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Heart flutter while sleeping and other problems
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Heart flutter while sleeping and other problems

Can anyone figure out what is going on with me?  I do not have, nor can I afford, health insurance right now.  Here's my story:

I am a 28 y/o male who has been experiencing a heart flutter/vibration/palpitation while sleeping since May 09 (that I know of).  Pretty much every night, within a minute of falling asleep, I am re-awoken by my heart vibrating.  You can still feel the ventricle contractions at normal pace, but there is also another beat (atrial I'm assuming), which is normally 200-300 bpm, and feels like a vibration.  Once I wake up it starts to go away.  It is normally 3-4 times faster than my resting HR, and will shift down to about twice as fast, then shift again to normal rhythm - each of these shifts is very quick (ie it will be 300bpm then 150bpm two beats later), and normally takes about 1-2 minutes to return to normal.  Once it finally shifts down to normal rhythm, my heart will usually then beat very hard a few dozen times, or more, before returning to relatively normal.  This happens nearly every night, but varies in intensity depending on my stress levels.  It also seems to occur only at certain times of the night - right when I fall asleep, about 3-4 hrs into my sleep, and then about 7-8 hrs into my sleep.  My wife periodically feels my chest when I'm asleep and she generally reports it feels normal, but I am not sure if she can always feel it, but I have made her feel it before, so I would think most of the time her observation is correct.

When it first happened last May I awoke at 4am and I though to myself, "Must be a small earthquake", which would not be out of the ordinary where I live.  But then I realized it was my heart and became very worried and went to the ER.  They did an echo and everything was fine (I was awake, so of course).  The doc did notice I had an ectopic beat though, which I didn't have before (I don't think), but now get daily and they fluctuate in frequency with my stress levels - some days my heart will skip every 3-4 beats all day long.  I later went to the county clinic (as I cannot afford health insurance), and the doc there put me on propranalol, but dismissed the vibrations - claiming that it is not my heart, and if it were, I would not be able to feel it.  He did recommend pressing on my jugular to relieve it, which worked, so he said then it had to be PAC or PSVT.  But I am 1000% certain the vibration is my heart - I am not the only one who can feel it.  I took the propranalol for about 6 months, then decided to step off it to see what happens and it has gotten better since coming off the meds, but has not gone away.  

That's the gist of what's bothering me right now, but there's more to this story that may give a clue as to what's going on, I don't know.  A little background on me:  I am 28, very fit, exercise regularly, eat healthy, don't smoke, don't do drugs or any other medications, drink moderately, only 1 cup of coffee a day, don't have any allergies, no other medical problems - I was the epitome of health and fitness before this started happening.  However, last year when this all started happening was one of the most stressful times in my life.  I am normally a "Type A", higher stress individual, but not to any sort of extreme (I'm not really even much of a worrier).  I was nearing the end of college (read: finals), newly married, working 3 jobs, getting very little and irregular sleep, and was very strained financially.  

In January 09 I experienced a sudden chest pain while bagging up some groceries at the store.  It was very sudden, sharp, and intense, deep in the center of my chest.  It was so intense in fact that it nearly knocked me over - I had to grab onto the counter to stay standing.  It really freaked me out, but I am so healthy that I figured it probably wasn't anything serious and I would just monitor any changes.  Then it happened about 2 weeks later while sitting in class, but less intense this time.  It kept happening every few weeks, for several months, but every time it happened it was less intense and not as painful, until it was just a slight uncomfortable twinge.  In the last 6 months or so it’s only happened once or twice, and only very slightly.

Then the sleep event happened in May, where I went to the ER and eventually got on the propranalol.  For about the first 3 weeks after the trip to the ER I was extremely stressed, worried, and scared about my heart issue, on top of being right in the middle of finals.  For those few weeks my heart constantly beat very hard in my chest, not fast, but like it was trying to leap out of my chest.  I had a lot of skipped beats, felt light-headed on the worse days, and generally felt like I could drop dead any minute.  I abstained from anything that could aggravate my condition - caffeine, alcohol, exercise, etc.  Eventually I calmed down and the symptoms improved.  This convinced me that it was likely being exacerbated by my anxiety and stress.  Over time I reincorporated things back into my normal life - exercise first, as I am a field scientist.  Then caffeine and alcohol each and they didn't seem to bother my heart much (alcohol moreso, but nothing much to worry about).  But my sleep issue remained and only fluctuated with stress levels.  So I tried eliminating the pills, which did help as I mentioned, but my problem persists.  And some nights it seems as though it is inordinately intense considering relatively low levels of anxiety/stress.  So I'm still confused about it.

