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Are Recurrent Episodes Of Heart Palpitations For Over Two Years A Serious Concern?
Question: Hi
Over the last 2 years, I've experienced some episodes with my heart. The first time I noticed something strange was when I started weight lifting around 2 years ago, I got a fast beating heart rhythm after a tough workout which disappeared shortly after. Over the following weeks, I noticed that this same thing happened after my training sessions, usually within 1-2 hours after training and would continue for anywhere between 1-5 hours and then disappear out of nowhere.
What happens is that my heart starts racing, I've noticed that this often happens after a shower after training or similar but also have occurred yesterday where I had a very anxious day and then got another episode. My heart speeds up in speed and I would say it beats irregularly at high speed but it's a little hard to say for sure, seems like a normal beat followed by 3-4 fast smaller ones and so on. It gives me a lot of anxiety, but I don't get pain or lose consciousness or similar, it's just really uncomfortable. After around 20 minutes I decided to try the Valsalva maneuver and it more or less dissapeared right after. My heart rate went from around 120 to 80 and continued to the 60-70. Today I've felt a little sore in the chest and slightly tired, like I ran a marathon or something like that or worked out my chest.
Patterns: I've tried this maybe 6-10 times over 2 years and out of almost all the cases it happened after heavy workout but not every time. Also I drink coffee and struggle with anxiety which was stressing me out yesterday and maybe could be the cause of this problem in yesterdays episode.
I've done some searching and it doesn't really stop my anxiety, so now I try here until I can visit a doctor. What could this be and what could cause this?
Over the last 2 years, I've experienced some episodes with my heart. The first time I noticed something strange was when I started weight lifting around 2 years ago, I got a fast beating heart rhythm after a tough workout which disappeared shortly after. Over the following weeks, I noticed that this same thing happened after my training sessions, usually within 1-2 hours after training and would continue for anywhere between 1-5 hours and then disappear out of nowhere.
What happens is that my heart starts racing, I've noticed that this often happens after a shower after training or similar but also have occurred yesterday where I had a very anxious day and then got another episode. My heart speeds up in speed and I would say it beats irregularly at high speed but it's a little hard to say for sure, seems like a normal beat followed by 3-4 fast smaller ones and so on. It gives me a lot of anxiety, but I don't get pain or lose consciousness or similar, it's just really uncomfortable. After around 20 minutes I decided to try the Valsalva maneuver and it more or less dissapeared right after. My heart rate went from around 120 to 80 and continued to the 60-70. Today I've felt a little sore in the chest and slightly tired, like I ran a marathon or something like that or worked out my chest.
Patterns: I've tried this maybe 6-10 times over 2 years and out of almost all the cases it happened after heavy workout but not every time. Also I drink coffee and struggle with anxiety which was stressing me out yesterday and maybe could be the cause of this problem in yesterdays episode.
I've done some searching and it doesn't really stop my anxiety, so now I try here until I can visit a doctor. What could this be and what could cause this?
Brief Answer:
The possibility of atrial fibrillation is there
Detailed Answer:
Hello,
There is a possibility of atrial fibrillation or PSVT in your case. Also, another possibility is of frequent PVCs. These are usually not worrisome. However, this can be just anxiety but should be evaluated. These can occur without any clear-cut cause or may occur due to structural heart disease. These are frequently aggravated by stress, anxiety, coffee, alcohol etc.
Firstly, you should get an ECG done and ECG may be normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You may need 24 hour Holter monitoring if ECG is not informative.
ln order to abort such episodes you should try to cough hard or perform Valsalva or pour cold water over the face.
You should decrease the consumption of coffee, and smoking or alcohol if any. Till the time your evaluation is complete, you can ask your local doctor for tab PROPANOLOL 20 mg once a day. This will take care of both anxiety and heart rate. Overall, there is a possibility of cardiac arrhythmias, which doesn't appear worrisome.
Hope this helps you and get back if you have any doubts.
The possibility of atrial fibrillation is there
Detailed Answer:
Hello,
There is a possibility of atrial fibrillation or PSVT in your case. Also, another possibility is of frequent PVCs. These are usually not worrisome. However, this can be just anxiety but should be evaluated. These can occur without any clear-cut cause or may occur due to structural heart disease. These are frequently aggravated by stress, anxiety, coffee, alcohol etc.
