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Palpiations and Shortness of Breath

I am a 35 yr old male in reasonably good health (Chol is little high at 230). I have had palpitations on and off for about 4 yrs, however, recently they have been worse. Most of my problems occur at night. Ususally right when I am falling to sleep, I sometimes wake up with a "startled" feeling, almost like my heart is beating too hard for me to go to sleep. Its a very uncomfortable feeling, but eventually I can fall asleep. However, recently, I was getting palpitations so bad (very strong beats), that I was awake all night. I went to my Drs and he put me on 25mg of Antelol. It didn't do much. He also had an EKG,ECHO,blood test, and Holter monitor which all came back normal. I am going to get an event monitor soon as well as see my Cardiologist who is booked up until Jan 29th. My biggest problem is that I get SOB not only when I feel my heart pounding during the night, but also during the day (my heart my be pounding as well, but I am less aware of it.

Could anyone tell me what is causing this? Again, I don't necessarily think its the spead of my heartbeats, but the strength of them. The palpitations I can handle, but the shortness of breath is making me nervous.

Thanks in advance!
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Avatar universal
Matty_boston,

Thanks for your inquiry.

Shortness of breath can be caused by many things: heart disease of many types, lung disease, muscular disorders, clotting disorders, anxiety, deconditioning, plus many others!  The number of different specific entities within each of the above categories is too numerous to name.

If indeed the EKG, echo, and holter monitors were all normal; then we have some reassuring information against your heart as the culprit of the shortness of breath -- but we certainly have not ruled it out.  Unfortunately, the internet is not an environment where I'll be able to help you figure out what is the cause of your shortness of breath; this symptom really requires "face time".

Now, palpitations can sometimes give patients the sensation of shortness of breath, particularly if the palpitations are from extra beats.  However, I would have expected that the holter would have shown these extra beats.  This scenario can be difficult to treat, and will require an ongoing dialogue with your doctor.  Some conditions where persons develop the sensation of "hard beats", without extra beats, include: anxiety disorder, hyperthyroidism, pheochromocytoma, alcohol withdrawal, and cocaine use.

Hope that helps.