Sorry for the long post, but I just want to make sure to include as much info as possible.  I have more to tell but it exceeded the post limit.  Does anyone have any idea what is going on?
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Avatar_m_tn
Additional information that may be of use:

One thing I think about though is my assumption that it was an earthquake.  I have always been a bit of a "nightowl" and go to bed late and sleep-in.  Even when I have long periods of regular, healthy sleep, if I don't set an alarm I can easily sleep 12+ hours daily.  I have also always been a bit of an insomniac since middle school, as well as experiencing regular migraines.  Often I will go to bed and cannot sleep for hours because my mind is racing - I have learned to deal with this by just staying up and trying to tire my brain out with stimulation before going to bed.  Anyway, this 'earthquake' thing has actually happened about once or twice a year since middle school (when I started having sleep problems and migraines).  I have never had the earthquakes verified, but the incident in question felt exactly as they always have.  So, I'm wondering if every time I've thought that, it was really just my heart doing its thing.  It's hard for me to say though.

Additionally, occasionally during the day, and seemingly unrelated to stress, my heart will suddenly kick it up a notch and beat a little faster and harder than it should be.  It might last anywhere from 15mins to hours.  I can't really correlate it with anything either, which is frustrating, but not as much as the sleep issue.  Other than that it's just the ectopic beats.  Nowadays I am careful about my stress levels, and anything else that can aggravate my heart.  I notice that while I am exercising I don't have much trouble, but once my heart rate slows down after exercising then I get a lot of ectopic beats and it can be very distracting.  This is especially of concern for me because my job requires very intense physical activity, besides the fact that I am a naturally active person.  Some days are worse than others, but it still interferes with me being able to live a normal life.

As for insurance, I have been unemployed since August but am starting a new job in March, but it's only a seasonal position (6 months - very common in my field), so there's no benefits - I've been in school though and haven't had coverage since 2007.  My wife's work doesn't pay to cover spouses, so it's prohibitively expensive to do it.  Once I start working though we are going to make ourselves afford some sort of coverage for me and then get a holter monitor, sleep study, and whatever else is required to diagnose this problem.  
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Avatar_m_tn
I also forgot to mention that the reason why the fluttering while sleeping worries me is that when I wake up just my core feels warm but my limbs are cold.  Once I wake up and it starts to calm down I can feel blood beginning to circulate again.  It's very unnerving and I'm worried about getting brain damage or something.  Sometimes I'm so cold that I shiver uncontrollably for 15 or 20 minutes before I warm back up again.
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1137980_tn?1281289046
The first thing that i would want to tell you is to relax and step away from this whole issue for a moment.  You are taking this way over the top Moses and it sounds to me that it is stress and anxiety related.  Sounds to me like sleep is your issue here and yep staying up too late and thinking way too much can set off a rapid heart beat.  It sounds to me like you've convered all of your bases here with what has been prescibed to you in helping you but the world is a very hard and stressful place now for everyone.  You may seriously want to think about going to Whole Foods or a store along those lines and buying yourself some Nightrest made by Source Natural.  All it really is is a vitamin that you take about a half an hour before you go to bed and it lulls you into a restful sleep not a deep sleep without interruption of sleep and you wake up feeling pretty darn good without any side effects.  I too tend to be a type A personality and my heart doc is constantly telling me to take it down a couple of notches and to pick my battles.  When taking an accurate heart rate for yourself the best way to take it is pressing two fingers but not the thumb or index on either side of your widepipe at the neck....watch the second hand of a watch and count the beats you feel thru your fingertips for 30 seconds and then double it and that is your heart rate.  A normal heart rate is anywhere from 70-120 in a non athlete.  If your heart rate is 300 trust me you would be in an emergency room and they would be converting you with an AED or I.V conversion...been there done that....i am apt to believe you possibly aren't reading your pulse correctly.  Moses choose your battles like my doc says....try to focus on the bigger picture ie: this time next month i will be..............this time next year i will have ............etc.  I know it is hard and i think many humans are having to deal with alot of things we didn't have to 5 years ago but its a whole new world now and we all have to adjust accordingly and move forward and power thru the tough times......don't let this anxiety and worries in your world get the best of you .....you have a family that cares about you i;m sure so be the best you can be in these times.....good luck
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Avatar_n_tn
Hi,
I am having the exact same problem and you are the first person I have found having the same experience. I am 48 and have always been extremely healthy and have always functioned well under stress. About 3 months ago I developed high blood pressure and was put on atenelol right after that I started having the same paps that you describe at night with a normal pulse rate. I have since had an echo, stress test, renal test, and spent the night in the hospital. Everything so far checks out normal. They had switched my blood pressure med 3 times. All of them have had side effects and it is very frustrating. I took the new one yesterday, which is Diltiazim, I had nightmares, a migrane (migraine), and felt like I had a fever. I am currently waiting to hear from the dr about what to do on this one.  I still woke up during the night and this morning with the paps. Have you found out anything about your condition since the post? Would love to hear from anyone with suggestions or comments. Thanks!
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Avatar_f_tn
As a scientist, Moses21, I'm sure you are very analytical.  I'm the same and it drives me crazy not to be able to find a clear solution!  I can relate to your situation very well - mine is pretty identical.  I have had a heart flutter for the past year or so that I can feel through the upper part of my chest, it happens almost every night/morning, and stops as soon as I am fully awake or sit up or just take a deep breath and hold it for a second.  Sometimes it happens at 1:00am or so if I am very tired and went to bed late, but usually happens as I am going from sleeping to awake in the morning.  I am female and completely healthy according to my regular doctor, although he gave me Nadolol, which I didn't take.  I am a type-A personality and work in a very stressful job, with a ton of hours, etc.  and have pretty bad sleep habits.  After having other symptoms I ended up in the ER twice, but the doctors found nothing and gave me xanax for anxiety.  Since then, I've been to several doctors, MD's and Naturopaths who have all found nothing, and the only one who has really helped me has been my chiropractor.  

