General anxiety and palpitations

[aarongr]

Hello
My name is Aaron and Im 29 years old. This is my first time ever posting to a web forum so be kind ;)

Back when I was 24 I started having odd symptoms, dizzy/lightheaded, fear that I was going to die, flushed feeling / warm feeling in back and neck and heart pounding. Visit after visit to the ER they would do an EKG, X-ray of heart, and blood work and said I was fine.  Finally a doctor talked to me about anxiety.  So I talked to my regular doctor and he diagnosed me with General anxiety.  I was put on Lexapro 20 mg I believe.  I was fine on the medicine for about a year and a half.  At the time there was no generic so with the cost and lack of libido I stopped. I was fine controlling my stress and anxiety for a few years.  Then I started having pounding and what felt like my heart was stopping and restarting.  My doctor started me back on Lexapro or a generic that was like Lexapro sorry I can’t remember the name.  This didn’t work for me this time, we doubled the dosage and still had the new and odd symptoms… the palpitations that at the time I didn’t know or understand. I stopped the Lexapro.
So FINALY I get told what was going on with my heart.  I have and extra impulse or electrical beat  “that might not be the correct term” in the first chamber.  So now I have Anxiety that feeds off my palpitations … or is it the other way around not sure haha.
So after complaining about the palpitations my doctor did an EKG, Echo, and holter monitor, Blood work.  The EKGs always “looked fine” as I was told. The Echo showed nothing out of the ordinary. The holter only showed I had some 700+ palpitations. Blood work was fine.  I started Metoprolol ER 100 mg once a day for High blood pressure and the doctor believed this would also help the palpitations by slowing the heart and help with the anxiety? This worked for about 2 years, I had the palpitations but where not crazy like the 700+ maybe 30-70 a day if I could feel them.  But I had to change the dosage because I am always tired now and have no energy and when I stand up my heart starts pounding I can feel it in my chest and neck.  Not like my palpitations.  I feel like my heart isn’t getting enough oxygen and I feel shortness of breath.  So as of yesterday I am no longer taking any meds, after seeing my doctor. No lexapro, no Metoprolol, nothing but a multivitamin and omeprazole magnesium for acid reflex.
I am so tired all the time and the pounding of the heart when I do even little things worries me.  I feel like I could almost pass out at times.  I feel weak.

So the big questions is do you think it is my Anxiety acting up again or is there something new going on?  With my anxiety I always worry. Any ideas I should bring up with my doctor? The last visit when we stopped the metoprolol we did the “lay down, sit, stand, sit” blood pressure. Thats why he had me stop it.

No drugs or alcohol, very little caffeine if any. Stress? Sure but it is little day to day stuff nothing big.

[SherryLynn]

Please Google omeprazole.  It can cause all the side effects you describe, especially the heart palpitations. Countless people have posted about anxiety, too. Good luck.

[marlinspike]

It sounds like you have had all the appropriate heart tests. 700 palpitations a day isn't considered out of the ordinary by doctors if they have been identified as PACs or PVCs and you don't have other heart issues (the echo would have found those). Many of us on here have a lot more and the drs still tell us we are OK. I found that I couldn't do a huge amount about my PVCs -avoiding coffee and heavy meals is good advice though - so I decided to work on the anxiety and negative thoughts. The anxiety and panic attacks caused by frequent palpitations made my life miserable, but there are lots of free resources on the web and some good CBT books that really helped. Try googling guided meditation and CBT. Best wishes.

[tom_h]

To put things into perspective, Aaron, there are people here who are experiencing thousands of "skipped" beats, beyond 15,000 per day.  I'm not making light of your situation, but pointing out how many you could be having.  Most cardiologists won't medicate unless your "skips" are in the thousands.

You use the term "pounding".  Is that in reference to your heart beating hard, or fast?

As you may realized already, it's perfectly normal for the heart to ramp up  in rate and "intensity" whenever you stand up from a seated position or lying position.  This is perfectly normal.

