How can i tell if my palpatations are serious or not?

[von123678]

Hi,

I have fast, slow and irregular heartbeats.

It has been happening for about four months now and getting worse.

I've had a 24 hr and a 7 day holter monitor but it never showed up on them as typically i never had an irregular episode while it was on just fast and slow periods.

Because of past anxiety problems i am not been taking seriously by my cardiologist and have been awful the last fortnight.

My pulse has been,slow,weak and extremely irregular which never happened with anxiety.

I am desperate and terrified.

Please advise

Yvonnex

[Mmuffinnn]

I have generalized anxiety disorder, panic disorder, SVT (AVNRT), multifocal atrial tachycardia, and long QT syndrome with one bout of torsades de points. I complained of palpitations for at least 15 years before any abnormalities were found on ECGs, holter monitor, or loop recorder. I only was able to find out when the palpitations kept up for a half hour and I went to the hospital. I had SVT and I was able to walk myself into the ER without a problem. I was cardioverted at the hospital and sent home. I had ten or more episodes before I finally saw a cardiologist. I had an EPS done and they ablated the AVNRT and most of the MAT, I had to have a second ablation done a year later to get the rest. The SVT wasn't really dangerous, if you're young and healthy it won't cause any real harm, but it is scary and uncomfortable. Due to scar tissue in my heart I now have had a bout of TDP and was luckily cardioverted in time. I take medications to keep my heart regular.
It is likely that your palpitations are not dangerous as long as they go away in a few minutes. If they keep up, go to the hospital. While it may be anxiety, it may be something like SVT. SVT won't kill you, especially if it goes away in less than half an hour, so try not to worry too much. I found the "valsalva manoever" to be helpful in stopping palpitations when they start. Try not to worry, but look after yourself. People with anxiety and panic disorders can have palpitations that are not caused by anxiety!

[von123678]

The nhs cardiologist,although i have slight mitral valve regurgitation said no to an echo,my last one was 2 -3 years ago.
he was politely horrible to me as if i had nothing better to do.
My new doc has referred me but said he may block the referral.
I tried private hosp and was going to pay but they said they only do 24hr or 7 day monitors.

Thanks for your support.
Yvonne xx

[r9c]

Yeah,i understand that,UK health system is like that,even its free there are alot of disadvantages,you need a GP approval,as in a referal letter before you can see a specialists,cardiologist.If the doctor in the ER dosent think its serious,more likely after a normal ECG,standard blood test they are likely to sent you home for anxiety diagnosis.

I experienced that alot,alots of trips to A&E with complaints of ligtheaded and palpitations then only the doctor agreed to refer me to the cardiologist,which of course will take a long time because they usually see patients who have abnormal ecg etc founded in the A&E,if yours just palpitations and normal ecg,it would at least i think takes 2-3 weeks appointment.
As for Echo,i dont think the cardiologist will repeat it if you have done it recently,usually they agreed to re do it after a year or so to see if theres any structural changes in the heart.I dont know the system in UK,but over here,if you have luck,you met a good doctor or a cardiologist,they would agreed most of the time to repeat those test again.The other way is to seek a private consultation with a cardiologist which will cost a lot of money but by doing so sometimes when you head back to the A&E with complaints of palpitations,the doctors there would care about you less because u decided to go the private health care system route,and sometimes there are a few mean doctors they would even said,if you dont trust him why bother come back to see him again,i have met those kind of doctors before trust me i felt like shouting him back stating who would like to come to the A&E if they arent feeling all those horrible palpitations.So if u can afford,better seek a 2nd opinion from a private hospital.

[Mom2four85]

what? that is horrible, is there anyone you can complain to?  there are many of us who have to have 30 day monitors because certain things will not show up on a 24 hour or 7 day monitor, WOW I am so sorry you've gone through this!

It makes me so angry to hear other patients are treated like this; to me it's discrimination based on a preconceived notion from a doctor who may or may not be right.  Please find another doctor or find someone to complain to and tell them you really need to have a 30 day monitor.   Is there any way you can go outside of your health system to get a monitor and pay for it or make payments?

[von123678]

I didn't have an episode with the monitors on, I asked for 30 day one and my doctor said no, that if i had a problem it would've shown on 24 hr monitor.
Asked cardiologist for an echo,he said no too.
They won't accept that i just want them to hear or see the irregularity then judge me on that.

They have not heard or felt it and are helping me no further.

I wrote to my doc and cardiologist pleading for them to help me and have heard nothing.

Yvonne xxx

[r9c]

If u did not have any palpitations or symptoms during your 24 hr holter it dosent mean theres nothing wrong,maybe the holter dint caught it so u can talk this with ur cardiologist and maybe request for a 30 day eveny monitor.

