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Is this an arrythmia?
I am 20 years old, male, caucasian, I have no family history of any heart problems, 3 great grandparents still alive and in their 90s (maternal side), and two grandparents dead from cancer (in their 70s). I smoked for a little over a year, I quit a month and a half ago.
A month and a half ago I began experiencing chest pains and shortness of breath. The chest pains sometimes hurt worse when inhaling deeply. My doctor listened to my lungs with a stethoscope and informed me I had bronchitis (I had no cough, I know that's typical with bronchitis so I don't know if it's possible to have bronchitis and not cough at all). He ordered a chest x-ray, blood tests, and prescribed Amoxicillin/Clav and nebulizer treatments 4x day with Albuterol + Ipratropium bromide. When I returned 10 days later, my shortness of breath was much better, but I still had the occasional chest pain. He said the x-ray showed "borderline hyperinflation of the lungs" and said this indicated the onset of COPD (never been diagnosed with asthma, but never seen a pulmonologist). He said the CBC was normal. He did an EKG there in his office and said I had a right bundle branch block and referred me to a cardiologist. The next day I did a stress echo, and the day following that I went to the cardiologists office for the results where he did an EKG. He said neither the stress echo/EKG nor that EKG showed signs of RBBB, and that my heart was in good shape. I did not have chest pains during any of the tests, though.
Fast forwarding, over the last two weeks every night when I arrive home from work and relax a little bit, I will get palpitations. If I get up to get a drink, or use the restroom, go upstairs, my heart will begin pounding heavily in my chest. This usually happens in the morning after I wake up as well, but doesn't when I'm at work out and about (my work involve constant movement, heavy lifting, etc). The most worrisome part is when I am sitting down at night, I get what feel like muscle twitches randomly around my body. The thing is, it somewhat feels like a pulse in that part of the body. Sometimes it will be in my neck (around my collarbone), sometimes an arm, leg, thigh, lower back, left side of my chest, once even on my butt. Sometimes it's just one twitch, sometimes it's several twitch feelings in a row in a quick succession. It doesn't really feel like a pounding, more like a tapping from the inside.
This has been alarming me more and more every day because my doctor told me to see him in one month from my last appointment (next week) but that's prior to these symptoms occurring and I haven't told him yet. At night I get anxious that at any moment my heart could just stop beating and I'd die. Usually these thought processes can cause palpitations themselves, even when I'm sitting down. One night I was watching TV trying to keep my mind off of it and I got a huge head rush, it was complete vertigo. It freaked me out to where I almost went to the ER because from what I've read if your heart stops beating it takes only a few seconds for you to pass out from lack of blood flow to the brain. I was afraid my heart had stopped beating for a couple seconds and I'd almost passed out from it.
It seems reasonable to me that the passing out, palpitations while sitting down, could be panic attacks, though I've never been diagnosed with any kind of panic disorder (or psychiatric problems of any kind). But the muscle spasms/possible arrythmia?
I have read one of the side affects of Albuterol, as well as certain antibiotics, can be muscle spasms, but these kind of sound like PVCs. Do these sound more like muscle spasms, do they sound even remotely like PVCs (I've found stuff about people having them in the chest/neck, but not legs/arms/back) or any other kind of arrythmia or heart problem?
Is it safe for me to wait 5 days to go see my doctor, or do I need to go to the hospital ASAP (he's closed Sat. & Sun.)? Or should I walk into his office Monday morning? I'm thinking I should specifically ask for a Holter monitor because these problems seem to ONLY occur during the evening hours, which is between 11pm-5am (I usually get home at about 10pm, go to sleep around 5, wake up around noon, and go to work at about 2pm).
