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Skipped beats and alcohol (Read 5942 times)
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Skipped beats and alcohol
Jan 02nd, 2009, 10:52am
I'm new to this site but it seems very helpful and it's good to know there are other people who may understand my anxieties.

Five years ago, after a heavy weekend (very late night Friday and a wedding on Sunday) I had a panic attack on a train. Whilst I haven't had a repetition of that (I had a few minor panics after that but realised I was in charge of that!) I have become acutely aware of my heartbeat. For 33 years I don't think I'd noticed it once!

Since then I have become aware of a skipping/thudding sensation in my chest at various times, almost always asssociated with drinking. After the panic attack I had various tests including the 24 hour monitor and nothing unusual showed up. When I went to the GP later over the skipped beats he said it was pretty normal to have that problem when drinking.

It seems that even the slightest drink can bring the skipped beats on. On occasions I have had just a few sips of lager or wine and I've felt them come on. This leads me to believe that I may just be bringing them on myself as I don't tend to notice them unless I think about them. However, I am quite certain that it isn't that simple.

The worst episodes have also been associated with heavy eating - four course meals with overly generous relatives and at/after weddings. The other time I might notice the odd skipped beat is early morning after my regular morning poo (apologies for the foul language!) but that could be my stomach rather than my heart.

All of these episodes settle/disappear during the night or by early morning - presumably once I've cleared all the alcohol out.

The connection with food as well as booze suggests to me that my digestive system is involved somewhere in all of this. I have read about the vagus nerve and sensitive stomachs and I have to say I do have a sensitive stomach and a very fast metabolism. IMy pulse sometimes increases (from 65 to 80bpm?) after eating and it might be that booze and excess food kick it into overdrive...?

Funnily enough, in the hours immediately after my panic attack (racing and pounding heart), I had to visit the toilet about 6 times. It wasn't simply an upset stomach - I really needed to go, if you get my drift. When I mentioned this to the doctor he said it had nothing to do with my panic attack but I am now convinced it was related.

I am 38, 168lb, average height and quite fit. Ironically, my anxieties have led to me doing less exercise over the past few years but I have resolved to do more exercise. I may feel a few skipped beats after an exerting cycle but that doesn't worry me that much - even though I hate every single skipped beat.

I have no other symptoms and (touch wood) I haven't ever had chest pain, shortness of breath, etc. If I wasn't so tuned in to my heartbeat I wouldn't know I suffered this odd problem but from time to time it does get to me!!!

I know the easy answer is to give up booze but I do enjoy a drink from time to time (I honestly don't think I'm an alcoholic) and I'm fed up with this thing praying on my mind.

I would be interested in and grateful for anyone's thoughts. Smiley
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Re: Skipped beats and alcohol
Reply #1 - Jan 2nd, 2009, 5:08pm
Welcome to the forum. Realize that alcohol is a CNS depressant and causes certain physiological changes to occur at varying levels of consumption. There is a direct connection between alcohol and the presence of benign palpitations and it occurs with such frequency that it's known as holiday heart, due to the fact that most people who consume large quantities of alcohol do so during the holiday season.

Your doctor is also quite wrong in the assessment that a bowel movement is not connected to panic attacks. It's important to realize that the nervous system is divided into two distinct functions, one called the sympathetic nervous system and the other called the parasympathetic nervous system.

You can think of the sympathetic nervous system as the gas pedal because it's responsible for raising heart rate and blood pressure, increasing adrenaline and respiration, causing the body to sweat and importantly here among other changes, reduces intestinal function.

The parasympathetic nervous system then, represents the brakes and is responsible for lowering heart rate and blood pressure, reducing adrenaline production and lowering respiration to baseline and equally important to our discussion, increases intestinal motility and peristalsis.

When you experience a panic attack, it is propelled by the fear that something dreadful is about to happen and thoughts begin racing wildly because there is no ability to control what is taking place with the body. The sympathetic nervous system runs amuk and sends the heart racing out of the chest and respiration is shallow and difficult, with sensations of not being able to get enough air. Light-headedness is common and generally the body feels as though it's about to suffer a catastrophic event of some type. Incapacitation is not uncommon for periods of several minutes with a severe washed out sensation that lingers for several hours to the remainder of the day in some cases.

