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Thanks for the explanation. I guess I will find out soon. What kind of palpitations would not be considered cardiac in nature? if something else is causing palpitations, what could anyone possibly do about that? The EP could then tell me it isn’t a cardio issue and send me on my way. Where would I possibly go after that?
I saw my cardiologist today for a scheduled appointment. I told him about the loop recorder. He said all it would do is confirm what I am already telling them about and suggested I hold off on it because all it will do is give them an action to take, such as medication, ablation, etc. he does not feel I need a ablation, as does my sisters EP, who happens to be the partner of the EP I am seeing. He explained a lot to me today. My heart monitor showed that along with skipped beats, I also have occasional PVCs, which caused the skipped beat to be slightly delayed. So, we still have no idea why the palpitations happen but he knows that it is not physical, no clogs, no low blood counts, no bad thyroid, etc.
He gave me three more bottles of Bystolic (beta blocker) to take when the palpitations occur.. he believes that a medication will fix this. He also said that there will be at least 5 people today who will have similar symptoms as me and assured me that there is no danger in these palpitations. Of course that does not make me feel better. I was told not to lie down on my back when this happens. Not knowing the origin of the palpitations is annoying.
Trusso, I see you're still obsessing over your non-problem. Let me try to explain some things:
Everybody gets the occasional skipped beat, from the youngest infant to the oldest citizen....As we age, we tend to get more problems with skips or irregular hearth rhythms, and as we age, we tend to get more hardening of the arteries, so the the easy jump to conclusions is that all irregularities are due to coronary artery problems. FALSE....Most are not. In fact, unless you're actually had a heart attack, blocked arteries don't cause palpitations of any sort. (Damaged heart tissue is like sticking a rock up in the middle of a smooth flowing stream-- it causes turbulence.) We see the same sort of thing in a brain tumor or stroke causing seizures.
Many things in biology are cyclic-- from the cycle of life itself, to the waxing & waning of the deer/wolf populations, to a woman's monthly cycle, the daily excretion of ACTH/ cortisone, sleep cycles, the pattern of stripes on a tiger's coat and the spontaneous contraction/relaxation cycles of cardiac muscle cells.
By selecting the right values for the constants, we can get the computer to print out any number of graphs, from smooth, regular cycles, to regular but variable patterns to occasional spikes (like the 17 yr cycle of the locust or "skipped beats") to chaotic patterns.
Genetics, modified by the oxidation of aging, determines how the cardiac cell membranes allow the periodic changes of the Na/K flux across the the membrane. Same principle-- https://www.youtube.com/watch?v=mjK49syrODY
https://www.youtube.com/watch?v=3c73d5GJ2V0 (skip to 2:00 of the video). Note the regular irregularity of two coupled units. Imagine how complex the situation is when you have a few billion cardiac cells coupled together.
When you go to the doc complaining of palpitations, they first make sure you don't have coronary disease that can be fixed, hopefully to prevent an impending heart attack. Then they want to make sure it isn't a/fib or cardiomyopathy-- both of which can cause embolic strokes- preventable with anticoagulants.
Other than that, it's basically a matter of "just one of those things" (sounds like your case) where nothing can be done, nor needs be done. These things tend to be governed by "limit cycles" and never get out of hand. No need to worry.
It sounds like you need a chill pill, not a cardiac med.
Last edited by guidoLaMoto; 11-12-2020 at 01:29 AM..
I don' think its just one of those things. This is not a nothing thing because I really cannot function normally while this happens for 5 or 6 hours at a time where I am constantly coughing and sometimes cannot speak as a result of it. So, I cannot work while it is happening. I cannot do anything productive while it is happening because it is too disruptive. I also cannot sleep while it is happening, so there are times that I wont be able to go to sleep until 5 or 6 am, which means I am not getting up for work or at all for the first part of the day. So, while this is nothing to you, it's effects have a major effect on me while it is happening. I never had a heart issue in my life and this comes out of nowhere and, oh well, this is how its going to be the rest of my life? Doesn't sound right to me. My cardiologist said that the PVCs and skipped beats could cause major problems in the future if they weaken the heart.
On the other hand, I understand that the entire body is so complex and is a miracle that it even works at all. There are millions of things that can go wrong and yet, for the most part they do not. There is not a cure for everything but I would think this issue is something that could be remedied somehow because something is causing it.