A month and a half ago I began experiencing chest pains and shortness of breath. The chest pains sometimes hurt worse when inhaling deeply. My doctor listened to my lungs with a stethoscope and informed me I had bronchitis (I had no cough, I know that's typical with bronchitis so I don't know if it's possible to have bronchitis and not cough at all). He ordered a chest x-ray, blood tests, and prescribed Amoxicillin/Clav and nebulizer treatments 4x day with Albuterol + Ipratropium bromide. When I returned 10 days later, my shortness of breath was much better, but I still had the occasional chest pain. He said the x-ray showed "borderline hyperinflation of the lungs" and said this indicated the onset of COPD (never been diagnosed with asthma, but never seen a pulmonologist). He said the CBC was normal. He did an EKG there in his office and said I had a right bundle branch block and referred me to a cardiologist. The next day I did a stress echo, and the day following that I went to the cardiologists office for the results where he did an EKG. He said neither the stress echo/EKG nor that EKG showed signs of RBBB, and that my heart was in good shape. I did not have chest pains during any of the tests, though.
Fast forwarding, over the last two weeks every night when I arrive home from work and relax a little bit, I will get palpitations. If I get up to get a drink, or use the restroom, go upstairs, my heart will begin pounding heavily in my chest. This usually happens in the morning after I wake up as well, but doesn't when I'm at work out and about (my work involve constant movement, heavy lifting, etc). The most worrisome part is when I am sitting down at night, I get what feel like muscle twitches randomly around my body. The thing is, it somewhat feels like a pulse in that part of the body. Sometimes it will be in my neck (around my collarbone), sometimes an arm, leg, thigh, lower back, left side of my chest, once even on my butt. Sometimes it's just one twitch, sometimes it's several twitch feelings in a row in a quick succession. It doesn't really feel like a pounding, more like a tapping from the inside.
This has been alarming me more and more every day because my doctor told me to see him in one month from my last appointment (next week) but that's prior to these symptoms occurring and I haven't told him yet. At night I get anxious that at any moment my heart could just stop beating and I'd die. Usually these thought processes can cause palpitations themselves, even when I'm sitting down. One night I was watching TV trying to keep my mind off of it and I got a huge head rush, it was complete vertigo. It freaked me out to where I almost went to the ER because from what I've read if your heart stops beating it takes only a few seconds for you to pass out from lack of blood flow to the brain. I was afraid my heart had stopped beating for a couple seconds and I'd almost passed out from it.
It seems reasonable to me that the passing out, palpitations while sitting down, could be panic attacks, though I've never been diagnosed with any kind of panic disorder (or psychiatric problems of any kind). But the muscle spasms/possible arrythmia?
I have read one of the side affects of Albuterol, as well as certain antibiotics, can be muscle spasms, but these kind of sound like PVCs. Do these sound more like muscle spasms, do they sound even remotely like PVCs (I've found stuff about people having them in the chest/neck, but not legs/arms/back) or any other kind of arrythmia or heart problem?
Is it safe for me to wait 5 days to go see my doctor, or do I need to go to the hospital ASAP (he's closed Sat. & Sun.)? Or should I walk into his office Monday morning? I'm thinking I should specifically ask for a Holter monitor because these problems seem to ONLY occur during the evening hours, which is between 11pm-5am (I usually get home at about 10pm, go to sleep around 5, wake up around noon, and go to work at about 2pm).
If you even think you have an enlarged heart or chamber, you should insist upon getting another doc to look at you and get another echo. Get them to quantify your size. Also, those 'self diagnosing ECG machines' are supposedly not always accurate. It's kind of like if you had a machine at the airport that shouted out 'MIDGET' 'NORMAL' 'GIANT' as you pass through the security gate for people 2 standard deviations away from average hight. You'd get a bunch of offended short people but not really isolate those with dwarfism or giantism.
I think stutterheart is on to something - I can't see how muscle twitches in various parts of your body can be tied back to an issue with your heart, except for one - stress/anxiety. It can make your muscle's twitch, it can make your heart skip beats all over the place, it can give you esophageal pain that feels like heart pain, it can make your extremities tingle, it can make you dizzy, it can make you feel light-headed, and on and on.
Thanks for your response! When I had the first normal ECG, the doctor showed me the paper. At the top, it had a bunch of stats, including Right bundle branch. Next to RBB, it said Blocked, but I don't know if the actual waves indicated a RBBB. The cardiologist did say that even if I do have a RBBB, it's typically nothing to be worried about, and that left bundle blocks are typically more dangerous.
