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Suggest treatment for scarce ectopic beats, anxiety and twitching in chest

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Posted on Sat, 12 Dec 2015
Question: Hi,

Im 28, 5 11 male non smoker and non drinker. I do have a bit of stress and anxiety going on lately. Back in august i had an echo and several ekgs which were clear along with a stress test.

I have been noticing recently that while laying down with my head against my pillow i will have a normal rhythm but occasionally have two heartbeats one after another. I am not having a pause or endopic heart beat afterwars. Its just inserted in the middle like 1..2..34..5..6..78. It isnt constant but it was happening every 10-15 heartbeats for that period of time. I was sleeping and had woken up from an emotional dream. I had recently broken up with my girlfriend and had noticed this the other night.

I do have occasional pvcs and pacs that have shown up on my holter which they hd no concerns. It has just thrown me into a panic because it seemed like a new issue that i havent noticed before.

I dont experience any symptoms when this happens i just happened to hear the double beats and it was happening a little more often in my rhythm where i was catching it happen more than once in a few minutes. They were always spaced out but I wasnt sure if i should be worried.

I havent slept great and have been a little low on sleep closer to 6-7 hours. I dont have caffine and only drink water, i had some kit kats 8 hours ago or more.

My heart is beating faster now because of nervousness but normal i believe. I do feel a ccasional sensations like a quick twitch in my chest which may be my stomach as it is a little upset.

Lastly whether related or not, two nights ago i was bending over to put batteries in a bathroom scale and between bending a few times and atanding up i ended up having abheartrate of about 60 bpm and it was forceful im assuming to keep my bp up from standing. It returned to normal shortly after i had stopped bending. I wanted to ask of that was normal as well.

Please let me know when you can.

Thanks,

Matt
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:

Hello XXXXXXX

Welcome and thank you for asking on HCM!

I carefully review you medical history, and would like to explain that all the above complaints seem to be related to pure anxiety.

The most important issue is the exclusion of any structural heart disease (your cardiac ultrasound, several ECGs, stress test and Holter monitoring confirm that).

You have a normal heart structure and function, young and active without any obvious coronary risk factors (non smoker, no high blood pressure, no diabetes, etc)

Regarding those scarce ectopic beats (as your doctor has explained you), I could assure you that they have no clinical significance, They may be present on the settings of an increased anxiety, and don't denote any risks for dangerous cardiac complications.

So, relax and don;t worry too much about it!

I think that some modification of your life style (regarding sleeping and daily physical activity) would be beneficial on relieving your anxiety.

I encourage you to engage on frequent sports activities (running, cycling, aerobics, tennis, etc) as they improve blood circulation, and also your psychological profile.

If the above is insufficient, a transient anxiolytic use, like Alprazolam could be of help.

You need to discuss with your attending physician about the above issues.


Hope to have been helpful.

In case of further uncertainties do not hesitate to ask me!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (18 hours later)
Thank you i do appreciate it and have been abke to calm down a bit.

Would you also have any input regarding what feels like something slinding or contracting in my diaphram area that doesnt hurt but leaves a sensation in my throat. I tend ti panic thinking my heart stopped or something unrelated.

I do likely have gerd or acid reflux. Ive had an abdominal ultrasound that showed nothing. I dont know if a large gas bubble can have the same affect and another thought was a sliding hiatial hernia maybe explaining my discomfort and an unremarkable abdominal ultrasound.

Regardless i do get pressure and or pain in that area, genereally not severe. When i feel the sensation i usually go into a panic not expecting it but am genereally fine and may even feel more comfortable afterwards.

At the time i was eating lentil chips on an emtpy stomach or i had not eaten for a couple or few hours.

If you have any input on that as well that would be appteciated.

Thank you so much for your time and help.
doctor
Answered by Dr. Ilir Sharka (4 hours later)
Brief Answer:
I would advise:

Detailed Answer:

Hi again, XXXXXXX

For better investigating a possible digestive disorder (GERD, hiatal hernia, gastritis, etc) I would recommend to consult with a gastroenterologist and possibly discuss the opportunity of a fibrogastroscopy exam.

Meanwhile, try to follow a more healthy diet (avoiding those spicy foods, cola and other caffeinated drinks, etc).

Anti-secretors like PPIs (lansoprazole, omeprazole, etc) would be of some help in reducing possible gastro-duodenal disorders.

I recommend you to consult with your attending doctor on the above mentioned issue.

Regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8608 Questions

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Suggest treatment for scarce ectopic beats, anxiety and twitching in chest

Brief Answer: I would explain as follows: Detailed Answer: Hello XXXXXXX Welcome and thank you for asking on HCM! I carefully review you medical history, and would like to explain that all the above complaints seem to be related to pure anxiety. The most important issue is the exclusion of any structural heart disease (your cardiac ultrasound, several ECGs, stress test and Holter monitoring confirm that). You have a normal heart structure and function, young and active without any obvious coronary risk factors (non smoker, no high blood pressure, no diabetes, etc) Regarding those scarce ectopic beats (as your doctor has explained you), I could assure you that they have no clinical significance, They may be present on the settings of an increased anxiety, and don't denote any risks for dangerous cardiac complications. So, relax and don;t worry too much about it! I think that some modification of your life style (regarding sleeping and daily physical activity) would be beneficial on relieving your anxiety. I encourage you to engage on frequent sports activities (running, cycling, aerobics, tennis, etc) as they improve blood circulation, and also your psychological profile. If the above is insufficient, a transient anxiolytic use, like Alprazolam could be of help. You need to discuss with your attending physician about the above issues. Hope to have been helpful. In case of further uncertainties do not hesitate to ask me! Kind regards, Dr. Iliri