Palpitations

[Machair]

I've had heart palpitations now for fifteen years on and off and all my tests have been normal, although I do have POTS and NMH with CFS. I get them mostly at night when I try to sleep, and they often feel like forceful beats and sometimes skipped beats. They are very scary- does anyone else have heart issues?

 

[Athene]

Have you had a 24 or 36 hour Holter monitor? A good one with six leads? (Some doctors give you a 2 lead Holter which is useless)

I get "forceful beats" a lot, even since my operation for arrhythmia. They come without tachcardia and without arrhythmia but the sensation is extremely unpleasant. I believe it is caused by sub-clinical inflammation which is caused by the infection(s) we have, which goes to some people's hearts but not others.

The skipped beats sensation definitely sounds like an arrhythmia to me. When people have sinus tachcardia (common with the majority of viral infections) they don't get this skipped beats feeling. Having them come on at night is typical of one type of arrhythmia.

The first line of treatment for arrhythmias is medication, and if your heart is being damaged by infection (in CFS the commonest are borreliosis, chlamydia pneumonia and mycoplasma pneumonia) this is important to prevent further damage. I have been taking a heavy antibiotic treatment for these infections (I have all 3 that I listed!) but after 3 months of it, I still get these forceful beats. I don't know how long it will take.

Instead of seing a normal cardiologist I would seek out an electrophysiologist. In my experience over 25 years I can tell you that regular cardiologists know very little about cardiac electrophysiology. It is a complex and vast field, with incredibly rapid progress in understanding which a doctor cannot keep up with unless it is his speciality.

My advice is to be persistent in getting this investigated. Don't let anyone fob you off by saying you are having "panic attacks".

 

[Athene]

I had an appointment with the doctor today and asked in detail about the forceful beats. he said if they come without tachycardia or arrhythmia they are definitely caued by Chlamydia pneumonia. It enters the blood vessels and nerves of the heart and causes inflammation.
He said for symptom relief you should take 800 to 1000mg of magnesium a day.
To eliminate the infection altogether you need a long course of antibiotics. I have been on antibiotics for 3 months and it still hasn't gone yet. And I am taking magnesium but it still happens, just a bit less than before.

 

[justy]

Hi Machair, i have also had palpiations for about 15 years and have had it investigated by 3 different cardiologists. I have had ECG's EEG's and 4 day monitor - all showing nothing. Mine is like a missd beat and then fast one(s) to make up for it. I can also feel it is going to happen and also stop it by breathing very deeply. Mine also tends to be positional and can be just one beat or go on for minutes at a time. I originally had it investigated because i had a heart op as a child - they say this has nothing to do with it.
Since cutting out sugar and wheat and taking magnesium mine has greatly improved.

 

[Lucinda]

Yes I get heart palpitations pretty much everyday. They are really bad. I also get discomfort in my chest area. My acupuncturist has always said there are problems with my heart, but whenever I have my heart investigated at the hospital, they just say that apart from having a fast heart rate (which they put down to anxiety) that my heart is fine.

I don't feel like my heart is fine, but what can you do? I was offered beta blockers to slow down my heart rate and ease the palpitations, as well as ease my problems with breathing and being all 'wired', but have heard so many people with ME say it made them really ill that it scared me off trying them.

 

[kahlan]

Yes i also get palpitations at various times along with having chest pain and pressure along with sob. i had a holter monitor as well as a nuclear stress test and was told i was fine by the same hospital that told me it was "normal" to have spasms and jerking during an MRI. If i understand correctly magnesium is helpful and eliminatiating processed foods; wheat and sugar can help? i also have severe GERD which i have been bandaiding so to speak due to limited resources and am extremely stress and not resting or able to eat well due to an abcessed tooth i have had for over a month (on antibiotics). Is it possible in some instances to have the muscles around the rib cage tighten that it incurs the palpitations? Sorry i cannot think of the term for it at the moment.

 

[Athene]

Hi Kahlan,

I think that your feeling of pressure is caused by inflammation in the heart tissue pressing outwards, rather than an inwards pressure. (With a tightening rib cage you would feel extreme shortness of breath rather than symptoms in the heart.)
This condition is called chronic (or sometimes subclinical) myocarditis.

With clinical or acute myocarditis you DO feel severely short of breath as the heart becomes too enlarged and engorged with fluid for the lungs to open up and it is also hard to breathe simply because it hurts to much.

