sharp painful heartbeats in throat?

Hello,

I'm a 24 year old male, my bmi is 22, I'm an ex smoker (8 packet years) and I have no family history of sudden cardiac death. I have a non immediate family history of afib and coronary artery disease (all affected were smokers or heavy drinkers, which happened at a late age). I have a panic disorder and obsessive compulsive disorder. I've had the following tests within the last 12 months:

stress test with a result of 11 mets

unremarkable echocardiography

numerous ecg's nil changes except for early repolarization

normal cholesterol

blood pressure between 90/60 and 120/80

holter monitor with isolated atrial and ventricular ectopic beats

numerous chest X rays

3 week event monitor with one recorded run of presumably SVT or sinus tachycardia at 190bpm

negative electrophysiology study at multiple sites with programmed ventricular stimulation at up to 3 extrastimuli
at the right ventricular apex

negative Felcainide challenge

and I am due for a table tilt test and possible magnetic resonance coronary angiography soon

My question is, I've been experiencing a painful heart beat when I engage in strenuous activity after drinking at times, I have no idea what this is. After all these tests, I'm not sure what to make of it. (these tests where done for palpitations and presyncope). I was fairly thorough in getting a full work up in order to figure out what was the cause of the palpitations, but I've been left with "it's most possibly SVT and panic attacks, no need to worry". I'm tired of worrying about heart issues, and hope someone can explain to me why it is I would get a sharp painful heart beat in my throat after drinking alcohol and exercising, any help would be highly appreciated.

[cardioid]

I thought I might add, that this was only happening when I would lay down. It wouldn't be nearly as bad standing up, and today it would happen when I run, but only when I breathe in and no where near as bad. Sorry about all the confusing and vague descriptions of the symptoms.

[michellepetkus]

I am a bit unclear if this is a continuous painful heart beat or if you are feeling isolated painful beats?  Have you discussed this with your doctor?  I would bring it up with them for sure but it sounds a bit like you are having some pacs or pvcs possibly triggered by stomach issues and adrenaline.  They are very common and not a concern in an otherwise healthy heart which is sounds like yours is.  Pvcs and pacs are quite common, it is believed that most will get them at some point in their life though most will never feel them.  I personally have pvcs and pacs myself and every so often sometimes they hurt in a few spots.  I have them most everyday but they don't always hurt so I am not sure why they sometimes do and sometimes don't.  It also sounds like you had an ep study done but they were unable to trigger your svt.  It could be that you are still too young for it to have fully developed.  I had an svt my whole life, avnrt, but it was very rare until my 40s when it decided to step it up.  But in general so long as you manage your episodes when your heart gets up to 190 a rapid heart beat/tachycardia isn't a threat to an otherwise healthy heart.  So I would say keep an eye on it and revisit your doctor if the episodes become more frequent or start to cause troubling symptoms but I would give them a call about your painful beats just to see what they have to say though it sounds like you don't have too much to be concerned about but only a doctor can say for sure so why not ask.  But regardless hopefully whatever it is will settle down and the painful beats will stop.  Take care and keep us posted on how you are doing.

[cardioid]

Thanks for the reply, I've spoken to the doctors since, and they don't think it's of any concern.

Thanks again.