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Throat sensation, heart rhythm related?
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Throat sensation, heart rhythm related?

Sir,

Male, 30, healthy lifestyle, chol. 4 mmol/l, BP 105/60, suffering from occational palpitations and anxiety.

Done the following tests: EKG stress test two times, echo two times, heart CT, a number of resting EKGs (one of them attached to my Medhelp profile) and 24 hour Holter, thyroid tests, electrolyte tests and blood count, all revealing excellent results. Good exercise capacity, completely normal EKG both during rest and exercise, appropriate blood pressure response to exercise and  completely normal heart with good contractility and relaxation on echo. Holter revealed a few PACs, no significant tachy, brady, PVC or pauses.

Non smoker, no stimulants.

Medications: 25-50 mg Metoprolol/day for PACs and sinus tachycardia.

Did possibly have a short event of SVT during a panic attack in 2010, 5-10 seconds, not confirmed on EKG.

Now I am experiencing a new symptom, which is occurring more often if I am anxious, but it may happen without anxiety. I get a brief sensation in my throat, it may feel like a pressure in the throat, lasting 5-6 seconds, or it may feel like a tickling or fluttering sensation with the same duration, or just like a short pressure from below. Sometimes I just feel my normal heart rhythm in the throat very well. All those sensations happen more often if I sit leaning forwards.

It tends to stop before I am able to check the pulse, but the times I have felt something almost similar (not sure about this) while checking the pulse, it feels more or less normal, but I can not say this for sure (if the event I picked up felt completely similar). Sometimes it feels like air moving around in the esophagus, but I am not sure.

I am very familiar with the various sensation of PACs (also the early PACs pumping beating towards closed mitral valve) but the sensation is not similar. No other symptoms.

Could this be an arrhythmia?
If not, what could it be?
Can someone have brief SVT without reentry pathways in the heart?

Thank you in advance.
Related Discussions
1766438_tn?1314117212
Dear is_something_wrong ,

Thank you for posting your query.

I have gone through your history and attached reports.  Arrhythmias do cause lot of anxiety and panic in almost every individual. After having being involved with many such patients, I understand your concern and anxiety. I shall try my best to allay your fears.

As per your history, I don’t think that your symptoms are related to an arrhythmia or any other heart ailments.

Though heart rhythm disturbances can occasionally produce symptoms similar to yours, the fact that you do not have associated palpitations and you’ve felt your pulse at normal rate and rhythm makes this possibility extremely unlikely.

Your symptoms could be due to gastroesophageal reflux disease (GERD) or reflux oesophagitis or globus hystericus.

GERD can typically cause reflux of food, a persistent trickle down the throat, a burning sensation in the throat amongst other symptoms.  Reflux oesophagitis is a condition where the oesophagus is inflamed due to the reflux caused by GERD.

Globus hystericus is a condition where the patient feels a lump in the back of the throat without there being an actual disturbance.

These conditions can be ruled out once you have been evaluated by a physician.

I would suggest that you see your physician or an ENT surgeon who after a detailed evaluation may be able to narrow down the possibilities.

Supraventricular tachycardias can occur even in the absence of re-entry pathways in the heart.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Prabhakar C Koregol
2 Comments
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1124887_tn?1313758491
Dear Doctor,

Thank you for your reply.

I examined my heart rate while noticing weird sensations in the throat, and I was able to "catch" an event where I was sure I had an arrhythmia. I am no stranger to PACs, but this felt different. I felt a "thump" in my chest or throat, which I would assume was a PAC, but the heart rhythm felt steady and regular. The sensation happened just when the normal beat happened, and that made me even more confused.

I cannot explain this, it could possibly be an interpolated PVC, but I would not think that should cause the next normal beat to feel weird? (I am somewhat afraid of this phenomenon because I understand it is a sign of an "early" PVC, in other words risk of R on T, though my cardiologist told me this is something I should forget). Could it instead be a fusion beat causing this sensation?

Or could this also be completely non-cardiac related?

As this often happens before sleep, it is a bit uncomfortable.

Best regards.
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