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racing heart after clean bill....RLR? (Read 3703 times)
blackirish
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racing heart after clean bill....RLR?
Aug 08th, 2010, 6:40am
 
I had started a different thread where RLR stated my symptoms were benign (which concurred with my electrophysiologist and GP).

Long story short, his diagnosis was that all of my palps were stress related. One episode of racing heart a few years ago, following an event monitor study, was chalked up to stress and basically a caffiene overdose. Heart is structurally normal, do have IRBB but am told that's no biggie.

Had my one year follow up with EP doc (U Penn Heart Dept, Philly) who gives me a clean bill of health, says long term prognosis is excellent, says only one more annual visit, then only as needed, etc. I work full time during the day and freelance nights and weekends being the sole bread winner for a family of 5. I also jog 3 miles an average of 4 times a week with a few hill sprints in there and am 40 yrs old, 5' 7", 183 lbs..BP in the 117 -120's over low 80's to high 70's on lisinopril and aspirin for pre-hypertension...not flabby but definitely need to lose it around the  middle.
No palp problem excercising or during any other activities (with the exception of two blips that the doc wrote off as non-issues). Doc said to ignore them and just work through it.

Doc said to cut out even decaf coffee and alchohol. Says alchohol can lead to A FIB. Followed doc's orders this week with the exception of having a cup of decaf at 9.30 AM yesterday morning. Worked on and off yesterday from like 10.30 AM to 1.30 in the morning...with a bunch of long family breaks sprinkled in plus a good jog and some push ups and sit ups around 6 pm. Was supposed to finish a big job by the night's end but didn't and didn't feel any overt stress symptoms as client is pretty easy going and I knew they would grant me a few more hours Sunday, no problem.  Around 1.30 AM while sitting at my computer, I felt my heart suddenly start to race with pronounced beats..tried to burp it away (irrational, I know) and pound my chest while counting to about 10 to roughly measure the duration. This is only the second time in two years I had something like this...all of my palps have been blips and dismissed by EP doc with the exception of the run that promted the event monitor and that was a series of racing beats accompanied by shortness of breath which cycled briefly, then quickly repeated....1,2, 3, 4, 5 pause then 1,2,3,4 and over.

Last night freaked me out as i remembered the event monitor from the other year I mentioned came up NSVT and GP freaked out but EP doc said no worries, heart is structurally normal. Was worried that last night was the onset of Ventricular Tachychardia...

Got really upset last night by the sustained run of fast, strong beats.
Called GP (who is my uncle...like having a bat phone to your doctor  Wink ) and he said no jogging today and call the EP doc in the am.

Okay, so here is the RLR question- If my heart is structurally normal, can a brief episode of racing beats lead to something really bad?

Thank you for your time and especially patience reading this long post!
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RLR
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Re: racing heart after clean bill....RLR?
Reply #1 - Aug 8th, 2010, 12:01pm
 
Okay, your heart is entirely normal. What took place is that your heart responded to a downward spike of hypotension by increasing both cardiac force and rate. Realize that when seated at the computer, it is much like the soldier who stands at attention for extended periods. It is very common for people to become still and motionless while attending to the computer. This produces decreased vagal tone.

The vagus nerve needs sufficient sensory feedback to regulate tone, which establishes the sort of demand necessary for the heart to maintain perfusion to the brain. Once vagal tone decreases to a certain extent, baroreceptors in the ascending carotid arteries signal the cardiac center in the brain that blood pressure has descended too low and the risk of feeling lightheaded or even fainting is high. The absolute quickest method for sufficient perfusion to be maintained is for heart rate and cardiac force to be suddenly increased, which you experience as rapid pounding heart. It is an entirely normal physiological response.

Nothing of your symptoms or experience would make me concerned otherwise. Your specialist is correct in that sufficient alcohol consumption can induce A-Fib but the amount must be quite high for it to occur. The condition is termed holiday heart because most people who do not characteristically drink much throughout the year, tend to overdo it over the holiday season and this concurrent use places them at risk for A-Fib. It is not, however, life-threatening but often requires cardioversion to return to normal sinus rhythm.

Eructation, or belching, to impart a change in the cycle of benign palpitations is actually quite successful and it is the pressure from gas or air within the lumen of the intestines or stomach which produces the evoked potential through the pneumogastric nerve, which as it ascends becomes the vagus nerve.

You'll be just fine.

Best regards and Good Health
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Best Regards and Good Health
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blackirish
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Re: racing heart after clean bill....RLR?
Reply #2 - Aug 8th, 2010, 12:08pm
 
Thank you, Doctor.
I should note that I had taken the dog for 20 min walk about an hour and a half before the episode but I guess that's fine.
Well, I've been sitting on my duff here working again all day so maybe it's time to stretch my legs Wink

Thanks again for your time. I'm going to follow up with my electrophyisiologist tomorrow as a precaution and appreciate your efforts here on the forum.

I'm not plagued by as much anxiety as the palps and such used to cause me but I see how many others here are still suffering from such concerns. You are providing a great service here and thank you for your efforts...most retired docs would be on the golf course all day...you are still here helping folks!
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