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Dr. Andrew Rynne

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Hi I have had episodes of irregular and faster beating

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 6644 Questions

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Posted on Thu, 27 Dec 2018 in Hypertension and Heart Disease
Question: Hi

I have had episodes of irregular and faster beating heart over the past 2 years now. It all started after I started training fitness after many years of fairly inactive life.

I'm 28, thin (63 kg) og 1.75m tall.
I have these episodes frequent a couple of hours after strenght training, but not always. Also if I don't train or stress then it can be months between these episodes.

This sunday I had another episode in a day where the only activity I had was sex with my girlfriend and in the evening it started while I was sitting in my car. I called emergency services since I wanted to get this checked and they listened to my heart and while listening to the heart my pulse was 104, but when he listened to my pulse in my wrist it was only 70. I feel some flutter in my chest with every beat when it is going on.

The doctor noted that I had a few irregular beatings while listening to my heart.

I don't have any pulse reader but I have used an app on my phone to keep an eye on my heart and it seems to work when my heart is normal and shows the normal curve (1 big wave followed by 1 smaller wave), but when I have an episode it cannot show my rate or it shows 1 big wave and then 2 smaller waves after before repeat.

My episodes usually lasts for 4-6 hours, they start suddenly. I sometimes feel sore in the chest the day after I had them but I haven't felt dissy or fainted.

What could this be? I noticed today it kept coming in smaller episodes only lasting a couple of minutes while I was having what I believe are panic attacks from the episode on sunday.
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Follow up: Dr. Ilir Sharka 0 minute later
Hi

I have had episodes of irregular and faster beating heart over the past 2 years now. It all started after I started training fitness after many years of fairly inactive life.

I'm 28, thin (63 kg) og 1.75m tall.
I have these episodes frequent a couple of hours after strenght training, but not always. Also if I don't train or stress then it can be months between these episodes.

This sunday I had another episode in a day where the only activity I had was sex with my girlfriend and in the evening it started while I was sitting in my car. I called emergency services since I wanted to get this checked and they listened to my heart and while listening to the heart my pulse was 104, but when he listened to my pulse in my wrist it was only 70. I feel some flutter in my chest with every beat when it is going on.

The doctor noted that I had a few irregular beatings while listening to my heart.

I don't have any pulse reader but I have used an app on my phone to keep an eye on my heart and it seems to work when my heart is normal and shows the normal curve (1 big wave followed by 1 smaller wave), but when I have an episode it cannot show my rate or it shows 1 big wave and then 2 smaller waves after before repeat.

My episodes usually lasts for 4-6 hours, they start suddenly. I sometimes feel sore in the chest the day after I had them but I haven't felt dissy or fainted.

What could this be? I noticed today it kept coming in smaller episodes only lasting a couple of minutes while I was having what I believe are panic attacks from the episode on sunday.
doctor
Answered by Dr. Ilir Sharka 58 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on Ask a Doctor service!

I passed carefully through your question and would explain these heart rhythm images could be related to skipped heart beats (extrasystoles).

But, you should know that some skipped heart beats are quite normal during physical activity or emotional stress.

They are related to the increased circulating levels of adrenaline and noradrenaline during these normal activities.

Anxiety can trigger this clinical situation too.

Anyway, the phone applications are not the best tools to examine your heart rate and rhythm.

For this reason, I agree with you on the fact that it is important consulting with a cardiologist and performing an ambulatory 24-48 ECG Holter monitoring in order to investigate for possible nature of these episodes ( benign arrhythmia or anything more serious).

I would also recommend performing some tests to investigate for possible metabolic causes that may trigger this situation:

- complete blood count for anaemia
- thyroid hormone levels for thyroid dysfunction
- blood electrolytes for possible imbalances.

You should discuss with your doctor on the above tests.

In the meantime I recommend focus on your anxiety and trying to manage it.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr.Ilir Sharka Cardiologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Ilir Sharka 0 minute later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on Ask a Doctor service!

I passed carefully through your question and would explain these heart rhythm images could be related to skipped heart beats (extrasystoles).

But, you should know that some skipped heart beats are quite normal during physical activity or emotional stress.

They are related to the increased circulating levels of adrenaline and noradrenaline during these normal activities.

Anxiety can trigger this clinical situation too.

Anyway, the phone applications are not the best tools to examine your heart rate and rhythm.

