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Avatar universal

very strange heart sensation followed by adrenaline rush and fast heartbeat - very worried about this

Hi. I'm a 26 year old female, neither fat nor skinny, no smoking, only occasional alcohol use. Prior to what I'm about to describe, the only heart issues I had were: occasional flip-flopping feeling which knocked the wind out of me but only happened maybe a few times a year, and a sort of flip-flopping or difficulty beating when lying down on my left side (sometimes, not every time I lay this way - started around age 13).

Background: Three years ago something happened to me that I still haven't figured out - my heart started beating very fast and my BP went way up (so high that with every heartbeat I could see the tiny capillaries in my eyes as an overlay on my visual field). Paramedics couldn't bring them down so took me to "A&E" (aka the ER - I'm American but live in England). Absolutely nothing out of the ordinary happened (that I'm aware of) prior to this incident, except for insertion of Mirena IUD one week prior - I do still have it but now think I'll have it removed.

Thus began months of seemingly random 'attacks' during which I'd get varying combinations of tachycardia, high BP, tremors esp in left leg, lightheadedness, inability to fully inhale, feeling of not getting enough oxygen even if I could breathe properly, and the list goes on. I also had a terrible feeling of physical anxiety (churning stomach, agitation, etc) but with no mental anxiety as the apparent cause!!! Attacks could last minutes or hours and any combination of symptoms would happen. And in between attacks, my heart would regularly do many strange things - tachy, brady, irregular rhythm, extremely forceful beats, 'flip-flopping' feelings, etc.

I also sometimes experienced a sensation of the heart stopping and restarting - immediately after the restart I would feel a MASSIVE, uncomfortable surge of adrenaline and the heart would beat very fast for a little while. I could never figure out if I was getting an adrenaline surge that caused some odd heart behaviour that I felt before I actually felt the adrenaline, or what. Sometimes my heart would also start beating EXTREMELY fast from resting for no reason at all - it was literally immediate - this was also accompanied by an adrenaline rush but no preceding feeling of the heart stopping.

These incidents gradually decreased in frequency over time, along w/ the other symptoms, until after three years I was feeling mostly recovered from whatever got me. I viewed myself as not entirely back to normal, but almost there. UNTIL a couple of days ago, when I had another (random as always - I was just riding in the car reading, no stress) heart stoppage -> restart -> adrenaline event. This one was the second most severe one I've ever had and I thought I might die. Luckily the heart DID start pumping again so I'm still here. By now I'm pretty familiar with flip-floppings and extra-strong beats, etc, and this definitely feels very different and much more worrying. I am afraid that if it happens again, the heart might not start on its own.

I should also say that when I say it 'stops', I mean it seems to stop pumping blood...I get the impression there is still activity going on in the heart but that blood is not being circulated. Could it be ventricular fibrillation, or ...? Maybe adrenaline is not causing this, but rather my heart goes into an abnormal rhythm and my body releases adrenaline in an attempt to self-shock into proper rhythm?

During the most severe incident in '06 or '07, my colleagues said I turned "white as a sheet" while it was happening. That time, I was clawing at my chest (reflex reaction, I didn't actually think that would help) and thinking "please start please start please start", knowing I'd die if it didn't. That time, it felt like the heart was quivering/fluttering but not pumping. All other times including the one a couple of days ago, it has sort of felt like the heart is contracting in extreme slow motion, or having some sort of muscle cramp.  

I cannot figure this out and would welcome any insight anyone has to offer. After it all began in 06, I had a stress test (slightly above avg exercise tolerance), echo (normal), stress echo (normal) and many ECGs. The cardio said my heart was perfectly healthy. No evidence of MVP (which I thought I might have). He said the only thing to remark on was that the heart was smallish, but not abnormally so.

My GP diagnosed me w/ 'anxiety attacks' w/out finding it necessary to order any physical testing whatsoever. (The above cardio is a friend of my parents who saw me while I was on vacation in the US). GP put me on citalopram which I went along w/ just to be cooperative, and propranolol to help regulate what he viewed as anxiety-induced tachy. Did not seem to find it significant that symptoms did not occur during periods of actual mental anxiety. Said it might be pheochromocytoma, but that he wouldn't bother testing as that's so rare. Ashamed to say I didn't and still haven't actually demanded said testing.

