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Dr. Andrew Rynne

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Could poor posture and slightly concave sternum area cause a sudden onset of heart palpitations?

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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4506 Questions

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Posted on Tue, 18 Dec 2012 in Heart Rate and Rhythm Disorders
Question: Could my poor posture and slightly concave sternum area cause a sudden onset of heart palpitations? Could a rib near my heart cause this? I went to bed 4 nights ago and awoke with palpitations every 5 seconds. Went to ER and a heart rythem specialist. All test checked out OK- and arrythmia's were caught on 24 hour holter monitor. I came home last night and while stretching felt a pop near my heart. Instantly the palpitations stopped and I've been symtom free for 24 hours. I'm convinced it was a rib or sternum issue.......may hernia?
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Answered by Dr. Anantharamakrishnan 28 minutes later
Hi friend,
Welcome to Health Care Magic

You seem to be a motivated person – it is great indeed to shun drinking and smoking.
The “poor posture and slightly concave sternum / rib / hernia” are not likely causing this. If it is, there are usually other associated features...
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Anxiety / Caffeine (too much coffee, cola) could contribute.
Medicines may be responsible – like phenylephrine, pseudo-ephedrine used for ‘cold’ / Salbutamol, salmeterol used for asthma /occasionally, there are abnormal nerve paths (bypass tracts) in the heart.
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Though they may be normal in many, it is advisable to investigate further.
Absence of symptoms is no proof of absence of disease! And absence of proof is no proof of absence.
     ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality)
     Treadmill exercise ECG (TMT) is done to exclude Ischemia (reduced blood flow)
     Laboratory work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) etc. Your doctor will suggest based on the situation.
     There are advanced techniques of investigations of increasing complexity more (some of them invasive), depending on need. The treating doctor may decide based on the situation.
If there are no clues and if you are still bothered by it to the extent of interfering with life style - there are more tests - like Electro Physiological Studies (EPS) – it resembles angio > a catheter is put inside the heart, electrical activity recorded, stimulation and suppression tests are carried out, suitable medicine tested and so on. The test is invasive, has a risk (though very small) and is not generally done unless there are compelling indications. He is called ELECTRO-PHYSIOLOGIST.

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     These beats could be normal in some persons. The feeling depends on individual sensitivity. Some do not feel them at all / some may feel every beat.
     A specific treatment for the beats may often not be necessary.
     The first line medicine is generally beta blockers. If they are not effective and if the problem is severe, several other classes of drugs are available – - acting by different mechanisms - your specialist will decide tailored to the individual / they may have side effects and need follow up.
There are other advanced treatment modalities - like RF ablation.
     Be in touch with your doctor - it is a question of time and you will be well. Medicine is well advanced nowadays – management is possible for almost all situations...
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Take care
Wishing speedy recovery
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan 33 minutes later
Thank you for the response.
Electolytes, thyroid and everything else checked out normal. It wasn't caused by caffine nor do I take any meds. How about a hypertonic nodule near the 5 & 6 ribs? Or any issue with the thoracic spine? I have a bad back due to lots of curvature. (don't take any meds for it) It makes no sense that it would stop the second I stretched out my left side.
doctor
Answered by Dr. Anantharamakrishnan 18 minutes later
Hi

A nodule on the rib is unlikely to cause this. if there is one, it has to be biopsied to know the pathology - but that has no relation to this.

Again, 'spinal issues' don't do this. The heart has nerves of its own - that are only partly influenced by external events - mostly by autonomic nerves. So they could be influenced by breath holding, straining and so on.


Regards
All the best
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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