RLR
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Hi Natalia and welcome to the forum. Based upon your description, I will tell you that some time spent here talking with members who share your symptoms will go a long way to help relieve some of your anxiety and fears.
Let's talk a minute or so about some physiology and a common misinterpretation made by so many sufferers who experience this type of palpitation syndrome. Benign palpitations are actually a part of normal variation in human physiology and do not constitute a sign of an impending cardiac event, nor are they capable of actually interrupting the normal function of the heart from a conductive or mechanical standpoint.
What typically occurs is that the first experience can lead to vigilance if it's prominent enough and from that point forward, there is a concern that the heart is not functioning properly. The pulse is checked regularly, along with blood pressure and sense of general well-being in order to determine if something is possibly going wrong.
This type of vigilence usually leads to a health anxiety disorder, wherein the patient becomes far more aware and vigilent to their physiology, particularly the heart. It's important to understand here that if anxiety is chronic and intense enough, it can invoke the fight or flight response that over time begins to demonstrate mild dysregulation of the autonomic nervous system in some regards. The physical changes that occur under these circumstances are often misinterpreted as symptoms of a disease or disorder. In other words, there is an immediate association between the experience of physical symptoms and some type of underlying physical disease.
This erroneous association occurs because in fact, the constant presentation of physiological response to fear can make a person feel ill in the general sense, with lethargy, numbness and tingling of the extremities, increased heart rate, bradycardia, palpitations, sweating, weakness, changes in vision, GI complaints and a host of other symptoms as a consequence of stimulation by the autonomic nervous system in response to fear.
It's also important to realize that many people who suffer from this syndrome adamantly state that they are not anxious or afraid and draw a clear distinction between their physical symptoms and the possibility that the underlying cause is actually being induced by something other than physical disease. To this extent, it is this almost innate and stubborn perspective which sends patients time and again to their doctor to have tests run that repeatedly turn out negative, a consequence that typically only serves to increase frustration and fears that the cause cannot be located and that the patient's sanity is slowly coming under suspicion.
When a person becomes fearful that something imminent is about to happen to them, it establishes a response by the brain to prepare the person to either repel the threat or escape from it. In order to do so, stark changes are made in the base physiology that increase muscle tone, heart rate, respiration and enhance alertness. These are just some of the changes made by the sympathetic nervous system and it's sort of the accelerator pedal of the body. Once the brain receives feedback that the threat is diminished, the parasympathetic nervous system slows the heart rate and respiration through the vagus nerve and together with other systems, the body returns to normal baseline function.
Surely you've experienced these symptoms under conditions when frightened or suddenly startled. Many persons feel their heart skip a beat or pound hard and steady, maybe sense a lump in their throat, breathe heavily and other physiological changes that are entirely normal under the circumstances. The trouble lies in the case where the response is invoked but there is no readily apparent threat with which to make a direct association. In other words, to experience a palpitation when frightened does not conjure thoughts that something is wrong with the heart, yet it's the very same physiological activity that is causing you to presently experience them. What you are experiencing has nothing to do with a physical disease, therefore all of the tests which are based upon algorithms of disease will turn up negative results for a very good reason.
The variation in presentation of the palpitations does not suggest something more sinister. The variation occurs for a variety of reasons, but mostly because of the precise entry point of vagus nerve stimulation upon the heart during the cardiac cycle. In other words, if it is superimposed upon atrial contraction, you may sense it as a flutter, whereas if it imposes upon ventricular contraction, you may feel it as a significant thud, or even during repolarization wherein some sufferers claim their heart paused for an extended period. In all cases, the underlying cause is the same and entirely harmless from a physiological standpoint. Realize that vagus nerve stimulation is incapable of interrupting the normal pacer of the heart. It's not physically possible.
So the key to a better understanding is avoiding the pitfalls of misinterpreting symptoms for something other than what they truly represent and realizing what's actually occuring during a palpitation event. Your heart is perfectly fine and you're in no danger.
We'll talk more.
Best regards and Good Health
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