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Heart Palpitations and Chest Pain
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Heart Palpitations and Chest Pain

Hi there, I have a weird situation going on with my heart that I've had for the past 5 months or so. I am male, 22 years old with no family history of heart problems, only high blood pressure and stress/anxiety problems. I am mildy fit (5' 10" about 175lbs) and work out about 2 to 3 times a week. Before the problems started, I drank pretty heavily on the weekends, about 8 beers a night and also smoked hookah. Over the course of having these problems, I have ceased all alcohol, smoking, and caffeine intake. Sorry but this story is quite a long one, I just want to make sure everyone knows all the details, so bear with me.

Back in January of 2012 I came down with strep throat and was prescribed Erythromycin. The next day I woke up with pains on the left side of my chest and constant heart palpitations about once every 4 to 5 minutes. I was taken off Erythromycin right away and put on Cephalexin. They also did an EKG but all results came back saying I had a healthy heart. For the next few months I was still having chest pains, random palpitations, etc. This was quite concerning for me and was constantly believing I was going to have a heart attack. I went back to the doctors and they referred me to a Cardiologist. The Cardiologist did an EKG and ECHO and all results were normal. Later that week (end of March), I was in Seattle and had a night of heavy drinking with a few friends. The next morning after about 5 hours of sleep and having a full cup of coffee, I proceeded to have 3 very scary panic attacks. I fully believed I was having a heart attack. Thankfully my friends were able to help calm me down but the rest of the day my chest was very fatigued and I was on edge.

I once again went back to the doctors and had an EKG done and once again the results were normal. During this time I was finishing my undergraduate degree in aerospace engineering so it was a very stressful time with all of my projects, tests, and heart concerns. I constantly had panic attacks but since I had been cleared of problems I was able to mentally calm myself down and keep them from getting out of hand. As time passed and I graduated earlier this month, the panic attacks subsided and I have been able to remove almost all stress. With this new found calmness and relief, I decided to get back to my exercising schedule. This includes working out daily since it is the summer and relaxing/running errands in the afternoon. Unfortunately after working out, the palpitations returned. I also had a weird feeling of a heartbeat in my throat. Once again I returned to the doctors and they had me complete a stress test (all was normal) and referred me to a counselor to deal with any sources of stress. Specifically today, I went swimming for about 2 hours and then went to the gym for about an hour doing heavy lifting. About two hours later when I was sitting on the couch watching tv, I had a series of heart palpitations which scared me greatly. I have since calmed down but am still a bit on edge and my chest is a bit fatigued now.

I believe that covers all of what I have been experiencing. My question is what could this possibly be? I have been all over the place, attributing it to gerd, stress, anxiety, the works. I just want to get back to my old lifestyle without the constant heart concerns. I eat healthy, exercise, and have cut out all caffeine, alchohol, and smoking. Should I stop lifting weights and switch to light cardio? I'm hoping the palpitations are just from stress from heavy lifting now. Should I get any blood tests done? Check my thyroid? I really don't know what to do. Any advice is appreciated, I just want to remove the worry and move on with my life! Thanks for listening.
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612551_tn?1247839157
From my understanding of your post you have been given a "clean bill of health" on your heart... albeit a good EKG does not prove you do not have a heart rhythm (electrical) problem.  So, you don't have any diagnosis/treatment for your problem.  Have you discussed wearing a heart monitor (a simplified wearable EKG) until your heart produces the symptoms.  Here I assume you didn't have the symptoms while you were on the EKG.  If you did, then the EKG tells you your symptoms are not related to hearth rhythm problems.  

Many people are able to capture an "event" by wearing the "Holter" which is normally done for just one 24 hour period.  I have worn a monitor for a longer period in one such study done on me.  I think I wore the monitor for two weeks, day and night - took it off only to take a bath.  That showed I had what was already known, Atrial Fibrillation, and it showed during the period I did not have PVC/PAC or other problems.
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612551_tn?1247839157
From my understanding of your post you have been given a "clean bill of health" on your heart... albeit a good EKG does not prove you do not have a heart rhythm (electrical) problem.  So, you don't have any diagnosis/treatment for your problem.  Have you discussed wearing a heart monitor (a simplified wearable EKG) until your heart produces the symptoms.  Here I assume you didn't have the symptoms while you were on the EKG.  If you did, then the EKG tells you your symptoms are not related to hearth rhythm problems.  

Many people are able to capture an "event" by wearing the "Holter" which is normally done for just one 24 hour period.  I have worn a monitor for a longer period in one such study done on me.  I think I wore the monitor for two weeks, day and night - took it off only to take a bath.  That showed I had what was already known, Atrial Fibrillation, and it showed during the period I did not have PVC/PAC or other problems.
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Avatar_m_tn
Thank you for your response. I have not had a holter heart monitor but have seen a lot of people have them when experiencing this. We eliminated all caffeine, chocolate, etc and seem to have controlled my heart palpitations. I still have a few every once in a while but I am just accepting them now. I still drink a few beers too which might attribute to these.

Recently I had about a 5 minute episode of where my heartbeat was slower than normal. Not in the aspect that the pulse was slower but the timing was different. Lets call the sound that sends out the blood "pa" and the returning blood noise "bump." In a normal heartbeat it is "pa..bump......pa..bump......pa..bump" but in my case it was "pa......bump......pa......bump......pa......bump." This was very scary for me and was able to contact a nurse practitioner and she said there was nothing to worry about. She did make sure that I was not taking anything that could be setting this off and said I should follow up with my cardiologist about the holter heart monitor. Everything seems to be fine now but I will be contacting my cardiologist tomorrow.

Once again thanks for your response!
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Avatar_f_tn
As you may know, electrolyte balance is important to smooth heart functioning.  Alcohol is a diuretic which alters blood electrolytes, and the more alcohol, the more dramatic the effect.  Here is a little article that may help you understand a bit more:

http://www.mayoclinic.com/health/heart-arrhythmias/ds00290/dsection=risk-factors
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