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Seeking perspective on health problem

JasconiusJasconius sword criminalmad onlineRegistered User regular
requisite disclaimer.... yes I have already seen multiple doctors and am seeing more.

I have an outstanding medical mystery and I am looking to crowdsource other peoples experiences to try and get some perspective and some clues as to what might be going on, or perhaps even peace of mind

About a month ago I started experiencing very occasional (like once a day) heart skipping-a-beat sensations. A couple of weeks after this began it became more than once a day, but still quite minor, like "oh... that just happened, I guess I'll see a doctor" type feeling. Sometimes it would come with a shot of adrenaline, icy veins, etc, but it didn't really provoke a response from me other than "i'll get it checked out".

Friday (four days ago), again, while totally at rest, I had a sudden warm feeling in my chest (no pain!) and a lot of tension and nerves. Long story short I ended up in the ER with what they diagnosed as an anxiety attack. It took them nearly an hour to calm me down. It was a pretty serious attack. Hyperventilation, shaking, etc. ER did the full work up. "Not a heart problem", says ER doc. Anxiety meds, sent home.

Since the ER visit, instead of getting gentle heart-skipping-beat sensations I'm getting very quick stabbing sensations in my chest about a couple of times a day, which come with a big rush of adrenaline and my whole upper body gets tense. Not overly painful. Let's call it a "2". Like if you had a bruise and someone poked it. There and gone again just as quickly. Very similar to what sent me to the ER, with the accompanying "warm" feeling and tensing up. I think the anxiety meds are keeping me from freaking out over this.

Keep my primary care appointment today, Doctor says "this is not cardiac, everything is clean". They want to put me on long term anti-depressants for anxiety. But I press on the heart because I was having these heart-skipping episodes before I had even a shred of anxiety or stress in my life. They do another EKG, she says that my resting pulse is a little low, and there's evidence of arrhythmia that does not seem serious, "minor" I think is the word she used.

I have no idea what that means or if I should be truly concerned.

I am puzzled because there's no real family history of these sorts of problems, and while I am not the most fit person in the world, I eat pretty well and I try to at least get my steps in, so I don't know why I'd get this sort of problem... but I equally don't know why I'd have anxiety problems on this level. I consider myself to be an exceptionally calm person. I have what most people would consider a high stress career, but I don't feel that way mentally. I've never felt overwhelmed or desperate or anything like that, and compared to most people I live a life of great comfort.

The one peculiarly consistent thing of this whole episode is that the problem only happens when I am calm or at rest. Out of maybe 15 or 20 incidents of this feeling in a month, all but 2 of them have been while sitting, reclined, or in bed. Exercise bike? no problem. Quarter mile jog? Feels great. Laying down on sofa for an hour.... nearly guaranteed bad feelings at this point. Getting to the point where I am almost afraid to relax.

Talking through this with other people has helped while I wait for my cardiology referral to get processed, so hence: thread.

P.S., they gave me Citalopram for anxiety. if anyones had this before I'm curious how it worked for them

Posts

  • Local H JayLocal H Jay Registered User regular
    I know you said you're seeing doctors, probably want specifically a cardiologist if you can but you probably already knew that

    Good luck

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  • ThundyrkatzThundyrkatz Registered User regular
    This is scary and its good you are seeing doctors. Very frustrating that the doctors don't have an easy answer for this for you! But you are not alone.

    I have had the same issues you described at first, but it never progressed like you said. for years I have had bouts of this "chest flutter thing", like a skipped beat. I have googled it and talked to the doctors and nothing. I also, separately, sometimes get a pain in the chest feeling like you describe, like someone was pressing on a bruise. I can run, do heavy chores, run on the elliptical, no issues. I Finally had a cardio stress test last year and I passed with flying colors. Doc said next step was to wear a heart monitor 24/7 to try to capture the event, which I am not excited about. So, like you, very frustrating.

    The only thing I can figure for me is that I do have a lot of acid reflux problems, and I have found a tacit connection of those to the odd feelings. Like the indigestion is manifesting in strange way. So, now I get the odd feelings, I pop a Tums, and I go on with my day and just ignore it. it always goes away eventually.

