Heart Palpitations

[Halie]

Hi, I realize that my GP is the best person to ask regarding this but I can't get an appointment until the new year and by then I will be working away and my GP surgery is miles away - and I'm 100% sure my GP will refer me on and that will take weeks.

First of all, I don't think it warrants a trip to A + E. It is a concern, but mostly I'm baffled by it and I'm wondering what it is. The reason I say I don't think it's worth going to A + E is because I had this about 5 years ago and sat in A + E for hours (not their fault) and had an ECG which found nothing. I felt like I'd wasted everyone's time and a nurse told me that feeling these palpitations is quite normal and everyone gets them. I asked around friends and some said it's normal, others said not - I went with my instinct and went to the GP who listened to my chest and referred to a cardiologist who said he could hear an ''innocent murmur'' and wanted to do a holter monitor to be sure. At the time I just got the impression that no one thought it was serious/anything to worry about and they were just going through the motions. Basically felt a bit daft and a time waster and have since assumed it's totally normal and everyone gets this - so I declined the monitor and never mentioned it again to my GP. I haven't really thought about it at all - just accepted palpitations as part of who I am over the past 5 years.

I generally get them on and off throughout the day occasionally. I always get them when nervous/stressed/after working out. But recently it's different - the past few days, when I'm at rest (like now - sitting on the sofa) I'm getting them constantly. The best way I can describe the feeling is a fluttering in my upper chest/lower throat which lasts a few seconds at a time, disappears for a few mins and comes back - for as long as 30 mins at a time. The feeling is quite strong - like the sensation you get of your heart beating when you've just jogged up some stairs.

I listened to my chest and my heart rate is 91bpm (I'm young and healthy so it's a bit raised but still within normal I guess) but when I listen to my heart with a steth I get a lub-dub for a bit and then nothing - it stops for a beat - and continues, or it makes 3 beats in quick succession. For the past couple of days it was intermittent - I noticed it a bit during the day. Today it has been all day regardless of sitting/walking. I've been sat here for half an hour and it's done it this whole time.

I don't feel sick or in pain, I feel slightly lightheaded but I'm pretty sure it's just tiredness.

I think a night in A + E will be useless, I can't see a GP till Feb, a cardiac referral will take weeks/months. I'm just tired of having no idea what my body is doing and why, and the sensation of having my chest flicked from the inside is irritating if nothing else.

Has anyone ever experienced this, knows anyone who has?

Yes, I have. It was anxiety related. Then it was oesophageal spasms. So basically indigestion. Nervous indigestion. They're flutters.

Same here. I have a heart condition unrelated to the palpitations. Cardiologist told me any digestion issues exacerbate the feeling of palpitations due to the Vegas nerve sp? Anyway I have more noticeable palpitations when I've over eaten or have indigestion.

Still always better to get it checked out x

• vagus ha

I get palpitations due to an ectopic arythmia, a benign condition. Worse when feeling stressed / anxious. Magnesium really helps. Too much caffeine makes my heart really thump & flutter. Symptoms much worse during perimenopause but HRT has made a big difference.

I used to get this really often, stopped drinking caffeine (except one a day) and it's pretty much gone, still get it occasionally. Have you been drinking more tea or coffee this week?

Panic can also cause it. If you are lightheaded you might be having a panic attack. Try an app called Thrive.

how much magnesium do you take Peace?

Any other symptoms? Palpitations can be related to thyroid disfunction

I used to but I have noticed that since I gave up alcohol they have disappeared!
Disclaimer: I drank a LOT.
You should definitely go and get checked x

I get horrendous palpitations when I drink too much coffee and when my period is due.

Can be a sign of anaemia also. Ask for that to be checked when you get an appointment.

I get an arrhythmia called PVC - premature ventricular contraction. I have been told they are fairly common and nothing to worry about. The heart beats too fast and then takes a pause almost like pressing reset. It sounds like could be these. But you need to have a 24 hr monitor to know for sure. If you went to a and e they would probably do a quick ecg and at least make sure it's nothing more serious. I think personally that it's worth going if you're really worried.

I get them, got thoroughly checked 5 years ago and told I’m completely normal. As others have said it’s worse when I’m hangover/anxious/have had too much caffeine. If it’s changed though I’d go and get it checked again, can’t hurt for your Gp to look into it.

I’ve got this at the moment. I know it’s nothing to worry about as have had many checks through a&e, gp and cardiologist but it scares the life out of me when it happens.

I am full of cold at the moment and palpitations came with that I think. Have just woken me up in a panic, which makes them worse. Pulse is fine though!

An innocent murmur is probably a slightly malformed heart valve that is not leaking (think back wash) and so will have no impact on your health. No big deal. The fast heart rate you were feeling back when is likely to have been some kind of innocent tachycardia, not a big problem unless you are getting loads of it, as it does wear the heart muscle out faster than just your regular heart rhythm. More than 2 hrs worth a year is about the point where you should be having it investigated properly and try and get it recorded on a holter to check it is an innocent variety.

The recent issues sound to me like you might be having runs of PVC or PAC (extra beats in your atria or ventricle) and if they are happening in 3s and frequently, you do need to get them recorded on an ECG. The other possibility is that you have some atrial fibrillation, and that should be recorded and you should be seen by a cardiologist soon as it increases your risk for a stroke.

So if it was me, I would be going to A and E tonight. The most difficult thing with heart arrythmias is getting them recorded. If you are consistently arrythmic right now, take advantage and get an ECG to get the process started.

In terms of immediate risk to you, I also wouldnt mess around assuming you will be fine, you might, but sometimes heart arrythmias can deteriorate into dangerous rhythmns and that is a very big deal. You also shouldnt let arrythmia go on for ages if you do have a murmur as it wears out your heart muscle.

