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Dr. Andrew Rynne

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What causes heart palpitations?

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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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Posted on Mon, 3 Apr 2017 in Hypertension and Heart Disease
Question: Are there reasons besides stress and anxiety that cause a person to feel a "bounding" pulse (or a strong pulse felt at different parts of the body)? Is it possible that a circulatory issue exists that wouldn't show on an echo of the heart and carotid arteries?
doctor
Answered by Dr. Rishu Saxena 1 hour later
Brief Answer:
Palpitations.

Detailed Answer:
Hi,

Initially I would give you a brief account of what symptoms are you having The symptom you are having are palpitations.A heart palpitation is the sensation that your heart has skipped a beat or added an extra beat,pulse can be felt as bounded.
Most of the time palpitation is usually associated with some pathological or physiological problem with the heart,
To rule out the cause of palpitations i would like to suggest you some of the baseline tests of cardiology like -
24 hour holter monitoring-A small device would be attached to your body for 24hours.It will keep a record of your heart beat (both rate and rhythm) for a period of 24 hours.You can also note the time during which you feel palpitations and the rhythm at that time could be seen on computer monitor during interpretation of the test.It is the basic and most important test for you.

7 days loop recorder- In case faulty heart beats are not recorded in holter ,A device called loop recorder would be attached to your body for 7days and it will keep a record of your heart beats for 7 days!
If they are normal you are clear from cardiac side.

Gold standard test for papitation is holter and electrophysiological tests. Many times they are missed in echo and carotid testings.

Follow up with reports.
Thanks

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rishu Saxena 31 minutes later
I don't think these are "palpitations" as I understand that term. That would indicate an irregular heart rhythm I believe... is that correct? This is more like a stong/powerful heartbeat with a regular rhythm (never really feels like my heart is "skipping" a beat). For example, I can feel my head move in XXXXXXX with my heartbeat when I lay down on a pillow.

I understand that stress / anxiety can be a cause for this, but as I really don't feel especially stressed or anxious, I was curious if there were other possible physiological causes.

24 hour holter and 24 hour ambulatory BP monitor were normal as well.

Thank you for the response.
doctor
Answered by Dr. Rishu Saxena 50 minutes later
Brief Answer:
Panic attack.

Detailed Answer:
Hi again,
No plapitations can be regular heart beats also.Like sinus tachycardia is also a palpitation.
Strong powerpul heart beat wth a regular rhythm is called sinus tachycardia; Variant of palpitation. All these are different feelings which patients explains to doctor.Every body is different so expression of symptoms are different
If 24 hours holter and stress tests were normal only possibility left is.

PANIC ATTACKS-
Panic disorder is a serious condition that can strike without any reason or warning and the symptoms last for about 10 minutes, such as; a fear for imminent death or losing control, chills, numbness of toes or fingers, stomach ache problem or nausea, trembling, dizziness, chest pain, shortness of breath and difficulty in breathing,papitations, tachycatrdia.

Panic attacks are often confused with cardiac problem.
-Cognitive Behavioral Theory.
- Anti-depressant medicines are used to cure panic disorders, such as Selective Serotonin Reuptake Inhibitors (SSRI), medications for reducing anxiety and certain cardiovascular medications such as beta-blockers to cope with situational anxiety.

As all tests are normal,
Suggestion
Psychiatrist review.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rishu Saxena 1 hour later
Thanks again for the response. I have an appointment with a Clinical Psychologist in two weeks. One final follow up question: Could a problem such as this be caused from a circulatory issue? For example, from a twisted or "kinked" artery?
doctor
Answered by Dr. Rishu Saxena 11 hours later
Brief Answer:
Very rare but possible.

Detailed Answer:
Hi again,
As per your query palpitations can be caused due to transient ischemia caused by a twisted artery,Though rare but possible.However only way to know if course opf artery is normal is Angiogram,Because direct visualization of artery and its path can be done only in angiogram with the use of radioactive XXXXXXX
Above answer was peer-reviewed by : Dr. Remy Koshy
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