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Undiagnosed chest tremor and heart palpitations
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Undiagnosed chest tremor and heart palpitations

In April I started waking up around 3am with what felt like adrenaline rushes.  My heart was beating harder and faster (125 beats/min) and lasted about 20 to 30 min and ended with headache.  I had a few of these until I finally got up.  This happened only when I exercised regularly during the day.  If I stopped exercising for a few days it went away.

The surges disappeared and were replaced by a tremor primarily in my chest.  The tremor is high frequency (described by my mom like I have a hummingbird in my chest) and can primarily be felt by others over my heart thought I can feel it throughout my chest and shoulders.  Often my hands tingle too.  When the tremor is strongest in the middle of the night, I am thirsty and I urinate a lot.  Checked my blood glucose and it's in the 80's or 90's. In the day, the tremor disappears immediately after exercise, but reappears a few hours later and I vibrate through the night.  The more I exercise, the stronger the symptoms become over a period of days.  I can often feel my heart beating but the beat seems regular (no arythmias) and not faster than normal.  If I let the tremor continue for 12 hours or so I end up with a headache.  Propranolol  kills the tremor.  Xanex doesn't help much.  My mood doesn't seem to affect it.  Stressful events don't seem to trigger the tremor yet it can be present when I feel calm or happy.  When I stop exercising for a few days the tremor seems to grow much weaker.

I was tested for pheochromocytoma (24 hour urine) during a period when the tremor was strong and the test came out negative.   I tremored for at least 10 of the 24 hours.  A variety of other things including thryoid and cortisol levels were tested when I was not symptomatic.  I also had hormone tests to see if it could be perimenopause but all hormone levels were normal.  An echocardiogram in April was normal.  I've asked for an MRI of my head but the doctor  refused saying there's no indication that its necessary.  Any ideas?
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I agree with the tests thus far, and the echocardiogram is a good initial test to exclude heart disease.

If palpitations, or an abnormal heart rhythm, is suspected, then a 24-hr Holter monitor or cardiac event monitor can be considered.  This can determine whether there is a heart rhythm abnormality that requires further cardiac referral.

A stress test, as suggested in the comments, should be considered as well.

These tests can be discussed with your cardiologist.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd
4 Comments
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Avatar_m_tn
Very weird symptoms.  Personally, I would stop exercisingsince it triggers the symptoms.  Have you tried to get a stress test done?    This is where you run on a treadmill while being wired and monitored.  I would get your doctor to order you that test.  If he refuses, immediately switch to a new doctor.  You do not want to ignore this issue; you don't want to ignore anything heart related.
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Avatar_f_tn
Hi! I have had similar issue for 3 years now... still no answers. I have had MRI's, CT's , kidney tests, ect... nothing found except a cardiac arrythmia ( now on atenolol) which suddenly came from nowhere after a very healthy life til now.
Good luck to you... if you find anything please let me know. I would love to hear your story and outcome, so please share. Thanks and best wishes in healing to you.
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188508_tn?1210551706
I had similar problems. Mine was caused by sleep apnea. If you snore then you should ask for a sleep study. When you stop breathing your brain sends adrenaline to wake you up, thus the rapid heartrate.Hope this helps.
Nuch
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