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Question for RLR: Neurological Issues and Palps (Read 4741 times)
bike21
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Question for RLR: Neurological Issues and Palps
Jan 17th, 2011, 7:12am
 
Hi there...I am new to this forum and I want to first start off by thanking everyone who has put this together.  The information that is on this site has been so incredibly helpful.  RLR, your insight and information is so easy to understand and has given me some much needed insight into what I have struggled with.  Thank you.  

I have had skipping beats or palps for several years.  I used to get one every few weeks or sometimes every couple of months--the frequency was very, very low.  About a year ago, the frequency increased exponentially.  I started experiencing them every day, usually in the afternoon and evening.  I would have many every minute and the episodes would last for hours.  I saw my doctor about them and he ordered a 24 monitor and it showed about 400 or so ectopic beats with a few episodes of bigemny (sp??).  My doctor said he wasn't concerned because there did not appear to be a dangerous rhythm.  As an additional precaution, he had me do a stress test and referred me to a cardiologist who performed a doppler echo.  Both tests were clear for any sort of heart issue.  I met with her and she said that I was experiencing palpitations, but they did not appear to have a pathological origin.  She talked to me about triggers and how to help them occur less frequently.  She mentioned beta blockers, but didn't think it was necessary right now.

I guess what really concerns me is that the frequency has increased so dramatically.  I know that stress and anxiety play a roll, but honestly my stress levels and anxiety have been relatively low.  There have certainly been other times in my life when my stress levels and anxiety where much, much higher and I never experienced them.  I am concerned that something is being missed.  If the structure of the heart is good as indicated by the tests I have had, could the cause be related to a neurological issue: a bulging disk in my neck or some growth somewhere in my brain or spinal cord, for example??  I often do have neck tightness/discomfort/pain--I think it is sleep related.  I have some bulging disks in my lower back, but wonder if I have some in my neck that might be pushing on the vagus nerve and causing some of this.  I did play football through college and I took some pretty bad hits--I'm sure I suffered from more than a couple of concussions.

So, I guess is was hoping to hear more about neurological factors that could be causing these palps and whether or not I need to get something additional looked at.  Should I be getting neurological stuff checked out??

Thank you for your help and support...
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RLR
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Re: Question for RLR: Neurological Issues and Palps
Reply #1 - Jan 17th, 2011, 4:26pm
 
Okay, these palpitations events are extra-cardial in nature, meaning that they do not originate from within the heart. They are actually being caused by inappropriate stimulation by the vagus nerve. You seem to be firm in your belief that physical symptoms are unswervingly associated with physical disease and this is not the case whatsoever.

Nothing neurological needs to be evaluated and increase in episodes like this often arise relevant to circumstnancs that are life-altering in nature. Any one of a number of common factors can produce the effect, including a change in a job, loss of a job, martial discord, loss of a loved one or friend, financial circumstances and the list goes on and on. It can also be relevant to age from the standpoint that life's issues are far less potent in youth than in middle-age or later years.

Lack of quality sleep is also directly related to the onset or increase in benign palpitation events. The fact that you are not sleeping well in the absence of a known cause would make me question whether stress or anxiety is more of an issue than you are presently suggesting. The context of stress and anxiety is often undervalued by those experiencing it and there is a standard belief that these factors are expressed in a universally identical context. Again, this is not the case at all. It is not necessarily the level of stress and anxiety, but rather the specific type and how you are perceiving and addressing it.

I see nothing of your description that would suggest an underlying pathology to be responsible for the increased presence of the palpitation events. Aside from the nuisance factor, these events have absolutely no potential to cause you harm in any manner at all. Again, they arise from mere stimulation of the heart and they are more akin to a random muscle twitch from a  physiological standpoint. No matter how bold the expression becomes, they do not have the ability to stop your heart or cause it to suffer damage.

Incidentally, the term bigeminy arises in this context merely due to the manner in which the diagnostic equipment is programmed to respond. The term is inappropriate where benign palpitation events are concerned. In other words, simply because the timing of the events occurs in a manner to suggest couplets or bigemeny, is not the type of classical form of the phenomenon which we observe in cases from other causes.

Best regards and Good Health

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Best Regards and Good Health
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bike21
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Re: Question for RLR: Neurological Issues and Palps
Reply #2 - Jan 19th, 2011, 6:53pm
 
Thank you, RLR.  I really appreciate you taking the time to respond to my post.  I found your words, as usual, comforting and reassuring.  I do recognize that I am pretty firm in my belief that these palps are due to a physical issue or disease.  It is hard to imagine that what I feel is just due to anxiety or stress.  I know I need to work on this belief system--I am addressing it therapeutically, but alas my brain is more active than I would like it to be sometimes.  I am definitely a work in progress...

Thanks again...

bike
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