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What Causes Irregularities In Heart Beat And Normal EKG Report?

Posted on Fri, 9 Oct 2015

Question: HelloI have an issue first of all I have hadmany tests done recently due to me having feeling irregularities in my heart beat I have had many EKGs that all show normal I have had an echocardiogram in March of this year which showed a structurally normal heart I passed that I wore a Holter monitor for 24 hours and all it caught were a couple of premature atrial contractions I've had a chest x-ray which came back clear blood test with everything being normal my blood pressure runs low normal like around 105/65 average. My resting pulse rateis around 65 beats per minute.

Answered by Dr. Ilir Sharka (1 hour later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I reviewed your recent medical history and your previous discussions.

You referred palpitations when exercising (mostly hard and fast heart beats), a strange feeling of discomfort.

As your cardiac tests have resulted normal (including numerous ECG, cardiac ultrasound, Holter monitoring, several blood tests) seems that your complaints are not related to any obvious cardiac disorders. Those scarse atrial ectopic beats reveled by the Holter monitoring has not clinical significance at all. They are present in every healthy person.

Also, regarding your blood pressure and heart rate, I would explain that it is normal to have such values, facing your young age and well fitted physical profile.

Could you please upload your performed tests and your medical prescriptions, for a review?

And after reviewing your already performed tests, a cardiac stress test would be advisable to definitely conclude your exact cardiac response on exertion.

All your symptoms seem to be related to pure anxiety.

Have you ever checked your thyroid gland function? Sometimes a thyroid dysfunction or a chronic anemia could be associated with increased anxiety levels.

If all your performed tests result normal, I would recommend consulting with a specialist of the field to help you manage your anxiety.

Hope to have been helpful!

I am at your disposal for any other questions whenever you need!

Best regards,

Dr. Iliri

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

Follow up: Dr. Ilir Sharka (8 minutes later)

Thank you for getting back to me. I am on my wits end. My only anxiety is with my heart. And it all started when i started getting pacs. I can not accept that it is what causea my episodes. Everytime things get good and start feeling better about things something like thia happens and here i go again. I want to accept that it is anxiety but when it happens it is ao scary. And then i go back to a weapy, scared zombie acting person that is afraid to do anything. I go back to thw cardiologist in october and i am hoping for a stress test. Is therw anykind of doctor i can see that can help with anxiety and excessive worry without taking prescription medications

Answered by Dr. Ilir Sharka (11 minutes later)

Brief Answer:
I recommend consulting with a psychotherapist and practice sports

Detailed Answer:
Hello again dear!

I understand very well how you are feeling!

You should know that PACS and anxiety are closely connected.

I would recommend consulting with a psychotherapist.

Behavioral therapy would help you manage your anxiety.

I would also advise you to practice Yoga, meditation and some sports like dancing, swimming, aerobics.

These physical activities act in your brain cells with the same mechanism as antidepressants. They help your brain get the lost balance and take control over anxiety.

A reduce in the caffeine intake would help manage your anxiety too.

Hope to have been helpful!

Please feel free to ask me whenever you need!

Best wishes,

Dr. Iliri

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

Follow up: Dr. Ilir Sharka (5 minutes later)

Ok. I will. I have started playing tennis some but am always scared i will drop. Did you see the other message i sent that was a continuation of my first message concerning what happened last night? Didnt know if your response was for both. Something happened and deleted most of that first message after i sent it. So therefore i had to send a second msg. Anyway it doeant show read so i didnt know if you responded without seeing the other part

Answered by Dr. Ilir Sharka (27 minutes later)

Brief Answer:
I recommend performing more safe sports

Detailed Answer:
Hello again!

I would recommend performing some more safe sports, as I recommended before.

I have answered to your primary question and one follow up. This is the second follow up.

I don't know if you are talking about the first follow up. I tried to answer to all your questions on the follow up.

If you have any other uncertainties, don't hesitate to ask.

Greetings!
Dr.Iliri

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

Follow up: Dr. Ilir Sharka (47 minutes later)

Ok. I did not know if you saw a different message where i wrote today that i woke up early this morning and was fine, got up and laid back down and when i did my heart did some weird thing. It went away pretty fast but did it again a few seconds later. So i got up and when i did my heart felt so crazy. Like nothing i had felt before. It was like it was straining to beat. Felt like your jaws feel when you grind your teeth. Kind of grindy and strained. Very weird. No pain, or shortness of breath was just very weird like something wasnt right and it was straining to beat. I woke up my husband to go to the ER because it totally felt like something was bad wrong. No pacs at all. Heart was beating but felt strained and grindy. By the time he got up, and dressed and to the door it was better. We went ahead and drove to the hospital but i didnt go in because all felt back to normal. I have no idea what it was but it definitely was not normal. And nothing i have ever felt before. I was sure my heart was stopping. And i am so afraid it was a warning to me that something bad is wrong. If this is a repeat im sorry. My phone os being weird

Answered by Dr. Ilir Sharka (7 hours later)

Brief Answer:
Your symptoms seem to be related to a panic attack

Detailed Answer:
Hello dear!

Thank you for the information provided. I have not read this question before.

I would like to reassure that your symptoms don't seem to be cardiac related.

A panic attack could be related to this symptomatology.

You should know that acute cardiac events (angina, arrhythmia) are associated with a different clinical scenario, including some other symptoms like changes in your blood pressure, dizziness and lightheadedness, difficulty breathing, chest pain etc. The heart is a pump, which function affects all the organs. So an acute heart dysfunction would result in a decrease in blood flow to all the organs, causing a more dramatic clinical situation.

So it seems to be just a panic attack.

I would recommend trying some alprazolam if the situation repeats. It is an anxiolytic drug, which would help in this acute panic attack.

You should carefully monitor your blood pressure if this situation reoccurs.

Hope to have been helpful!

Best wishes,

Dr. Iliri

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