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679466 tn?1247006054

Pounding or Forceful Heartbeat

For about 2 years I've noticed a more forceful than normal heartbeat.  It is NOT fast, or irregular - just stronger than normal. (Docs call this positive inotropy)  I have a good cardiologist but he is now scratching his head.  I've had an ECG, ultrasound, holter monitor, 2 weeks "King of Hearts" monitor, sleep apnea work up and sleep study, thyroid and parathyroid work up, also tests for adrenal tumor. (blood and urine catacholamines).  I have even had the new cardiac CT scan and have a Ca score of zero! ALL NORMAL.

The symptom is more noticeable lying down (many rhythm issues are), does not change with exercise.  Never any chest pain, or any other symptoms of cardiac problems.  I do take Atenolol (50 mg in the AM) and that helps.  (if I skip the dose the beat is much more noticeable and strong).  I have moderately elevated BP but controlled with medications.  

ideas?  tests I should pursue?  
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679466 tn?1247006054
Thanks to you both.  I am not overweight (6'1" and 190 pounds) and have been in good shape all my life.  Because of back problems I have let the exercise slip lately.  However, when I do exercise (30 min on bike and weights) the heart symptoms do NOT increase.  Still feel the strong beat but no pain, no Extra strength or rate in beat.  

Beginning to wonder about an electrical or bio-chemical problem.  COULD THIS BE 'NORMAL'?  Could it be that some people simply feel their beat more?  As you said, perhaps we are "more aware" of our heart beat.  

I'm ready to find an answer and either quite worrying or treat it.  

I tried the Pay To Post question to Cardiologists here, but it did not work.  
Helpful - 0
Avatar universal
My heart pounds quite often without a clear underlying explanation.  Alcohol is an occasional noticeable contributor for me but not a necessary element.  Are you overweight by any chance?  Is your heart the higher end of normal in terms of size?  I got a copy of my cardiac MRI and, with my heart being high end of normal, I noticed that my heart appears a little crammed in there (moreso than the other mri's I found on line), -the front of the heart is right up against my ribs, back of the heart is right up agaisnt the vertebra - basically it seems clear that someone with a sensitive nervous system might notice reverberations as all that tissue shifts and rubs.  At times when I sit still you can see the ribs on my left side over my heart vibrate with the heartbeat.  I also know from testing that my lung's are significantly larger than normal and my stomach (at endoscopy) was viewed as having an "odd" (according to doc) twisting shape with the pictures showing that my stomach arches up on the left side of my chest (coincidentally or not, large meals often GREATLY enhance my cardiac awareness).  Also, when I try to sleep (regardless of empty/full stomach etc) I can easily count each heartbeat instead of counting sheep - this is especially pronounced if I try to sleep with my chest on the mattress instead of sleeping on my back.  So, at least in my case, I feel like my chest and abdomen are pretty packed in which likely exacerbates, or is the cause of, my "unusual" cardiac awareness.  At times it makes me a little crazy but I do my best.  Other than losing weight (I could stand to lose 50 pounds) I'm not sure there's much to be done.  

PS - I do have occasional PVCs, PACs and GERD but my heart is considered normal and healthy according to US standards (multiple echos, cardiac mri, nuclear stress test, stress test, holter etc).  I'm 30 and male.  

Good luck!
Helpful - 0
Avatar universal
I HAVE HAD FORCEFULL BEATS FOR 14 YEARS  SINCE I WAS 50 YRS OLD.  MOSTLY AT NIGHT WHILE TRYING TO SLEEP AND LOST MANY NIGHTS OF GOOD SLEEP ONLY TO HAVE THE "SPECIALIST TELL ME NOTHING NEW OR OFFER ANY SOLUTIONS.. I AM ON   TAMBACOR, LOPRESSOR, AND NORVASC..GENERICS.........DOCTOR DOES NOT SEEM ALARMED...???  GOOD LUCK
Helpful - 0
679466 tn?1247006054
thanks.  so far all my monitors, ECG's, over night and even two week ECG's show no PVC's.  I do know that an occasional PVC is "normal".  wish that is what this was.  I'm thinking this is a chemical (ion) problem, either imbalance or something else.  

thanks for the note.  
Helpful - 0
Avatar universal
this sounds like what I experience on occasion.  They ususally are PACs or PVCs.  ANd they are usually benign.  You can read alot about them on this forum.  They are scary I have to admit.
Helpful - 0
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