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What Do Ectopic Heart Beats And Low Heart Rate Indicate?
Question: Hi doctor i have had 2 cardiac work ups done in the past year by 2 separate cardiologists. Both times my heart showed structurally normal and i passed both stress tests. I also had 2 48 hour holters done. The latest holter showed sinus rhythm with 400 single pacs and a few bigemy cycles and 2 couplets, No runs. It also showed 15 PVCS unifocal. I had slight bradycardia at rest 26 % of the time and lowest heart rate was 41 while sleeping. Highest heart rate was 164 during an anxiety episode. Lately i feel an increase in Etopic beats and palpitations at night and when i wake up in the morning. I also get some during the day which are less noticeable. I am a little concerned even though my cardiologists both insist my heart is very healthy. I eat a very good diet and i have lost 80 lbs over the last year, I used to weigh almopst 300 lbs and now weigh 215 Lbs. I do not exercise because i am afraid of arythmia but my cardiologists say i should start.
Today I had a doctors appointment and I suffer from anxiety especially when I go to my cardiologist for testing. During anxiety my blood pressure goes up. Today before my tests my BP went up to 150/105. After the ecg was complete and I started to calm down it went down to 150/90. I have it checked regularly and my BP is usually 140/80. Can anxiety cause this?
Today I had a doctors appointment and I suffer from anxiety especially when I go to my cardiologist for testing. During anxiety my blood pressure goes up. Today before my tests my BP went up to 150/105. After the ecg was complete and I started to calm down it went down to 150/90. I have it checked regularly and my BP is usually 140/80. Can anxiety cause this?
Brief Answer:
Your symptoms are caused by anxiety
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain that your symptoms are related to "white coat syndrome".
This is a very common syndrome, which occurs in up to 40% of patients. It consists in having higher blood pressure than usually when going to the doctor.
It is caused by anxiety and a kind of fear, when consulting with the doctor.
Anxiety increases the level of circulating catecholamines, which may trigger ectopic cardiac beats or other atrial arrhythmic disorders and also increase your blood pressure.
This episodic hypertension (which is also called "pseudohypertension") doesn't cause harm to the heart (according to many studies), and doesn't need to be treated.
As you refer your blood pressure usually is 140/80mm Hg, and this is your real blood pressure, which is within the normal limits.
All the cardiac tests that you have performed are compatible with a normal heart in a healthy person.
So do not panic!
All these symptoms are caused by anxiety, and the more you relax, the more you feel better.
Hope to have been helpful!
Greetings! Dr. Iliri
Your symptoms are caused by anxiety
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain that your symptoms are related to "white coat syndrome".
This is a very common syndrome, which occurs in up to 40% of patients. It consists in having higher blood pressure than usually when going to the doctor.
It is caused by anxiety and a kind of fear, when consulting with the doctor.
Anxiety increases the level of circulating catecholamines, which may trigger ectopic cardiac beats or other atrial arrhythmic disorders and also increase your blood pressure.
This episodic hypertension (which is also called "pseudohypertension") doesn't cause harm to the heart (according to many studies), and doesn't need to be treated.
As you refer your blood pressure usually is 140/80mm Hg, and this is your real blood pressure, which is within the normal limits.
All the cardiac tests that you have performed are compatible with a normal heart in a healthy person.
So do not panic!
All these symptoms are caused by anxiety, and the more you relax, the more you feel better.
Hope to have been helpful!
Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi doctor. Yesterday I went to my cardiologist for a check up. I explained some of my symptoms to him not all as the office was very busy. They did an ecg which showed sinus rhythm with normal intervals. He insists that a holter is not necessary right now. However today when I went shopping I was getting strange symptoms. I would feel rapid heart beats or palpitations so I checked my pulse it was at 110 . It would last 5-10 seconds then slow down. It kept repeating this a few times. This happened 15 minutes after I ate a whole grain bagel
Brief Answer:
It is just anxiety and GERD!
Detailed Answer:
Hi XXXX!
I don't believe that a new Holter will yield any different results compared to the prior ones, considering the first two Holter reports and the unchanged symptomatology.
