Sudden Onset Of Palpitations

[kovacs]

I'm 53,don't smoke, never drank,no drugs,no coffee.  Had palpitations since  13 years old but rarely. Sometimes on a daily basis and other times with days or weeks of no skips.
About two weeks ago the palpitations started coming in a regular manner at about 3-5 per hour pretty much every hour of the day. This of course was frightening and I worried and became more aware of every skip. By the third day the skips were at every minute with a few doubles/triples ( each with only a few regular beats between them.  I was in terror so I went to the local ER.
They took Xrays,blood work,EKG's a 24hr holter monitor. The ER doc saidthe PACs were frequent with an occassional PVC but  they were probably benign. He suggested I see a Cardiologist as my blood pressure was quite high at 180/100. I have always had white coat hypertension and at home with the nurse neighbor taking it was 145/90.The Cardiologist  reviewed all the tests including more blood work, echocardiogram, his conclusion was  even though I was having lots of skips , the condition was benign and my blood pressure was more of a concern. He recommended Atenolol 50mg and said it should resolve lessen the palps. Fearing  the potential side effects I took half dose first as within 4 hours my bp was at 110/75 with a scary pulse rate of 52-56. My resting rate is usually 62 The pressure and low pulse rate continued all day. I started a advanced excercise diet program about 8 weeks before these palps started and lost 25 lbs. Lots of cardio and weights. The blood work showed slight elevation in magnesium.Scared to death.

[CCF-M.D.-CRC]

Dear kovacs,
Palpitations due to PACs and PVCs are very common and are in general benign.  Beta-blockers such as atenolol are helpful in suppressing these palpitations.  Normal systolic blood pressure (upper number)should be less than 130 and normal heart rate is between 50 and 100 bpm.

[kovacs]

Couldn't finish my original question so I hope the Doc sees this.

1.Could the palpitations be a precursor ( warning me of a heart attack to come shortly) of a heart attack as I had read somewhere else on this site

2. Could the onset and escalating number of PAC's/PVC's be viewed as an ominous sign.

3. Could the diet ( natural, reduction in calories to 1800 a day) to the heavy excercise workout workload ( One & half hour weight training per day, 20-30 min walking on treadmill at 3.5 mph at full 15 degree incline and a 6 mile real bike ride in 20 minutes daily) have caused a sytem overload. Did I throw the heart out of whack. I lost 25 lbs in the 8 weeks before the onset of palps.

4. I was told that a change in the stomach area due to weight loss places the heart in a new and less constricted environment and could be the cause of it trying to reset.

I'm grasping at straws here because I can't seem to accept that they came out of the blue for no reason and remain.

I've had them now almost three weeks without letup.

Can anyone shed some light on this situation. I am getting to the end of my rope. A few skips every minute all day and maybe night time too seems a bit much. In years before, I would go through bad spells lasting a few weeks but nothing like this.

One nurse told me "Welcome to old age"

[ubersax]

Hi,

I've had frequent PACs for about 4 years now (no PVCs, just PACs). They usually only happen a few times during the day, especially during recovery from strenous excersise. I'd normally have a PAC about every 3-10 normal beats for about 5 minutes before they would go away. Sometimes I'll have one out of the blue while reading in bed or something like that. All the docs told me that they were completely harmless and not to worry about them.

I was pretty mellow about the whole thing until I started to have PACs while resting on the climb up the cables on half dome in Yosemite, NP. It was a pretty scary place to be having PACs, being so isolated and on a 45% grade granite slope.  Anyway, I went back down, went back to my doctor and they told me that I could start taking a low dose of a beta-blocker.  They started me on 25mg of Atenolol.  That slowed my heart rate down to about 45-55 bpm and I felt more or less like a sloth.  It did seem to stop the PACs though, but I really didn't feel like exercise. I went back to my doctors and they gave me another prescription for propranolol 10mg, 3 times a day.  I've been on that for about 6 months now and feel great.  The PACs are few and far between, my heart rate is at about 70 bpm, and I feel about as energetic as ever.

To make a long story short, everything that I've been told about PACs/PVCs by my doctors and everything that I've read on this message board has lead me to really BELIEVE that most PACs/PVCs are benign. I know they can be really frightening, but you can cope with it once you accept that they really are harmless (that can take a while and is very tough).

