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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can physical activity and anxiety cause ectopic heart beats?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 6293 Questions

Posted on 5 days ago in Hypertension and Heart Disease
Question: Hello....I am 72. In mid-2015, I had an echo of my heart. All was good....but I did have mild ascending aortic deficiency, but mild only (41 mm). Last week, I saw a cardiologist since I also allegedly have PAD & claudication but mildly. And, I also have spinal stenosis that causes moderate neurogenic claudfcation. This cardiologist sent me for another Echocardiogram since she heard a murmur. But since 2012, I have seen 4 doctors including a heart specialist (no murmur), 2 GP's (1 heard a murmur) and an internal medicine specialist (no murmur), and my current GP does not hear a murmur, but this current cardiologist does. I am an anxious person and suffer from white coat syndrome plus hyper-vigilance from Chronic PTSD. But at home, my blood pressure is 120/58 when I am relaxed. My total cholesterol is very low, and under guidelines for PAD, I walk 4 times a week for 35 minutes, eat well and sleep well, but I am very anxious about this upcoming Echo and what it might reveal. I do suffer from PCV's occasionally so when that happens I do the Valsalva technique and they go away. NO PCV's when I walk. The PVC's could be linked to the vagus nerve since I pass a lot of gas, or they could be linked to anxiety. What is your opinion? I do not understand how I could get valve sclerosis in only 2.5 years when in mid-2015, all was good.

Hi again ~ yes, I do suffer from hypo-thyroidism and take synthroid.
I had an ECG last week = all is good.
My bowel movements are normal and I have two every day. But, I feel like burping after I eat.
I have been walking like that since 2012 and intend to continue. I gave up smoking and I barely drink (wine the very odd time - one small glass).
A neuro-surgeon told me that my L5-S1 nerve root is compressed on both sides leading to claudication. A vascular surgeon told me in writing that the neurogenic condition predominates over the vascular one and that my vascular is mild to moderate, if that. Neurogenic issues can affect the ABI readings and mimic vascular conditions thereby leading to false positive or negative vascular conditions.
Since the nerve root at L5-S1 is compressed severely by a disc, the blood vessels in the nerve root going down my leg are affected and this in itself could affect any Doppler readings of my leg arteries, would it not?
The murmur was discovered by stethoscope. And as I said, only two of 5 doctors ever heard it...

Any more comments? I believe that the murmur is only anxiety...what do you think?
After I have the echo in early April, I will scan it and put it on here for you to view, OK?
Answered by Dr. Ilir Sharka 32 minutes later
Brief Answer:

I would explain as follows:

Detailed Answer:


I passed carefully through your question and would explain that some ectopic heartbeats or palpitations are quite normal in every healthy normal individual during anxiety or physical activity.

From the other hand, cipralex may trigger palpitations as it is known to cause QT prolongation. For this reason, I would recommend you to follow up with resting ECG every 6 months to exclude this possibility.

Irritable bowel syndrome can also trigger palpitations, due to extensive gas.

I would also recommend checking your thyroid hormone levels for possible thyroid dysfunction.

Regarding the heart murmur, it could be related to anxiety. Anyway, I would like to directly review your cardiac ultrasound for a more professional opinion.

You should know that cardiac ultrasound reports may be different, even when performed at the same time by different machines or technicians due to inter-observer variability, which is related to the technique used during the measurement and the machine resolution.

In the meantime, I would encourage you to follow your healthy lifestyle.

Regarding claudicatio, it could be related to the spinal canal stenosis.
Nevertheless, I would recommend performing a Doppler ultrasound of the leg arteries to exclude peripheral arteriopathy.

Regarding White Coat syndrome, it is related to the psychological stress during the doctor consult and does not need to be treated.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Dr Ilir Sharka, Cardiologist

Brief Answer:

My opinion as follows:

Detailed Answer:


I agree that the murmur could be related to anxiety, as you suffer from White Coat Syndrome, as it was variably heard by different doctors.

The cardiac ultrasound is the best tool to examine your heart function and structure and to investigate for the possible murmur causes.

As it is OK, there is nothing to worry about!

Hope to have clarified some of your uncertainties!

I would be happy to review your test reports whenever you will upload them for a second professional opinion!

Hope I have answered your query.

Take care

Dr Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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