Go in, get it recorded and get treated.

To the PP who said they have a cold and woke with palpitations, have you been taking sudafed or other decongestants, pseudoephedrine is one of them? They can cause palpitations and are worth avoiding if you are prone.

Also as another PP said, if you are prone, take magnesium supplements. Its very easy to get low on it, and lack of it will increase the chances of arrythmia.

Thanks for the responses everyone.

@cathyclown that's interesting - I had bloods done at the start of the year (fatigue, excess urination) and was told I am anemic. I started taking a supplement but stopped when it ran out months ago and forgot all about it. Might be worth me starting those again.

@SeatoSki thank you, that was really informative. I will see how I get on for the next few days and if it recurs I will get it sorted and book in with my GP. It's odd how some days it's very noticeable all day and other days it seems to disappear. As other's have mentioned I'll make note of caffeine/indigestion/anxiety etc.

Thanks everyone

Another option, if you have the money, is to buy a Kardia from AliveCor (I got mine in Amazon). Its a little sensor that you attach to the back of your phone, and then download the app. Its lets you record a ECG on your phone and then you can email it to your doctor, or show them when you see them. It also gives you a basic read right there and then as to if you are stable or should go to the doctors. My cardiologist recommended it to me and he is the head of department at one of the top hospitals, so its well regarded. Its great to get the recording when it happens and not have to go crazy getting to the doctor immediately to get an ECG.

That sounds really good seatoski. Does it give your actual trace or just tell you if you need to be seen pronto?

It gives you your actual trace, not as detailed as a 9 lead, but very good.

Then it will give you an initial quick read - stable, seek advice, and an urgent one that I havent seen yet (thankfully). It also detects and will label suspected Atrial fibrillation and will in the future be able to detect what the other abnormal rhythmns are, at the moment if its not A fib or sinus rythmn it just says unclassified so you know something is off.

You can then choose to send the trace to their physicians for a read (it charges your credit card if you want to do this) or you can save it as a pdf and email it to your doctor. I have done this several times. I have also taken my phone in and shown them on the screen.

I bought one for my Dad who has A Fib and it helped him work with his doctor to get his dosage of beta blockers dialed in. It also gave him a lot of confidence that anytime he felt a bit funny he could check and see if his heart was acting up. Mine has been used to record my SVT which happens every couple of months so that they could treat it.

Fab device (I have no connection beyond being a very happy customer!)

Three quick beats after a PVC is highly likely to be normal heart rate turbulence: it's supposed to happen after a PVC. I wouldn't be worrying about some sort of tachycardia. Your description does sound like classic PVC's which, absent any structural defect, are benign. They cannot harm you (though it sometimes feels like they will).

Anemia/iron deficiency will cause, or exacerbate this. I have always had PVC's, and when my ferritin became low, they massively increased in frequency. This makes sense as they are known to be triggered by lower than usual oxygen in the blood.

I think guidelines say if you are getting more than six a minute and it's not stopping, it's worth going to A & E. You will almost certainly be sent home after being checked out, but the reassurance that they are normal might well be worth it.

I'd had palpitations for years (non-smoker, mainly veggie, very fit) but they it worse when I hit 40. I finally got round to a 24hr monitor three years ago. Diagnosed with supra ventricular tachycardia after that. I forget the precise cause but it's something to do with having a 'dual carriageway' bit of heart that goes a bit haywire every so often and pumps too fast. Caused by stress, tiredness and too much caffeine, which explains why I can't take cold remedies with caffeine in.

Now I know what the problem is it doesn't worry me so much and the consultant said it tends to tail off in older age.

Even if you don't go to A&E please go back to your GP and get the 24hr monitor. I was able to work and go to the gym wearing it and the kids never knew I had it on.

Seatoski. Thank you, that sounds great.

I think it would be worth seeing your gp and having some bloods done just to check nothing else is going on.

I was diagnosed with Addison’s disease and severe anaemia in September and my overwhelming symptoms (that drove me to the gp) were strong palpitations and missed beats. Sometimes I would lie in bed trying to sleep and it was like I could feel my whole body vibrating with every beat. Just awful. Since I’ve been diagnosed and begun medication I don’t even notice anything anymore.

I had episodes of feeling like my heart was quivering and had flutters and kept getting chest tightness. I had various exercise tests, echocardiograms and a nuclear stress test and nothing could be found. I had previously had other heart and lung scans etc as I have chronic pulmonary oedema, which is normally caused by heart failure. That was ruled out, but I take furrosemide to control the pulmonary oedema issue.

Over the years the palpitations and fluttering/quivering./tightness became more frequent with the added symptoms of lightheadedness, sweating and near fainting. The attacks becane longer. It came to a climax with severe symptons that wouldn't stop a couple of years ago when I phoned NHS for advice and they sent an ambulance. The paramedics got there while it was still going on and got readings of 200 beats per minute. The A and E department were put on standby and I was taken straight into resus. I was diagnosed with Supraventricular Tachycardia (SVT) and given an urgent referral to a cardiologist. I had the holter monitor for three days, which confirmed that I was now having several episodes daily, between a couple of minutes and a couple of hours. I was also having many premature contractions, and it was runs of these that seemed to trigger the SVT. After a further echo a slightly leaky valve was found - that's pretty common and not of concern. I was constantly tired and generally felt ill.

I was initially prescribed daily beta blockers, but although they stopped the tachycardia and premature contractions I had too many side effects. I now take a calcium channel blocker daily and all is good. I have my life back.

The thing is, it can be difficult to find and diagnose problems like this due to the episodic nature of it. Unless you have symptoms during the ecg they don't know what's wrong. So it may be worthwhile getting the monitor, especially if you have frequent troublesome symptons.