At a point where the event subsides, the parasympathetic nervous system takes charge and slows everything down to baseline. Realize that the vagus nerve innervates the GI tract as the pneumogastric nerve and bowel movements are induced by a parasympathetic nerve response. This is why you experienced continuous urges following the panic attack. It is also the specific reason that you experience palpitations following very heavy meals or cases where indigestion stimulates the vagus nerve to respond.

Realize that benign palpitations are merely stimulation of the heart by the vagus nerve as a parasympathetic nerve response, much like the one which stimulates the bowel and GI tract. When people become anxious and apprehensive, they set in motion something called the fight or flight response. This innate mechanism uses both the sympathetic and parasympathetic nervous system responses to cause physiological changes necessary to either fend off a threat or escape from it. In order to do so, you might well imagine that the heart rate and respiration is increased, as well as many other changes to increase strength, speed and agility. Once the threat has passed, things return to normal. These changes are a very regular event and the most common example would be reacting to a horror film or thriller wherein frightening events cause the body to respond in such a manner.

Understand also that palpitations are very common during frightening events, but people dismiss them as entirely normal due to the circumstances. In fact, I'm sure you've heard someone who was recently frightened exclaim "my heart skipped a beat!" or "that made my heart stop!" These are but a few of the examples wherein a parasympathetic response caused a palpitation to occur.

When palpitations occur in the absence of an external frightening event, people misinterpret it as a sign of heart disease or a sign that something bad is about to take place. In fact, it's simply due to a parasympathetic response because the fight or flight mechanisms are sort of stuck in the on position inside the person with chronic anxiety.

The palpitations can never cause your heart any kind of damage, nor will your heart ever stop as a result. It's merely a signal being delivered to the heart because the body is attempting to turn off the effects of the fight or flight mechanism. In the case of the anxious person, they misinterpret the physiological changes as symptoms of an underlying disease, which is entirely incorrect. They are unable to realize that anxiety at elevated levels can cause physiological changes to take place that are entirely normal of conditions such as what we've discussed earlier about fearful events. The anxious person is apprehensive and afraid much of the time about present or pending events, causing the brain and body to respond exactly as if it were a real threat to their survival. Just like when you are frightened by a scary motion picture, the brain does not distinguish between real threats and those which are only perceived to be real. The body responds in all cases.

This is the standard case for all people with chronic anxiety who are very healthy but yet feel sick because they believe the physiological changes to represent disease rather than merely a response to anxiety.

You're going to be just fine.

Best regards and Good Health  
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Best Regards and Good Health
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Re: Skipped beats and alcohol
Reply #2 - Jan 2nd, 2009, 11:49pm
Dear Nitro,
I get loads of ectopics when I've been drinking too( and No! I'm not an alcoholic!!!)
I've had them for decades and through the information and support of this forum I've learnt to accept them and ignore them. About 2 Xmas ago I had thousands and thousands of the pesky things and I ended up in bed for a week thinking that I was overstressed with work and too much play (!) but with hindsight I can see it was too much wine and raging heartburn after all the rich Xmas food and chocolate that I had celebrating! I don't always get them after alcohol but I couldn't say for sure because these days I honestly ignore them. I'm not as conciously aware of them as much any more.
Occasionally I think..oh yeah...they're still there...and I come onto the forum and find the reassurance that I need to remember that they are nothing to worry about.
You need to read the info on here and make yourself realise that they're nothing important and learn to ignore them. I did and I'm a total 'worry-wart'!!!
Kind regards and Happy New Year
Toto x
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Re: Skipped beats and alcohol
Reply #3 - Jan 3rd, 2009, 2:03am
Hi Nitro
Re panic attacks needing to make you dash for the nearest toilet - yes! Normal effect of panic attacks! Always when the panic is over though.
and many of your other yucky symptoms are also familiar too.
Don't worry.... Although often I am a fine one to talk!
bead  Wink

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