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What Causes Irregular Heart Beats Despite A Normal ECG?
Question: Hello again my good doctor.
I have now undergone tests at a cardiologist. I had a ecg done resting, a ecg while cycling done, and ultrasound.
However, was wondering. I do have a history of irregular heartbets. But most often they are "normal" irregularities, the kind I feel are not dangerous. But every now and then, I feel there are another kind of irregularities. The are VERY strong , irregular beats. This morning I woke up because of that- it felt like a small explosion in the chest, really hard. Afterwards I felt a bit nausea for a while before I fell a sleep after a while. I was wondering if this might be dangerous, or if I actually have atrial fibrillation as one netdoctor explained that to be like this: x beeing beats: x..x..xx...xxxx..x.xxx..xx.x...XX..xx..xxx..xxX..
This is a good way of explaining my irregular heartbeats at times! They dont feel like the regular extrasystoles I normally have.
I have now undergone tests at a cardiologist. I had a ecg done resting, a ecg while cycling done, and ultrasound.
However, was wondering. I do have a history of irregular heartbets. But most often they are "normal" irregularities, the kind I feel are not dangerous. But every now and then, I feel there are another kind of irregularities. The are VERY strong , irregular beats. This morning I woke up because of that- it felt like a small explosion in the chest, really hard. Afterwards I felt a bit nausea for a while before I fell a sleep after a while. I was wondering if this might be dangerous, or if I actually have atrial fibrillation as one netdoctor explained that to be like this: x beeing beats: x..x..xx...xxxx..x.xxx..xx.x...XX..xx..xxx..xxX..
This is a good way of explaining my irregular heartbeats at times! They dont feel like the regular extrasystoles I normally have.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome back on HCM!
Regarding your concern, I would explain that your symptoms could be related to anxiety.
Your performed cardiac tests have shown that you have a normal heart structure and function.
From the other hand, you cardiac stress test has excluded possible myocardial ischemia.
Coming to this point, I would like to explain that some ectopic heart beats are quite normal and not harmful when they originate in a normal heart structure.
They could be related to activation of sympathetic nervous system (from physical or emotional activity), which leads to a load of chatecholamines (adrenaline and noradrenaline) in your blood, causing palpitations, tachycardia and ectopic heart beats.
So this clinical situation does not seem to be anything serious, considering the fact that all your cardiac tests have resulted normal.
From the other hand, I would recommend checking your blood electrolytes (because an imbalance is possible considering vitamin D deficiency and possible adrenal gland dysfunction).
Regarding atrial fibrillation, I would explain that it causes irregularly irregular heartbeats. It is usually detected on ECG recording, and can not be distinguished by the patient.
So, to conclude, I would recommend performing a new 24-48 ambulatory ECG monitoring or a Loop monitoring which helps detect possible episodes of cardiac arrhythmia.
Hope to have been helpful!
I am at your disposal for any other uncertainties, whenever you need.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome back on HCM!
Regarding your concern, I would explain that your symptoms could be related to anxiety.
Your performed cardiac tests have shown that you have a normal heart structure and function.
From the other hand, you cardiac stress test has excluded possible myocardial ischemia.
Coming to this point, I would like to explain that some ectopic heart beats are quite normal and not harmful when they originate in a normal heart structure.
They could be related to activation of sympathetic nervous system (from physical or emotional activity), which leads to a load of chatecholamines (adrenaline and noradrenaline) in your blood, causing palpitations, tachycardia and ectopic heart beats.
So this clinical situation does not seem to be anything serious, considering the fact that all your cardiac tests have resulted normal.
From the other hand, I would recommend checking your blood electrolytes (because an imbalance is possible considering vitamin D deficiency and possible adrenal gland dysfunction).
Regarding atrial fibrillation, I would explain that it causes irregularly irregular heartbeats. It is usually detected on ECG recording, and can not be distinguished by the patient.
So, to conclude, I would recommend performing a new 24-48 ambulatory ECG monitoring or a Loop monitoring which helps detect possible episodes of cardiac arrhythmia.
Hope to have been helpful!
I am at your disposal for any other uncertainties, whenever you need.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response!
I have had ectopic heart beats almost all my adult life- and feel I know them well. What I don't like, is that there is some thing quite other feeling to these extreme hard beats that woke me up today. I thought I was dreaming it, but then after a couple seconds I had a couple more. Also strange that my irregular beats often comes when really scared, or have adrenalin AND I can "produce" my heart to skip beats by positioning my upper body a certain way.
But anyway- I will follow up on what you said with my doctor. I am currently taking vitamin D and hoping this will better my life a bit. It was very low.
Regarding the heart issue I felt this morning- I have never experienced to wake up because of it before. It was SO hard: The x is regular. Big X is what woke me : x x x XX x x x XX X
Thankfull for your services. Its is really hard to live like this, no question it gives anxiety- but I dont feel that triggers these episodes. Especially not when I am sleeping.
I have had ectopic heart beats almost all my adult life- and feel I know them well. What I don't like, is that there is some thing quite other feeling to these extreme hard beats that woke me up today. I thought I was dreaming it, but then after a couple seconds I had a couple more. Also strange that my irregular beats often comes when really scared, or have adrenalin AND I can "produce" my heart to skip beats by positioning my upper body a certain way.
But anyway- I will follow up on what you said with my doctor. I am currently taking vitamin D and hoping this will better my life a bit. It was very low.
Regarding the heart issue I felt this morning- I have never experienced to wake up because of it before. It was SO hard: The x is regular. Big X is what woke me : x x x XX x x x XX X
Thankfull for your services. Its is really hard to live like this, no question it gives anxiety- but I dont feel that triggers these episodes. Especially not when I am sleeping.
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
I am glad to have been helpful!
I would also like to explain that some sleep disorders can lead to a similar autonomic reaction, leading to tachycardia and ectopic heart beats.
From the other hand, awakening from sleep is another kind of physical stress (your body changes from a situation of total relax to a situation of alertness and physical activity). This leads to activation of the sympathetic nervous system, causing a similar symptomatology.
Cortisol is a hormone, produced by your body to help manage physical and emotional stress.
So adrenal gland dysfunction would also contribute in this clinical scenario.
Besides the Loop monitoring or Holter monitoring, I would recommend checking your blood electrolytes, to exclude possible electrolyte imbalance (which is very common in vitamin D deficiency and adrenal gland dysfunction and can lead to cardiac arrhythmia).
Hope to have clarified some of your uncertainties.
Best wishes,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
I am glad to have been helpful!
I would also like to explain that some sleep disorders can lead to a similar autonomic reaction, leading to tachycardia and ectopic heart beats.
From the other hand, awakening from sleep is another kind of physical stress (your body changes from a situation of total relax to a situation of alertness and physical activity). This leads to activation of the sympathetic nervous system, causing a similar symptomatology.
Cortisol is a hormone, produced by your body to help manage physical and emotional stress.
So adrenal gland dysfunction would also contribute in this clinical scenario.
Besides the Loop monitoring or Holter monitoring, I would recommend checking your blood electrolytes, to exclude possible electrolyte imbalance (which is very common in vitamin D deficiency and adrenal gland dysfunction and can lead to cardiac arrhythmia).
Hope to have clarified some of your uncertainties.
Best wishes,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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