You have a normal sinus rhythm, and those unpleasant heart rate feelings always occur when you get anxious. We know already your triggering factor. You need to find the right modalities how to avoid anxiety, instead of looking for solutions in a cardiologist office.
My advice is to keep going on those psychological scheduled programs, to provide a better management of every unexpected situation, and controlling of your stress and anxiety.
As you have GERD, those postprandial symptoms may be related by taking spicy food. You don't have to worry! Nothing is going wrong with your heart! Just relax! Leave anxiety outside your mind as much as possible!
Best regards! Dr. Iliri
It is just anxiety and GERD!
Detailed Answer:
Hi XXXX!
I don't believe that a new Holter will yield any different results compared to the prior ones, considering the first two Holter reports and the unchanged symptomatology.
You have a normal sinus rhythm, and those unpleasant heart rate feelings always occur when you get anxious. We know already your triggering factor. You need to find the right modalities how to avoid anxiety, instead of looking for solutions in a cardiologist office.
My advice is to keep going on those psychological scheduled programs, to provide a better management of every unexpected situation, and controlling of your stress and anxiety.
As you have GERD, those postprandial symptoms may be related by taking spicy food. You don't have to worry! Nothing is going wrong with your heart! Just relax! Leave anxiety outside your mind as much as possible!
Best regards! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi doctor thank you for your reply. I'm trying not to check my pulse it is just scary when I can feel my heartbeat throughout the day. I know it is because I'm more aware of it by thinking about it but even sometimes when I am distracted I will have palpitations. Is this only anxiety? Also will this sensation ever go away? It seems also like every time I eat anything this starts. Should I be tested for something else?
Brief Answer:
I would explain as follows :
Detailed Answer:
Hello!
I would like to confirm that your increased awareness about heart rhythm issues seems to be be a pure psychological effect.
Anxiety is the main cause of this clinical scenario.
Regarding your postprandial symptoms (food related complains), I would suggest to discuss with your doctor for a possible fibrogastroscopy and to try any PPIs ( for example: omeprazole, pantoprazole, etc.).
Hope to have been helpful!
Greetings!
Dr. Iliri
I would explain as follows :
Detailed Answer:
Hello!
I would like to confirm that your increased awareness about heart rhythm issues seems to be be a pure psychological effect.
Anxiety is the main cause of this clinical scenario.
Regarding your postprandial symptoms (food related complains), I would suggest to discuss with your doctor for a possible fibrogastroscopy and to try any PPIs ( for example: omeprazole, pantoprazole, etc.).
Hope to have been helpful!
Greetings!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi doctor I have one last question before I close the discussion. Today has been a very busy and hectic day at work. I just finished and I had lots of anxiety today. Now that I'm finished I have a birthday party to attend. I am driving and getting palpitations. Skipped beats and fast heart rate. Is this normal? I also checked my pulse and felt something that felt like a double beat. Is that dangerous?
Brief Answer:
You have to look after your excessive anxiety.
Detailed Answer:
Hello XXXX!
Having anxiety and palpitations time after time is a normal happening of everyone's life. But being always, almost every day at an increased psychological inexplicable alertness and unjustified awareness is an important indicator of excessive anxiety.
Your palpitations and ectopic beats feelings though quite unpleasant, are not dangerous. Do not worry about them! There aren't actually any life-threatening conditions. So, relax!
Remember, your heart seems perfectly normal.
Have a nice weekend and a pleasant birthday party!
Regards! Dr. Iliri
You have to look after your excessive anxiety.
Detailed Answer:
Hello XXXX!
Having anxiety and palpitations time after time is a normal happening of everyone's life. But being always, almost every day at an increased psychological inexplicable alertness and unjustified awareness is an important indicator of excessive anxiety.
Your palpitations and ectopic beats feelings though quite unpleasant, are not dangerous. Do not worry about them! There aren't actually any life-threatening conditions. So, relax!
Remember, your heart seems perfectly normal.
Have a nice weekend and a pleasant birthday party!
Regards! Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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