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Palpatations during exercise,Heart Problem? or Vagus Nerve?
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Palpatations during exercise,Heart Problem? or Vagus Nerve?

Hello, my name is Todd, im 24 years old, 6' 195lbs, moderately active for the most part (except for the past 2months due to palpatations)I'm in pretty not GREAT but decent shape. been playing sports since 2002 (football, Track. I play Football for a semi-pro football team and our season usually begins in mid July. Okay, so about a couple months ago (April 1st, 2012), when i was at football practice(A.M. practice), I was doing some light jogging just to warm up. All of a sudden my Heart started Palpatating uncontrollably for like 10-15seconds; It was a normal tachycardia like its supposed to happen when you exert, then THUMP it slows down (1-2 seconds in between beat type feeling). It caught me off guard which made me halt and voluntarily cough. No pain, no dizziness, no numbness, just pure FEAR of DYING! eventually i resumed practice and it happened again after practice/THUMP palpatations again, only this time it was for about a second.
    So later that night i was just laying on my couch just relaxing then FWOOM! palpatating again! felt like a ballon filling with air (3-5secs). I think it's fair to mention that I was thinking incessantly about the occurances from earlier that day in regards to those palpatations, right befeore the last one happened (anxiety?). I decided to go the the ER room and they ran an EKG and doctor perform a stethescope and both ended up completely normal. He wrote it off as possible anxiety and all is ok.
    Then sometime in May when i was playing basketball with my friends I started getting those palpatations again THUMP...I was getting worried so I went to see my PCP and He ran CBC Test, Magnesium, Cholesterol test, Thyroid test. ALL Normal. My cholestereol was: HDL-88, LDL-130, Triglycerides-54.. LDL little high but overall good nontheless. He he performed the stethescope though (june 1st) he did hear a SLIGHT heart murmur but quickly regarded it as my heart being strong (rated it as 1 out of 6). Ive never had a murmur problem so it scared me a little when he told me that, so he had orded me an echocardiogram for me which I just had finished on June 22nd. the results for that came back NORMAL. the Ejection fraction was 60%. and cardiologist told me that I had a SLIGHT thickening veryborderline thickening of my heart muscle but that was because Im an athlete, according to them,(but i havent worked out in 2 months). So I did a holter monitor recently and havent recieved the results back and i also have a stress test coming up aswell. Reason for these tests is because I believe im getting exercise induced palpatations and idk why this could be happening?...any Suggestions to why after all these"normal" tests im having palpataions during exercise? am I in danger? u hear about people dropping dead all the time and it can be alarming! Please, If anyone has any input it would be glady appreciated!
                                                        THANKS!!

P.S. I Have no medical problems as far as STD, Diabetes, anemia. NOTHING lol. except I have been diagnosed with the H. Pylori bacteria in the stomache a month agao and recently finished the 14 day PREVPAC with no major side effects. could H. Plyori be the cause?
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1124887_tn?1313758491
Hi Todd!

I think you can be assured that your heart is healthy, proven by your normal echo (a slightly enlarged left side of the heart is a normal and natural response to exercise and the reason why the resting heart rate is lower in well-conditioned people), and your exercise capacity.

That doesn't rule out that you may have arrhythmias that subjectively may feel like the end of the world. They can happen in everyone; healthy hearts or sick hearts.

I have some questions:

1. Did you have the symptoms during the Holter test?
2. Is your heart rhythm regular or irregular during the events you mention?

It's not possible to suggest what is causing your palpitations. It may be that you get runs of so-called bigeminy, where half the heart beats are ectopic beats, giving a sensation that your heart rate is 50% slower for a short time. It may also be an inappropriate vagus response, as you say, but that's very uncommon during exercise (it's more common after exercise). The Holter test will rule out any dysfunction in the sinus node (the natural "pacemaker"). There is a condition where atrial fibrillation may alternate with bradycardia, but that's very very uncommon.

I think the Holter test (given that you had symptoms) and the stress test will give you the answers you seek. Good luck! :)
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Avatar_m_tn
is_something_wrong,
   Thank you for your respone, it's greatly appreciated.
To answer your first question, I did have a Holter monitor placed on me back in January aswell as a stress test. Both tests came back normal. They only found 1 PAC on the holter test then and was told those were completely normal. The reason for those tests then weren't because of exercised induced palps(I self diagnosed myself lol) but because at the time I was having some moderate palpatations that would speed up and slow down (I can feel it do that). but after those two tests in January, I felt fine up until April when they started interfering with my exercise which never happened. So, here we are today and I still haven't heard back from my 2nd holter test yet, but I do have a stress test later today. hopefully I get answers today.

