heart palpitations for a week so far

[Dave2436]

Last July I had an episode that I thought was a heart attack. I was just finishing a shower and got hot and flushed, sweaty, a fast pulse and dizzy with extreme weakness. It was a horrible experience but after about 5 minutes it started going away. My wife, who is an RN, said it was probably anxiety since I was extremely stressed out. She gave me a Xanax and I felt better. I made an appointment to see a cardiologist the next day and he ordered a stress test EKG, an echocardiogram, Doppler ultrasound of the carotids, and a holter monitor for 24 hours, along with ordering blood work. Everything apparently came out normal, with the exception of the blood work, which showed slightly elevated AST (47) and ALT (69). Five previous blood tests dating back to 1997 all averaged 24 for both AST and ALT. The doctor prescribed Xanax and suggested that I start taking a blood pressure med, which I have not done since I am borderline with a BP of about 128/79. About a week ago I was again stressed out and felt a tight band around my chest, which is the usual way I feel when stressed out, and it went away the next day. The following day I started getting heart palpitations, on average of a few per minute. It's been a week now and they are still happening but seem to have slowed down a bit. I rode my recumbent exercise bike for half an hour and feel good while exercising. I'm wondering if these palpitations are a result of stress and if so, how can I get them to stop. If not, what could be causing them and more importantly, should I go back and see the cardiologist for a follow up? I am a 57 year old male with no significant medical history. My parents are still around and doing fine in their 80's, and my siblings are also healthy. Thanks in advance for any comments.

[david2951]

  From one Dave to another, it sounds like you are doing much better so that's great! I would also point out that if your palpitations were going away during exercise that's a really good sign, because a lot of benign arrhythmias tend to naturally phase out when the heart rate goes up during exercise. All the more evidence that what you had was probably just stress and caffeine messing with your heart rhythm

[Dave2436]

Thanks for taking the time to reply. I went to see my cardiologist and he said there was nothing to be concerned about. The timing couldn't have been worse though. By the time I made the appointment, the heart palpitations had started becoming less frequent and had stopped completely two days before the appointment. I explained how I had been drinking Columbian coffee for two weeks prior to the start of the palpitations and he said he was sure that was the cause, and that it took a couple of weeks for my body to rid itself of the caffeine. It's been a couple of weeks not and no more palpitations. I am very relieved.

[MichelleP_3811]

I would say to go and get a check up but it sounds like you already have which shows your heart is structurally doing good so what you are feeling is likely stress and adrenaline related.  The shower incidence could actually have been a case of a drop in blood pressure.  When you take a hot shower your blood vessels dialate or something and it causes our bp to drop a bit and when that happens our heart rate can rise to compensate.  Your extreme reaction may be that you had a bit of dehydration going on as well.  So if it happens again simply make sure to rest and drink a lot of water and it should pass but obviously if it doesn't then seek medical help.  As for the palpitations, not sure if you mean pacs or pvcs (extra/skipping beats) or if you are having a fast beat.  The only way to know for sure is to get them captured on a heart monitor. I would contact the doctor who did your tests and let them know what you are feeling and see what they have to say, especially if you haven't discussed this with them. They may already have captured a few on your ekg but if not and if they are daily a 24 hour monitor is your best bet to find out what they are and how many you are having.  That said, in a healthy heart, it is likely what you are experiencing is benign.  A doctor really needs to make that ruling but chances are if you work to manage your stress your symptoms will subside. Also, if I push myself in my workouts I can get more pvcs and pacs so just try to make sure you aren't pushing yourself too hard and see if that helps the palpitations.  Take care and keep us posted on how you are doing.