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What Causes Huge "thump" Feeling In Chest And Premature Heart Beats Followed By A Pause?

Posted on Thu, 23 Jan 2014

Question: Dear dr, My skipped heartbeats pvcs/pacs came back with a vengeance recently. I had seen a cardio 1 year ago when I first felt them. ECG normal n holter shows 461 skipped beats . It come n go this one year only to return with full force recently . I can feel a huge "thump" in the chest especially when I lay flat on my back. Other times it felt like a premature beat followed by a pause. What's the difference between the 2? It's driving me insane! I'm feeling miserable . Do I need to get them checked again ? The thumping hard "twitched" felt seemed to be different feel compared to the skipped beats. Pls advise

Answered by Dr. Benard Shehu (4 hours later)

Brief Answer: Atrial/Ventricular extra-systoles causes&treatment Detailed Answer: Hi XXXXXXX The huge "thump" you feel in the chest especially when you lay flat on the back refers to the ventricular extra systoles. The premature beats followed by a pause is related to atrial extra-systole. The origin between the site of the extra heart beat (extra-systole) is the difference between them. If I was your caring doctor would ask to repeat again ECG, holter monitoring, cardiac echo to re-evaluate your situation. Meanwhile, I'd advise to talk to your cardiologist to start a drug from betablocker group to dominate the extra heart beats and make you feel better. You don't have to feel "insane"! Once on betablocker, you will be ok. However, above-mentioned tests should be repeated. Take care! Dr.Benard Feel free to ask me other questions you might have!

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Benard Shehu (3 hours later)

Thks for ur reply. I'm 34 yrs old, 178cm in height n weigh 61kg. I had never drink alcohol ever n less than 4 cigrettes per day. Basically I XXXXXXX eat junk food and careful on my diet. My family had no history of heart dieseases..I XXXXXXX know y this happen ? I will go get it evaluated, meanwhile what do u tink is the possible closest diagnosis ?? Are they pvcs pacs based on what u said earlier ?? What cause it and other than beta blocker , what can I do? Basically I had no other symptom other than the twitches and thumping .. There is no dizziness, pain etc. I'm not looking for consolation .. I'm currently working away from my home and medical services in the new city is not quite advance. Therefore I jux need some advice based on your experience.. Thks agin. Appreciate lots!

Answered by Dr. Benard Shehu (8 hours later)

Brief Answer: Lifestyle&Diet Habits afect irregular heart rhythm Detailed Answer: Hi back XXXXXXX Thank you for following up! I am glad to come to know that you do not drink alcohol and you are careful on your diet. You are saying to work far away from your home. I'd ask if the foods you eat at this place is different from your hometown? Changes in the lifestyle and diet habits can also attribute to the symptoms you are having. Although your diet is healthy, I'd advise to: - eat slowly and often and always small portions - avoid taking coffee/energetic/carbonated drinks - do not lay down immediately after eating - have your dinner at least 4 hours before sleeping I'd suggest to check : - your thyroid hormones levels - blood sugar level (fasting, oral glucose tolerance, HbA1C) - lipid profile To my opinion, it could be related to stress or work-overload. However, to give the final diagnosis, I should have the results of the requested tests. PVCS and PACS are both irregular heart rhythm both referred to the earlier diagnosis or premature ventricular contractions and premature atrial contractions respectively. Take care! Dr.Benard

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Benard Shehu (8 hours later)

Thks I will get it evaluated. Yes I'm away from home and lifestyle is bit different .. Example weather. Is cold n dry , which I had nv experience in my country . I XXXXXXX know if it's a possible trigger , n sometimes body movement can trigger the skipped beats eg. Turning upper torso, reaching for objects etc. May I know y is this so? Anyway I had anxiety disorder for 8 years. N very tuned in to body sensations . But I'm afraid that drs push it to anxiety.

Answered by Dr. Benard Shehu (6 hours later)

Brief Answer: Cold weather and anxiety may trigger arrhythmia. Detailed Answer: Hi back XXXXXXX The cold weather at the place where you work could be a factor of causing irregular heart beats to you. This does not mean that you should be worried about as it is a perfect reaction of the body to cold weather conditions. With regards to "turning upper torso" or "reaching for objects" as possible triggers, I'd say yes if such action is done suddenly and rushing. I'd advise not to rush or not to over-stretch your muscles to avoid such reactions. Being anxious can also contribute to irregular heart beats too. Stress-relieving techniques and above-mentioned advice can also give a hand. All the best Dr. Benard p.s If you are satisfied with my answer than, please close this query and rate my answer.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Benard Shehu (3 hours later)

Dear dr, I went to see the cardio n he felt my pulse. And the skipped beats were there 2 times when he felt my pulse for about 20secs. My exact ECG and 24hr holter was 8 months ago . The cardio said that since there was n increase recently , he think is still not necessary yet. He advised me to take some medication, he prescribed trimetazidine 20mg. And a tcm medicine n told me to relax. N said it doesn't improve then perhaps another ECG n holter. I'm trying my best to relax, but still the twitches are felt when I'm relaxing on my sofa, watching tv and I count my pulse at 65beats per min. It's not pounding yet it stil skipped when my heart is beating normal. Is really annoying n scary..

Answered by Dr. Benard Shehu (4 hours later)

Brief Answer: Advice to perform Holter monitoring. Detailed Answer: Hi again, Thank you for following up. You are reporting to be taking trimetazidine 20 mg. In rare cases, trimetazidine can cause extra heart beats. However, I still insist to repeat the 24 hours Holter monitoring to exclude organic problems. Although an annoying situation, you should try to keep relaxed and not to repeatedly check your pulse. If the pulse is 65/min, it is perfectly normal and there is nothing to be worried about. Looking forward to have the results of Holter monitoring! Dr.Benard

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Above answer was peer-reviewed by : Dr. Yogesh D