It was really helpful for me to read through this message board and see that there were other people who were feeling the same way I did. I also found that I could deal with them much better if I stopped taking my pulse all of the time. It's very difficult to think that those pauses and thumps in your heart beat are harmless and it sure is terrifying for a while. Lots of people have gone through the same thing you're going through now.  That fact really helped me settle down and to accept that I'd be OK.

If atenolol is making you feel really bad or is causing more palpitations, you might want to think about switching beta-blockers.  That really did the trick for me.

P.S. Hankstar is one of the better informed people who posts here and he's got a lot of good advice.

[kovacs]

Hey, thank both of you for your kind and encouraging words. As I mentioned these skips have bothered me since childhood but in these last three weeks I've had more palps than in all the other years combined.

What scared me was when I read that the palps could be a harbinger or a fore warning of an impending heart attack. I thought that if you had different palpitations than I have perhaps you could have a heart attack if the palps were not addressed. Of course what do I know.

Nevertheless, thank you both for your help and I await the docs comments.

My email is ***@**** if you guys ever come up with anything

[pikamom]

I bet it has something to do with your weight loss/increased exercize. Did you lose the weight very fast? That is hard on your system. Did you use any kind of diet pill including "natural" supplements/energy drinks? These things are known to increase palpitations. Also, just becoming aware of these sensations has got you concerned and even frightened which could be exacerbating your situation. If your cardiologist says they are benign then they probably are. Try to relax...meditation or prayer. Proper exercize, sleep, diet. Plenty of water and avoid things known to cause palpitations including tea/coffe/soda/diet supplements/cough and cold meds. Hope things settle down for you soon.

[kovacs]

Thanks for your comment.

I went on a natural diet as my weight was too high ( New Years Resolution) and lost 25lbs now a few more. No diet supplements just a caloric reduction to about 1800 cals. Drank plenty of water, cut out fast foods and all junk foods such as candy cake etc. Went on a strict regimine of excercise ( had always been quite athletic but let it slip away the past few years). The excercise was easy for me and it progressed to what a few friends and relatives said was to much for my age. Weight training,high rate/max incline treadmill,6 mile brisk bike rides in the evening along with an occassional daily walk or jog. Quite a departure from the relative sedentary lifestyle of just a few months before. Anyhow the palps started a few weeks ago ( even though I've had them on and off for maybe 35-40  yrs but not even close to these numbers of them) slowly increasing till they got very worrisome. Took all the tests but they remain showing no sign of slowing. I almost think that I damaged the heart but the cardiologist doesn't think so.

So here I sit with palps as my constant companion and I wait for what I expect to be a heart attack especially if I start having 4-5-6 not in a row but within a minute or so. This is when you are sure the big one is evident. It doesn't come and you get a reprieve. Its a sick relationship that tires you, consumes you and put a strain on relationships, work and sheer existence.

But we go on, someday we will die but the palps serve as a constant reminder of this mortality.

I was long winded again, sorry, just wanted to thank you for your concern and helpful comments.

***@****

[arthur]

As everyone coming across your post will probably tell you, as long as your doc/cardio finds nothing physically wrong with your heart, these palps are benign.  That is not to say they can be easily ignored.  I went through much the same levels of anxiety.  I would recommend you get hold of as much data and knowledge as possible re. PACs/PVCs and your specific problem; it's the unknown that we fear the most, and once you understand what it is you have, the anxiety should go away.

As an aside, a lot of skips (PACs, PVCs, and other related arrhythmias) are caused by rapidly firing foci (isolated cardiac tissue) that are usually located at or near the pulmonary vein connections to the back of the heart.  With age and with wear and tear, and with changes in physiognomy, their electrical noise may find a way to reach the pacemaker circuitry in the heart.  This happens to lots of people and when it does, no one can explain exactly why, because the knowledge just isn't there yet.

I have PACs at a clip of 0-5 / min every single day.  Some days are better than others (the whole thing only started 2.5 years ago).  I exercise my head off, play competitive sports, and yes, find the skips aggravating when exercising.  They won't kill you, but the anxiety they breed will.  So, get some more info, don't rely on this web site alone, or the Web in general, since there is a lot of misinformation out there.  Talk to a cardio or two and settle on one you can trust.  Things will improve, guaranteed.

[kovacs]

Thank you for your comments and information.