    I will say that I have had that panic freak out feeling you describe before when some crazy new feeling happened and that was awful, took hours to calm down. Getting old (45 now) has really sucked. If you can separate those two things. The strange flutter feeling from the panic attack. Maybe you can reassure yourself that you have done everything you can with the doctors and you are otherwise in good health and try to just chalk it up to getting old?

    I wish you the best of luck!

  • dispatch.odispatch.o Registered User regular
    edited October 2020
    https://www.mayoclinic.org/tests-procedures/holter-monitor/about/pac-20385039

    Request a cardiologist and ask about a Holter Monitor if you haven't had a study done. You wear it all day for a few days and it records/uploads to be reviewed. It's not as accurate as a 12 lead but it's a more real-time tool instead of a diagnostic snapshot.

    Arrhythmia can be no big deal or it can be something you take medication the rest of your life for. I'm not a doctor and even if I was, I'm not your doctor.

    If it's atrial fibrillation there are basic stimulus that can cause it.

    https://www.healthline.com/health/atrial-fibrillation/triggers

    If it's general anxiety / panic disorder similarly there are coping techniques.

    5-4-3-2-1 is very popular and an effective tool

    https://www.urmc.rochester.edu/behavioral-health-partners/bhp-blog/april-2018/5-4-3-2-1-coping-technique-for-anxiety.aspx

    I recommend doing some light reading and writing down the things you were doing or thinking about after/during an attack while pursuing additional diagnosis.

    Edit: Panic / Anxiety isn't just being scared or startled. I don't think people appreciate the awesome power of fight or flight instincts and adrenaline.

    dispatch.o on
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  • ShadowfireShadowfire Vermont, in the middle of nowhereRegistered User regular
    I was diagnosed with afib early this year (thanks, dad), and felt a lot of the things you're describing. But at the same time, they should have picked up on it during any of the EKGs you had done. I would second getting a referral to a cardiologist. They might do a full holter, but I wore a Zio patch for a little over a week and got all the information we needed. The only negative to it was that it got itchy after a few days.

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  • JasconiusJasconius sword criminal mad onlineRegistered User regular
    i have two separate cardio referrals, one of them is in 3 weeks and one of them is supposed to be this week (waiting on a call)

    so just waiting in limbo for that

    i feel good right now, ive been sleeping extra, when I wake up in the morning I feel great, like nothing ever happened, and as the day wears on I get kinda frayed and that's when it's been happening

  • PaladinPaladin Registered User regular
    edited October 2020
    There are minor forms of "arrhythmia," which is a term I use loosely because in a lot of what we call arrhythmia there actually is a rhythm that keeps the heart pumping regularly.

    Skipped beats are fairly nonspecific and can be actual skipped beats or just a person misinterpreting the changes in heart rate that occur with breathing in and out.

    I'm not going to diagnose you over the internet, and I want you to stop reading up on this stuff if it's causing you anxiety or causing you to jump the gun on false assumptions. Basically, there are benign causes of skipped beats.

    One is premature ventricular contractions, which is basically the pacemaker in the heart being a bit lazy, the ventricles get impatient, and they take over for one beat. Caffeine can make the ventricles more excited than usual.

    Another is called a Mobitz Type I Second Degree AV Block, which occurs when the AV node in the middle of the heart has a bit of a tough time recovering from carrying a signal from the atria to the ventricles. It gets a bit more tired out each beat until it's not able to recover in time and fails to carry the signal entirely, which gives it enough time to recover, and the cycle continues. This is actually common in young people and athletes, especially when sleeping.

    Do you have either of these? I dunno. But they exist, and it is possible to have a benign or semi-benign heart issue that you really don't need to worry about.

    Paladin on
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  • ThundyrkatzThundyrkatz Registered User regular
    Not for nothing @Jasconius , but we are in the middle of some seriously messed up times. You said this started a month or so ago. You may have become accustomed to being very stressed out without realizing it and your body may be pushing back on you a little?