[von123678]

Hi,

I totally sympathise with you,one of my most annoying issues is that due to my anxiety no healthcare professional can see past it.
All i want is tested,them to feel the irregularity then judge me.
Not decide before feeling or hearing the problem first.

I hope you get the required treatment and wish you all the best.

Yvonne xxx

[Mom2four85]

I can't say this enough...there is no way to tell if they're dangerous or not unless they see them on EKG or monitors; that way they have an idea of where they originate and possibly if there's anything else going on, such as damage or dysfunction in your heart.

I was told mine was stress for years, even when I complained of chest pain, shortness of breath, fainting and palpitations...forward to April 2007 - same symptoms just add in a ton of pvc's, still told stress related, even though my ekg showed problems.

By June 2009, I had over 50,000 multi focal pvc's that I was told was not dangerous and my echo was "normal" and I had no structural damage - but in 5-6 weeks time from my appt in June, somehow my pvc's became malignant and my symptoms severe that it led to polymorphic VT and SCA and heart muscle damage.

I didn't quite believe my first EP when he told me I was sick and needed surgery so I got 2 other opinions, one of which was the head of a large teaching university here in FL and she made less of my symptoms than the other 2 dr's did...really makes me wonder about the so call "normal".

[von123678]

I am not ashamed to have anxiety or depression or anxiety attacks which i've had for a number of years. I just meant my usual anxiety attack symptoms have always been fast pulse, fear, breathlessness, light headedness etc, which i had under control for a number of years.
I have not been able to walk, run,hoover,sleep properly, help my disabled mum.
I feel breathless,dizzy and my pulse goes fast,slow and often very weak. I feel strange and go very cold.
My diazepam had been controlling my anxiety and i have restarted my antidepressant with the doctors approval.

I am not saying what i have definately isn't anxiety and i don't disagree with any comments,i appreciate your input.
I just want them to feel or record the irregularity and make the judgement from that, then i will move on.
My dad has felt my pulse irregular several times and although i don't think it is what he has, he is convinced that it is.

Thanks.

Yvonne xx

[r9c]

Yes,wat both yarrow & CFS56 said make sense,if u do only feel ur pulse race when ur anxious then its much pretty safe to say that its anxiety causing it.People i known who have electrical problems with the heart such as SVT,the pulse just race for no reason,and when it does it hits like 150s to 200s and i am sure i experienced that and it does feel different from those palpitations you feel from anxiety.

[CFS56]

I am agreeing with Yarrow on this.  There is no shame in having anxiety attacks.  When I opened up about mine I was amazed by all the people that were like "yes, I have those too".  Yea, I have a bit of an electrical problem that causes my heart to do strange things once in a while but it's made a thousand times worse when that's all I think about and get all anxious about it.   I was actually much releaved when I figured out that a lot of my "heart" problems were anxiety.  That is something that will not kill you and you can get control over.  Much better than a potentially life threatening heart problem.

[yarrow]

Yvonne, you say:

"My pulse only goes fast when i'm having anxiety attacks. "

Do you see a possible relationship here?  As CFS56 says, feeling strange (in your chest, throat, even your ears--believe it or not), and having dizziness and shortness of breath are absolutely part and parcel of anxiety.  You are describing a textbook case.  In answer to my questions--serious questions--about your ability to perform normal physical activities when you feel what you think are odd heartbeats, you merely answer that you "get a strange feeling in my chest and throat, breathless and feel dizzy. I can't walk far and am terrified permanently."  

"Terrified permanently" is a most telling choice of words.  It says a lot.

I ask again:  Can you do your your normal daily activities like walking, dressing yourself, going up and down stairs, even breaking into a run now and then?  Do you experience fainting, nausea, and disabling shortness of breath?  Do you break into the worst, most drenching cold sweat you can imagine?  Do you have crushing heart pain that makes you so sick that you absolutely have to sit on the curb wherever you are because you are so physically ill that you cannot take another step?  If the answer to these questions is 'No,' you almost certainly--given your frequent examinations--have no heart problems of any consequence.

I often wonder why people would seemingly rather die than seek professional help for anxiety and panic.  Are people so ashamed of having a minor emotional problem that it would be preferable or even desirable to have a life endangering heart problem?  

