• question-icon

    What causes ectopic heartbeats upon waking up?

Posted on Fri, 21 Jul 2017 in Hypertension and Heart Disease
Question: Hi. I have been having strange episodes upon waking up of ectopic heartbeats. Sometimes once every 2 to 3 beats. They seem to gradually go away as I get up and go on with my day. Though I do get a random ectopic beat here and there. Ive had an ekg done it revealed nothing. Also a 24h holter monitor which revealed occasion atrial and ventricular ectopics but they were deemed normal as well. Nevertheless its still a scary sensation and it causes me anxiety and fear. Is there a reason this happens so much when ive just woken up?
Answered by Dr. Ilir Sharka 49 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:

Welcome and thank you for asking on HCM!

I passed carefully through your question and would explain that a few ectopic atrial and ventricular heart beats in a healthy and normal heart (resulting from the cardiac ultrasound) are normal in every normal person.

They can be related to physical or emotional stress (anxiety).

Have you performed a cardiac ultrasound to examine your heart?

I would like to directly review your Holter and echo reports for a more professional opinion, if you can upload them.

The reason, we these ectopic heart beats occur mostly after waking up, may be explained by the fact that waking up imposes a great stress to your body. You should know that during sleep your body and mind are in total relax, a state when you are not alert about the external stimuli. But waking up, makes you to pass from this situation to another situation, when your body tries to be alert to every external stimuli (light, noise, walking, moving, thinking, etc.)..

Certainly these changes are more prominent in susceptible sensitive persons.

But, before concluding that it is just anxiety, I would recommend performing further tests to exclude other possible causes:

- a cardiac ultrasound (if you have not performed it yet)
- complete blood count for anemia
- blood electrolytes for possible imbalance
- thyroid hormone levels for possible thyroid dysfunction
- cortisol plasma levels for adrenal gland dysfunction.

You should discuss with your doctor on the above tests.

Hope you will find this answer helpful!

I remain at your disposal for any other questions!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 11 minutes later
Thank you for your reply. Unfortunately I dont currently have access to my 24h monitor tests as they were done quite a few months back.

I forgot to mention that in addition to the ectopics my heart rate sometimes fluctuates greatly from slow to fast (65bpm to as high as 90bpm) within just a few seconds. Then back to normal.

I havent had a cardiac ultrasound preformed yet but will speak to my GP about it.

Also I am currently taking Synthroid 112mg because i had a very underactive thyroid last year (hypothyroidism) I assumed this wouldnt have an affect as the medication has regulated my thyroid issues.
Answered by Dr. Ilir Sharka 51 minutes later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

A thyroid hormone imbalance could explain all these heart rate fluctuations and the ectopic heart beats.

From the other hand these heart rate fluctuations could be related to anxiety and the stress imposed to your body by the process of waking up. But, they are not indicative of any serious medical disorders (considering also your Holter monitoring results).

Anyway, I would recommend performing a cardiac ultrasound and checking again your thyroid hormone levels.

Hope you will find this answer helpful!

Kind regards,

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


Practicing since :2001

Answered : 7428 Questions


The User accepted the expert's answer

Share on

Recent questions on  Holter monitor

doctor1 MD

Please type your query here. Since this query is directed to our panel of specialists and super-specialists, please mention your problem in as much...

doctor1 MD

My grandmother feels weak and dizzy every morning. She is not a diabetic. We have taken her to the hospital four times. I had them take her off her...

doctor1 MD

I am 69 years, weight 80kg, height 66 inches.Have a problem in speech which is not clear and is slur . Not diabetic, always worried about my family...

doctor1 MD

MY UNCLE IA 70yrs old .operated for his heartattack with bypass 16yrs back now he is having supraventricular ectopics holter study done showed 3240...

doctor1 MD

My husband has had these symptoms for over a year: extreme fatigue , dizziness & slight headache. These symptoms have come and go all this time. he...

doctor1 MD

Hi. I’m 20 years old, female. I have been having many problems for the past 5 months now. I didn’t have a primary care doctor at this time so when...

doctor1 MD

im a 36 yr old female. last month i had a vertbral artery dissection that caused 5 strokes. they put me on 325 mg aspirin and lipitor . lately ive...

Get personalised answers from verified doctor in minutes across 80+ specialties

152 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. Ilir Sharka
  • Q - What do the following stress tests, echo and holter monitor test result...

  • Q - Suggest alternative treatment for congestive heart failure

  • Q - Suggest treatment for hypertension and GERD

  • Q - Suggest treatment for high BP and tingling in arms

  • Q - What causes sharp pain in chest area relieved by burping?

  • Q - Suggest treatment for afib, severe sleep apnea and high heart rate?

  • Q - What causes shortness of breath with normal chest X-ray?

  • Q - What causes severe pain in my calf muscle in Tietze syndrome?

  • Q - What causes altered sense of smell when diagnosed with sinus tachycardia?

  • Q - Does page syndrome increase the risk of heart attack?