Question: Seems less forceful. Hi,

I have been concerned with what seems like a newer issue. I could be completely mistaken and am just noticing in the past few months.

My concern is my pulse strength seems to fluctuate quite a bit beat to beat depending on what I'm doing. Whether exercising or laying down, and just standing. Since I have become worried I don't know what to think "normal" would be.

Most beats that I feel on my pulse are firm and are of a consistent strength and seem normal to me but there are times where periods of beats feel soft or weaker whether it's a few beats in a row, every few or couple beats, or one here or there. They don't feel like palpitations where I have an early beat and a pause it seems less forceful.

I have a hearing loss and laying down on my pillow I can hear some of my heartbeat in my ear. When those soft pulses happen it sounds like a partial heartbeat. I will say my hearing loss is a bit more on the moderate side so I can't hear all of the noises very well. I can typically only hear a lub or dub in my right ear where my left i can maybe hear both. During a soft beat it sounds like the lub part is missing but it may just be softer below my hearing level.

I have been to the cardiologist recently and she listened and said everything sounds good. Despite that, I am only in one position when she listens, lying on my back. I don't know for sure if any of those softer beats happened while she had listed or if some did and it was really a non issue.

To By honest my fear is that every time I go to the cardiologist everything is generally fine because it may all be in that moment or body position. She didn't listen to me standing, laying on my side, or on my stomach. I did have a holter, stress test, and echo last year but I don't recall ever noticing what I am now. I'm worried it's some occasional valve issue or some kind of a block, or regurgitation. I guess they could just be bouts of pacs or pvcs perhaps since I am slightly concerned taking my pulse sometimes and are having many in a short span?

I just would like to know if my worry justified and do I need another opinion if it could be something more serious that has evaded the detection of my cardiologist or is it a normal occurrence whether pac/pvc related or not?

Thanks,

XXXXX

Thank you, my last echo was done in July, the stress test in August, and abdominal ultrasound shortly there after. I've had a barium swallow at the beginning of this year, and multiple ecgs within a few months ago. I haven't had an upper endoscopy or another holter (last XXXXXXX july).

I've had blood work done somewhere around the end of last year that came back clear which included thyroid.

Would they all be considered put of date by now?

Understood, thank you!

I did also want to ask, when taking my pulse at my carotid location not every pulse is perfectly smooth. My interpretation of it would feel like my heart beats and it pushes the blood up the artery but on occasion its like the blood sloshes against the wall almost feeling like a vibration. It's like the artery isn't completely full for the beat. I don't know if that explains the sensation I notice from my fingers. For comparison sake I think my gf's pulse does the same but I wasn't sure if it is something that is normal for how the body works and I'm over analyzing big time or again if it related back to some kind of regurgitation despite my cardiologist not hearing anything concerning. She did listen to my carotid arteries and my chest. This has just been related to my initial question because it's not every beat and it's not all the time but it does happen often. If these things are normal I'm just hoping to relax understanding how all of this works so I could know what's happening or why it's not of any concern.

Thank you, I will asap however it has taken time and because these tests are so expensive especially for more than one it will take me some time to get rechecked.

I did also want to ask for your opinion on missed beat or whether it would classify as an actual pause. I think I may have just had one while I was sleeping and I get these rarely but typically once per 1-3 months. My heart stops for what seems closer to the 2-3 second mark and during that time period I get a progressive tightening sensation in my chest/neck until I get another heart beat. It is terrifying because they feel uniquely different than a regular palpitation which I get fairly regularly.

I mentioned this to my cardiologist and she has never commented on them. Since they happen far less frequently I don't think it has ever shown up on any of my previous tests.

Any final insight would be appreciated, thank you so much.