[von123678]

I understand what you're saying but i have suffered anxiety 20 years and had many anxiety attacks and hospital attendances due to this.
My pulse only goes fast when i'm having anxiety attacks.
The irregularity never happened while the tapes were on, if they could catch it on me and then judge me on that then i will be happy.
I am not looking or feeling for pulse problems.
I feel strange in my chest and throat and that's when i know its happening.
Thanks for your comment.
Yvonnexx

[CFS56]

I hate to chime in on the anxiety bandwagon...I know how tired you are of hearing it.  But honestly, you need to consider it.  I was in and out of the ER 5 times in a 3 month period last year...I would get so upset when I was released and given discharge instructions for a panic/anxiety attack.  But finally one of the nurses asked me if all I thought about was my heart and didn't I have better things to do.  I was furious.  Then I got home and thought about it and realized she was right.  That was all I thought about....I finally realized that I was causing a lot of my problems.  So I tried to stop, I forced myself to do things, stopped checking my pulse every 2 minutes and tried to get on with my life.  It was very difficult at first.  But it got better.  I still have my moments but all in all I am much better than a year ago.  I was afraid to go anywhere or do anything. You have seen doctors, had all the right tests and diagnostics, so you can feel assured that there is nothing bad wrong.  And with the dizziness and shortness of breath...that is part of an anxiety attack.  I also have chest pain, numbness in my face and tingling in my hands and fingers.     I really hope you will consider that it is anxiety.  

[von123678]

Hi,

thanks for all of your comments, saw my old doctor today and as usual she couldn't see past my anxiety. Said that if it was structural fault that it would've shown up.

I only know its happening when i get a strange feeling in my chest and throat, breathless and feel dizzy. I can't walk far and am terrified permanently. I am not looking for problems.

It came on suddenly 4 months ago and my dad has felt it and is convinced that its what he has which isn't structural,it involves signals to the heart and its intermitent.

I have emailed a private hospital for help as the doctor said no to a 30 day monitor.

Thanks very much.

Yvonnex

[itdood]

Listen to yarrow!!

I tell this story all the time.  My grandmother lived in constant fear of palps starting in her late 50s.  She lived around the corner from the ER, she'd just walk over whenever it acted up.  I remember as a kid going there with my Mom to pick her up and bring her back home.

She died when she was 95.  It wasn't her heart that got her.  She died from compliations of dementia.  Cardiac arrest would have been merciful towards the end but her heart just did not want to stop.

[yarrow]

yvonne, as you have undoubtedly read here and elsewhere, ectopic beats or palpitations are very, very common, which is to say that everyone--everyone--has them.  The heart rate changes dramatically in the course of the day, too, depending on what we're doing or how we're feeling.  However, not everyone perceives these changes.  People who are more in tune, for better or worse, with the little twitches and noises our body makes are more likely to feel odd beats or rhythms.

The fact that your ectopic beats are so rare that they haven't been caught on either a 24 hour or 7-day Holter indicates that they aren't very likely to be anything bad.  You appear to be quite young, which again makes serious heart trouble unlikely.

You ask, "How can I tell if my palpitations are dangerous or not?"  Take note of how you feel and function when you're having your funny heartbeats.  Can you do your your normal daily activities like walking, dressing yourself, going up and down stairs, even breaking into a run now and then?  If you can do these things without fainting, nausea, terrible shortness of breath, breaking into the worst, most drenching cold sweat you can imagine, or crushing heart pain, the chances are that what you are experiencing is not dangerous.

One of the markers of an anxious person is that compulsion to put your fingers on your pulse.  If you're not having any of the terrible symptoms I mentioned, counting your pulse is only heightening your anxiety.  It's a nervous tic that gives you no useful information.  

Sure, you can go to another doc and get a 30 day monitor.  It won't hurt.  But if it, like the others, shows nothing significant, what will your response be?

In that case, would you consider getting treatment for your anxiety?

[Will1977]

You know, I never had one single premature beat or anything when they gave me the 24 hour holter. I even had a 3 day and nothing. I have wore a 30 monitor for 90 days and only had pvc and pac's. Now I am on another excursion with the 30 day monitor and have finally caught it and it is SVT, at least that is what one recording has shown. I have sent another recording last night but have not heard back on the results. I hope it is not bad because the rep taking the transmission asked me if I had any symptoms, but she also said she did not need to contact my doctor. So I hope it was more of the same. My point though is that these arrhythmias come and go with no warning and are random. It might take a long while to find them. If you doctor will not oblige you in a 30 monitor simply move on and find another doctor more sympathetic, cause honeslty we all need a doctor to be sympathetic with these things, They are not easy to live and deal with.

[von123678]

Thanks that's very kind and thoughtful of you.
Yes when it feels abnormal its scary no matter what anyone tells you.
My biggest problem is that i'm labelled with the anxiety tag nowand its hard to remove or for anyone to consider i may have anything not anxiety related and the fact i got tests done a few years ago when my pulse was fast and it was anxiety i don't have a hope.
The fact a 24 hr and 7 day monitor have not shown the irregularity i don't think they'll entertain me for a longer one.
I hope to see the doctor tomorrow and convey how desperate and scared i am and that my dad has felt the severe irregularity and that he is experienced with having atrial fibrillation for 20 years.
That all i want is for them to hear,feel or record it at its worst then judge me on that.

I hope I am brave enough to be bold.

Thanks, will let you know how i get on.

Yvonne x