Helpful - 1
Avatar universal
This is my lucky day.  I just happened to find this site and found out I am not alone.  I think I feel better already!!
I too get palpatations and it is driving me crazy.  I am constantly aware of my heart beating (hard).  I am going tomorrow for a Thallium Stress Test.  My Stress Echo did show something but the Doctor doesn't feel it is causing the palpatations.  Can't imagine having this for the rest of my life.  I already take Atenolol and Diovan HCT.  I wonder about the Diovan..Have a feeling it does not agree with me. Any one ever taken Diovan??  Thanks for any input.
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Avatar universal
I USED TO SIT RUN AROUND WITH MY FINGERS ON MY NECK TAKING MY PULSE IT SEEMED LIKE A HUNDRED TIMES A DAY BECAUSE I THOUGHT MY HEART WAS BEATING WAY TOO FAST. MY PANIC ATTACKS WERE PRETTY SEVERE THEN. I WOULD DEFINATELY GET AN OPINION FROM A CARDIOLOGIST FIRST. MY TEST ALL CAME BACK NORMAL. THE LESS I WORRIED THE BETTER IT SEEM TO GET. I STILL HAVE "EPISODES" BUT THEY SEEM TO BE A LOT LESS FREQUENT AND BROUGHT ON BY STRESS AND ANXIETY.  I WISH YOU THE BEST OF LUCK....DWINE
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I have had a rapid heart rate along with shortness of breath for the past couple of months. I am 31 yrs old and are 24 weeks pregnant.  I have expressed my concerned to my OB the past two visits and he just told me to hold my breath or to strain like I am trying to have a bowel movement.  It kida worries me but I really do not know what to do about it.  I don't know if I am overreacting or if my concerns are warrented. My hear rate is rarely under 120 resting, if I am doing anything I mean anything it is always over 130 and takes hours for it to go down it is never under 100 at anytime.  Do any of ya'll have any ideas or advice? thanks, froggur
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Avatar universal
I am a 20 year old male and have had palpitations most of my life due to the fact I had a tumor in the adrenal gland when I was 8.  But I have been living a very happy life up until several months ago I've become so worried about my heart and health in general.  I have been diagnosed with panic disorder.  I think a lot of us here fail to accept the fact that panic disorder is a real disease because the symptoms feel so real that you think you are going to die.  I myself, have not accepted my diagnosis of panic disorder.  I tell all my doctors there is something physically wrong with me, but all tests come out negative.  Anyhow, my symptoms of my panic attacks seem to be strictly palpitations.  Most of my teenage life I will get strong heart palpitating beats and they will go away the next beat.  But now the palpitations I get are rapid heart beat and that gets me really scared cause I feel my heart is going to be out of control but it goes away in a few minutes.  Xanax seems to help a bit, but like someone else said, I would hate to be on this drug my entire life.  I also get left leg twitches a lot and a bit of left arm twitching.  I got to see my psychiatrist for the first time yesterday and he believes I have an anxiety disorder but also believes I have a pinched nerve.  So I am a bit relieved we have found something.  But like I said guys, try not to worry yourselves to death by looking up stuff on the internet; I still do it too.  Eventually so much anxiety will make you depressed and your symptoms worse.
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Avatar universal
IM NEW TO THIS SITE BUT WHEN I READ YOUR MESSAGE I HAD TO RESPOND. YOU SOUND JUST LIKE I DID. I HAVE HAD PAC'S & PANIC ATTACKS FOR 12 YEARS NOW. I WENT TO A CARDIOLOGIST AND WORE A MONITOR FOR 2 WEEKS. EVERYTIME I RAN TO THE EMERGENCY ROOM WITH SYMPTONS I WOULD RELAX FEELING SAFE TO BE AT THE HOSPITAL AND BY THE TIME THEY CAME IN TO SEE ME I WAS FINE. I WOKE IN THE MIDDLE OF THE NIGHT THINKING I WAS HAVING A HEART ATTACK! I WOULD BREAK OUT IN A COLD SWEAT, COULDNT GET ANY AIR, SHAKING,IRREGULAR HEARTBEATS. IT IS A MISERABLE FEELING. THEY WANTED ME TO START TAKING XANAX. I DIDNT DO IT THOUGH-I DIDNT WANT TO BE DEPENDENT ON ANY MEDICATIONS. I DID HOWEVER START TAKING A BETA-BLOCKER WHICH FOR THE MOST PART CONTROLLED MY PAC'S. I STOPPED TAKING THESE AFTER 2 YEARS AND I CAN SAY NOW THAT THE SITUATION IS BETTER. THE MORE I WORRIED THE WORSE THE SYMPTOMS GOT. EVERTIME I HAD A "PANIC ATTACK" I CALLED MY MOTHER AND SPOKE WITH HER ON THE PHONE UNTIL I HAD RELAXED. BY THE TIME THE CONVERSATION WAS OVER I WAS FINE. IF IT WAS VERY COLD OUTSIDE I WOULD GO OUTSIDE WITHOUT A COAT UNTIL I WOULD START SHIVERING. IT MAY SOUND STRANGE BUT IT REALLY HELPED. I GUESS I THOUGHT MORE ABOUT BEING EXTREMELY COLD THAN WHAT WAS GOING ON IN MY HEAD.AS SOON AS I FELT IT COMING ON I WOULD DO SOMETHING TO TAKE MY MIND OFF OF IT AND THEY STARTED TO GO AWAY. I DO GET THEM EVERY ONCE IN AWHILE WHEN IM VERY STRESSED OUT, BUT I GET UP AND CLEAN THE HOUSE OR PLAY SOME LOUD MUSIC OR WALK.IF YOU WANT TO YOU CAN EMAIL ME AT ***@****   GOOD LUCK  DWINE
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Avatar universal
In reading the above I have noted there has been several mention of GERD/acid reflux along w/shortness of breath.  I have a question as to how many of us that are experiencing the palpatations are also on an Rx for acid refux...  I had NEVER before this past month experienced eposodic palpatations, until I my Rx for Prevacid was increased from 30mg once daily to 30mg twice daily for 12days, then returned to once daily.  By the 3rd day of the once daily 30mg Prevacid I was experiencing the palpatations/shortness of breath and like most of you thought that I was going to die right then and there!  

Called my GP and was put on a holter for the 24 hours and experienced the palpatations while on them.   Talked to my GP about the experience on the Prevacid and questioned if the 30mg was too much and she decreased my Rx to 15mg per day.   I had not taken any Prevacid for over 48 hours and was beginning to feel better palpatation wise, however the reflux acid was up, so after having the new Rx filled took one 15mg of Prevacid.  Within 45 minutes the palpatations were back with a vengance.  

My GP refered me to an Internist who mentioned that only one episode was noted on the Holter of a heart rate incrase to 145bpm... she did not mention the palpatations showing up.  (I was kinda 'scattered' at that appt. and didn't think to ask all the relevant questions.)   I talked to her about the Prevacid and she advised me to quit taking it and manage the reflux w/Pepcid AC or Pepcid Complete over the counter, she advised 1 in AM and 2 in PM.   The package insert says not to take more than 2 in 24 hour period.  For 6 days followed package and did not take more than 2/24 hrs and slowly noticed a decrease of the palpatations.  Today there was increase of acid so I followed the Internists directive that I could take 3/24hrs one in AM and two PM... the palpatations are back along with a feeling of 'distortion of reality'... i.e. like when you have 'medicine head' from taking cold medications... ICKY!