Its the insidious way in which these palps came that is causing me concern. I was hoping that the same way/manner the began perhaps they would diminsh and leave. I'm sure that my heightened awareness causes stress and the stress exacerbates the palpitations. I have difficulty in sleep and not much of an appetite. Just today I gave myself kind of a stress test. 12 minutes on a treadmill at 4.0 mph,  going up 3 degrees of incline every 2 minutes till 15 degrees and then down for the last two minutes. My heart went slowly at about 8 minutes to 125-130 and upon slowin/stopping, within 2 minutes was at 88 then by 5 minutes 80.

The problem was that I experienced the palps not more than at rest but at 125 beats they seemed to be more regular and much harder feeling. The same seems to happen after I eat a meal.

Anyhow, the reason for my makeship stress test was due to something I read at another site which stated that having palps or more of them during exercise is reason for concern of other underlying problems and of course the underlying problem is not addressed.

I should just resolve myself to the fact that I'm getting older and probably can't do near the stuff I did before. I should listen to my wife who echoes what the nurses said " Welcome to old age". I just don't seem ready to lay it down.

When I read what I write it seems its all mr, me and that usually is not who I am.

Thanks again for your support.

[arthur]

I am 54 and play soccer in a 40+ league.  I also play in other leagues with no age limit.  The competition is fierce and I do have problems keeping up with 20-30 year olds. I know someday will come when I cannot play any longer.  That day is not today.

Attitude.

[kovacs]

I too was somewhat of a mans man in bygone years. 7th degree black belt in the martial arts, came in 4th in the Eastern United States Full Contact Karate Championship, held the bench press record for the State of Ohio P.O.,used to run the hundred in 9.75 and could have gotten any College scholarship for football that I wanted. I led an active life since. Don't smoke,don't drink, never took drugs,tried to live life with integrity. My one fault was as I got older,both my wife and I liked to eat a bit much and the weight piled on. We began our diet and exercise program which was showing great promise and bang, the palps sidelined me like nothing I could have ever imagined.

You are right, we can't just roll over and die even though this condition seems more than it is. After all its not a toe or a cold, its the very essence of your life and it reminds you that all is not well. I understand that it is probably a benign condition but its nature tells you that something is out of sync and a problem exists albeit more a bother than a death sentance.

Again thank you all for your wonderful comments and support.

[Mr. Know it all]

Did your diet program include any Ripped fuel or any other diet aids which contain any ephedra?.  Its most likely the weight training which may have caused sweating out the little magnesium you had in your body.  A diet pill is a diuretic and will cause pvc's and deplete magnesium.   I am  a big believer that most pvc's and other skipped beats are directly related to lack of magnesium in the body.  If the pvc's are not related to any other disease states than It can be linked to Magnesium deficency.  Magnesium Glycinate will restore a normal sinus rythem and cure you of musclse cramps, twiches, high blood pressure and dozens of other aliments .
***@****

[rustynail]

You might do well to consider diet. I have found a wide variety of food products impact pvc's. Stimulants are high on the list. Coffee, tea, and chocolate are high on my list. Alcohol is another. If you have unusual episodes consider unusual items in the day's diet. It's not a cure for me, but it helps.

[aquarius]

Hi everybody,
Need advise and your thoughts on it.  I am 25 and i na good health.  About 2 years ago began having rapid heart beat, anxiety, and shortness of breath at times.  Well, Cardiologyst ran all the tests:stressm, Echo, EKG, even cathelisis or something like that.  She found nothing wrong except for a mild form of mitral valve prolapse with very little regurgitation.  She told me not to worry about it .  So, after that I stopped panicing and symptoms pretty much went away.  
However, 6 months later I ahd a really bad stressful time at work and that is when I felt palpitaions and went back to the cardiologyst.  Of course, she said it was probably nothing and prescribed 25 mg of atenolol as necessary.  But these palpitaitons come so unexpectadly and scare me.  Sometimes I have 1 0r 2 a day and some days I have more.  
Mine main question is this.  Recently I noticed that often my palpitations are followed by a rapid heart beat of anywhere between 120-160 which lasts for maybe a minute or more.  I don't know if it is because palpitaions cause my heart to race or if it is because i become anxious and cause it myself.  What do you guys think and does anyone have anything like this?
I am also wearing an event monitor now trying to catch some of these incidents and see what my cardiologist thinks.
Thanks!