Myocarditis is usually caued by viral infections but can also be caused by bacteria.
Some pathogens will alter heart rhythms only after the subclinical myocarditis has dragged on for a long time, which means your ECG will be normal and the only sign of the condition is that you can feel this pressure. There is a test involving a biopsy of the heart muscle which can prove there is inflammation, but it is highly invasive and even when they do find out you have myocarditis, they do nothing much, because it is usually caused by a virus that cannot be treated. Even when the cause is bacterial it is hard to eliminate.

In my case I started with an acute, life-threatening infection called fulminant myocarditis. I had antibiotics for a year which reduced it to a low-grade, chronic infection - which is what I think you have - but didn't eradicate it. Many years and a heart operation later, I am trying antibiotics again. The operation was fantastic adn improved my health immeasurably, but I can still feel the infection rumbling away in there. Having had the infection so severely I am acutely aware of what my heart is doing and I am determnined to get rid of these germs before they reduce me to that condition again.

Here are some links

http://www.mamashealth.com/myocarditis.asp (basic intro)

http://emedicine.medscape.com/article/156330-overview (more detail on different types)

 

[lucy]

I had very strong ones. I would have a skipped beat, and then the next beat would be maximum possible beat. This meant, that my chest was in some kind of convulsion. Not so pleasant at work. I had them during day, while at night as soon as I would lie down, I would have very strong fast beats. All has improved with Omega 3, and now I get 1-5 per day, while before I had up to 5 per minute. It was also improving when taking antibiotics. My dr. says it is normal.

 

[free at last]

Hi Machair, i have also had palpiations for about 15 years and have had it investigated by 3 different cardiologists. I have had ECG's EEG's and 4 day monitor - all showing nothing. Mine is like a missd beat and then fast one(s) to make up for it. I can also feel it is going to happen and also stop it by breathing very deeply. Mine also tends to be positional and can be just one beat or go on for minutes at a time. I originally had it investigated because i had a heart op as a child - they say this has nothing to do with it.
Since cutting out sugar and wheat and taking magnesium mine has greatly improved.

Bingo again Justy, i get the same as you, had it for most of my life, i also deal with it by a kind of cough, not quite a cough like a clearing of the throat cough, sometimes it works sometimes it doesnt, the ones that are the scaryiest are the multible beats that miss for about a min, feels like your going to have a heart attack untill the rythm returns to normal

 

[sleepy237]

I have them often Justy sometimes i feel them other times i dont but i know by taking my pulse i have them more frequently 1 upon awakening and on exertion. They were foound on recovery on stress testing but the cardio said they were benign. I think irregularities are common with CFS/ME x

 

[lucy]

I was just 'researching' about the vagus nerve and remembered this thread were palpitations with cough have been mentioned. I am reading about this nerve, because now I get palpitations after eating lunch and staying sit. The stomach-heart connection slowly set into my mind (I admit it was obvious also before, but I have recently learned that some ideas, even present in the head, need time to mature and appear trusted). And guess what, vagus connects lungs and throat too. So it kicks from the stomach/intestines, up the heart to lungs. This blog post explains quite well in a simple language how this nerve messes things up. My nearest goal will be to get out of war with this nerve and become friends.

 

[ahimsa]

I've had heart palpitations now for fifteen years on and off and all my tests have been normal, although I do have POTS and NMH with CFS. I get them mostly at night when I try to sleep, and they often feel like forceful beats and sometimes skipped beats. They are very scary- does anyone else have heart issues?

I think that most of the time heart palpitations are not life threatening. Please get a cardiac workup by a doctor to be sure (and others on this thread have posted some interesting information about infection). But it is true that some people have extra or irregular heartbeats (VEs? PVCs?) and don't even feel them. They only find out after they have an EKG or holter monitor (24 hour EKG).

I also have NMH as part of my ME/CFS symptoms and I have had heart palpitations for years. Fortunately, they are just background noise for me and are not uncomfortable or frightening in any way. So mine may be different from yours. I don't know all the different names for palpitations, or what the different kinds are (not a doctor, LOL!), so please forgive any errors in terminology.

I had a holter monitor in 1991 (30 years old at the time) which showed 571 ventricular ectopics (VEs, is that the same as PVCs?) for a 24 hour period. Max VEs per hour was 255 (this happened when I walked up a flight of stairs, the rest of the day was pretty much sedentary). Average VEs per hour was 28. I also had 22 Supraventricular Ectopics. The holter monitor was considered normal meaning no arrhythmia. Obviously it did not mean that nothing was wrong since my NMH was discovered in 1995. But it meant that my heart was working within some reasonable limits (although one doctor did scrawl a note on my chart that 255 VEs in one hour might mean something....) Anyway, I'm still here 20 years later, no heart attack, just very disabled, mostly from the symptoms related to the NMH but also sometimes due to post-exertional exhaustion.

