Low pulse and palpitations

[stormchaser1980]

Hi,

I'm a 30 year old female and for the last 6 months or so I've been having palpitations. When the palpitations occur my pulse is between 57 and 71, sometimes the feeling is like a flopping feeling in my chest and sometimes it feels as though my heart is pounding, occasionally with a slight sharp pain.

I went to the Dr's and asked to be tested for hypothyroidism as I also had the majority of the symptoms and the tests all came back fine, I was also tested for diabetes, cholesterol levels and many other things which also came back normal. I had an ECG but as I had been rushing about and was stressed about visiting the hospital my pulse was about 120 (the usual for when I have exercised) so it didn't really help at all and the Dr presumed this was my usual pulse even though I explained it wasn't.

He has suggested putting me on Beta Blockers which I'm wary of taking, when I questioned why I was being prescribed something that will lower my pulse further I was told it was because palpitations mean I had a high heart rate (which I have explained several times I don't have) and that it would be fine for me to take them.

I'm currently quite over weight and don't do all that much exercise so this isn't linked to being fit and healthy. When I lose weight my pulse and bp go down.

I have had the pounding feeling for about an hour now, my pulse is currently 67 and my bp is 112 over 70. This feeling happens at various times throughout the day, usually while sitting or laying.

I'm not stressed, don't drink or smoke, I have 1 latte most days and usually drink water, skimmed milk, fruit juice or herbal tea the rest of the time.

Is there anything you can suggest that may be causing this feeling or anything else I can ask to be tested for?

Thanks in advance for any help.

[LivingInHope]

So you did have an EKG and may want to ask about an event holter monitor  so you can hopefully find out what's happening with the heart beat when you are actually feeling the palpitations and flip-flopping and an echocardiogram to check the valves and heart structure.  Mentioning to the doctor you go to next time how long ago it had been prior to these concerning symptoms that you had seen a doctor will be a helpful hint to that doctor that you are not a hypochondriac.  When you were tested for hypthyroidism, did they test only TSH, or did they run free T3 and free T4 also?

  Your orthostatic blood pressures and pulses look like you do not have orthostatic intolerance.  

  While normal resting heart rate is considered to be 60-100, athletes might normally run lower than that, because they are in condition.  But a non-athlete female's heart rate I believe typically runs a little faster than a non-athlete male's heart rate (least they used to think in babies female hearts faster than males typical).  And since you are not an athlete, when your heart is dipping below sixty, that is a bit slow.  

If you were feeling chest pains when you were laying flat and all heart tests come back normal, you might consider looking into whether you have acid reflux and if that could be esophageal spasms.  Esophageal spasms can feel like it's a heart problem.  

[stormchaser1980]

Thanks for the replies LivingInHope and baldie453.

LivingInHope - The test I had was the one with the 12 sticky pads on my chest and various other areas and then it did like a 10 second print out of my heart rhythm, I'm not sure which test that is - I thought the referral form had said ECG but I'm not sure.

I did say to them at the time that I thought that test was pointless, I had rushed from the doctors office to catch a bus to the hospital and then had walked about a mile to get to where I needed to be and then had the test straight away with no period of resting and the nurse that took the reading said that my heart rate was high and redid the test to 'get a better result' whatever that meant!

I did the orthostatic blood pressures and pulses as you suggested, bp after laying was 111/67 and pulse was 76 - the whole time it felt like my heart was pounding and going to tear through my chest! BP after standing for a few minutes was 113/74 and pulse was 76, pounding feeling wasn't so bad standing up. 76 is strangely high for me, especially since I haven't been all that active with it being a Sunday morning.

You mentioned 'The fact you're de-conditioned could potentially affect the heart racing more easily upon exertion', when I exercise it doesn't actually feel that bad, the problem is actually while resting - either sitting or laying (such as while laying flat for that test).

I will arrange an appointment with my doctor for when I'm next off of work and ask him about the tests you mentioned.

baldie453 - I agree with you about the beta-blocker compounding my low heart rate and still haven't started taking them for that reason.

I'm in the UK so unfortunately with our healthcare being free they aren't all that keen on referring you for tests and wouldn't make a cardiology referral without finding a problem first which is a pain.

Thank you for your suggestion of Magnesium Chloride, I have just Googled and found that Magnesium is available in our local health store and it mentions 'Magnesium is also necessary for muscle function (including function of heart muscle)', I do take multivitamins already that contain 100.0mg (33% rda) of Magnesium so perhaps increasing my intake may be helpful.

I'm still not 100% convinced about the test results coming back normal for hypothyroidism, especially since low heart rate is a symptom, so I'm continuing to increase my iodine intake and cutting out goitrogens as well.

Unfortunately, I think my doctor was led by my mentioning that my gran had been taking beta-blockers and I think they were prescribed to get rid of me rather than sending me for more tests. I asked if there was anything else he could test me for as something was clearly causing so many symptoms and he said no! This is the 1st time I've been to the doctors in about 10 years so I'm hardly an hypercondriac so I can't really understand the attitude.

[baldie453]

I have had palpitations/irregular heartbeat for years and I was put on a beta-blocker and was on it for many years. My heart rate became very low. I do excercise daily(walking), but not any real cardio workouts, etc. I had to have a treadmill stress test last month and my cardiologist commented on my low heart rate, when I saw him prior to the stress test. Over a few weeks time he lowered my beta-blocker dose to 1/4 of what it had been. When I had the stress test he could not get my heart up to the target rate and told me to discontinue the beta-blocker altogether. My heart rate is finally getting back up to normal rates, both at rest and while exercising.

I would seek further testing, etc., as a beta-blocker, in my opinion, would only compound your low heart rate issue. I am not a Dr. and would suggest that you see your primary or get a refferal to a cardiologist, if your insurance requires that you get one.

I have been taking Magnesium Chloride(Mag 64), for about 6 or 7 years, at my cardiologists reccomendation, to help with irregular heartbeat/palpitaions. It does seem to help, but does not totally eliminate the issue. You may want to ask your Dr. about this. Just a suggestion.

I hope some of this is helpful and I wish you good luck.

[LivingInHope]

I take it you meant you had an EKG, since you mentioned your heart rate rather than the structures of your heart?  With the flip flops and chest pain, the doctor should have also ordered an ECG- echocardiogram- to look at your valves, and anatomical structures in the heart.  If you feel the pain with exertion, you might ask the doctor if a nuclear medicine stress test would be in order.  

Since you normally have low blood pressure and your heart rate went up to 120 with some excitement and you said it gets that way with exercise, I do wonder whether or not you might have an orthostatic intolerance problem.  Might I suggest you do orthostatic blood pressures and pulses?  You would take a home blood pressure monitor, lay down for 10 minutes, take your blood pressure and pulse.  Then, stand up for at least one to two minutes, and take them again.  What do you get?  

The fact you're de-conditioned could potentially affect the heart racing more easily upon exertion.  With the flip-flopping & palpitation feelings & flux in your heart rate- you might also ask the doctor about an event holter monitor to see what kind of fluctuations you are getting throughout a day, instead of the very abbreviated EKG test, which they do while you're resting for oh, so short of time.