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

[Wundergecko]

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...

[chance92]

Everything original poster mentioned , is happening to me aswell
triggers = masturbation , lack of sleep , alcohol
I , do also think that i have that sleep syndrome you have been mentioning since i haven't fallen asleep before 2-3  am since ages. So it might be associated?

[tom_h]

Many people confuse a panic attack with a bout of SVT, supraventricular tachycardia.  It's important to know the difference as the treatment for each is very different.  When SVT starts, it comes on suddenly.  With that there is often a surge of adrenaline as it's very startling and disconcerting.  You may feel a uncomfortable pressure in your chest area, It's not uncommon to pace around and feel a little breathless.  But stop for a moment, and feel your pulse in your wrist or neck.  A panic attack heart rate is measurable. An SVT heart rate is usually too fast to accurately count.  Typical SVT rates are 3 to 4 beats per second, and you'll quickly lose count.  SVT ends abruptly as it starts.  Adrenaline will often cause the sinus rate to be elevated slightly as you come out of SVT, but when SVT ends, it's unmistakable.  If you drop from 240 to 100 beats per minute, you know it.  And I think you have to use a little logic too in determining what you just experienced.  Panic attacks build. They feed on themselves going from an uneasy feeling to panic and hyperventilation.  SVT begins in an instant and is often accompanied by a head rush, and surge throughout the body

I am amazed at how this particular topic resurfaces.  The title describes perfectly the feeling when SVT commences.  I think viewers see it, and say "Hey, this what I'm feeling too!"  

I can't stress how important it is to differentiate between SVT and anxiety or panic attacks.  While the symptoms may feel similar, the treatment is entirely different.  If a physician treats you for panic attacks when you really have SVT, you most likely will continue to have episodes.  Reporting this, you will be given stronger medication, continuing down the wrong path.  Treatment for anxiety neurosis ie. panic attacks include some dungs you don;t want to needlessly get involved with.  I know this as my wife is on several.  While drugs like Paxil (Paroxetine), Effexor (Venlafaxine), and other SSRI's and SNRI's work miracles for anxiety, they "bind" tightly with your body. Once you're one them, getting off of them is extremely slow, hard and painful, and you should not needlessly take them if you really don't have an anxiety issue.  

In summation I suggest to those who may find this thread because it describes their symptoms to stop for moment, and listen to their body, try to count the pulse, and use a little logic in determining what they may actually experiencing.  If you go to a physician, just describe the symptoms and how it occured.  Don't lead the physician with accounts of feeling anxious.  I assure you that all of us who have SVT feel anxious every single time one occurs.  Don't accidentally get put on the path of a wrong diagnosis!

[ColtKeller]

Hi,

I read your initial post and a few of the comments, however there are so many replies I admittedly have not read them all, so if something I mention has already been explained then I apologize.

I am 27 years old and about two weeks ago I had what I can only describe as a completely random panic attack. I had never suffered one before, so when it happened I was, to say the least, quite terrified. I was sat on my couch watching TV when all of a sudden a strange feeling came over my entire body and my heart began to race. I shot up from the sofa and paced around my kitchen, hand on chest convinced I was having a heart attack. It seemingly went away as quickly as it started and my heart soon slowed down to a normal rate; nonetheless I was still considerably shaken after this experience.

A few days later I felt terribly weak/dizzy, much like the symptoms of a virus, only without the nausea, and I would also experience short surges of adrenaline intermittently throughout the day. They weren't often, but regular enough to cause concern. Eventually I started to feel better, however I still experienced these short surges of adrenaline. I went a few days without any surges at all, but today I have had two or three surges and figured I should at least investigate what the hell is going on. So I came across your post from over 4 years ago and here I am.

I'll give you some details about myself for some context. I have always been an anxious/nervous person, however I have never, repeat never, had an anxiety attack of any kind before that one incident I mentioned, which is why it was so frightening, given that I was simply sat watching TV. I have sometimes let my nervousness get the best of me, which resulted in near panic attacks, but I always managed to calm myself down. I won't go into detail, but I have a lot going on in my life, however I tend to not let things worry me (or at least I thought I didn't) and never spend much time thinking about my troubles. From what one person said in a reply to you, I am wondering if my fears are manifesting themselves in the form of these adrenaline surges. I am a smoker and a chemist friend of mine suggested that perhaps the albeit very brief lack of oxygen to my brain was causing my body to overcompensate with these surges. I don't think this is the case, as I have suffered a couple of surges even without having a smoke. I don't necessarily have the healthiest diet and have put on a little weight recently, I also consume a lot of caffeine on a daily basis, not to mention an irregular sleeping pattern, which from what I have read could be contributing to these anxiety surges.

