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What Causes Unusual Heart Palpitations?
Question: I had several cardiac tests done twice over the past 6 months. The most recent tests were done last month. I did a stress test, echo, ECG, 2 holter monitors etc... The results of the stress test and echo came back normal showing a structurally normal heart. My holter showed 200 PACS and 15 single unifocal PVCS. I have a resting heart rate which goes around 54 which worries me but my cardiologist says it is normal and my heart is healthy. Also during sleep my heart rate went down to 41. I get worried because when I wake up in the morning I get a lot of what I think are PACS. for example this morning I could feel a lot of them and my heart starts racing. I have also noticed another thing.
I suffer from anxiety and I had something happen tonight after dinner. I was just sitting at the table talking when I felt my heart starting to race. My heart rate was around 150-160 bpm . It felt regular. The rhythm wasn't off just fast. Could this have been caused by a PAC or anxiety . I did some deep breathing and it passed after 2-3 minutes. Could a PAC or PVC cause the heart to start racing?
I suffer from anxiety and I had something happen tonight after dinner. I was just sitting at the table talking when I felt my heart starting to race. My heart rate was around 150-160 bpm . It felt regular. The rhythm wasn't off just fast. Could this have been caused by a PAC or anxiety . I did some deep breathing and it passed after 2-3 minutes. Could a PAC or PVC cause the heart to start racing?
Brief Answer:
Need Event Monitoring
Detailed Answer:
Hi friend
Welcome to Health Care Magic
This palpitation is most likely benign / especially so, being associated with normal ECHO and TMT. Structural issues and ischemia have been effectively ruled out.
These beats are common and often may be normal. These are not always symptomatic.
The feeling depends on individual sensitivity – some do not feel them at all / some may feel every beat.
Specific treatment is may not be necessary, at present. If only, you have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up. You only need follow up, by your physician.
PAC or PVC could theoretically initiate tachycardia (racing rate). It needs to be documented. You have already had Holter – that records for days / and continuously.
You may need EVENT MONITOR – which records for weeks / and only at times , activated by patient. Your description is suggestive of SICK SINUS SYNDROME – (tachycardia–bradycardia syndrome). It is an intrinsic disease of the conduction system (nerves of the heart).
Anxiety does add to it but may not explain all the features / and preferably an exclusion diagnosis
We generally advise to go for Event Monitor. If there are no clues and if the problem is still bothering to the extent of interfering with life style, we may need advanced techniques of investigation – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. Prognosis is generally excellent in such situations. If confirmed, a pace maker is the definitive solution.
Keep following with your cardiologist. The treating doctor alone could conclude better based on total clinical picture…
Good luck
God bless you
Need Event Monitoring
Detailed Answer:
Hi friend
Welcome to Health Care Magic
This palpitation is most likely benign / especially so, being associated with normal ECHO and TMT. Structural issues and ischemia have been effectively ruled out.
These beats are common and often may be normal. These are not always symptomatic.
The feeling depends on individual sensitivity – some do not feel them at all / some may feel every beat.
Specific treatment is may not be necessary, at present. If only, you have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up. You only need follow up, by your physician.
PAC or PVC could theoretically initiate tachycardia (racing rate). It needs to be documented. You have already had Holter – that records for days / and continuously.
You may need EVENT MONITOR – which records for weeks / and only at times , activated by patient. Your description is suggestive of SICK SINUS SYNDROME – (tachycardia–bradycardia syndrome). It is an intrinsic disease of the conduction system (nerves of the heart).
Anxiety does add to it but may not explain all the features / and preferably an exclusion diagnosis
We generally advise to go for Event Monitor. If there are no clues and if the problem is still bothering to the extent of interfering with life style, we may need advanced techniques of investigation – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. Prognosis is generally excellent in such situations. If confirmed, a pace maker is the definitive solution.
Keep following with your cardiologist. The treating doctor alone could conclude better based on total clinical picture…
Good luck
God bless you
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Doctor Thank you for your response. I did have a 7 day event monitor and my cardiologist says I do not show symptoms of SSS. He says a resting heart rate of 54 is not abnormal. He also states my anxiety is what is causing my heart rate to go up along with acid reflux. Can this be true? I have had 2 different cardiologist tell me the same thing
Brief Answer:
Yes
Detailed Answer:
Hi
Anxiety can cause palpitation / palpitation can cause Anxiety – this is a vicious cycle
The heart rate of 54 is normal indeed, in a given individual / The numbers are statistics from the general population / and 60 to 100 are the usual, general limits, that need no further investigation. You have been fully investigated and everything is normal..
Reflux will benefit from Prokinetic agents (like Domperidone) and Proton pump inhibitors (like Omeprazole). An upper Gastro Intestinal endoscopy (gastroscopy) can evaluate it. Gastro-enterologist is the specialist in the field and the procedure is don in a conscious state..,
Regards
Yes
Detailed Answer:
Hi
Anxiety can cause palpitation / palpitation can cause Anxiety – this is a vicious cycle
The heart rate of 54 is normal indeed, in a given individual / The numbers are statistics from the general population / and 60 to 100 are the usual, general limits, that need no further investigation. You have been fully investigated and everything is normal..
Reflux will benefit from Prokinetic agents (like Domperidone) and Proton pump inhibitors (like Omeprazole). An upper Gastro Intestinal endoscopy (gastroscopy) can evaluate it. Gastro-enterologist is the specialist in the field and the procedure is don in a conscious state..,
Regards
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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