Unrelated to ME/CFS (at least, I'm pretty sure it's not related) I also have some type of tachycardia. I've had it since I was 11, long before I ever got sick with ME/CFS. Since I was only a kid it was scary the first few times that my heart started racing (180-200 beats per minute). But it always stopped after a few minutes, and the doctor said that as long as my heart went back to a normal rhythm on its own then everything was okay, so I learned to ignore it.

Unlike ME/CFS and NMH/POTS, this other tachycardia of mine is not at all disabling. I finished my college degree, got a full time job, and was able to exercise (aerobics classes, running, hiking, lift weights) with no problems at all. The tachycardia NEVER stopped me from doing anything. It's just annoying and a bit tiring, especially as I get older (a couple of times during the last few years it has lasted 15-20 minutes and that is VERY tiring). So, even heart problems that sound scary to the average person (my husband was kind of freaked out the first time I let him feel my heart rate during one of my tachycardia episodes) are not necessarily a big deal.

This blog post explains quite well in a simple language how this nerve messes things up. ...

Thanks for posting that link but I hope you don't mind if I warn folks before they read it that the blog post sounded quite condescending to me. (I'm not criticizing you, lucy! I'm criticizing the doctor who wrote that letter). Also, the audience seemed to be people who were otherwise well (or at least able to function normally, not those who lost their job, or housebound, etc.). Their only symptom seemed to be heart palpitations. It was not written for people with ME/CFS.

Anyway, even though I agree with the doctor's main message that palpitations are usually nothing to worry about, the message was delivered in a very patronizing manner. And the part at the end, where he gave this advice to his patients, was the topper:

So kick up your heel, give a shout, grab the keys and your husband's credit cards with the highest limit and PREPARE TO SHOP!

Grab my "husband's credit cards" and go shopping? Seriously? Is the doctor who wrote this letter stuck in the 1950s or what?

 

[soxfan]

I have had this problem for about 3 years now. Mine seem like just very loud, hard, thumping beats. It is as though I feel and hear every single beat. I get them the minute I lay down and it even feels as though my body is being pushed into the bed with each beat. They have been much worse this month (lots of stress) and now it even feels as though my body is swaying or bouncing with each beat. They are even waking me up several times each night.
I don't have fast or skipped beats..they just feel very forceful.

 

[lucy]

hope you don't mind if I warn folks before they read it that the blog post sounded quite condescending to me

Right thing to do, only the first half of the article is useful. I myself usually skip such things (just like my heart decides to skip some beats) because I face them so too often. In the last month I met 4 doctors, 3 of them mentioned graded exercise and the fourth was talking a lot about my anxiety, which I do not feel I have (I know what it is, because I developed anxiety when I had insomnia for many weeks in a row).
The main thing about the vagus nerve is that if your palpitations are caused by it, it means that it is dysfunctional, then many other conditions could be related. Vagus nerve is doing lots of things in the body, and there are exercises to improve it's health.

 

[dotdot]

I've had palpitations and 'skipped' beats for years, moaned at my GPs, had tests, sent to a Cardiologist etc etc etc, but all tests came back clear, except, at a routine time each evening, monitoring showed that my 'skipped' beats were not actually skips, but a slightly weaker than normal beat followed by a normal one, which, felt, in comparison to the weaker one, much stronger. I've been told it's not a problem...

The palpitations, for me, are something different altogether - due to alteration in Estrogen levels. As soon as I started on HRT the palpitations stopped. If I change doseage, up or down, the palpitations are back for a couple of days, then resolve. If I stop HRT altogether, the palpitations are back permanently (along with the flushing and over-heating).

If the GPs I'd consulted had known about the relationship between Estrogen and palpitations, my Premature Menopause may have been picked up much earlier.

 

[Leslie]

I've had heart palpitations now for fifteen years on and off and all my tests have been normal, although I do have POTS and NMH with CFS. I get them mostly at night when I try to sleep, and they often feel like forceful beats and sometimes skipped beats. They are very scary- does anyone else have heart issues?

Yes, I have had them for years, but now it is worse. It could be anxiety now that has made them worse being sick. As I sit and type I am getting them, and dizzy....feel lousy today and have for over a month now. I used to have a few scattering of good days....those are gone, frustrating.