     It's kind of interesting that you mentioned with a slightly thickened heart comes with a slow heart rate in conditioned athletes, which would explain my resting heart rate at between 51-57 bpm. My blood pressure on avg is around 119/78 during the day, so guess no problems there.
    To answer your second question, it feels no irregular to me, especially noticeable during exercise as I had one last night during football practice when I was running around. itll just involuntarily slow down spontaneously and beat irregulary for a couple seconds, causing me to cough. Again, no pain, no dizziness, just uncomfortableness. Let me ask you this, can anxiety cause all these symptoms that is occuring? I believe I have that because all i've been thinkin about for about 6 months was if I had heart problems...every other day ATLEAST!
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Avatar_m_tn
**excuse me, it DOES feel irregualr to me (typo)**
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Avatar_m_tn
is_something_wrong,
   Thank you for your respone, it's greatly appreciated.
To answer your first question, I did have a Holter monitor placed on me back in January aswell as a stress test. Both tests came back normal. They only found 1 PAC on the holter test then and was told those were completely normal. The reason for those tests then weren't because of exercised induced palps(I self diagnosed myself lol) but because at the time I was having some moderate palpatations that would speed up and slow down (I can feel it do that). but after those two tests in January, I felt fine up until April when they started interfering with my exercise which never happened. So, here we are today and I still haven't heard back from my 2nd holter test yet, but I do have a stress test later today. hopefully I get answers today.

     It's kind of interesting that you mentioned with a slightly thickened heart comes with a slow heart rate in conditioned athletes, which would explain my resting heart rate at between 51-57 bpm. My blood pressure on avg is around 119/78 during the day, so guess no problems there.
    To answer your second question, it feels no irregular to me, especially noticeable during exercise as I had one last night during football practice when I was running around. itll just involuntarily slow down spontaneously and beat irregulary for a couple seconds, causing me to cough. Again, no pain, no dizziness, just uncomfortableness. Let me ask you this, can anxiety cause all these symptoms that is occuring? I believe I have that because all i've been thinkin about for about 6 months was if I had heart problems...every other day ATLEAST! .
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1124887_tn?1313758491
Hi!

What I think is happening, is what I suggested earlier, a so-called run of bigeminy. I would assume that your premature beats are PACs, as they are very common in young men, also during exercise, actually more common in those who exercise a lot. An athletic heart is more vulnerable to atrial arrhythmias, you wouldn't believe how many professional cyclists end up with atrial fibrillation after their career is finished, but that's the extreme version.

Of course I can't diagnose you, as I'm not a doctor, so the best way to find out is to wear a Holter monitor while exercising, or if you could provoke the arrhythmia during a stress test (even better as you will be wearing a full 12 lead EKG).

Your resting heart rate is great, and so is your blood pressure. You already know that your cholesterol is great, but keep in mind that all those tests just imply that you do not have coronary artery disease, which is blocked arteries to your heart. No one would expect that you had this disease at 26 y/o, usually this happens to people 50+ who smoke and have an unhealthy lifestyle. An echo may rule out heart diseases, but arrhythmias can happen in everyone, no matter how perfect the heart is.

It sounds like your doctors are doing a great job. The only thing you need is a certain diagnosis - that is not possible to give without actually seeing the phenomenon.

The fact that you get an urge to cough makes the bigeminy theory more likely, as it's a classic sign of premature beats, by the way.
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Avatar_m_tn
    Oh, ok. So, I would imagaine that on the blood test they use: Platelets-(which is 222), Hematrocit, Troponin levels( tested once when I first thought I had a heart attack back in 2010 with my first real "episode". came back as 0.0) to rule out CAD, correct?
    Next question is can bigeminy turn into something serious? can't believe i've never heard of that. I now only get the palpatations when I exercise recently, EVERYTIME I work my heart up...it just goes from about 135bpm to about 55bpm while im jogging..HATE IT!! it's only been happening since April. I wonder if Anxiety is causing all this.
    
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3868731_tn?1348408647
Do you have gas problem ??
I am also having palpitations... not mostly related to exercise but it comes anytime... i have got all those tests done like you all came normal except the sinus tachycardia. ECG.. echocardio.. lipids.. cholestrol.. all came out normal..
i feel palpitations more often after eating meal.. and i do burp also frequently since like 6months the same time when palpitations started...
only a person having such symptoms can know how depressing it could be at times.. i am 26 yr and have a moderate lifestyle and i have a little belly fat not much though.. 34 waist..
doc has kept me on beta blocker..
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