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Hearth rhythm problem when resting

Hi! I am 27 year old male. In good health, no prior history of any medical problems, normal height/weight. Couple weeks ago I started noticing that when I lay down and I am on my side (either side) sometimes I feel an extra beat in my heart (i don't feel my heart beating other than once in a while all of a sudden i feel a heart beat that seems to be "out of place". Usually if I turn and lay on my back or just get up and walk around it goes away. I don't feel anything throughout the day; it happens at night when I go to bed, and sometimes when I wake up in the morning.
I do have a pretty stressful job so I am not sure if this is a contributing factor.
Any ways I can try to minimize it naturally before going to a doctor and starting some kind of medication? Could regular exercise help minimize those episodes. It really bothers me when I feel the first one and then I feel like it gets worse cause I start worrying about it.
Any feedback would be greatly appreciated.
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4610897 tn?1393869202

Thank you for your question.

The symptoms you are describing are called palpitations, which are unpleasant sensations of a forceful or noticeable heartbeat. It is not uncommon for patients to notice them before bed, because they have “tuned out” distracting stimuli in everyday life.

This is a very common office complaint that brings patients in to seek care.  The goal of evaluating this complaint is to capture your heart’s electrical rhythm on an electrocardiogram tracing at the time you are having the symptoms. An ECG in the office is the first test, but will not usually diagnose what is going on unless a patient is having those symptoms precisely during the 6 seconds the patient is hooked up to the ECG machine. Therefore, this is best evaluated with an ECG monitor that is worn for 24 hours up to 4 weeks (depending on how frequent the symptoms are), which monitors the electrocardiogram/heart’s electrical rhythm for 24 hours. It is called a Holter monitor or an Event monitor. With an event monitor, a patient can record when they are having the symptoms, and the physician can interpret the ECG at that precise time. It can lead to the diagnosis of a dangerous electrical rhythm that could be potentially harmful or signals the presence of heart disease, a benign condition like premature ventricular contractions (PCV’s) or premature atrial contractions (PAC’s) that can be treated with a medication like a beta-blocker, or a normal electrical rhythm. In the latter case, you can rest assured knowing the symptoms are not due to your heart.

Without a diagnosis, it is impossible to offer treatment. However, in general, I tell to prevents patients with palpitations to avoid caffeine/stimulants, sleep deprivation, and avoid excessive alcohol consumption.

-Dr. S
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