Trusso, I to was offered meds but told side effects could be worse. I opted out of meds, but thankfully though very distracting/tiring when it happens continuously I can handle it and know at least it’s not my heart about to give out. I also was told could weaken the heart but ONLY if happening a certain percent of the time(mine was still well under that number). If it was at or above threshold they would of considered ablation. Bigeminy is what they said the skipped beats were doing(every other beat skips). Also, my cardiologist said that there are about a dozen other reasons palps can happen unrelated to the heart.. we never fully discussed those but I know the GI tract could cause problems.. I’m guessing you have explored those already.
Quote:
Originally Posted by guidoLaMoto
Trusso, I see you're still obsessing over your non-problem. Let me try to explain some things:
Everybody gets the occasional skipped beat, from the youngest infant to the oldest citizen....As we age, we tend to get more problems with skips or irregular hearth rhythms, and as we age, we tend to get more hardening of the arteries, so the the easy jump to conclusions is that all irregularities are due to coronary artery problems. FALSE....Most are not. In fact, unless you're actually had a heart attack, blocked arteries don't cause palpitations of any sort. (Damaged heart tissue is like sticking a rock up in the middle of a smooth flowing stream-- it causes turbulence.) We see the same sort of thing in a brain tumor or stroke causing seizures.
Many things in biology are cyclic-- from the cycle of life itself, to the waxing & waning of the deer/wolf populations, to a woman's monthly cycle, the daily excretion of ACTH/ cortisone, sleep cycles, the pattern of stripes on a tiger's coat and the spontaneous contraction/relaxation cycles of cardiac muscle cells.
By selecting the right values for the constants, we can get the computer to print out any number of graphs, from smooth, regular cycles, to regular but variable patterns to occasional spikes (like the 17 yr cycle of the locust or "skipped beats") to chaotic patterns.
Genetics, modified by the oxidation of aging, determines how the cardiac cell membranes allow the periodic changes of the Na/K flux across the the membrane. Same principle-- https://www.youtube.com/watch?v=mjK49syrODY
https://www.youtube.com/watch?v=3c73d5GJ2V0 (skip to 2:00 of the video). Note the regular irregularity of two coupled units. Imagine how complex the situation is when you have a few billion cardiac cells coupled together.
When you go to the doc complaining of palpitations, they first make sure you don't have coronary disease that can be fixed, hopefully to prevent an impending heart attack. Then they want to make sure it isn't a/fib or cardiomyopathy-- both of which can cause embolic strokes- preventable with anticoagulants.
Other than that, it's basically a matter of "just one of those things" (sounds like your case) where nothing can be done, nor needs be done. These things tend to be governed by "limit cycles" and never get out of hand. No need to worry.
It sounds like you need a chill pill, not a cardiac med.
Just curious of your opinion Guido, if a patient was found to have two arteries with 15-20% blockage and they were 32 years old female, would you recommend baby aspirin daily? Also, would you say that blockage is concerning for the age(otherwise healthy, no big risk factors but grandpa died 40s of heart attack, only history besides high cholesterol runs in family)? Was told even babies can show signs of buildup and normal for age.. but concerns me still. Also I am very hesitant to take daily aspirin(or any meds) if it’s not absolutely necessary. After having my heart cath I no longer worry about the palpitations but now just worried about the blockage found..
Just curious of your opinion Guido, if a patient was found to have two arteries with 15-20% blockage and they were 32 years old female, would you recommend baby aspirin daily? Also, would you say that blockage is concerning for the age(otherwise healthy, no big risk factors but grandpa died 40s of heart attack, only history besides high cholesterol runs in family)? Was told even babies can show signs of buildup and normal for age.. but concerns me still. Also I am very hesitant to take daily aspirin(or any meds) if it’s not absolutely necessary. After having my heart cath I no longer worry about the palpitations but now just worried about the blockage found..
Bummer. Sorry to say, a strong family history of early heart disease is THE most reliable predictor of early future problems.
I'd suggest baby aspirin daily and statins-- not because they lower chol, but because they have other often ignored effects on arteries. You deserve the benefits of every little trick in the book. ..Regular vigorous exercise is important (does more good than lowering chol). If you're prone towards DM/metabolic syndrome, watch your diet--avoid obesity.
If your Grandpa was the only family member to die young, then maybe you don't really have that genetic predisposition. A 10-20% blockage is not in itself that bad. The MASH experience in Viet Nam showed us that many healthy 19 y/o's have that already.