All ECGs were normal except once at A&E when they caught random very hard beats interspersed w/ regular beats - v. hard beats could be seen as an extra-long downward spike on the readout. Of their own volition (as opposed to at my request), A&E sent this to a cardio (different one) who didn't bother to look at it and just told me not to worry. Thanks, buddy! So, not really knowing how to interpret these readouts, I still don't know if that was significant.

I'm currently seeing a neurologist for delayed sleep phase syndrome. After hearing all this, he very kindly volunteered to arrange for me to use the clinic's Holter monitor; he'll then send the tape to a cardiologist. Not sure when this will happen, though, as it's the NHS (meaning things do not tend to happen promptly).

At the time of the latest incident, I was on amoxicillin but no other meds continuously, although I have been taking lansoprazole at night only, for a week and a half to two weeks. A few days prior to the incident, I had taken myself off of the pramipexole that I'd been on for a week, as I was having trouble swallowing (for which the amoxicillin and lanso were prescribed - possible sinus/throat infection or gastric reflux - doc and I wanted to attack on both fronts in order to avoid the return of the laryngospams I'd had during recent respiratory infection).

Thanks in advance to anyone who might be able to help...
194 Responses
363281 tn?1518219421
It sounds like anxiety, however, I would see a cardiologist for all this. You said you had seen one in 2006, well, I think I would see one again as your symptoms are not getting better and you are describing things that really only a qualified cardiologist can help you with.

Good luck and please keep us posted. I know how scary these things are, I have them, and at times, you really DO feel like you are going to die, it is the worse feeling ever, in my opinion.
Avatar universal
Hi SassyLassie,

Thanks very much for replying! I didn't realize I'd written so much...I doubt anyone else read it :). I may see if I can get to a cardiologist, although unfortunately I can't afford to go private so don't have all that much control over the situation (don't know if you are familiar w/ the British NHS, but your GP has to deem it necessary to refer you to a specialist before you can see one - even then the wait can be long).

I find that some doctors tend not to take me very seriously because I am in my 20s (they assume that the most benign explanation for my symptoms must be the correct one, and say as much). The neurologist I'm seeing seems very good, though, so hopefully he will come through w/ the Holter monitor.

I'm not glad that you have a rambunctious heart too, but I am glad to know I'm not the only one thinking I'm on the verge of death during some of the incidents. Yes, it is the worst feeling ever.

Best of luck to you!

177337 tn?1310063499
I get that same thing about 2 or 3 times a year.  It isn't the same as the pvcs.  You feel your heart pause for at least a couple of seconds.  Then it switches gears and speeds up.  Mine has been clocked at 220 beats per minute after one of those pauses.  My doctor told me not to worry.  I did get the fast rate caught on tape and it was PAT (a form of svt I think)
My doctor said that the pause felt longer because of the timing of the early beat...then because it was a longer pause, it had time to switch pathways..thus the PAT.  I don't feel any quivering but my doctor said even though I feel nothing in my pulse that it could be beating really fast and weak and I just don't realize it.  Anyway, I was told not to worry so I'm passing that to you.  As long as you have been checked out.
Good luck with the monitor.  
Frenchie
Avatar universal
Hi Frenchie,

Thanks so much for posting!!! It does sound like we're experiencing something very similar if not the same. It's good to know I'm not alone. Also good to know what your post-pause tachy has been categorized as...this gives me something to look into should I get checked out again.

I'm glad to hear your doc has given you the OK and this is definitely reassuring for me to hear in terms of my own situation as well. It makes more sense and is less worrying to think that the pause is just part of the oncoming tachy and not an actual stoppage in and of itself.
267401 tn?1251856096
I can relate to a lot of what you wrote - I haven't clawed at my chest so much as gone into a catatonic state, frozen, hand over my heart or at my carotid, waiting for my heart to start again.

But I've also experienced that very strange sensation of adrenaline rush - for me it feels like a sickening woooosh, I feel flushed in the neck and face, sometimes I sweat a little.  For me it's usually after the episode is over.  First ten or so times it happened it was pretty frightening.  Then I got an event monitor, was able to record quite a few of them, and my cardiologist was unimpressed when she saw the strips.  Diagnosed as "short bursts of PAT" (aka PSVT).  She said I could go days with my heart in that rhythm and it would not harm me.

