Night heart jolt that awakens me

[MRB564]

I have been experiencing what I call a "jolt" maybe even a stoppage, not sure, that wakes me from a dead sleep. This began occurring in April of 2012, after it happens on a couple of nights and I experienced an elevated blood pressure for a sustained time, I did go to the ER to make sure I was not having a heart attack. I'm an active, self employed 48 yr old with no prior history of heart disease. I wasn't having an MI, so I was released and scheduled to see a cardiologist. Had an echo, & stress test with what I learned was a slightly abnormal stress test, even though I reached 98th percentile for my age. Had a cardiac cath, which showed my heart to be in good health with large, clear carotids and no blockage. I was initially prescribed to be on 2.5mg of Norvasc daily and an aspirin daily, which I took from May until December. I was getting daily migraine headaches and muscle cramps, so I decided to see if the headaches would disappear by getting off the med. The headaches are gone and my bp has been in the area of 117/75 when seated and resting which is where I normally am. I was experiencing these "jolts" prior to the medication, while taking the medication, and now that I'm off the medication. I have not worn a holter monitor nor had a sleep study. Has anyone experienced similar symptoms or aware of what might be causing this to happen? Any insight would be appreciated!

[achillea]

"...another community member's post where she/he basically said that the one of half of the heart goes out of whack while the other half is beating normally"

The heart doesn't work like this.  It's really two separate pumps, the right side receiving oxygen-poor blood back from the body and sending it to the lungs for more O2, and the left side receiving that fresh blood and sending it with a powerful contraction out to the body.  

The explanation is not rocket science, but it does take a little thought.  Here's a link to a helpful animation:

http://www.heartfailurematters.org/EN/Animation/Pages/animation_1.aspx

You may be feeling a PVC, in which an earlier than usual beat fires off in the left ventricle (the biggest pumping chamber).  The ventricle hasn't had a chance to get a full load of blood with one of these, so most people do not even feel this tiny contraction, because very little force is required.

However, after one of these PVCs--which EVERYONE has sometimes--the left heart takes a slight pause before firing on the 'next regularly scheduled' beat.  During this pause, the ventricle has a chance to fill with a bit more blood than usual, which it can do because the heart's chambers are elastic.

Now, for efficiency's sake, the ventricle must pump out all the blood it receives, so at the aforementioned next scheduled beat, it gives an extra hard contraction, which you perceive as a giant Ka-Boom.  It's kind of spectacular if you're a sensitive type, but it's normal, and most people don't even feel it.

[MRB564]

I read some of the other threads today and I've pretty much come to the conclusion that I am likely experiencing PVC's when I sleep, although I would rule out getting a sleep study done too.  Usually the "jolt" is over my heart and it seems like it's missed a beat or something although I can't say for sure because I'm typically asleep and then awakened by the sudden intense beat of my heart. I read another community member's post where she/he basically said that the one of half of the heart goes out of whack while the other half is beating normally. When this happens the improperly functioning side significantly fills with blood so when it does kick back in the compression is much stronger than normal, hence making it more like a super strong beat.  When it happens to me, it feels like my heart has slammed into my ribs, and it's quite alarming to be awakened by this action.  I think I'm gonna follow up with my cardiologist first and I imagine he's gonna want to have me on a holter monitor to try to capture the activity.  Thanks for your response!

[achillea]

You might want to google an odd term, "hypnic jerk."  

I get these, and so does my husband.  They can wake you right out of a perfectly nice sleep!

Here's a little more info:

http://www.discovery.com/area/skinnyon/skinnyon971114/skinnyon.html

[Jerry_NJ]

Sorry I can't give any direct help, but what you say makes me think a sleep test, that includes apnea testing (maybe it always does) would be the safest course forward.

Have you tried to check you heart rate when you are awaken by a jolt?  If you HR is low, you need to establish what that is for you personally, say 60 bpm or less I'd guess you didn't stop breathing... but then as confessed I don't know anything about what "speak".  I do have trouble sleeping and have considered asking for a sleep study, but I haven't.  I am over 20 years older than you, and that contributes is a major way to my sleep problems.