For this reason, I agree with you on the fact that it is important consulting with a cardiologist and performing an ambulatory 24-48 ECG Holter monitoring in order to investigate for possible nature of these episodes ( benign arrhythmia or anything more serious).

I would also recommend performing some tests to investigate for possible metabolic causes that may trigger this situation:

- complete blood count for anaemia
- thyroid hormone levels for thyroid dysfunction
- blood electrolytes for possible imbalances.

You should discuss with your doctor on the above tests.

In the meantime I recommend focus on your anxiety and trying to manage it.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr.Ilir Sharka Cardiologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ilir Sharka 40 minutes later
Thank you Dr. Ilir Sharka.

The hardest part is to contain the anxiety as I keep feeling adrenaline rushing through my chest, which seems to give me some minor skipped beats. It happens continously through the day since I had the last episode on sunday evening. I cannot really play video games as they make me too excited now and same goes for fitness as I am afraid to provoke another episode.

The thing is that I don't get skipped beats while I excercise, they always come hours after training and while I am at home relaxing after training or taking a shower. My heart rate has returned to normal when they appear and they are feeling much harder in my chest making me super anxious, which makes it into an evil cirkle.

The doctor gave me a mild beta blocker to help lower my episode, which I can't say if worked, as my episode continued for 2 hours after taking it.

I worry a bit extra about this since I have a childhood friend who've just returned from hospital after having heart stop, blood cloth in the chamber and diagnosed with afib, he is only just turning 29. Seeing as we are having somewhat similar symptoms it makes me a bit nervous, though my symptoms disappear on their own after some hours, but I feel they are getting more frequent even without training but from stress/anxiety now.

How do I tell if it's dangerous? I don't know when I can get a holter test, waiting to hear from the hospital and I don't even know if I can provoke an episode while wearing it, so the waiting time is getting at me.
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Follow up: Dr. Ilir Sharka 0 minute later
Thank you Dr. Ilir Sharka.

The hardest part is to contain the anxiety as I keep feeling adrenaline rushing through my chest, which seems to give me some minor skipped beats. It happens continously through the day since I had the last episode on sunday evening. I cannot really play video games as they make me too excited now and same goes for fitness as I am afraid to provoke another episode.

The thing is that I don't get skipped beats while I excercise, they always come hours after training and while I am at home relaxing after training or taking a shower. My heart rate has returned to normal when they appear and they are feeling much harder in my chest making me super anxious, which makes it into an evil cirkle.

The doctor gave me a mild beta blocker to help lower my episode, which I can't say if worked, as my episode continued for 2 hours after taking it.

I worry a bit extra about this since I have a childhood friend who've just returned from hospital after having heart stop, blood cloth in the chamber and diagnosed with afib, he is only just turning 29. Seeing as we are having somewhat similar symptoms it makes me a bit nervous, though my symptoms disappear on their own after some hours, but I feel they are getting more frequent even without training but from stress/anxiety now.

How do I tell if it's dangerous? I don't know when I can get a holter test, waiting to hear from the hospital and I don't even know if I can provoke an episode while wearing it, so the waiting time is getting at me.
doctor
Answered by Dr. Ilir Sharka 13 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

I understand your concern and would explain that there is really no way to differentiate if your symptoms are related to anxiety or cardiac arrhythmia.

If during these episodes, there is no changes in your blood pressure values, no blurring vision or dizziness, we can conclude that it is just anxiety.

From the other hand, I would recommend trying alprazolam at low doses 0.25mg during these episodes. If it helps improve your situation, you should consider anxiety as the main cause of your symptoms, as this drugs acts mainly on anxiety and its effects are usually noticed within 30minutes from the intake.

Yoga and meditation can help manage anxiety too.

I would also recommend avoiding coffee intake and checking the above mentioned tests (which are more easy to perform compared to the Holter monitoring).

The Holter monitoring will definitely help calm your anxiety and exclude any cardiac issues.

Hope you will find this answer helpful!

If, you have any other questions, please don't hesitate to ask me again!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka 0 minute later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

I understand your concern and would explain that there is really no way to differentiate if your symptoms are related to anxiety or cardiac arrhythmia.

If during these episodes, there is no changes in your blood pressure values, no blurring vision or dizziness, we can conclude that it is just anxiety.

From the other hand, I would recommend trying alprazolam at low doses 0.25mg during these episodes. If it helps improve your situation, you should consider anxiety as the main cause of your symptoms, as this drugs acts mainly on anxiety and its effects are usually noticed within 30minutes from the intake.