[Mr. Know it all]

There is substantial experimental evidence of the vital role of Mg in maintaining cardiovascular integrity and normal function. Large-scale dietary surveys have shown that American diets are usually Mg deficient, inadequately meeting requirements under conditions of growth and development, stress, or disease and drug therapy that cause Mg loss. Mg has long been used for parenteral treatment of convulsions and hypertension of eclampsia, and more recently, as a therapeutic modality in refractory cardiac arrhythmias (although usually as a last resort). Mg has potential value in the management of cardiovascular diseases treated with Mg-wasting drugs that intensify Mg deficiency. Such diseases and treatment also predispose to Cl loss induced metabolic alkalosis, which with Mg deficiency, contribute to refractory cellular K depletion.
The fact that chronic Mg deficiency is silent and difficult to diagnose - serum Mg levels being an unreliable index of the cellular Mg status, has militated against early treatment or supplementation with Mg. Studies should further assess the Mg status in persons with conditions that may cause Mg deficiency or those being treated with Mg- and K-wasting drugs. All of the ions that are lost should be repleted - Mg, K, and Cl (to prevent or correct metabolic alkalosis). It is further proposed that optimal Mg intake throughout life, and especially under conditions of normal anabolism and stress, may reduce the risk of cardiovascular disease, and even of sudden unexpected cardiac death.

[No Bypass / No Stents]

Sometimes I think that this is the arrhythmia forum rather than the heart forum.  The number of messages for arrhythmia problems outweighs all others several times over.

Are the ratio of arrhythmia complaints on this forum representative of the percentage of arrhythmia to all other heart disorders in the general population?  If so, coronary artery disease, although deadly, is much less of a problem in the general population than rhythm problems.

I had a perplexing PAC or PVC problem about a year after having a heart attack, but fortunately I worked through it, and now my heart beat is steady as a rock under even the most adverse conditions.

I really wonder if environmental conditions, both dietary and electromagnetic, might be some of he cause of this epidemic of heart rhythm problems.  I know that we are going through the hight point of a particularly violent sun spot cycle.  Also we have never been bombarded with so much electromagnetic radiation as in the last few years with all of the cell phone towers and other microwave transmitters.  And of course our food supply is as corrupted as the Enron board of directors.

In my case, beta blockers, aggravated the problem rather than helped.  I went off of them against doctors advice and it turned out to be the right move.  

It's amazing, and maybe even criminal, how people really get hosed up by the medical establishment seeking treatment for arrhythmia problems.  Botched ablations leading to pacemakers for 27 year olds.  I think that people should spend a lot more time looking for he environmental, dietary, or physical root cause, before seeking these drastic treatments.

[kovacs]

Thanks for your comments.

I also have the same feelings about the sheer numbers of palpitation sufferers. The medical establishment either doesn't really know what is causing them or views it as another way to develop strategies for masking a " simply benign condition", sometimes in a small percentage with dire circumstances.

Even though in my case I have had palps since childhood ( very few in number) the sudden onset of the escalation in frequency was alarming enough for me to seek medical help. I recieved only reccomendations of medication. Of course all test were performed and a root cause could not be identified.

I suggested the possibilty of my recent diet/exercise/weight loss but the docs just pooh poohed it off. It was the only thing different in my lifestyle.

Anyhow, I would like to hear how many palps you were having and how or why they are now totally resolved.

Also my email is ***@**** if you have the time to respond.

Thanks again

[kovacs]

Tried to go to the website you offered but won't come up.

Tried with aniety as you spelled it and also anxiety no luck.

Is the dash supposed to be there, I tried it both ways with no luck.

Could you give it once more here or email it to me.

Thanks  ( ***@****

Frank

[Sam R]

Your situation sounds similiar to mine. I started having frequent PACs about ten years ago (regardless of sun spots & before cell phones were common).  I had all the tests like everyone else on this forum  &  they all came back ok.  I think the toughest part is accepting that nothing is wrong.  I kept thinking that if everything is normal then why am I having these "skips"?  The anxiety  they create makes it worse.

This is what I think:  Your diet may have something to do with it .  1800 calories sounds kind of low with all the exercise you engage in.  Did you enter a Karen Carpenter lookalike contest?  You may be low on  pottasium as it is depleted with exercise.  However, I wouldn't try supplements.  One potassium tablet equals only 3% of daily requirement so you would have to take 34 tablets  a day! Try bananas, kiwi, oranges, apples etc.  Almost all fruit is high in potassium.