Oddly enough, once I learned these couldn't kill me, I started having less and less of them.
267401 tn?1251856096
One other thing - I took a quick look at the side effects of the Mirena IUD, and many of the potential side effects are symptoms you're experiencing:

http://www.drugs.com/sfx/mirena-side-effects.html#system_33551

http://www.drugs.com/cdi/mirena-iud.html

Avatar universal
Thank you Wisconsin2007 - I did end up having the Mirena taken out at the beginning of Sept. Unfortunately I've still been having some palpitations and today had another scary stop-start event, but I've just had my first real period w/ PMS & everything in about 5 years, so I'm hoping that once my hormones settle down things may improve. Either way, I am just trying to focus on what you and Jkfrench have said, because it sounds like I've got what you've got and it can't kill us. Still waiting on that Holter...
Avatar universal
Also thanks for detailing that you also sometimes get the adrenaline rush - this is has been a worrying aspect of the episodes for me as others don't generally seem to describe this. But if you've got something similar on tape as PVST, I think that's a lot more likely to be the issue for me than my heart stopping and adrenaline being released to achieve a shock-paddle effect, which is what sometimes worries me.

I will post here again if I find out anything further about what's behind my symptoms.
Avatar universal
You managed to describe your symptoms in a way that I was incapable of  telling my doctor and subsequently cardiologist when the exact episodes started happening to me in 2002. Then, after the ultrasound, EKG and Holter monitor, all the cardiologist could come up with was that one of the chambers of my heart was slightly enlarged, but nothing to worry about.

These attacks went away on their own but came back tonight for the first time in 8 years. The fear of my heart stopping is so great I'm afraid to go back to sleep...  The subsequent "adrenalin surge" is so great that I physically shoot up from bed by the shear force of the momentum of my heart "re-starting".

I can't say I'm under any unusual stress, but I did spend the entire Sunday (today) in the -5C outdoors building an ice rink. I did have about 4 glasses of red wine thereafter though.

Anyways, I'm somewhat relieved that I'm not alone and that the common diagnosis of doctor's is that there is nothing to worry about.

I have a feeling this has something to do with the electrical controls of the heart - perhaps slight changes to diet, environment cause it to temporarily malfunction.
Avatar universal
I completely understand everything you wrote and have had similar symptoms.  I just read for the first time about this 'adrenaline surge' , and that it often happens at 4 - 5 in the morning, which makes a lot of sense, because that is when I have had the attacks I've had.  Almost every morning, I wake up at those times.  I have horrible attacks in which I feel like I'm going to die, I have an intense feeling that my heart doesn't beat enough or properly, and then these adrenaline surges, and then I feel much better.  
What I wonder is if these adrenaline surges happen as our bodies' defense to 're-start' our heart and keep us alive because our hearts really are, as we suspect, stopping... or if it's just anxiety and these sensations that are making our adrenaline surge.  How do you find out which came first??

The advice I want to give you though, is to check out your thyroid if you haven't yet.  Especially because of what you said about not having your period for so long.  I have a thyroid disease and I know that these heart-related attacks are connected to that, so check that out asap!
Avatar universal
Hi, thanks for replying to my thread! It really helps to know that others are going through this and have not keeled over from it. Sorry to hear you've had another incident after so long :(. I completely understand about the fear it creates...it's terrible.

I also feel like there is something electrical going on here....just not sure exactly what that is or what triggers it. Perhaps it is PAT as a couple of the others have posted? I think that the tachy of PAT stops abruptly, though, whereas with my episodes it just trails off gradually into a normal speed after the adrenaline rush.
Avatar universal
Hi Mayush, glad that you too have contributed your experience with this. It must be very stressful waking up most nights with this problem, not to mention how it must be giving you sleep deprivation. For me it doesn't tend to happen when sleeping, or if it does it doesn't wake me up. I do sometimes get irregular and/or very weak heartbeat at night, though (much more when this all began than recently, thankfully). No adrenaline after that for me, though...I just have to endure it until I fall asleep and then it's gone in the morning.

Thanks for the tip about thyroid...is yours overactive, or...? When this heart stuff started for me, I thought it might be that my thyroid was overactive, but the blood tests I had (tests as part of investigating my longer-standing night terrors, not the cardiac symptoms) at that time apparently came back normal for thyroid function.

However, I've heard some things about standard thyroid tests not being completely reliable, so I need to investigate that, I think. I did have another round of blood tests last year as part of being diagnosed with Delayed Sleep Phase Syndrome, and the neurologist who reviewed the results said they indicated borderline sluggish thyroid and that I should have that tested again in the future. If your experience has given you any insight on the most accurate testing/interpretation, please share!

Thanks,

wundergecko
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