    ShadowfireOrcaCalicaDisruptedCapitalistNightDragonZilla360
  • OrcaOrca Registered User regular
    Not for nothing @Jasconius , but we are in the middle of some seriously messed up times. You said this started a month or so ago. You may have become accustomed to being very stressed out without realizing it and your body may be pushing back on you a little?

    Entirely possible. A new and exciting COVID-19 development for me has been an occasional bout of anxiety starting about a month ago too. I've never had anxiety problems before!

    Yay for persistent environmental stressors! Yay for the sympathetic nervous system firing off with no target!

    This might be something in that vein. You're doing the right thing following up with your doctors.

    CelestialBadgerZilla360
  • JasconiusJasconius sword criminal mad onlineRegistered User regular
    yesterday was my best day since visiting the ER... since i don't have advanced cardiac diagnostic equipment at home I've been trying to rule out more common causes

    yesterday I spent most of the time trying to enforce good posture and not over-stressing myself, and I only had one attack and it was very mild

    i noticed the attacks were only coming at the end of the day after I was getting physically worn down and especially when I was sitting in a stupid way. Wondering if some sort of aggravated nerve is a possible cause.

    I keep testing myself every day with mild exercise and I never have problems then. 95% of the time it's while sitting or leaning.

    Cardio appointment Monday morning

    ShadowfireBouwsTElvenshae
  • FiendishrabbitFiendishrabbit Registered User regular
    Do your attacks feel worse if you take a deep breath? If so it could be PCS (which while more common in kids and young adults can happen to adults as well).
    Generally a lot of the chest muscle/nerve cramp/pinching stuff happens when you're resting, because when you're moving everything is moving about and is never in a single position for a very long time.

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  • JasconiusJasconius sword criminal mad onlineRegistered User regular
    edited October 2020
    someone suggested PCS to me and I looked into but I don't think it fits perfectly. my pain is very mild, sometimes not existent, and it lasts for like.. literally 2 seconds. its there and gone.

    what I get could be best described as tensing, discomfort, something like that, I feel things in my chest flexing like a spasm almost.

    because of the location it is scary, sometimes I feel like its my heart, and I get a STRONG rush of fight-or-flight feeling. but it never hurts anything more than someone gently poking a bruise

    but nonetheless it creates a feeling of fear/dread/anxiety

    Jasconius on
  • SatanIsMyMotorSatanIsMyMotor Fuck Warren Ellis Registered User regular
    edited October 2020
    I had similar symptoms some time back and after wearing a holter monitor for 24 hours was diagnosed with Wolf Parkinson White syndrome. Not at all saying this is what you have but posting to let you know that, with similar symptoms, it took them close to 4 years to diagnose me. So be mindful of your symptoms and be patient.

    SatanIsMyMotor on
  • EncEnc A Fool with Compassion Pronouns: He, Him, HisRegistered User regular
    Jacs, I had similar effects last year which, after an ER visit, many cardiologist meetings and treatments we eventually diagnosed as caffeine-induced panic attacks. I incredibly rapidly and out of nowhere developed a sensitivity to caffeine that trigger panic-attack like effects. Changes in diet eventually solved it, but I can't drink caffeine beverages now without having similar effects.

    Does that mean you have a dietary thing? I have no idea. But there are ten thousand things that can cause similar feelings, from serious heart problems, to neurological problems, to things as common as radiating GERD pains. Keep up the visits to your doctor, its usually a matter of crossing off things from the list until you have one or two things possible remaining.

    Thundyrkatz
  • CelestialBadgerCelestialBadger Registered User regular
    After I got some sort of flu a few years back I got heart palpitations, but they mostly seem to have worn off right now. I saw a cardiologist who said it was nothing.