The reason I suspected it's not a simple muscle contraction is that they're very new, and only began happening post-chest pains. That and they somewhat feel like a pulse. It's as though I'm feeling my pulse on my neck, but it's much harder and faster and happens at random, pinpoint spots on my body.
About your mention of enlarged heart, three or four years ago the same doctor did an ECG and it was fairly normal, except I think he said something about the left side of my heart was enlarged (I don't remember the specific technical term). I had high blood pressure at the time, and I do now, and I am aware that is a cause for left ventricular hypertrophy--though I do not remember for certain that this is what it is. The cardiologist said nothing about this, so I assume it has either gone away or was not a cause for concern. I don't know if my BP is necessarily high, but borderline (at least according to the machine at Wal-Mart :)) It is usually around 140/85 when I check it.
Thanks for your advice, I think I will just go look for a new doctor. This doctor seems overeager to always prescribe drugs to treat the symptoms without doing much to find out what the underlying problem is. I go in with a cough and I leave with six prescriptions, so I think I'll return to my next visit and be a bit more persistent about the tests needed and then look elsewhere for a GP.
Again, thanks so much. You've eased my mind.
The reason I suspected it's not a simple muscle contraction is that they're very new, and only began happening post-chest pains. That and they somewhat feel like a pulse. It's as though I'm feeling my pulse on my neck, but it's much harder and faster and happens at random, pinpoint spots on my body.
About your mention of enlarged heart, three or four years ago the same doctor did an ECG and it was fairly normal, except I think he said something about the left side of my heart was enlarged (I don't remember the specific technical term). I had high blood pressure at the time, and I do now, and I am aware that is a cause for left ventricular hypertrophy--though I do not remember for certain that this is what it is. The cardiologist said nothing about this, so I assume it has either gone away or was not a cause for concern. I don't know if my BP is necessarily high, but borderline (at least according to the machine at Wal-Mart :)) It is usually around 140/85 when I check it.
Thanks for your advice, I think I will just go look for a new doctor. This doctor seems overeager to always prescribe drugs to treat the symptoms without doing much to find out what the underlying problem is. I go in with a cough and I leave with six prescriptions, so I think I'll return to my next visit and be a bit more persistent about the tests needed and then look elsewhere for a GP.
Again, thanks so much. You've eased my mind.
If you have a branch bundle block, they should be able to capture it on a normal ECG. BBB tend to be ongoing and don't just pop up like some of the other tricky arrhythmia. I'd say there is a high chance that the general practitioner didn't know how to read the ECG. It's VERY tough to interpret those things, even for doctors. And causation is often ambiguous. My dad has a branch bundle block and his EP told him that if he dies before 90, it won't be because of that. If your cardio said you are ok, there is little reason to think you are not ok. Still, having a stress echo and perhpas a portible event monitor for 30 days.can almost conclusivly rule out the more-dangerous conditions such as Long QT, Brugada Syndrom, Hypertrophic Cardiomyopathy or Wolff Parkinson White.
I'm not sure I am convinced that what you feel is anything other than plain vanilla muscle twitches. What makes you think they originate in the heart muscle? Often times, a PVC will feel like a little fish flopping in your throat but I don't think it would manifest in your back or neck. As for the chest pain, can you differentiate between skeletal muscle feeling and your heart? I'm not sure, but I think the only reason you would have chest pain in the heart is from a blocked artery...I don't see your heart 'hurting' from arrhythmia. and given your age, I don't think you have corronary artery disease.
Don't worry about your heart stopping. The heart rarely just stops, even in the young athletes that die suddenly. The heart is chemically unstable so that it is never polarized but instead, always in flux between polarization and depolarization. Just look at pictures of a heart still beating after it's been taken out! What an amazing organ: it just WANTS to keep beeting, even if it is in a whacky rtythm. The thing to fear, if you are going to fear anything, is ventricular tachycardia which is when the current gets all discombobulated and out of sync so much that your ventricles quiver instead of pump. It's almost always in people with an enlarged heart or with one of the aforementioned syndroms. There's no reason to suspect that you have it. For most victims, death is the symptom.