Firstly, you should get an ECG done and ECG may be normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You may need 24 hour Holter monitoring if ECG is not informative.
ln order to abort such episodes you should try to cough hard or perform Valsalva or pour cold water over the face.
You should decrease the consumption of coffee, and smoking or alcohol if any. Till the time your evaluation is complete, you can ask your local doctor for tab PROPANOLOL 20 mg once a day. This will take care of both anxiety and heart rate. Overall, there is a possibility of cardiac arrhythmias, which doesn't appear worrisome.
Hope this helps you and get back if you have any doubts.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hi thanks for your answer, I tried to reply to this, but it seems like it didn't send.
Since I had the last episode a couple of days ago I've been super nervous, anxious and in general on edge. I feel a tightening feeling in my chest, not very painful but just like the pressure is this normal?
I was wondering could all this be caused solely by anxiety or adrenaline?
The times I've had the episodes has been an hour or 2 after very physical workout with high pulse (I was not used to exercise) and I've had 1 episode after a heavy allergy from pollen and a lot of anxiety where I've taken medicin that could cause heart related things?
Bear in mind the longest they've lasted has been for 4-6 hours and sometimes I can experience fast ones only lasting a minute or two. I have no one in my family who's had issues with heart or similar.
Since I had the last episode a couple of days ago I've been super nervous, anxious and in general on edge. I feel a tightening feeling in my chest, not very painful but just like the pressure is this normal?
I was wondering could all this be caused solely by anxiety or adrenaline?
The times I've had the episodes has been an hour or 2 after very physical workout with high pulse (I was not used to exercise) and I've had 1 episode after a heavy allergy from pollen and a lot of anxiety where I've taken medicin that could cause heart related things?
Bear in mind the longest they've lasted has been for 4-6 hours and sometimes I can experience fast ones only lasting a minute or two. I have no one in my family who's had issues with heart or similar.
Brief Answer:
Yes, this can happen with anxiety
Detailed Answer:
Okay. Chest tightness can occur with anxiety, arrhythmias, even asthma. Other common cause is Gastroesophageal reflux disease. This should be considered if also having upper abdominal pain, nausea, bloating, burping, increase in pain on food or lying down, sour water feeling in throat or chest burning.
So I mentioned above, it's worthwhile to rule out the possibility of arrhythmias in you. And this is usually not worrisome. So you not have undue stress due to this. Meanwhile, keep watch over your pulse rate and regularity. Its normal for pulse rate to rise after exercises. For your age group, maximum allowable pulse rate with exercises is around 180-190, but should settle to normal after 5-10 min of exercise. All the best.
Yes, this can happen with anxiety
Detailed Answer:
Okay. Chest tightness can occur with anxiety, arrhythmias, even asthma. Other common cause is Gastroesophageal reflux disease. This should be considered if also having upper abdominal pain, nausea, bloating, burping, increase in pain on food or lying down, sour water feeling in throat or chest burning.
So I mentioned above, it's worthwhile to rule out the possibility of arrhythmias in you. And this is usually not worrisome. So you not have undue stress due to this. Meanwhile, keep watch over your pulse rate and regularity. Its normal for pulse rate to rise after exercises. For your age group, maximum allowable pulse rate with exercises is around 180-190, but should settle to normal after 5-10 min of exercise. All the best.
Above answer was peer-reviewed by :
Dr. Prasad
Thanks again.
Just to sum up and clearify.
My pulse during exercise is all normal, I don't exceed 180, but I can get up to that area when running. After stopping my pulse drops down again but stays around 80-100. And when I got the episodes they started after I got home and usually around 1 hour after I come home take a shower or similar then my heart starts racing up again and my heart beats feels irregular until suddenly after a couple of hours it slows down and gets back to 68-75 and I feel tired in my chest but it continues to beat normally.
I was thinking if that could be a delay from exercise? I usually left working out extremely tired and used, almost shaking from the hard workouts and feeling weak.
Also I get anxious when my heart beat is beating faster, so naturally fitness made me slightly nervous and focused on the heart beat.
I forgot to add that I also struggle maybe with IBS or something that shares same symptoms and has frequent issues with my stomach since I was a child, but never been diagnosed.
Just to sum up and clearify.
My pulse during exercise is all normal, I don't exceed 180, but I can get up to that area when running. After stopping my pulse drops down again but stays around 80-100. And when I got the episodes they started after I got home and usually around 1 hour after I come home take a shower or similar then my heart starts racing up again and my heart beats feels irregular until suddenly after a couple of hours it slows down and gets back to 68-75 and I feel tired in my chest but it continues to beat normally.