  • JasconiusJasconius sword criminal mad onlineRegistered User regular
    preceding all this i had, unprompted, already substantially rolled back my caffeine intake. I already didn't drink very much (one cup of coffee, two sodas on average per day...) got down to just a cup of coffee, now only doing tea since the ER visit.

    another day of generally taking it easy has begun to put my mind at ease. i still had one small episode but nothing compared to last week.

    it was tuesday when I made this thread that I thought I was staring down the barrel of days or weeks of *real problems* before I could see a specialist... as I had major attacks on both Monday and Tuesday. On both those days I thought I was going to have to weigh another ER visit before I could see a specialist. But now that I've found a way to at least tone it down substantially, I think I can peacefully ride things out to my appointment now

    CalicaElvenshae
  • ArtereisArtereis Registered User regular
    edited October 2020
    I've had these, with the first one happened in college and I thought I was having a heart attack. Turns out my mom gets them, too, so apparently it's inherited. I've done a few ekg tests and all came out fine. I haven't had one for several years now, but they're super alarming when they kick in.

    Artereis on
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  • KetarKetar Come on upstairs we're having a partyRegistered User regular
    Shadowfire wrote: »
    I was diagnosed with afib early this year (thanks, dad), and felt a lot of the things you're describing. But at the same time, they should have picked up on it during any of the EKGs you had done. I would second getting a referral to a cardiologist. They might do a full holter, but I wore a Zio patch for a little over a week and got all the information we needed. The only negative to it was that it got itchy after a few days.

    I spent some time working as a certified cardiac technician, and the work I did was analyzing the data from people who wore Holter monitors for extended periods of time. The most common out of the ordinary finding was afib that would only occur sporadically and had never been caught on an EKG. That kind of thing is exactly why doctors prescribe Holter monitors.

    FeralEncdispatch.oElvenshaeFiendishrabbittynic
  • NightDragonNightDragon 6th Grade Username Registered User regular
    edited October 2020
    I had exactly what you're describing as a teenager (without any anxiety symptoms, almost always in those same body positions), and then again a few years back in my mid 20's. Same health level as you, too. When it happened more recently, I was having them much more frequently. I figured this time it was probably anxiety, but went to the doctors to check my heart just in case. They gave me an EKG, found an arrhythmia, sent me to the cardiologist to check it out. The cardiologist found a normal EKG, so he had me wear a Holter monitor for 24 hours to record my heartbeat over the full day. After, I came into his office and they gave me an echocardiogram, and had me run on a treadmill while hooked up to some monitors.

    The results came back that I had bigeminy - basically, an extra heartbeat after my normal heartbeat, with a short pause after - but it wasn't constant, and would go away when I was exercising (which is apparently very common for people with this condition, which is in itself not particularly rare!). Even though I was worried about the same heart-attack-like symptoms you mention in your OP, my condition was diagnosed as benign and nothing to worry about. The feeling of my heart skipping a beat was actually me feeling that extra beat, a PVC. When I asked the cardiologist how I might've gotten this condition, he said it can sometimes happen after a bad bout of the flu...and sure enough, I'd had a bad case of the flu when I was a teenager, so we think that's probably where it came from.

    I still get these PVC's now and then, but they're much rarer (and I'm on anxiety meds now). I still get the same pains and tight feeling in my chest, but it's more anxiety-related than anything. When I can detect that heart-beat-skip feeling, it also briefly increases my anxiety because it's my heart, and so it can be a bit of a catch-22 when I'm feeling particularly anxious in general. I think the anxiety exacerbates the bigeminy, because after going on the anxiety meds I haven't had any other doctor detect anything abnormal on an EKG.

    It's great you're still looking for answers and working with medical professionals, but I wonder if you may have something similar (including the anxiety, which can be hard for you to detect if you're used to it) based on how close your entire post is to my own experience. The Holter monitor was hella uncomfortable to wear for 24 hours, but I agree with the other posters that it would be a great thing to ask for, and could help you find some answers. :)