He told me I have fatigued adrenals (google adrenal fatigue heart flutter), which totally makes sense given my poor diet, lack of sleep, and terrible work stress at the time.  Supplements, a better diet, and lots more sleep have made a  big difference, plus I left my stressful job.  However, I still have the morning heart flutters, and did have the super-sharp chest pains that another poster on here mentioned.

What I have found that (hopefully) is the solution - for the past week or so, I have been taking an iodine supplement (Iodoral) to help my thyroid.  Try taking your temperature when you wake each day for a few days as a low body temperature is symptomatic of decreased thyroid activity, then if it's low I would try the Iodoral.  It's readily available on the internet, as is plenty of documentation on its uses, etc.  It's a pretty safe and inexpensive thing to try while you are waiting to get insurance.  Apparently tired adrenals can become a drag on the thyroid, and my body temperature had been around 96.5 degrees consistently and my chiro said that was too low so gave me the supplement.  I feel more energetic, and I have not had the flutter since I started taking the Iodoral!!  For me this is huge, because I have tried so many things to figure this out.  It's only been a week though, and if it comes back I will post here again, but keeping my fingers crossed.  Keep in mind though, that I have also been making myself go to bed at 9:00pm, am eating a low carb diet with small meals every three hours to manage blood sugar levels, and doing some meditation and yoga to calm myself and turn off my brain as my chiro says people who do an overabundance of thinking, like those in technical professions, are susceptible to much more physical fatigue than you would imagine. You may find it worthwhile to read up on adrenal fatigue and see if you think any of the symptoms affect you.  If so, the good news at least is that it is very treatable on your own.

On the chest pain the other poster mentioned - something about adrenal fatigue seems to cause muscle changes - low blood sugar or electrolyte imbalance maybe?  that cause the sharp pains with no exertion.  I bought a book on trigger point therapy (myofascial) and found very painful trigger points in my chest muscles exactly where the stabbing pain was coming from.  Over a few days of massaging, the trigger points, which are like super small incredibly tight knots in the muscle, went away and I have not had the pains since.  Unfortunately, stretching does not help, because the surrounding muscle pulls away from the knot and the knot remains, which can create even more problems.