Side effects of ASA & statins are minimal. If you don't have the bad genes, they won't hurt. If you do, they may significantly prolong your life. Why take a chance? (As my father, a WWII vet, always said, "There are no atheists in a fox hole under heavy bombardment."
I don' think its just one of those things. This is not a nothing thing because I really cannot function normally while this happens for 5 or 6 hours at a time where I am constantly coughing and sometimes cannot speak as a result of it. So, I cannot work while it is happening. I cannot do anything productive while it is happening because it is too disruptive. I also cannot sleep while it is happening, so there are times that I wont be able to go to sleep until 5 or 6 am, which means I am not getting up for work or at all for the first part of the day. So, while this is nothing to you, it's effects have a major effect on me while it is happening. I never had a heart issue in my life and this comes out of nowhere and, oh well, this is how its going to be the rest of my life? Doesn't sound right to me. My cardiologist said that the PVCs and skipped beats could cause major problems in the future if they weaken the heart.
On the other hand, I understand that the entire body is so complex and is a miracle that it even works at all. There are millions of things that can go wrong and yet, for the most part they do not. There is not a cure for everything but I would think this issue is something that could be remedied somehow because something is causing it.
I may have missed it but have you had a pulmonary workup?
I'm not saying he has a psychosomatic problem ("imaginary" problem)--But anyone with any organic health problem feels something about it-- anxiety &/or depression-- to some extent-- usually not enough to affect anything, but sometimes more debilitating than the illness itself.
IN this case, the cough accompanying the dysrhythmia seems to be the real problem. It remains to be seen if the PVCs are causing the cough or the cough is causing the PVCs-- maybe (as I've suggested, I think, before)-- maybe it's a "seizure disorder" of he vagus nerve (that would explain both the cough & the PVCs.)...A hiccup, for instance, is actually a little seizure of the vagus.
The squeaky wheel gets the grease. Pts have to be careful about complaining too much. It can lead to unnecessary and potentially dangerous tests & treatments....OTOH- they do need to communicate how debilitating their condition really is. Sometimes symptomatic relief is necessary....
...If Trusso were my pt, at this point, satisfied there's not serious organic pathology here, I'd try Dilantin (usually used as an anti-seizure drug; can be used for PVCs) seeing that he can be essentially immobilized for hours at a time.
I never went to doctors other then an annual check up. Definitely not a hypochondriac. Never had an anxiety attack. Do I have stress and anxiety? I guess I have stress and thanks to these constant bouts of palpitations, it surely makes me anxious, I do know that I cannot cause this to happen by worrying about it.
I surely don’t want to be “that” patient who cries wolf and don’t think I am. I did take it upon myself to go to any doctor that may have a clue. Neurologist asked why I was bothering to see him. I told him that someone mentioned the vagus nerve. He just said that vagus nerve slows my heartbeat but mine is speeding up so he could not help. ENT did tests for acid reflux and allergies. No one has suggested seizures. My cardiologist told me there is no way this is anxiety based and that my issues are very real. That said, he isn’t too considered because he ruled out the major stuff.
When it happens to me at work, all the women there (I work in a healthcare) get very concerned and ask if I feel alright because I am usually the happy, funny guy with the friendly personality. They have made me sit dishpan while they take my pulse, oxygen level and blood pressure. They also are afraid I have Covid from the coughing. That said, people stare me down if I am coughing out in public. I almost had to leave a doctors office because of it while I was in the waiting room. Hell, I am watching tv and it just started a few minutes ago out of the blue. My cardiologist suggested that I not watch tv or a computer screen, but rather read a paper book. He thinks the screens may cause me to be over sensitized to the blue light or something like that. That sucks because I prefer to watch tv to try to keep my mind off of it. The palpitations are definitely causing the cough and not the other way. I can feel it.
This is all new to me. Other than a couple of not at fault car accidents and my gall bladder being removed, I have been pretty much problem free until this year. Nothing hereditary that I am aware of. All grandparents lived well into their 80s. My mother had slight diabetes (no insulin, just a pill) snd slight high blood pressure. Dad died at age 68 but not sure what the cause is since we hadn’t spoken in so long at that point. Definitely no depression here. I am too happy for my own good. People usually complain to me about why I am so happy all the time. I am just one of those mysteries of modern science. I wish I was more generic.
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