    NightDragon on
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  • SimpsoniaSimpsonia Registered User regular
    A little different perspective here, but had a kind of similar issue a couple months back. Had been feeling very conscious of my heart beat, felt it pounding in my chest at times, sometimes felt like it skipped a beat. One day had a fair amount of pain on the left side of my chest and went to the ER, pain that was in a little different location from my normal heartburn. Went in, did blood tests, EKG, chest X-Ray, the whole nine yards and was told the same thing, not a cardiac event. EKG looked totally normal. Followed up with a GP for a real diagnosis, since the ER was only concerned with making sure I wasn't having a heart attack and sent me on my way. Doc checked me out, couldn't tell exactly what it was, but did explain some of the issues I had been having. The pounding conscious heart rate and feeling like I had skipped a beat was due to a very low heart beat. My resting heart rate is usually in the mid-50s (and got as low as 45 when I was in the ER). The doc explained that with a heart rate that low, you can often feel it pounding because it's pumping so much more blood per beat, and the skipped bea is just because it is so slow you can lose track of the tempo and think you missed one. Do you know what your average resting heartrate is or have a fitness tracker that tracks that data?

    DisruptedCapitalist
  • DisruptedCapitalistDisruptedCapitalist screaming Registered User regular
    I have exactly the same problem. The symptoms first appeared in my late teen years but started to occur with more and more frequency as I got older until around 2005 or so when I was really freaking out and going to the ER several times over a short period. After my doctors did the full check on me (the same as you! Stress test, Holter Monitor) and ruled out everything about my heart, he instead started talking about anxiety/panic attack. Since then I've been on SSRI's to manage the attacks and they've never occurred again (except once in 2011 when I thought I had gotten over it -- HA! -- and I stopped taking the Paxil. BIG MISTAKE. The was the year I got a CT scan of my heart just to prove that I didn't have an aortic dissection.) Since the first incident in 2005 I found out my condition is most definitely hereditary. My great grandmother used to frequently visit the hospital. My grandfather had frequent panic attacks, my mother and one of her brother's have it, and me and two of my cousins have it too.

    All I can say is thank all that is good that we have SSRI's in our modern era. I can't even imagine what my grandparents and great grand parents went through with absolutely no relief for the attacks.

    Anyway. When I had the Holter monitor it had noted every time that I had heart palpitations and each and every one was determined by my cardiologist to be normal and benign. They were all mostly brought on by the anxious wreck I had become.

  • JasconiusJasconius sword criminal mad onlineRegistered User regular
    Simpsonia wrote: »
    A little different perspective here, but had a kind of similar issue a couple months back. Had been feeling very conscious of my heart beat, felt it pounding in my chest at times, sometimes felt like it skipped a beat. One day had a fair amount of pain on the left side of my chest and went to the ER, pain that was in a little different location from my normal heartburn. Went in, did blood tests, EKG, chest X-Ray, the whole nine yards and was told the same thing, not a cardiac event. EKG looked totally normal. Followed up with a GP for a real diagnosis, since the ER was only concerned with making sure I wasn't having a heart attack and sent me on my way. Doc checked me out, couldn't tell exactly what it was, but did explain some of the issues I had been having. The pounding conscious heart rate and feeling like I had skipped a beat was due to a very low heart beat. My resting heart rate is usually in the mid-50s (and got as low as 45 when I was in the ER). The doc explained that with a heart rate that low, you can often feel it pounding because it's pumping so much more blood per beat, and the skipped bea is just because it is so slow you can lose track of the tempo and think you missed one. Do you know what your average resting heartrate is or have a fitness tracker that tracks that data?

    i have a somewhat low resting heartrate, at least in relative terms. I wear a fitbit 24/7... its trivial for me to get down to 55, which, for not being much of an athlete, was at least curious to me, which is why I pressed my GP for a cardiac referral for them to at least *look*

    the lowest heartrate I've ever had while awake was 48 which is a bit O.O

    in any case, yesterday I was symptom free after a second consecutive day of taking it very easy and enforcing posture, icy hot, heating blankets, an advil at night... I didn't even take the anxiety med yesterday (it was prescribed as needed)

    so starting to feel better that this is maybe an irritated nerve or some sort of awful subconcious stress problem... I don't think icy hot is a prescribed treatment for heartbeat problems....

    SimpsoniaDisruptedCapitalistKetarHappylilElf
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