Heart palpitations

[Leanne053]

Hello,

Ive been to the doctors a couple of times over the years for heart palpitations, I've had many ECGs and they've always come back normal, as does my blood work.
I started taking Venlafaxine at the end of March and been on a 150mg dose for coming up to 5 weeks.
I'm certain my heart palpitations have gotten worse. I know we shouldn't drink red bull but I have one every now and then, well I won't be anymore because last time within minutes of drinking it my heart was pounding and this lasted for hours afterwards. Again with alcohol if I have a drink, even 3 glasses of wine my resting HR last night was 104 and then if I stood up and walked it shot up to 139! I then have terrible heart palpitations the next day. I feel like my heart is pounding, racing and I can feel it in my neck!
I'm becoming increasingly concerned that there is something underlying with my hear that maybe a ECG can't show? Is that possible? Is it worth speaking to the doctor or will they just say "don't drink red bull and alcohol"!
I am 29 yo female, healthy weight, no other medical conditions.
Thank you for any replies 

Yeah :) which luckily was fine

I've found the ferritin one

Ferritin is fine, but your vitamin D is in the lower end of normal. Do you take vitamin D daily ?

They prescribed me some vitamin d at the time and I now supplement daily

Can you see how old the results are ?

Are you having heavy periods ?

They are a year old but the most recent I have unfortunately! But these blood tests were done specially for my complaint of heart palpitations

No I have very light periods

Those last results you posted are all pretty dire. Ferritin needs to be around 70 if not higher, your B12 is low in range, folate isn’t great and looks like your Vitamin D isn’t good either. If you look up the symptoms of all these deficiencies you’ll probably find palpitations mentioned on a couple of them. If your GP is unwilling to treat then you may need to start supplementing on your own.

I suppose all you can do is go back and say that they are making you uncomfortable, and it’s worrying.

it might be worth asking your GP if it’s worthwhile having a Holter type monitor - you wear it continuously for a few days. It gives a reading over 24 hrs for several days. It might show more than an ECG which is just a brief snapshot.
it might be helpful to keep a diary of food/drink during this time so that you could identify any possible links.

Ooops okay. I do now take vitamin d and b12 every day and a multivitamin, should I start taking iron and vitamin c tablet too? Thanks for your reply

My ferritin was 7 and I felt awful. I only realised how bad it made me feel when i started taking medication.
You could buy some ferrous Fumarate over the counter and see if it makes you feel better.

Atrial Fibrillation is a possibility. Often EKGs don't detect it on a one off as it happens erratically. Maybe get a week long monitor, where you press a button if you feel the palpitations and they then read the full report and identify if you have arrythmia.

In most cases Afib is easily treated with beta blockers and anti coagulants. It is not life threatening, but if untreated can lead to stroke. Sometimes an ablation or "shock" treatment is needed to sort it out. Just another option to ask about.

I have Afib, and while I didn't drink alcohol or fizzy energy drinks, that is not a cause as such, maybe a trigger that can set it off though. I would never have known as I had the occasional jump and bump but nothing that annoyed or worried me. I was in hospital for another procedure and they found it while I was there!

Oh right okay might be a good idea, thank you

Okay sounds interesting! I think it's time to speak to the doctor again so I'll suggest this

Personally I’d ditch the multivitamin and start taking an iron supplement. They can cause some pretty rotten digestive ‘issues’ so be warned. I’ve got some Ferrograd which seem to be the only ones which don’t have this effect on me. If you can, get your GP to do more blood tests in a few months to see if there is any improvement.

Atrial Flutter and Atrial Fibrillation (which is what the AF abbreviation is usually referring to) are two different things.

Arrhythmias and ectopic beats only show on an ECG if they’re happening at the exact time the ECG is being done. So you probably need to see your GP again to refer you for a holter monitor, which is an ECG you wear for several days so they can see everything your heart is doing at that time. It has a button to press when you feel symptomatic, but it will also pick up anything happening in the background that wasn’t noticed by you.

Venlafaxine can have some cardiac side effects, especially at high doses, so it’s definitely worth discussing with the GP, but do not stop taking it.

The bit you mentioned where your heart rate elevates on standing is called “Orthostatic intolerance” - it’s where your autonomic nervous system isn’t responding adequately to initiate vasoconstriction in your lower legs and force the blood back up to your heart, so the heart has to work harder to send what blood it does have available to your brain, etc as some of your blood volume will be pooled in your legs or abdomen. It might help to do a bit of reading about this prior to GP appt so you can arm yourself. I have this, eating and alcohol are triggers for mine too. Lots of people have developed autonomic dysfunction/Orthostatic intolerance after having covid.

In the mean time, make sure that you are very well hydrated and try adding a bit of salt to your meals. Dehydration tends to hugely increase the episodes of Orthostatic intolerance.

Thank you I'll look into buying some :)

@ZealAndArdour thank you I'll have a good read later this evening. I really want to get to the bottom of it so lovely to have so many responses!

I have Extrasystole, which gives me the sensation of a skipped heartbeat or palpitations. It's monitored, so I do a 24 holter once a year and a heart stress test too, first on an exercise bike and then via a drug to speed the heart up (both done in the hospital)

I can tell you it's brought on by the following:

Caffeine ( I have one coffee a day, but no more)
Alcohol
Tiredness
Heat Exhaustion
Stress

Those triggers match mine! I'll have a google! Lots of googling to do tonight haha!Thank you

Your Potassium is borderline in those test results and low potassium will cause palpitations. Especially if it has fallen lower since. Can you get your most recent results or ask GP to retest? Also, if you were taking B12 supplements when it was tested, it could be a falsely high result

I've just googled low potassium symptoms and they fit too. I had low potassium once before and was given dissolvable tablets but think that was Jan last year. Thank you, I'm having my Venlafaxine reviewed by psych on Tuesday I'll see what they have to say and then speak to my own gp

I had this and it was my thyroid!