse and I'm not sure they're actually necessary for whatever's wrong with me. It seems like my GP isn't actually listening to what I'm telling him and is throwing drugs at the problem. What happened tonight is a good example of this:

I was doing some work this evening, which is similar to what I've been doing for the last 9 months with no symptoms, when I started getting lots and lots of skips. Now, I figured maybe I ate something that triggered it, or tiredness and stress could be responsible. I also had bad indigestion which I felt could be linked. So I decided to relax, go to bed and chill out. I was calm, but kept jolting awake as I was going to sleep which has happened a lot lately, and got lots of skips. I had a disrupted sleep for two hours, during which time I was aware I was still having lots of skips. I woke up with indigestion and a raised heart rate 90bpm and felt terrible, very hot and dehydrated and not well, but still completely calm. I stood up and went to the bathroom and then boom my heart rate rocketed up to 150bpm out of nowhere. It took ten minutes of drinking water and deep breathing for me to calm it down. I was reasonably composed throughout this episode.

I could chalk all that up to symptoms of anxiety and take the pills I've been offered but my issue is this: I do not feel any more anxious now, than I did when I was getting no symptoms. There is nothing that has changed about my lifestyle to cause this. The biggest anxiety for me is having these events come out of nowhere, and even now I know what they are and can successfully manage them. But they're rotten, they shouldn't be happening, if they don't cause you to avoid doing things then they ruin them while you're doing them. So it's incredibly frustrating to have a doctor turn around and say "You're just over anxious about it" - well, YES I WOULD BE, because they aren't solving the problem. They just say you're heart is fine, this is in your head, take some serious medication. I'm the one experiencing these things, and I know the difference between a panic attack induced by my being stressed, and an inappropriate and excessive physiological response, PVC or tachycardia, which comes out of nowhere and is the biggest cause of any anxiety in my life. I feel like I'm in a chicken and egg battle with my doctor. Perhaps I should go somewhere else for a second opinion.

[MichelleP_3811]

Since the 190 beat happen out of the blue unprovoked it is likely that is an svt of some sort.  The other rapid heart beat is likely sinus tachycardia since it rises and falls slowly with exertion and stopping.  The skips and pinches are pvcs.  What I have come to realize is most people who have heart rhythm problems tend to have a number of them.  I had and svt called avnrt that was correct but now I am dealing with pvcs which does seem to cause my heart to beat faster than it should/sinus tachycardia.  None of the issues I have been told are life threatening.  Just annoying.  So if your heart is structurally fine there really isn't anything to worry about.  Just do your best to take it easy when you are having an episode.  
With time you will be better able to manage your symptoms and hopefully not fear living your life.  Take care.  You are not alone.

[MFoot]

Thanks for your comments. I can't provoke the 190 heart rate jump - I've tried under monitor to no avail, and just when I think I know what's causing it, it happens out of the blue -  so far it's only been half a dozen or so times over the last decade so it isn't frequent but it is very scary. The skips and pinches happen more often, as do the lower rate tachycardias, though thankfully not recently so I have to concede stress might have been a factor there. I'm going to look into the Linden Method to tackle the anxiety side of things.

Whenever I've been monitored the tachycardia has just been a standard beat but too fast, I'm not sure what that's called. It has never been monitored at the peak of 190. Neither have the flutter type tachycardias.

Even if I try to ignore it I have problems living a normal life which is probably stress related. When I go out if I have a few drinks (I don't drink much - probably 2-4 units when I'm out) and go to bars/clubs I get paranoid about my heart rate which can rise to around 120-130 - is this normal factoring in alcohol, dancing exertion, nerves when on dates etc? When my heart gets that high I get concerned about skips, panic attacks (where I get lots of skips/pinches and a high heart rate over a short space of time) and over-stressing my heart.

[tom_h]

".....heartrate sensor which reported a jump from 130-190 staying at 190 for 2-3 minutes before slowly falling."

If this is the case, you could probably rule out Supraventricular Tachycardia (SVT).  This type of tyachycardia starts and stops abuptly with no ramping.

[MichelleP_3811]

I should also note that my cardiologist even left the ablation for the avnrt up to me.  I was starting to get almost daily runs of tachycardia so I think in the long run it would have damaged my heart but sporadic runs of tachycardia, especially those that arise from the atria are not life threatening.  Even in the long run.  The only thing cardiologist are really concerned about is the structural integrity of the heart.  That and that you don't have runs of sustain vt.  If you are clear of those then you are likely going to be fine.

[MichelleP_3811]

I lived my whole life with tachycardia.  I had a condition called avnrt which means I had an accessory pathway into my avnode that would sometimes cause the electrical signal to get stuck in a loop.  I would have episodes of my heart racing at upwards of 230bpm.  The odd thing is I never felt threatened by the episodes.  For the longest time I thought everyone did it and did not even realize it was my heart.  As I got older though the episodes increased in number and duration. I had an ablation to correct the problem about 6 weeks ago.  After it was cleared up however, I discovered I had another problem of pvcs.  These are premature beats in the ventricles that cause the heart to pause a beat.  These I have been told are not life threatening where the avnrt could have been had I let the episode go unchecked.  The odd thing is though the pvcs are less of a threat they make me feel worse than I ever felt from an avnrt episode.  The point I am trying to make is sometimes the things going on with us feel worse than they actually are harmful.  If your heart is structurally fine then essentially you have nothing to worry about at this point in time.  But even though the pvcs are not life threatening they are a bother so you may want to consult your doctor on how to manage them so you can at least feel as though you can function.  What I will also say is when my pvcs are flaring my stomach is affected.  I am not sure if it is gas pushing on the heart or something else but if you have heart burn you may want to try some antacids and see if it will help you feel better and maybe even slow the pvcs down for you.  It is worth a shot.  As of the 190 heart beat how often do you get it?  If you can provoke it fairly easily you may be able to get an event monitor and at least capture it for your doctor to diagnose.  It wouldn't hurt to ask but it will only be worth it if you know you can get an episode captured.  Finally stressing about your condition will make things worse.  When things start to flare up for you just remind yourself that your heart is structurally fine.  But if you at all feel as though your life is in jeopardy then get yourself to an ER.  Good luck and hang in there.  Having lived with arrhythmia problems my whole life it has become apparent to me that our hearts are pretty resilient muscles.

[MFoot]

I have been getting bad indigestion the past few months, though I can't say as whether that has always been the case with these episodes. How could that be linked to these symptoms? Thanks.

[suzy74601]

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check out this website it helped me some along with this website.  

Its not easy.

[suzy74601]

Do you have heartburn or indigestion on a frequent basis?  This can cause all you have stated.  

I have done all the research looking for the answer as to why I have them.  I am going to be honest. I have test after test and all is fine.  I am even on a beta blocker for it bu tcurrently trying to ween of that made my quality of life worse.  

I am not telling you this is whats wrong this is just my case.  I believe my stomach and hormones play a roll but I also thin kthat my nerves are getting the best of me.  Maybe try a nerve pill or anxiety pill for a few days to regroup then see how you feel?  

Please keep me update I am curious about this.  I believe that my nerves are not my friend lately and making this so much worse for me