I have been aware of my anxious disposition for a long time, yet I always believed I was self-aware enough to overcome any kind of problems anxiety threw at me. I don't really like being in unfamiliar social situations, but with a couple of drinks in me I can make small talk with the best of them. Perhaps this is my body's way of telling me to work on my emotional state, although I consider myself a well reasoned, rational person that hardly ever gets angry or stressed out. I have a great relationship and can count on one hand the number of arguments I've had with my partner of 5 years, so it is even more troubling to me that something is causing these adrenaline surges with the aloof attitude to life that I have.

I would just like to thank you for your original post, as suffering these surges can be quite scary at times and you, plus everybody else that commented let me know I am not alone, which made me feel a lot better. Just to clarify, I have had no real heart troubles since that one incident; it is mostly just a matter of these pesky adrenaline surges.

[Wundergecko]

Hi,
I think it's down to a lot of things for me, mostly not medication-related. In 2006 I was on propranolol daily for a while, but have only taken it as needed since then. I currently take one 40mg pill about every 10 days or so, on average. No other meds.

I think that for me personally - and of course everyone's need to do this or not will be different - what helped most was working on myself. I can't remember how much I've said about all that in this thread, but basically, I was extremely anxious all the time and had no idea that I was so anxious. I also had other psychological/emotional inclinations to work on. That's not to say that there isn't some SVT pathway or something that makes me more susceptible to this stuff, just that - and I wouldn't ask anyone to take my word for it - the mind and body are extremely integrated and things got a lot easier when I was able to see this and deal with my life accordingly.

I would say that being exposed to CBT-style methods was the first thing that really helped me take control of my own thoughts. Other things that helped: EFT, chakra cleansing, personal development articles. I know how that sounds to some people (e.g. I would, and pardon the dissonant phrasing, be crucified on an atheist/skeptic/rationalist forum), but I cared more about being able to function than about cultural approval of my methods. I didn't concentrate on these two till later, but a good diet and regular aerobic exercise are also really great and the exercise bit has helped me a lot. I think it's contributed to me having hardly any daytime palps now, as my heart is stronger. A bonus is that I don't worry about my heart when I get out of breath going up the stairs, because I don't get out of breath going up the stairs.

I hope you're able to find a combination of things that work for you, whatever they may be. I understand what you're saying about knowing that certain fears are irrational but feeling them and having to deal with them anyway, and the impact this can have on your life. Do try the medication and best of luck with it all!

PS - I do still get adrenaline surges on rare occasions. Propranolol is great for dampening these, but while it's kicking in, a thing that helps me is telling myself that my body's just gone a little nuts but it's temporary and I'll survive it just like I always have before. Kind of like being in the ocean and waiting for a wave to pass, which it always will. If you can convince yourself of this it helps avoid prolonging the surge through worrying that it's fatal, that you'll faint, etc.

[imanning]

Thanks for you reply.  I'm glad to hear you are doing so much better.  Do you think it is because of the propranolol?  I've read that it can really help with the adrenaline surges and that is what I have a hard time dealing with on my own.  What you've said about trying the medication one at a time and at home to test it out is exactly what I was thinking of doing.  I have a holiday event coming up that I am already anxious about.  Are you taking any other medication besides the beta blocker?

Also, what you mentioned about all of the other risks in life that can be unpredictable and the fact that the medications have been used safely for years by millions - it all makes so much sense to me.  Unfortunately, the fears I have are irrational and even though I know they are irrational, when the panic and anxiety sets in and the adrenaline surges, I have such a hard time being rational.  Most of my life, before my phobias became established, I was a very calm, logical and sensible person.  Now I feel so crazy sometimes because I feel as I will totally lose control and collapse, faint, or at the very least, run out of the room when in stressful social situations.  Although I have suffered from PVC's for 13 years, this social anxiety part (which I believe developed because of the PVC's) started 2 years ago.  

I am going to try the medication because I feel as if it's my last chance at being normal again.  

[Wundergecko]

Hi imanning,

Thanks for your post. I'm sorry to hear you've been suffering from heart stuff like the rest of us, but glad that the magnesium has helped so much with the day to day PVCs. If you were having something like 20 a minute, I don't know how you coped! I am doing better, thanks - my problems are mostly sleep-related now. I can't sleep on my back without my heart going crazy, but I can live with that.

Social anxiety and medication anxiety are hard. I would definitely recommend that you give one or both of your meds a try and see how you feel. Think about it this way: there so many risks in life that have a lot of unpredictability associated with them (you could get hit by a bus or a stray bullet upon leaving your house, for example), but Xanax and propranolol have gone through trials, have been on the market a while and seem very safe for those without contraindications. I was a bit scared to take propranolol myself but now I think it's great. Maybe you could try that one first and then if you still need it, add the Xanax. Up to you and your doctor, of course, but maybe trying out just one at a time would help you get past the phobia of an adverse reaction. You could also give it a test run before you have to be social, when you're just chilling out at your house, so you'll be able to reassure yourself that if things get weird somehow, you won't be in front of people.