I'm sorry you have had such a rough time.  It sounds to me like you had a panic attack as a result of the benign palpitations.  I have had those before, too, and i know how scary they can be.  Once you realize that the palpitations are indeed benign, you can begin to retrain your mind to not produce such a response to feeling them.  If I were you, I would feel very confident knowing that one of your palpitation events was caught on the monitor, was proven to be benign, and you're free to not worry about them any more!  Many people with palpitations WISH to have theirs caught on a monitor so they can have that extra reassurance.  Panic attacks are so horrible and it feels like something life-threatning is taking place, but in reality it's just adrenaline doing its job to protect you from a perceived threat.  I hope this helps.  If nothing else, know that I have been there, too!

jfit wrote on Feb 5^th, 2012, 2:42am:


Hi Julie,

I've had palpitations that depended on how I laid down and I once had them so severely that I couldn't breathe (it felt like I was really scared but only the physical sensation - no actual panic) - fortunately my episode only lasted a few seconds. Did your attack feel at all similar to getting into very cold water?

I have had periods of a few minutes where every fourth beat was being skipped and that feels terrible but Holter and stress tests and an echocardiogram all came back as normal. The cardiologist was confident enough that he cleared me for a cycling trip to Tuscany (V hilly) which was a bit grim due to the palpitations but which I managed without serious problems.

In my case there appears to be a link to chronic sinusitis - the palpitations are triggered by the movement of the debris draining from my sinuses. Initially my sinuses were so blocked that the drainage was so slow as to be imperceptible (which made the diagnosis difficult) and the palpitations could last days, now as they're starting to clear, I still get palpitations but they only last a short time.

I'm sure RLR will reassure you that it's only your vagus nerve that's being stimulated (as I was by the various specialists) and that it's not dangerous but it is very unpleasant and it's worth trying to find the root cause. Maybe keep a log of what you are doing when they're triggered to see if you can spot a pattern?

Best of luck,
Mark

This type of scenario is not uncommon and very typically occurs as a result of trapped air within the lumens of the intestines or at the level of the esophagus, both of which can induce diaphragmatic pressure and ultimately cause wayward or inappropriate stimulation of the vagus nerve, the result of which is a response by the heart in the way of a palpitation event. Realize that lying on the left side causes greater pressure on the pericardium, esophagus and stomach because they are all anatomically situated left of midline. In other words, there is greater force by gravity upon the organs when lying on the left side versus the right side and it is this differential which produces a disparity in physiological response.

The manifestation of vagus nerve-induced palpitation events is well-known by women who have been pregnant. Realize that it naturally creates a change in your architecture downstairs, so to speak, and the potential for irritation of the vagus nerve and subsequent wayward stimulation is quite high. Eating during pregnancy typically involves sometimes radical changes in dietary choices, many of which result in gastrointestinal discomfort, the nature of which results in trapped air or gas in the stomach and intestines, a consequence that is exacerbated by the crowded presence of the growing fetus.

It's also natural for the heart rate to increase following a significant palpitation disturbance, but it's an entirely normal and purposeful physiological response. When some benign palpitations occur, they can induce a slight and momentary down-spike in blood pressure. If pressure falls too low, you are well familiar with such a consequence because it lowers perfusion to the brain and results in syncope, or fainting. In order to try and prevent this from occurring, the cardiac center in the brain receives information from pressure sensors in the carotid arteries that pressure is too low. The most expedient method to restore pressure is for both heart rate and cardiac force to be increased, resulting in rapid, pounding heartbeats. Once pressure is restored to safe levels, the rate and force of your heart slows to normal once again. The sensation during the corrective period can sometimes be quite dramatic and fear that something is wrong is almost always induced, resulting in the typical responses to sudden fear, ie sweating, breathlessness, racing thoughts, paresthesias or tingling sensations and a host of other physiological characteristics.

It's important to remember that when you begin experiencing benign palpitations, changing body position will often disrupt the onset of further palpitations. By contrast, continuing to lay in the same position can likewise cause the palpitations to continue and sometimes produce a very dramatic, yet harmless, presentation which almost universally causes panic or near-panic responses by the affected individual.

I see nothing whatsoever of your symptoms to suggest anything greater to be present, or any indication that you are at any health risk whatsoever from such symptoms.

You're going to be just fine.

Best regards,

Rutheford Rane, MD (ret.)