Hope you find this helpful – good luck!
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Avatar_f_tn
do you get a feeling like a rush of blood going through your heart? i had a problem when i had a panic attack in my doctors, my atrium was beating faster than my ventrical so ecg was showing atrial flutter but it was only anxiety, propanolol was helpful for me as it made my anxiety calm down, i think you worry bout it forget about your heart you seen doctors and you are fine, i get ectopic beats and they worry me so i forget about them n they go, try forgetting bout it look forward to something in your life
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Avatar_m_tn
Hello. My name is Jason. I'm a Psychiatrist in England. I have starte dto experience symptoms similar to those you describe. If I lean on my front with right arm sort of underneath my I experience a flutter in my chest although my pulse at the time is normal or even slow. It's a very unpleasant experience. I am planning to go to my doctor for investigations and will let you know how I got on. Jason
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554610_tn?1215905711
My experience:  started with flutters, then BP got higher, awake every night 3am, numerous tests, only thing found adrenal adenoma, had bradycardia, skipped beats, first degree heart block, ended up in Emergency numerous times, like a heart attack but not.  Was always treated with pain meds.  Heat intolerance, breathlessness, some anxiety, progressed over four years to hypertension, not controlled by any meds.
Symptoms bad now,  numbness in hands arms, burning flank, pain, headaches etc. point to diagnosis of pheochromocytoma (adrenal gland tumor) causing the problems.  Probably benign.  Surgery soon.  Had to go through a lot of doctors, some caring, most thinking I was imagining it....yeah right!!!  Would suggest to anyone with something similar, get thyroid, parathyroids & adrenals checked.  I had sleep study, angiogram etc.. and lots more...nothing else showed up.  Took a cardiologist to put it together.
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Avatar_m_tn
Unbelievable!

Like moses21, I am 28, physically fit/athletic, not smoking/using drugs, using only little alcohol, eating rather healthy, but I do have hypercholesterolimia which was found about two years ago. I actually went to doctor because I had "weird sensations from heart", and the high cholesterol was found via a bloodwork. (LDL 4.3 unmedicated then, was few months of the medication and LDL was 4.9). Back to 40mg of statins...

Since that stressful job, I have had heart issues that have recently become worse, even though I quit the job nearly year ago and went back to school to study music (which I love!) :)

Anyways, as far as I can tell, I suffer from atrial flutter and more recently also from atrial fibrillation. Both seem to occur rather "randomly" after meals (mostly when I lie down/compress my torso) and while at sleep. Flutter happens only when asleep, but afib happens also after meals.

I usually wakeup after 3-4 hours of sleep to a fluttering sensation in inner ear, and then it turns to wildly racing pulse from 60-150. Pulse (from wrist) feels completely random, few slow beats, then some rapid ones and back to slow. Usually standing up stops it. Both cause mostly grief and annoyance since I really could use my sleep...

Alcohol has clear effect on afib, after drinking it happens much more often.

Sometimes I feel dizzy, shortness of breath, numbness of jaw/face and a feeling of "impending doom" - BUT this most certainly is not an anxiety attack! I am still not feeling afraid, panicking or anything like that. It is just a feeling that "everything is not right". And it most certainly is not. It feels like someone wakes you up with a bucket of cold water, waking you up instantly - and completely. I feel like I´ve had a shot of adrenaline, my eyes are completely wide and open, although I should be very sleepy after few hours of sleep. After the "attack" has passed, it takes roughly 30 minutes to "cooldown" and to fall asleep again.

I´ve been at ER couple times, but as the flutter/afib is gone in few minutes after I wake up, they´ve never catched it. Same with meals / lying down.

Today, for the first time, I also had the "sense of feeling cold" after the afib. I was shivering for like 15-20 minutes, although I was under a very warm blanket in a room of 24C.

I do have some scoliosis at my neck and at first the doctors thought my c2/c3 joints were "at block", that there would not have been disc at all between them, but now they´ve noticed it´s there, but it´s just very small/hard to notice. I have no idea if this has something to do with vagal afib or not.

People tend to say, they have vagal afib mostly when they are sleeping on their left side. Well I tend to wake up fluttering/afibbing from my right side.

