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Sharp and short heart twinges, palpitations. Holter monitor test normal. What might be happening?

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Practicing since : 1981
Answered : 922 Questions
Yes hi. I've been getting heart 'twinges' the last couple of days and nights. They are very sudden and happen either in bed, or just when I'm moving about, not necessarily being very active. I wondered whether it could be a parasite of some kind, because it almost feels like something moving, but the twinge is sharp and short. It's happened periodically throughout the day and it's just happened a couple more times now, just before going to bed. I've not had any serious heart problems before. I do not have high blood pressure, although I have had some palpitations before. I wore a holter monitor for 24hours and the results came back showing no problems. That was before the twinges happened.
Posted Thu, 12 Jul 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Anil Grover 57 minutes later

Thanks for writing in.
I am a cardiologist and read your question with diligence.
Before I can meaningfully answer your question I have a question which I want you answer. Reason is no parasite moves below your clothes over the heart for you to feel. Therefore either it is turbulance of blood you are feeling akin to cats purring or it is palpitation which can be felt as if someone is pounding your heart from inside.

If it is later, which is my first possibility does it comes on like bolt from blue lasts for a duration of time and stops as abruptly as it came then it is Proxysmal Supraventricular Tachycardia. If it is not abrupt in onset and offset than it is probably inappropriate sinus tachycardia. These things were investigated before when Holter was done. It is quite possible to miss in 24 holter and pick these some other time.

If it is cat's purring type of feeling it is due to turbulance of blood. Did it start abruptly and some feeling is always there. It is exertion which aggravates it.

Do you ever get chest pain?

Once I get a reply from you in followup, I will be able to analyse better. Looking forward to your reply
Best Wishes.

Dr Anil Grover
Above answer was peer-reviewed by
Follow-up: Sharp and short heart twinges, palpitations. Holter monitor test normal. What might be happening? 15 hours later

Thank you so much for your time and consideration. I really appreciate your help.

To answer your question: mostly it feels like cats purring, never like someone is pounding from the inside of my chest.

But most recently, it has been neither.

I have felt a CONTINUOUS but MILD ache with occasional MILD TWINGES.

I say ‘twinges’, because this feels like a sudden brief darting sensation, almost as if it were electrical – it literally only lasts a few seconds. It is NOT painful, but because it is unexpected, it can make me jump in surprise. It is very strange and obviously upsetting, especially at night.

Last night, it happened several times just as I was trying to sleep, and I almost decided to go to a hospital. However, it was late, so I lay down and tried to ignore it. My husband is travelling at the moment, so the fact that I was alone, was upsetting. Fortunately, I slept ok, and this morning everything was fine, I didn’t feel anything and the twinges had gone. Now (it is late afternoon) the mild ache is back, but there are no twinges.
Answered by Dr. Anil Grover 1 hour later
Hello There,

Thank you for your patience in answering my questions. It could be arrhythmia which was not picked up last time when Holter was done, as episodes are more frequent now, it is quite possible that it will be picked up this time.

Classical continuous cats purring sensation occurs in a rather pompous sounding but not so difficult to completely cure is ruptured sinus of Valasalva, it can happen in small VSD which does not require any treatment.

For all three conditions I listed above you need to see the doctor. I hope your husband would be back but you can walk to the regular ER and get seen by doctor. Your doctor, after complete physical examination may decide to go for an x-ray chest, an echocardiography with Doppler and/or Holter but within hours the diagnosis will be made. Which is good for all rather than living in suspense.

I assure you that there is cause for concern but not for panic. Let me know what the good doctor says.

With Best Wishes,

Dr Anil Grover, Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
Follow-up: Sharp and short heart twinges, palpitations. Holter monitor test normal. What might be happening? 2 minutes later
Thank you. I will take your advice and let you know.

Best wishes

Answered by Dr. Anil Grover 26 minutes later
Thanks a lot, please close the query with comments any time hereinafter.

My email id for letting me know is YYYY@YYYY
Above answer was peer-reviewed by
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