Yoga and meditation can help manage anxiety too.

I would also recommend avoiding coffee intake and checking the above mentioned tests (which are more easy to perform compared to the Holter monitoring).

The Holter monitoring will definitely help calm your anxiety and exclude any cardiac issues.

Hope you will find this answer helpful!

If, you have any other questions, please don't hesitate to ask me again!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 8 hours later
Hi again Dr.

When I had the last episode the doctor took my blood pressure and said it was normal and I think he said it was something like 135/80. But I could be wrong. He also wrote in the report that I had light irregular beats.

I have no dizziness nor do I have any blurred visions etc. I do have some slight tightness in the chest and especially the day after I feel sore and tired in the chest. I feel that the episodes start immediately out of nowhere.

Is that an anxiety medicine?

I am avoiding coffee since the episode, I drink decaf now to somewhat help withdrawing from coffee routine.

I had my blood taken for other reasons this summer and my thyroid numbers was normal but I haven't had my vitamin and electrolyte numbers tested though I take supplement for that and drink occasional some electrolyte drinks.

I feel a lot of adrenaline rushes in my chest lately and they seem to spike my heart and they have given my a small XXXXXXX version of an episode that would last a couple of minutes.

Why would I get these episodes from training and why are they showing hours after I am done training?

I have also gotten it ones directly after Sex imedeately after climax.

Can anxiety really cause this episode that lasts for hours?

Thank you for your time Dr. I will be meeting with a cardiologist in 8 days.
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Follow up: Dr. Ilir Sharka 0 minute later
Hi again Dr.

When I had the last episode the doctor took my blood pressure and said it was normal and I think he said it was something like 135/80. But I could be wrong. He also wrote in the report that I had light irregular beats.

I have no dizziness nor do I have any blurred visions etc. I do have some slight tightness in the chest and especially the day after I feel sore and tired in the chest. I feel that the episodes start immediately out of nowhere.

Is that an anxiety medicine?

I am avoiding coffee since the episode, I drink decaf now to somewhat help withdrawing from coffee routine.

I had my blood taken for other reasons this summer and my thyroid numbers was normal but I haven't had my vitamin and electrolyte numbers tested though I take supplement for that and drink occasional some electrolyte drinks.

I feel a lot of adrenaline rushes in my chest lately and they seem to spike my heart and they have given my a small XXXXXXX version of an episode that would last a couple of minutes.

Why would I get these episodes from training and why are they showing hours after I am done training?

I have also gotten it ones directly after Sex imedeately after climax.

Can anxiety really cause this episode that lasts for hours?

Thank you for your time Dr. I will be meeting with a cardiologist in 8 days.
doctor
Answered by Dr. Ilir Sharka 13 hours later
Brief Answer:
I would explain as follows:

Detailed Answer:
Dear XXXXXXX

Thank you for the additional information!

I understand your concern and would explain that anxiety can trigger all this clinical situation.

It may last even per hours, depending on the individual (especially sensitive persons).

The slightly elevated blood pressure values could be explained by anxiety (it is known to increase the heart rate and blood pressure values.

From the other hand, it is important checking blood electrolytes. As your symptoms start some hours after physical training, they could be related te dehydration and electrolyte imbalances caused by sweating.

Anyway, an ambulatory ECG Holter monitoring, coupled with a cardiac ultrasound, would definitely help exclude any cardiac issues.

I remain at your disposal for any further questions.

I would be happy to give a second opinion on your tests, whenever you will be able to upload them after having the results. You can ask me directly at any time!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka 0 minute later
Brief Answer:
I would explain as follows:

Detailed Answer:
Dear XXXXXXX

Thank you for the additional information!

I understand your concern and would explain that anxiety can trigger all this clinical situation.

It may last even per hours, depending on the individual (especially sensitive persons).

The slightly elevated blood pressure values could be explained by anxiety (it is known to increase the heart rate and blood pressure values.

From the other hand, it is important checking blood electrolytes. As your symptoms start some hours after physical training, they could be related te dehydration and electrolyte imbalances caused by sweating.

Anyway, an ambulatory ECG Holter monitoring, coupled with a cardiac ultrasound, would definitely help exclude any cardiac issues.

I remain at your disposal for any further questions.

I would be happy to give a second opinion on your tests, whenever you will be able to upload them after having the results. You can ask me directly at any time!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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