Also keep in mind that there are a number of concealed conditions.  These are cardiac issues which reveal themselves only when they are occurring.  When they're not happening, your hear will look electrically and structurally normal.  It is this situation than often leads a short-sighted physician to diagnose a patient with "anxiety" when in fact that have a legitimate cardiac issue.  SVT is a classic example.  Too many physicians can't think outside of the box.  It's up to you to provide an accurate, detailed account of what you're feeling.  Recounting events like "my heart felt like it was pounding" is a sure way to get you led down the path of a misdiagnosis.  It much better to log the events.  Write them down on paper,  Recount what and HOW you were feeling, where you were at the time; were you watching TV or were you standing in a crowded train station.  Recall how fast your heart rate was by palpating and counting the beats.  Did it skip?  Did it suddenly start beating fast?  Writing this stuff down will help the physician when he's listening to your heart with a stethoscope and hearing a perfectly normal beating.

[MichelleP_3811]

So from what you have stated it sounds like just run of the mill ectopic beats and no svt which is good.  The extra beats are of even less consequence then so do your best to continue to try and ignore them as well work on your stress and anxiety.  I had it most my life and I'm still prone to it a bit but it is manageable so just try and set your mind to it and hope for the best.  Take care.  

[aarongr]

Thank you michellepetkus!  My palpitations are like this, sudden beat followed by a stop / slow normal beat, then a second sudden beat. They come and go no rhyme or reason. Mostly at night when I want the sleep! I have learned to roll over and forget about them.  I no longer let the palpitations bother me though, after all the ER bills and every test coming back ok. My general anxiety disorder plays into them a lot I’m sure.  I’m the type of person to get a cut and assume the worst. “they are gonna cut off my hand” haha
I am going to look into getting a blood pressure machine to keep track of it, and look into a heart rate watch like you talked about.  I stay away from caffeine as much as I can.

Anyways thanks for listening and replying! Helps with the anxiety to know I’m not alone!
I’ll keep you updated if anything changes.

[MichelleP_3811]

Welcome to the forum.  Stress may be a contributing factor to your symptoms but in general it sounds like you have run of the mill ectopic beats.  Extra beats in your atria it sounds like that cause your heart to react and speed up.  Or it could be that you get a number of them in a row that makes it feel like it is speeding up.  One thing I will ask, do you notice when it is going fast, does that start and stop in what feels like one beat?  Have you tracked how fast it is going?  They sell sports watches that can help you read what your heart rate is.  If you happen to have an svt on top of the extra beats your heart might be racing at speeds over 200bpm.  This would cause me to feel very short of breath and feel as though I would pass out.  The episodes didn't last long for me but it can be hard to diagnose because the doctor has to catch it on a monitor to see it but they can tell by the fact that it starts and stops in one beat. If you feel yours ramp up or slow down then it is likely just a response your heart is having from the ectopic activity.  I would say also check your blood pressure.  If it is generally low then it could be causing your heart to react and make you feel light headed.  If this is the case then you may be able to add some sodium to your diet to help alleviate the issue.  As well no matter what the issue is definitely start drinking lots of water.  Stay away from sugar, carbohydrates and caffeine or energy drinks as those will cause the heart to act up.  

Now here is the thing, in an otherwise structurally normal heart, which yours has been deemed to be, these extra beats are considered benign.  My doctor didn't even recommend going on meds. They usually are only prescribe to help a person feel better but sometimes they do have the effect of making the situation worse.  So the meds aren't going to fix the issue completely.  The biggest things to try and pay attention to are any gerd or acid reflux as that is one of the bigger triggers and general stress and anxiety.  If you are generally stressed and anxious it could be triggering you to have these extra beats which then brings on more anxiety.  But rest assured that your heart is healthy so the beats are of little consequence.  The heart can handle what is going on.  We just need to learn to not let it stress us out or we can make things worse.  So I would say anytime you start to feel anxious, worried or upset regardless of what your heart is doing, stop and take deep breaths and try to calm your nerves.  It is amazing the tension we can carry in our bodies and not really be conscious of it.  Now that you have symptoms it might do you well to try and be more aware of how you are reacting to your world.  Deep breathing and things like yoga and meditation can help you develop a more relaxed approach to life and subsequently will help your heart function better.  Best of luck, I do hope you can get a handle on your ectopic beats.  And give your heart a bit of time to rebound from the meds you are on.  It can take a little bit but I would suspect at some point you will get your energy back.  Take care and keep us posted on how you are doing.  You have found a site that has lots of folks in the same boat as you so you are in good company.  Talk to you later.