Dd having constant ectopic heartbeats - she wants me to ask some questions.

[VentricularEctopics]

Dd is 21, very fit and active (runs long distances and goes to the gym), healthy weight and generally fit and well.

She is very anxious and is autistic.

A couple of days ago she started to have constant palpitations (has had them before probably related to anxiety), after a few hours went to A&E where an ECG identified an extra heartbeat, which she was told were ventricular ectopics. She had blood tests checking thyroid, iron levels, and to see if there were any cardiac crisis markers - all came back clear and she was discharged with instructions to talk to her gp.

She’s talked to her gp, who was very reassuring, sent some information, said that some people get them for a while and that her blood test results were reassuring.

Dd is mainly reassured, but is still worried and it feels weird and wrong! She’s not feeling well in herself, but it’s difficult to know what is anxiety related. She keeps feeling dizzy, but can feel like this due to anxiety anyway.

The constant extra beats are a sensory nightmare and she can’t switch off from it at all. Intrusive thoughts means she’s going from thinking she’s being over dramatic to thinking she’s dying.

She daren’t have caffeine or alcohol, eating feels weird, she daren’t exercise.

Does anyone else have this? Any advice? How do you learn to live with it?

I’ve advised her to ring her gp tomorrow to talk it all through and see if there’s medication that might ease it. I’ve also said if she keeps feeling dizzy she should go back to A&E.

I’ve had a look at POTS, and whilst I’m not sure about some of the symptoms there are some things that have been an issue for her all her life.

I’ve sent her a link, it’ll be interesting to hear what she thinks.

I have them. It’s anxiety. Sometimes I have them all the time. Sometimes not for weeks. Keep exercising. It usually makes them go away as you’re distracted and your heart is beating faster.
You can take beta blockers if they are really bad. I prefer not to.
The more you think about them the more they are there unfortunately

I've had these for many years and they were worst when I was pregnant. I seemed to get a lot of low vitamin/mineral levels in pregnancy so I think the previous poster's advice to take multivits etc. is good.

I had this after covid, a bit older, at 35. I’m
also autistic and found them really distressing. They are definitely exacerbated by stress and I have to
keep on top of exercising now. I was on a low dose beta blocker for a few months when they were really bad and it’s a lot better now a year later. When it was severe I had to drink so much water, so much more than you’d think, and that really helped - I was basically constantly drinking. I still get them every so often but have had them investigated and everything has been found to be normal.

I know you said she is generally fit and sensible, but its time to get serious and ask her to be absolutely truthful.

Over the last 2 weeks or so, has she taken any medications, drank more coffee/tea/redbull/other caffeine products than usual, taken recreational drugs, herbs or supplements. Has she had an average varied diet (compared to an average person), has she slept well, exercised at all/loads. Does she have any other medical diagnoses apart from autism?

Does her heart feel the same as when she was at the hospital and got the ECG, or does it feel more constant? If it feels about the same, she is not likely having PvCs one after the other, just maybe every third or tenth beat..which while uncomfortable and needs assessing isnt a screaming emergency
If she really is getting PVCs immediately one after the other, it is rare but she should go back to A and E tonight. The difficulty is going to be in assessing that as her sensory perception seems like it is heightened. Maybe have her set the stop watch on her phone for 60 seconds and have her count how many PvCs she feels. Less than 60 means they are likely not constant.

It sounds like you are not actually physically with her, is there someone who is who could help her?

My mum's heart kicks out an extra beat every 3 or so beats. She is in her 60s and has had this all her life. It has never caused her a problem and likely never will.

I’m about 400 miles from her. I do trust that she’s being truthful though. The last couple of weeks have been similar to other weeks. She came home for a few days, she’s worked, she doesn’t take any drugs, she’s on antidepressants and has been for the last 2/3 years.

She says the heartbeat is the same as it was in hospital, and that there was an extra beat every time, that they assessed her, did bloods and were reassured that she could go home and carry on with the gp.
I can ask her to time them but I don’t want to trigger anxiety, I think for now it would be best to let her gp suggest next steps. I’ll try to talk to her before she goes to bed.

She is currently with a friend who she lives with.
At other times she’s either on FaceTime to me, sleeping, or with other friends.

Depending on what the gp says she may come home for a few days.

Thinking about it logically if the hospital checked her ecg and were ok to discharge her and the heartbeat is the same it’s likely to be the non emergency type?

Correct, when I last had a problem a&e would not let me go until I begged them to and promised to come back in for more tests. This was after a reaction to a vaccine made my heartbeat go mad but they did still let me go and it settled back to normal abnormality in a day or so! If they let her go without a fuss then she's likely fine, it's quite a benign condition, just annoying. The holter will confirm how often the extra beats are and she might be given beta blockers if they are frequent enough, that's it.

The reason I asked if she thinks it feels the same as when she was assessed with the ECG, is that we know that her rhythm then was safe to send her home, so it is highly likely that it is safe now and it is her sensory sensitivity/anxiety that is heightening it all up. You are correctly deducing the same thing.

I would ask her friend to keep an eye and if friend gets worried to take her back to A and E. Its good that she has someone with her

I'm on propranolol (beta blocker) for my palpitations and it works fine. I'm also autistic and I know how uncomfortable they are.

She’s been prescribed propranolol now and she’s seeing a gp this afternoon.

We talked this morning and POTS seems to be a possibility - she fits many of the symptoms - so she’s going to ask the gp.

She feels exhausted and even walking to her local pharmacy wiped her out - does this sound normal? (I wonder if that would fit more of a POTS profile than the ectopics alone?).

Had she already started taking the propranolol when she felt exhausted? That can make you feel like you're wading through concrete at first before you adjust to them!

I wouldn't say ectopics alone have ever made me feel wiped out but extreme anxiety/panic will do that to you.

Has she had covid or another virus recently?

She was exhausted before.

I strongly suspect that there’s a huge element of anxiety going on, but she’s not in a headspace to accept that yet.

She’s seen a gp, sadly a very dismissive one so didn’t really have an opportunity to ask questions. She’s going to rest for the week, take propranolol, and if she’s no better in a few days going to ask to see a different dr.