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Heart Disease  (Expert Forum)
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Palpitaions
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MedHelp Member's Question

Palpitaions

by noreaster, Mar 01, 2004 12:00AM
Tags: Heart
Hi and thanks for taking the question. I am a 27 years old female. Since last fall I’ve been feeling uneasy about my heart. It started with the feeling of tiredness, chest tightness and  an occasional chest pain and a slightly faster than normal heart rate (120b/m)at times. I visited my physician, had a blood test (+ TSH level) and an EKG. The EKG showed signs of left ventricular overload and I was advised to go to a cardiologist who said that everything was fine. When I visited my family doctor in February (same complaints) she put me on some anti-anxiety medicine which actually took my mind off the problem a bit. However, I'm still experiencing some symptoms I'd like to ask about.

First of all is it normal that I'm aware of the change in my heart rythmn when I change positions (for example when I stand up?) On some days these palpitations are pretty strong.

Secondly, can anxiety cause my chest and abdomen heave/shake with every heart beat? I can see it whenever I lie down even when I’m wearing a thick sweater. It gets worse with exercise.

I never noticed it before so it's kind of puzzling.

Also,I know that anxiety can  be responsible for chest pain. What about upper back pain?

Doctor's Answer

by CCF-M.D.-RCJ, Mar 02, 2004 12:00AM
noreaster,



Thanks for the post.



C1:"The EKG showed signs of left ventricular overload"



EKG evidence of hypertrophy (LVH = "overload") is not standardized for persons under the age of 40.  If we read every 27 yo's EKG with high volts as having LVH, we would be over-diagnosing tons of LVH.



Q1:" is it normal that I'm aware of the change in my heart rythmn when I change positions"



I don't experience this, and the vast majority of the general public doesn't either. But that doesn't mean that this sensation is abnormal for you.  I don't know why you experience this sensation, but learning to cope with it will clearly be important for your peace of mind.



Q2:"can anxiety cause my chest and abdomen heave/shake with every heart beat?"



Anxiety is an emotion, so a direct effect on your chest is obviously not possible.  However, anxiety can lead to increased heart rate and contractility via release of adrenaline.  As anyone who exercises knows, adrenaline can lead to heavy respirations and chest pounding.



So the short answer to your question, is both yes and no.



Q3:"What about upper back pain?"



Anxiety can lead to a multitude of symptoms, with pains just about anywhere.



Please note that I am not saying that your symptoms are caused by anxiety.



Best of luck.





Member Comments (18)

by starion, Mar 01, 2004 12:00AM
Ask the doctor/cardiologist to evaluate you for orthostatic intolerance, which CAN cause rapid increases in heart rate when you change positions from lying or sitting to standing & even more with exertion.  If you're not satisfied that the cardiologist has figured out WHY you're having your symptoms, tell the referring doctor & ask for a referral to another cardiologist for a re-evaluation.  For my workup (I have rapid heart rate or tachycardia), we did an electrocardiogram, exercise stress echocardiogram, regular echocardiogram, and 24-hour holter monitor test.  We will be repeating the 24-hour holter test off my meds to see if they are causing the tachycardia.  Head up tilt table testing is frequently used to diagnose orthostatic intolerance.

Aloha,

Starion

by mbimom, Mar 01, 2004 12:00AM
To: noreaster
Just a comment to you, I was about your age when I first noticed my heart pounding out of my chest at times.  When I told my doctor he just blamed it on anxiety gave me xanax. It wasn't until years later it started pounding so fast and it wouldn't stop so I went to the ER and was finally diagnosed with SVT and eventually had an ablation to fix it. Through all this I found out that I also have a bicuspid aortic valve with moderate regurgitation.  For this I need antiobiotics before surgery and dentist visits and I get a echo every year.  My old doctor completely missed the boat on that one. My advice to you would be you know if something is not right with your body find a doctor who will listen to you, I finally did and it is amazing how different 2 doctors can be.

by noreaster, Mar 01, 2004 12:00AM
To: starion and mbimom
Thanks for the insight.  You’re right about me not being satisfied the cardiologist’s explanation. I never used to freak out when it came to health issues so this anxiety thing came as a surprise and I got confused. That’s what brought me to this forum.  I don’t want to go to another cardiologist before checking things out and learning more. The first visit was no fun (I felt bad I went) and I’d rather not go through it again unnecessarily.

by I'mallheart, Mar 01, 2004 12:00AM
To: noreaster
hey i know what your going thru..i too am 27 mine also started in fall..i had ekg, fine echo fine,holter and event recorder fine..i still feel like ****. i am on atenolol cause everytime this happened thats what they would give me to get my heart rate at normalality again. i take 25 mg a day, it has made less noticablr signs . maybe check into this..i would also get an holter and event recorder so they can have it when somthing comes up..i also do have anxiety..and this i think is what alot of us in here deal with..i too have pulsations in abdomen, i lso have in both sides of neck..did an ultrasound and was okay..i am not skinny cause usually on skinny folks they say its more noticable..oh well guess we are blessed to have a strnd beat..i am 5-7 180... are u at all skinny? i also would get your thyroid checked..mine was alittle off but they said nothing big..best of luck email if you want

***@****

dave

by noreaster, Mar 01, 2004 12:00AM
To: i'mallheart
Thanks. Great to hear from a person with a similar problem. Don't know about you but it really scared me at first. If I put a book on my stomach it would move.

I also feel the pulsation in my neck sometimes.  

I'm not skinny. On the contrary - I'm a bit overweight.

I had my thyroid checked and it was fine.

Thanks again.

by boopie, Mar 01, 2004 12:00AM
I am 28.  Today i went to my doctor to see the results of my Holter monitor which i received after my scary visit to the ER last week when i got so consumed with them that I thought my only choice was to go.  10 years ago these palps started and i got an EKG with 0 palps showing and they said i was fine and was sent home. 2 1/2 yrs ago, i again (different ins.) tried to find an answer to these bizarre almost constant beats...Dr said "It's Normal, Everyone has them" My ins. would not cover any testing,   NOW.. no longer on any insurance.. They say it is PVC's.. the Holter said 5% of my heart beats are these PVC's. Good?? Bad??  It doesn't feel good! I am going to get an echocardiogram tomorrow and the dr. gave me Toprol-XL 50mg. to see if it helps..As i see i am not the only one here who feels like this runs theirs lives.. Every morning i am so thankful that i wake up. Thank you to all who have posted!! does anyone have any personal info on the meds i was given? Side-effects? You have no idea how much calmer i feel knowing that i am not the only one who lives with this on a daily basis..

by Heathbar, Mar 01, 2004 12:00AM
Hi all, been lurking for a while but thought

I'd say Hello. I'm a 34 yr old male. I have

around 3 to 4 hundred pvcs that I can feel

everyday. My cardio has me on bisoprolol as

a beta blocker. Is one better than another?

I'd take any relief, it's been over 2 yrs now.

by boopie, Mar 02, 2004 12:00AM
To: Hankstar
Hey Hank...  So what exactly does moderate mean???  And yes you were exactly right.. it's alittle over 6000. Honestly,,, i'm just glad that i can start to recover mentally... I suppose i was getting extremely wrapped up and somewhat obsessed about the Palps.. and am so glad i found this forum to make me realize i wasn't helping my condition. Thanks for your imput on the med's... I've spent the last 10 yrs thinking i could drop dead at any moment.. but now i have "hope"...AGAIN... Thanks to you all!!! :)

by Momto3