Hello,

I have been going through hell with these palpitations as I am sure a lot of you can relate. Since my doctor is telling me that my heart is healthy, I am trying so hard to accept that these palpitations are a manifestation of the anxiety and stress I am currently experiencing. One question I have though... When I am sitting at my desk just doing my thing I am able to control the palpitations. I will feel one occasionally, but it really just comes and goes. My issue is, when I have stand up and walk ANYWHERE my heart starts thumping and pounding like crazy. I get out of breath and just feel very faint. I am not out of shape, so this is all very concerning for me. Why are they so directly related to any type of movement or motion? For example, I actually work as a therapist. I was sitting at my desk talking with a client about a very stressful situation. I WAS FINE. I got up and walked to the restroom and my heart was thumping out of control. What does it mean when my palpitations are so directly related to movement/motion? I know people have posted asking for answers from a doctor... maybe rlr? Anyway, all answers welcomed. Thanks, Heidi

Okay, welcome to the forum and I've read your posting and concerns.

The symptoms you describe are associated with a physiological phenomenon termed orthostatic hypotension. It's important to realize that when you stand suddenly, your body must engage a number of physiological changes in order to overcome the effects of gravity upon your circulation. In other words, when lying down the body relaxes vascular tone and less work is necessary by the heart to pump blood through the vascular network because the effects of gravity are lessened and blood pressure typically decreases.  

When you stand, vascular tone must be increased in order to maintain adequate perfusion of blood to the brain. If the body is not able to do this quickly enough, blood pressure is too low and you begin to feel light-headed from insufficient perfusion. In order to quickly compensate, the quickest method by the body to increase blood pressure is by increasing cardiac force, which you feel as a sudden and forceful pounding of your heart.

This physiological process can become disturbed and mildly inefficient in the presence of anxiety sufficient enough to influence the nervous system and as a consequence, you can sense the effects more often and more prominently. Medications designed to lower blood pressure can also produce the effects as well and discussion with your doctor should be made to determine if dosage is right should the symptoms persist.

Best regards,

Rutheford Rane, MD (ret.)