    I have run 17 marathons  and numerous shorter distance races in the 10  years I've had PAC's  and I figured if I was going to have a heart attack it should have happened by now.  If the docs tell you  you're ok,  then relax  and eat tons of fruit!

[kovacs]

Thanks for your interesting comments.

I also feel that there is a nutritional/exercise basis to the palpitations.

In bygone years I was always very athletic so the exercise program came as nothing new. At 1800 calories I felt good and not very hungry. Never did I feel that it was negative and if I would have felt the need to eat more I would have. The electrolyte situation was one I had not addressed as I drank plenty of water but in hindsight due to all the sweating it was probably alarmingly low.

You would think by now the system would have reset and I'd be back to normal.

However in the last 3 weeks I have refrained from almost all the strenous exercise but continued with the diet. The palpitations continue. At this point I find myself in a constant state of alertness and am probably pushing adrenalin into my system 24/7.

I also have noticed that if I can get engrossed into reading, intelligent conversation or an interesting TV program, the palps will decrease but never to the point they were before onset.

The only thing I know for certain is that I know nothing. I don't think the docs know or if they do its easier to alleviate the symptoms by using drugs. They will look no further or simply there is not enough info available on this " benign " condition.

I marvel at how many people suffer from this. It seems countless.

Nevertheless, thank you for your comments as they are comforting and lend another perspective to my search for an answer for at least my case.

[arthur]

The root cause of palps, namely the really "benign" ones like PACs and PVCs, is only beginning to be understood.  I profess no deep secret knowledge, however, I do understand that a skip, a premature depolarization, is simply the early movement of ions through an ion channel or two caused by an external input of ions.  This external input probably comes from one of the infamous foci (usually located at or near the pulmonary vein connection to the heart, but can be located within the heart).  These foci are tiny islands of cardiac tissue that are electrically (ion pumping) active, instead of being structural members of the heart.  We all have these critters, and for many of us, they never get noticed...because they're isolated...however, for reasons not completely known (there are suggested reasons, like "stretch" due to age and/or exercise) their ion pumping activites leach out and reach normal heart ion circuitry and interfere.  

You have to remember, doctors are not scientists.  They are artists saddled with the challenging job of aligning symptoms to possible causes according to well-established correlations.  They tend not to provide a scientific underpinning or speculation as to what an individual is beset with.  The younger doctors, more in touch with medical research, may be a bit more detailed in providing explanations...and that's that.  If you really want to know what is bothering you and why, you need to look it up yourself...and don't rely on the Web!  In my case, it's what I did for about a year to figure out what may be causing my palps and PAF...and then I discussed it with five cardiologists before I settled on an EP (academic researcher) who knew what I knew.

[kovacs]

The comments/information you put forth make a lot of sense and I have seen it elsewhere in my search.

Another theory is that the heart sits supported by other organs and when the placement changes ( In my case, to date losing 35lbs)the heart finds a kind of new home and complains a bit.

Lots of theories, some make more sense than others but nothing definitive.

I tell my family to imagine having a hiccup, not bad, now have up to a hundred an hour pretty much 24/7 and the big picture is more understood.

Anyhow, I thank you for your informative comments. They are reassuring and well recieved.

Email me anytime.

Frank

[pikamom]

I'd be interested to know "where" everyone feels their palpitations. Normally I can't feel my heartbeat at all. When I'm anxious like speaking in a group, I feel it beating hard in my chest and even echo in my head. When I get PVC's I feel them in the hollow of my neck like a flutter and once in a while when they are strong and in runs my lips will feel pressure like the blood supply to my head is cut off. Tachycardia feels fluttery in my chest and lightheaded, like the heartbeat is weak. I first began having PVC's in my middle twenties during a time of stress and mentioned it to my doctor. He wasn't concerned so I just continued my life and when I felt them it wasn't upsetting at all. But now that I've got this tachycardia problem and angina that needs treatment from the cardiologist, I seem really aware of my heartbeats and feel them every day.

[Mr. Know it all]

I come from the school of thought that says, if your at rest. you should not feel your heartbeat.  If you do..its beating too hard.  I think feeling your heartbeat at rest is the result of highblood pressure.  I believe Magnesium suppliments will cure such a condition(assuming its not being caused by another disesase state) and restore the rythem of the heart to normal.
When a doctor is left clueless he resorts to saying your just nervous or its benign

[arthur]

Check your spelling before posting your note...you'll be a lot more believable.