I was thinking if that could be a delay from exercise? I usually left working out extremely tired and used, almost shaking from the hard workouts and feeling weak.
Also I get anxious when my heart beat is beating faster, so naturally fitness made me slightly nervous and focused on the heart beat.
I forgot to add that I also struggle maybe with IBS or something that shares same symptoms and has frequent issues with my stomach since I was a child, but never been diagnosed.
Brief Answer:
Okay, these are not directly related to exercise
Detailed Answer:
So, these episodes are not exercise related, but entirely different. So you get anxious after the episode begins, but anxiety doesn't not initiate these episodes, right. So such sudden rise in pulse rate without any appropriate reason makes the possibility of arrhythmias like atrial fibrillation stronger. Arrhythmias are usually associated with dizziness, shortness of breath, palpitations, chest pain or discomfort. Although, anxiety we can't entirely rule out. One may get pulse rate of 120 with anxiety as well but rise and fall is gradual, and pulse is regular. So investigations should help to reach a diagnosis. Meanwhile, should avoid precipitating factor like excessive coffee, alcohol, smoking, do deep breathing exercises, yoga etc to calm yourself.
Also, you should once deworm yourself with Tab Albendazole 400 mg bedtime once and repeat after two weeks for your symptoms. Also, if having any of gastritis symptoms I mentioned above, should have antacids like Pantoprazole or lansoprazole for 5 days.
Okay, these are not directly related to exercise
Detailed Answer:
So, these episodes are not exercise related, but entirely different. So you get anxious after the episode begins, but anxiety doesn't not initiate these episodes, right. So such sudden rise in pulse rate without any appropriate reason makes the possibility of arrhythmias like atrial fibrillation stronger. Arrhythmias are usually associated with dizziness, shortness of breath, palpitations, chest pain or discomfort. Although, anxiety we can't entirely rule out. One may get pulse rate of 120 with anxiety as well but rise and fall is gradual, and pulse is regular. So investigations should help to reach a diagnosis. Meanwhile, should avoid precipitating factor like excessive coffee, alcohol, smoking, do deep breathing exercises, yoga etc to calm yourself.
Also, you should once deworm yourself with Tab Albendazole 400 mg bedtime once and repeat after two weeks for your symptoms. Also, if having any of gastritis symptoms I mentioned above, should have antacids like Pantoprazole or lansoprazole for 5 days.
Above answer was peer-reviewed by :
Dr. Prasad
As far as I've noticed they don't happen while exercising even if I push myself a lot, but they come like an onset within an hour after my training. I've only had them after intensive training or very heavy excersises. My only episode was 2 days ago was not related to excercise but I was very anxious before it happened since I struggle with some health anxiety.
I can't say for sure if I was anxious prior to the episodes since I pay a lot of attention to my heart and exercise can make me nervous. I don't breath properly when I do weight lifting and I was also wondering if this can upset my heart and together with exercise or imbalances can cause the arrhythmia?
I can't say for sure if I was anxious prior to the episodes since I pay a lot of attention to my heart and exercise can make me nervous. I don't breath properly when I do weight lifting and I was also wondering if this can upset my heart and together with exercise or imbalances can cause the arrhythmia?
Brief Answer:
Unlikely to be due to improper breathing
Detailed Answer:
Okay..Its not related improper breathing associated with weight lifting. I think, you are too much health anxious. And considering this background of anxiety, I would suggest to calm yourself and see. You try to divert your mind from the health thoughts, and do your routine activities including exercises and see if symptoms recurs. You should assure yourself regarding benign nature of this. You are unlikely to have any major cardiac problem as you can perform such intense exercises with much symptoms, although you should get yourself evaluated. So try to reduce anxiety and let see the effect.
Unlikely to be due to improper breathing
Detailed Answer:
Okay..Its not related improper breathing associated with weight lifting. I think, you are too much health anxious. And considering this background of anxiety, I would suggest to calm yourself and see. You try to divert your mind from the health thoughts, and do your routine activities including exercises and see if symptoms recurs. You should assure yourself regarding benign nature of this. You are unlikely to have any major cardiac problem as you can perform such intense exercises with much symptoms, although you should get yourself evaluated. So try to reduce anxiety and let see the effect.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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