As I had had the palpatations with two different 'type' of acid reducing drugs, I began to do some research on the net and found that Protonix, Prevacid, Prilosec, Nexium and Pepcid all have the advisment in thier package inserts that 'adverse experiences occurring in < 1% of patients' included on average to following: Cardiovascular  System  -angina, arrhythmia,  bradycardia,  cerebrovascular  accident/cerebral  infarction,  hypertension/hypotension,
migraine,  myocardial  infarction,  palpitations,  shock  (circulatory  failure),  syncope,  tachycardia, vasodilation

What is odd is that when I first questioned the my Dr's, both the GP and Internist if the medication was at the root of this they both said absolutely not... that is until I provided them with the literature from the package inserts.   Then they said it was quite possible!

My question is, is there anyone else that is experiencing the palpatations/shortness of breath and are also on RX for proton pump inhibitors or other acid reducers?
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Avatar universal
A5
Hello, my name is Ali and I am 27... this has been going on now for a week. It started as I was falling asleep at night. I would wake up feeling I could not get a good breath. Each night it has gotten worse and now I can't even sleep. I wake up numerous times during the night feeling startled, feeling like I can't breath and that my heart is either going to stop or that my heart is beating too fast. It happens as I am just falling asleep and when I have been sleeping for an hour. I have been waking up though, about every hour with this feeling. I don't even want to go back to sleep at this point. The thing that scares me is that it is happening to me during the day and at night...but it is worse at night. The only way I can describe it is that when something startles you and your body reacts. My chest feels heavy, and I feel as if I can't get a good breath. I have an appointment Friday with my doctor. and I did go to a medical center on monday... that doctor felt I am suffering from panic attacks. Can panic attacks occur like that over and over again? I am scared there is something wrong with my heart. I do have acid reflux and a year ago i had an echocardiogram. about five years ago i had a stress test and wore a holter monitor. all came back normal.  this is just freaking me out because i have never felt this before and it has not stopped for days. some of the things I am feeling sounds similar to other postings. thanks...
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Avatar universal
Message for BGA:

I read your message again, and in particular the bit about pain in between your shoulder blades at the back.  Question: is it a burning pain?

I had exactly (still do have) that problem, and I had it diagnosed.  Let me know the answer to above.

Andy
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Avatar universal
Thanks BGA for your posting which give me hope that we're not alone - I was the one who posted the myoclonic jerk phenomenon.  Like you, I cannot 'nap' like 'normal' people can.  Even if I feel tired in the afternoon at home, as I start to doze off, I get the 'jerk' sensation.  I can't remember ever being able to 'sleep' except at bedtime, and we know how that is !!!

Don't worry about the long term effects of the jerking sensation, I've been told there's no long term damage to the heart.  Have you tried freeing your mind of any anxiety before bed?  Long reading sessions that prepare your body and brain for 'sleep' are helpful, and try not to get to agitated before sleep.

Regards,

Andy
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Avatar universal
BGA
Hi All,

I am F, 31 years old. I get exactly the same thing and thank you to the person who posted the info about the myoclonic jerk, I had not heard about that before. I get my "jerks" both when I nap and go to sleep at night. Sometimes I get so scared I have at times thought I was going to have a heart attack. My biggest fear is that it is doing long term damage to my heart. Does anyone know if this can be the case? I have had EKG's and an Echo with all coming back normal. My Dr. told me I was too anxious about things and there wasn't actually anything wrong with my heart or lungs though. I too get spasms/pain in my chest and back (in between shoulder blades) on a daily basis, and am having pain above my right breast as I type. Again Doc says it's all stress and anxiety (muscular). It's been this way for almost a year now and I'm sort of learning to live with it. My Mom had MVP but Doc says I don't have and have a healthy heart? Thanks to all that post their stories here...it's nice to know I am not alone...
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Avatar universal
Andy,

I haven't taken a nap in a long time, but if I remember correctly, yes I do get them when I take a nap as well.


Please check your email. I have emailed some info.


Take care,

Matt

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Avatar universal
Andy,

Thanks for your reply! I am glad I am not alone. I just wanted to mention that the "startled" feeling I get is NOT the typical startled feeling that everyone else might get when sometimes falling asleep. It is about 10x worse than this. Since I am half asleep, it is hard for me to determine what is going on with my body. I am not sure if its my heart beating too fast or not, or if I stopped breathing or something else.

Anyway, I was wondering, do you get the "normal" startled feeling like everyone else, or is yours different like mine?

Thanks again! Look forward to hearing from you.

Matt

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Avatar universal
Matt,

I forgot to mention.  Do you have the same problem if you decide to take a nap in the daytime?  

