Hi, I'm new to the board.
A few years ago I started having palpitations that were coincident with anxiety and panic attacks that started when our third child was born.  My GP and Cardiologist both chalked them up to stress. I underwent cognitive behaviour therapy and the attacks and palpitations both subsided. Months went by and one day I had way too much caffine which induced a really scary episode of racing heartbeat where I actually grew short of breath. This prompted my doc to put me on an even monitor for a few weeks. He thought he saw sustained ventricular tachycardia and referred me to an electrophysiologist. The specialist determined that the ectopic beats I experienced were of no concern as my heart is structurally normal. He chalked my episodes up to stress. The specialist is at U of Penn's cardiac care center in Philly and I have a lot of confidence in his opinion.  He recommended cutting out all caffine (which I have) and alcohol (which I haven't) to eliminate any potential palpitation triggers.

Both he and my primary instructed me to relax and get on with my life. I will follow up with the electrophysiologist this summer which will mark one year from my last appointment.

The palpitations I experience are typically never anything more than the slightest "blips" and are often indistinguishable from gas or esophogeal disturbances.  

I am generally pretty healthy.
I'm 40 years old, pre-hypertensive, have incomplete right bundle branch block (which a cardiologist told me was a non issue, especially after a few EKG and stress tests over time) , and take baby aspirin and a very low daily dose of lisinopril to control the BP.


I drink about 2 glasses of wine 3 or 4 times a week and still have serious stress management issues. I can have really extreme fight or flight adrenal responses to confrontations in the workplace with no palps or symptoms. I can be sitting at my PC, calmly working and have a little "blip" of a palp. I do sometimes notice them after sitting down before my PC right after eating.  I also can experience the odd palp when drinking wine at night. I probably drink too much on Fridays and or Saturdays on occassion and know that isn't good.

I tend to obsess about health issues and probably oversensitive to certain bodily sensations I've most likely been experiencing my whole life. It's only in recent years that I've become hyper-aware of them as fear of mortality tend to preoccupy me as I worry about taking care of my wife and three kids and being there for them.

Sorry if this is a little bit of a ramble here and thanks for your time.

Thanks for your reply.

I actually just had a small pinch deep in my chest when stopping jogging suddenly (and heavily) to answer a phone call.
I run at least 20-30 minutes about 3 times a week and also do a fair bit of walking.
I told the electrophysiologist about getting small blips such as this very rarely when exercising (jog, kayak, and surf) and he said not to worry.
I'm 5' 7" and 183 lbs, 30 over the recommended BMI.


Not really concerned as my work up last year said I was fine, just sharing to let others here know they are not alone. I get all of the anxiety symptoms related to these experiences after one happens: immediate worry and concern, mentally cycling through all of the "what if the doctor is wrong" scenarios.
If like me, your doctor has said not to worry, the best thing to do is not worry.
I'm not saying I do that successfully...I have definite problems coping successfully with stress in a healthy manner and worry about this stuff as much as anyone I suppose but I really try to bear down and work my way through it mentally.

The type of palpitations you are experiencing are the result of inappropriate vagus nerve stimulation of the heart. It is quite common for GI disturbances to produce the events because the vagus nerve innervates the GI tract as the pneumogastric nerve. When excess air from aerophagia, or gas from indigestion, becomes trapped at certain levels within the intestines, it can produce irritation of the pneumogastric nerve. An evoked potential results that travels upward along the right vagus nerve to its terminal endings, one of which is the heart.

Diagnostic tests with algorithms designed to detect elements of pathology will always be negative because the palpitations are not the result of any type of cardiovascular or heart problem. It's merely a wayward signal as a consequence of chronic stimulation of the nervous system due to anxiety and or stress. This is the exact same response experienced by persons who have been suddenly startled or frightened, often exclaiming "Gosh, that made my heart skip a beat!"

The only reason you believe the palpitations in this instance to be pathological is because they are seemingly occurring in the absence of a known stimulus. Therefore, they must be a sign of trouble. This is not the case whatsoever.

You'll be just fine and this type of disturbance can never transform into some type of pathology associated with the heart because it is extra-cardiac in nature. In other words, they do not originate from within the heart or as a consequence of cardiovascular problems of any kind. What is actually taking place is more akin to a muscle twitch of sorts, but it cannot interfere with the heart's performance. What you feel when they occur is far more dramatic that what actually takes place at the level of the heart. The palpitations can never wear the heart out or reduce your lifespan by even so much as a second in time.

Best regards and Good Health

Oh and I whittled the hooch down to one night a week. Save this past week, jog 3 to 5 times a week. About 3miles a session including some hill sprints. Also Kayak once in a while and once I get past a particularly grueling stretch of side work...will be back surfing on the weekends soon!

For those who can I really recommend exercise to burn off that "nervous" energy. Good for CV health, good for stress...it's win-win all around.