Anyways, I am going to doctor in few days and hope to get some bloodwork tested (adrenaline, thyroid, potassium, iodine, magnesium) since it seems that issues with those might have some effect here.
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Avatar_n_tn
Hi Moses, how are you doing? I have been tormented by a left chest mild vibration, gurgling sensation between the shoulder blades, which many (twenty and counting now) different docs on three continents (Canada, UK, China and Singapore) cannot determine the cause of. A UK doctor (number 17) said she could hear a loud systolic murmur, so promptly put me on 120 mg propranalol. I was on that for several years and it shut down the symptoms. My main family doctor decided from the outset my condition was psychological, and refused to treat me. I had to sort of agree with him (though i was adamant that i actually could feel something whereas he refused to accept this); so he put me on an SSRI, Sertaline, which i was on for about. A year. In 2007 my symptoms had improved so much, that i came off the beta blocker, and for that year i had NO issues. In 2008, i flew to Singapore to validate the potential of the long-distance relationship i had started in 2001 with a Singaporean gal. It started off badly, as she found fault with everything (especially that i was unemployed at that time, though i have worked full time for most of thirty years). That year, the 'vibration' started coming back; and i started again on the beta blocker. Eventually, i was feeling great and sleeping well, and able to work again (after about two years of great misery and being broke, and facing a disciplinary at my old UK job) and was only on 40 mg propranalol a day. My world changed again in 2010 when my Mom called to tell me that she had been diagnosed with colon cancer. I followed up from Singapore and flew to Canada to be with her twice; but she succumbed early in 2011 and i was forced to take care of her funeral, as my three brothers who live in the country could not deal with it. In early 2011 while i was working in China, my 'arrythmia' came back with a vengeance...possibly due to heavy drinking of Chinese wine (52 per cent alcohol and God only knows what other contaminants!) and smoking a pack of Chinese cigarrettes a day (i have never been a big smoker and all told smoked for about three years, starting six years ago...and i ahve quit twice for three months and am now quitting for the third time). But i got a new symptom (or perhaps, one i had not taken seriously, when i was diagnosed for the first time with mild sleep apnea in 2005) which was, i often stoped breathing in my sleep, sometimes for a minute or so. The worst thing is that i found even when resting, that i would just fail to breathe (my mind seemed to be too focused on too many other things, and it 'forgot' to tell my brain to breathe), and this began happening even when i was resting. Even resting on my left and right side, i would soon get a 'flutter' (the 'vinbration' of the past eventually became quite severe, and became a regular, frightening flutter). I have had four stress echoes, several cardio visits, many doctors visits and have talked to countless people; but when i finally bought a CPAP machine (over Amazon rather than my local Specialist Clinic, which wanted $4000 for it and i got the same new machine for $1000) it did, after several months of trials with different settings (and some horrible sleepless nights with constant bad flutter) make a huge impact. My stress levels are now significantly reduced; i can fall asleep normally now; i dont wake up every hour, often with flutter or irregular heartbeat, as i did before; i breathe better when i sleep (not constantly shallow breaths); and my AHI has gone from 21 to 0.6 or so. My 'flutter' definitely seems to be heart-related; yet (thankfully) it does not show up on the ECG, Echo, or recent Holter Monitor. I think it is definitely pulmonary in origin; and partly the result of more than thirty years or more of sleep apnea. What still troubles me a lot, is that i do not know the source of the 'arrythmia' but i suspect it may be the twelve mercury amalgams i have, plus two or three root canals (one with an amalgam sandwich which is infected); and severe relationahip stress (my fiancee refusing to relocate to Canada with me, after ten years and worse, her believing it is not a problem for me to just deal with it, and stay with her in Singapore, abandoning my Canadian home, family, church and friends and, indeed, all my plans for the future which i had thought would be spent mainly in Canada). Anyway, i am also taking quite a few supplements and these do seem to help (but of course, will not do anything for the amalgams) plus Alpha Lipoic acid, which i believe will help chelate the mercury in my brain (and which is likely interfering withbmy normal breathing). I hope this post has been helpful to you. Do you have amalgams? Have you been tested for sleep apnea? Please letme know how you are doing! I have the same symptoms as you except for the sharp chest pain (sometimes i do get a dull aching pain left centre if i have a 'bad night' with many apneas) but i believe all of these symptoms will resolve with God's guidance and grace, while i focus on living purposefully and doing good.
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