Andy
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Avatar universal
Matt,

Like you, I get the 'startled' feeling at least 10 times worse than your average person (who probably hardly realizes the startling in the first place if you know what I mean).  My heart pounds and races very fast and I lie in bed wondering what the heck is going on and how I'm gonna stop this from happening.  So far I've had no success, but It's reassuring to read that others are experienceing exactly what I am!

If you wanna keep in touch you can email me at ***@****

good luck once again.

Andy

PS - the more I think about this condition, the more anxious I become at bedtime, and hence the vicious circle.  :)
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Avatar universal
Matt,

I think your problem originates from a state of [unconscious] anxiety.  You may not think you suffer from anxiety, but deep down you may well do.  I suffer from EXACTLY the same symptomps you describe, and have done for many years.  I've accepted that I'm an anxious person, which is a major contributory factor to the pounding heartbeat just as I'm drifting off to sleep.  I've had all the usual heart tests, including 24-hour monitor, but nothing significant showed up.  I am very fit for my age (40), and I go to the gym 3 or 4 nights a week.  One of the causes of palpitations is heavy exercise near to bed time.  When I exercise, my palpitations are much worse as I go to sleep.  One thing you might want to look at is the term 'hypnic' 'hypnagogic', or even 'myoclonic' jerk.  Do a search in Google and you will be inundated with information on this unusual phenomenon.  Basically, some people believe that as you are about to fall asleep, your brain thinks that you are about to stop breathing, thus it sends a signal to your body to 'jerk' you awake, with the resultant pounding of the heart and other symptoms that follow.  Any way, I've searched hundreds of sites in search for an answer to the frustrating, and often very frightening episodes of sleep jerk/heart pounding.

Good luck, and try not to worry about this benign condition.

Regards,

Andy
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Avatar universal
This is an observation in regards to shortness of breath. I have been prescribed to take niaspan 1500 Mg per day. I have noticed that when I walk a certain distance or moderate activity I experince shortness of breath.  was wodering that  if someone has been experiencing the same? if so, please post your comments.

Thank you.

E.A.
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Avatar universal
Dear friend,
I'm not a Dr., but, for an adult the normal heart rate, in rest (physycal and emotional), is from 60-100 bpm. Some people that are very conditioned, like athlets, could have heart rates about 50 bpm without any pathology.
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Avatar universal
hi, how fast should a heart beat per minute?

is 97+ bpm fasT? or normal?
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You might want to check out the following website, it gives some information on what causes palpitations such as yours.http://www.etenet.com/Apps/Library/Corporate.asp?ID=394
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Avatar universal
hi.  I'm a 17 year old male, and I think I may be having palpitations.  Sometimes it feels like there's a burst of adrenaline and my heart beats faster.  It usually doesn't last for very long.  Its just that since I've been having them ( off and on for a couple months ) I've become very aware (uncomfortably aware) of my heartbeat and its getting to the point that I sometimes I can't concentrate.  anytime I'm lying down all I can hear/think about is my heart beat.  
also, sometimes I feel a sort of muscle contraction in the heart area. Sort of like a muscle twitch that you'd feel in you arm or something. I can't tell if just the muscle in my chest or if its my heart. Am I just paranoid or are these legitimate concerns?
any advice would be appreciated.
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Avatar universal
Hi,

I am a 17 yr old male. kinda young huh?

i sometimes experience palpitation when i bend down or during sleep at night. is it a serious problem? please assist.

after i recover from palpitations . * few days later, i feel tired easily. sometimes when i just wokeup, roughly 2hrs later i feel slightly giddy and weak. please assist.
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Avatar universal
Palpitations can be worrisome.  I have learned recently that if you are of thin build, you are more prone to having palpitations.  If they last just a short time, they probably are not of great concern.  
If you are becoming fatigued and weak you may be anemic.
I had requested a Holter monitor to check the function of my heart.  
I would recommend you have a blood test to check your hemoglobin and if you have regular palpitations, ask for a Holter monitor.  They strap it on you for 24 - 48 hours and it records your heart rythm.
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Avatar universal
I am having the same forceful heartbeat late at night and in the early morning hours.  It startles me awake and is very uncomfortable. It does subside sometimes after a half an hour, sometimes longer.
I have been diagnosed with hyper-dynamic circulation disorder and was told that is was basically a benign condition.  If it got worse to take Atenelol.
Well, it sure did get worse and I ended up in the hospital with a cardiac episode. My troponin levels 10 hours after the incident were at .9.  Normal levels are .03 to .04.
I was put on a cardiac protocol for the next 2 days and complete bed rest.  I just turned 40 and am being told by doctors and nurses that I am too young to be having these kind of heart problems.
You know your body best and if you suspect something is not right, keep searching for answers until you get them.
Don't always take the word of the cardiologist, they are only human after all and make mistakes.
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