What Are The Underlying Causes For Strong Pulses In My Chest?

Posted on Mon, 13 Jan 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 13 Jan 2014 Answered on

Tue, 4 Feb 2014 Last reviewed on

Question : In the last 3 months, I completed three EKG exams and the last one in conjunction with an echocardiogram. I am doing all these test to satisfy a potential life insurance company. My doctor believes that I am healthy and that a small variant in my EKG (I believe it's called a inverted T something....) is normal for me. The last EKG/echo exam was completed last Tuesday. However, in the last 4 weeks I have noticed that at night I feel one or two strong pulses from my chest with a slight pause in my breathing. Then, instantly everything goes back to normal,except that I become frightened that something is happening to me that I don't understand. I explained this to my doctor but she said my test all look find and that I am just being aware of my own heart beat. Is she right, or could it be something else? I am seeking advice because I just experience this sensation twice this evening,only seconds apart. I am in no pain and I am breathing normally. But just scared. Thanks in advance for any guidance and advice. XXXXXXX

Answered by Dr. Anantharamakrishnan (48 minutes later)

Brief Answer: Relax / No suggestion of serious illness Detailed Answer: Dear friend, Welcome to Health Care Magic The description sounds like Anxiety… It is better to have a few tests – to rule out and get yourself reassured Irregular heartbeats can be DOCUMENTED by ElectroCardioGram (EKG). Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly or precipitated by a specific activity, one needs Holter or event monitor. TMT – Treadmill exercise ECG; preferably with thallium isotope – will exclude ischemia (reduced blood flow (Coronary Artery Disease) Over The Counter (OTC) Non-Steroidal Anti Inflammatory Drugs (NSAID) / muscle relaxants / anxiolytics may be useful in the meanwhile... Good luck Take care Wishing all well God bless

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (3 days later)

Thank you for your prompt response. I failed to specify that the last KGE/ECHO was also on a treamill. my docter advised me that the treadmill/stress test was also designed to induce fluters and arrhythmia. As I mentioned in my last email, my doctor did not notice anything that caused her concern.Since my last email, I have felt the "flutters" in my chest area around 4 times. After each event i usually continue to breath normally and i and not in any pain. Do you still believe my symptoms are a product of anxiety?°

Answered by Dr. Anantharamakrishnan (40 minutes later)

Brief Answer: Holter is indicated... Detailed Answer: Hi Exercise does not always bring out arrhythmia / at times, they may even abolish them! The test is useful to exclude ischemic heart disease (Coronary Artery Disease)... It is very reassuring to know that it is normal.... Ambulatory monitoring is the best option to detect arrhythmia… If there are no clues and if the problem is still bothering to the extent of interfering with life style, Electro Physiological Studies (EPS) is an option…the test is the gold standard but it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. Anxiety is likely / but I will prefer it to be a diagnosis of exclusion. And when the suggestion is strong, it ought to be corroborated by Psychiatric assessment and assistance… The treating doctor may suggest them depending on need, based on his assessment of the situation. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (6 minutes later)

Thank you. I'll try to relax.

Answered by Dr. Anantharamakrishnan (11 minutes later)

Brief Answer: Great Detailed Answer: Hi You are well You will be well Enjoy life God bless you Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar