RLR
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Hello and welcome to the forum. Based upon your posting, you've definitely landed in the right place. I'll take a second and tell you a little about this forum and some of the folks who are members and then we'll get to the task of answering some of your concerns.
I am a semi-retired neurologist and some time ago began offering my support when this site was part of the Resonance program for women, which at some point was abandoned. I had the forum re-created by some very gracious hosts and what you presently see is the result of their efforts.
My presence here is not to offer you medical advice or treatment in any way, but rather to explain matters of medicine in ways that the average person can better comprehend and relate to their symptoms or general health concerns. As with all new members, I will tell you emphatically never to use the internet as a source for your medical needs or attention, but rather merely as a source to better educate yourself about health matters already presented to your primary care physician or specialist.
As for the members of the forum, they are an absolutely wonderful group of people which all share common symptoms associated with anxiety, stress and the physical symptoms associated with the disorder. This would include benign palpitations of the type you are describing in your post.
Okay, now to the matter at hand. It's important to realize that there is a rather symbiotic relationship between the psychological manfiestations of anxiety and the subsequent physical symptoms. It's oftentimes very hard for patients with anxiety to define any particular point in time that may have represented ground zero, so to speak, wherein the anxiety was established. Many persons experience transient or situational anxiety, a very common experience under warranted conditions. It's only when anxiety persists beyond a certain timeframe that it becomes a problem.
I preface my comments in this way to share with you that it's important to look into your past to try and understand the origins or basis for your anxiety. From a medical standpoint, we can explain the neurochemistry and potential imbalances which produce symptoms of anxiety, but there is most always a social environmental trigger that establishes the chronicity of the disorder that most affected persons find to be inescapable in many instances. In other words, loss of a loved one, a divorce, new job or loss of a job, bearing children and similar circumstances are all potential antecedents to anxiety disorder.
More specifically to your concerns, body position can have a dramatic effect on the potential for vagal-stimulated palpitations to occur. You have to realize that from an anatomical standpoint, the vagus nerve innervates the GI tract as the gastric nerve. The vagus nerve utilizes acetylcholine, a neurotransmitter, to communicate electrical impulses and when a disturbance occurs at a terminal point of the vagus nerve, it can cause a signal to be transmitted. This signal makes its way along the vagus nerve and when it encounters the heart, it imposes the signal upon the normal sinus rhythm and you sense it as a flutter, a skip or other abnormal pattern depending upon precisely where in the heart's cycle the signal is imposed. Realize that nothing at all is wrong with the heart and the signal is coming from outside the heart. It is not a sign of heart trouble in any manner whatsoever. As I've told countless members and visitors to the site, in over 40 years of practice, I've never even once heard of a person suffering any type of cardiac-related event or heart damage as a consequence of palpitations of this type.
Pounding heart in these instances is a very common response to palpitations because they create a slight change in blood pressure that is sensed by something called baroreceptors in the major arteries. These receptors signal the cardiac center in the brain to increase cardiac force to compensate and you feel it as heavy, rhythmic thumps which can sometimes even be felt in the ears and the extremities on occasion. It's an entirely normal physiological response.
The main factor to initially realize is that these symptoms, while certainly frightening at times, are entirely harmless to your heart and will never cause a catastrophic event. One of the most productive approaches to anxiety disorder and panic disorder is the use of cognitive-based therapy, combined with short-term anxiolytic treatment if warranted. This combination allows for patients to gain rapid benefits from short-acting pharmaceuticals while opening themselves up to the opportunity to allow cognitive restructuring techniques to point out errors in thinking and belief patterns known to exacerbate anxiety.
The good news is that you're going to be fine and you're in no physical danger as a consequence of anxiety-related palpitations.
Lastly, doctors don't necessarily broach the subject of vagal-stimulated palpitations because there is no body of research to support it. Since it is harmless in nature, science can afford little diversion from more serious conditions. Thus, if it doesn't gain notoriety in the literature, it is not recognized. Nevertheless, it does exist and causes the same exact effects on the heart when a person is suddenly startled or frightened. We'll talk more about that later.
Feel free to post and talk with members here. They're a great bunch of folks.
Best regards and Good Health
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