Definitely get checked out but also explore the possiblity that it is a mixture of a lot of things. Perhaps you have some PVC's that are real but really freak you out and some of the other symptoms, maybe combined with acid reflux or a pulled skeletal muscle or connective tissue between your ribs, are anxiety related. It might be wise to say to your doc "look, i think there is something off here and I know you are thinking it's just anxiety. I want you to throw anxiety aside while you work on me and let's treat that differently, because I think I may need to explore the possibility that it's a factor, but for now, just assume it plays no role."
I'm not sure I am convinced that what you feel is anything other than plain vanilla muscle twitches. What makes you think they originate in the heart muscle? Often times, a PVC will feel like a little fish flopping in your throat but I don't think it would manifest in your back or neck. As for the chest pain, can you differentiate between skeletal muscle feeling and your heart? I'm not sure, but I think the only reason you would have chest pain in the heart is from a blocked artery...I don't see your heart 'hurting' from arrhythmia. and given your age, I don't think you have corronary artery disease.
Don't worry about your heart stopping. The heart rarely just stops, even in the young athletes that die suddenly. The heart is chemically unstable so that it is never polarized but instead, always in flux between polarization and depolarization. Just look at pictures of a heart still beating after it's been taken out! What an amazing organ: it just WANTS to keep beeting, even if it is in a whacky rtythm. The thing to fear, if you are going to fear anything, is ventricular tachycardia which is when the current gets all discombobulated and out of sync so much that your ventricles quiver instead of pump. It's almost always in people with an enlarged heart or with one of the aforementioned syndroms. There's no reason to suspect that you have it. For most victims, death is the symptom.
Definitely get checked out but also explore the possiblity that it is a mixture of a lot of things. Perhaps you have some PVC's that are real but really freak you out and some of the other symptoms, maybe combined with acid reflux or a pulled skeletal muscle or connective tissue between your ribs, are anxiety related. It might be wise to say to your doc "look, i think there is something off here and I know you are thinking it's just anxiety. I want you to throw anxiety aside while you work on me and let's treat that differently, because I think I may need to explore the possibility that it's a factor, but for now, just assume it plays no role."
Are you still on the Albuterol nebulizer or are you using a simple inhaler now? The nebulizer works more efficiently at getting the meds into the lungs. I have asthma and when I have to go to the hospital to use the nebulizer, I get those body twitches, like little grasshoppers under my skin. Kind of creepy actually. But it wears off. Albuterol also affects the heart beat/rate.
As for alcohol, I personally can't drink it because a few hours after I have a beer, I get the heavy pounding heart beat and slightly increased rate. Drinking that cold beer on a hot summer day just isn't worth the hours of heart thumping that comes after it. You may want to hold off on the drinks until you're off the meds.
Clavamox is pretty safe to use unless a person is allergic to the penicillin type drugs.
Since there was some question about having a heart block, I think it's reasonable to wear a monitor for awhile. Many arrhythmias only happen on occasion and they're hard to catch. But again, you'll have to wait till you're off the albuterol since that affects rhythm anyway.
Hope you feel better soon. I'm going through an asthma episode now and it's no fun having trouble breathing.
As for alcohol, I personally can't drink it because a few hours after I have a beer, I get the heavy pounding heart beat and slightly increased rate. Drinking that cold beer on a hot summer day just isn't worth the hours of heart thumping that comes after it. You may want to hold off on the drinks until you're off the meds.
Clavamox is pretty safe to use unless a person is allergic to the penicillin type drugs.
Since there was some question about having a heart block, I think it's reasonable to wear a monitor for awhile. Many arrhythmias only happen on occasion and they're hard to catch. But again, you'll have to wait till you're off the albuterol since that affects rhythm anyway.
Hope you feel better soon. I'm going through an asthma episode now and it's no fun having trouble breathing.
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