Think I may have AF but not diagnosed... - Atrial Fibrillati...

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Think I may have AF but not diagnosed and feeling frustrated.

AmandaMatDrum profile image
22 Replies

Hi Im a 48 year old woman and have had palpitations all my life but never been concerned about it until this last year when they have increased significantly along with random episodes of my heart suddenly racing while resting or asleep. My resting heart rate is around 70 and this has gone up to between 100 and 110 during these times and lasted for hours at a time - for one episode it woke me at 2am and didn't return to nearer normal till 6pm the next night. I've had monitors to wear for up to 3 days, which haven't picked up anything which I wasn't surprised about as nothing happened on those days. I now have a consultant who I met about 2 months ago and didn't like much as he wouldn't listen to me, joked a lot and tried to give me beta blockers (which he said I would be on for life) which I don't want to take until I have a diagnosis. He was annoyed that I hadn't gone to A and E when I had a racing heart and said I should go when I had any other symptoms but that they really want to catch my racing heart to be clear about what is going on. However 2 weeks ago I woke up to significant palpitations - which I can only describe as my heart feeling like it is missing beats every few seconds and jumping in a way that I am constantly aware of and keeps me awake at nights. Because of this I have been to A and E three times in the last 2 weeks - the first time because of the symptoms above lasting 24 hours. On this occasion I had an ECG, they picked up ectopic beats clearly and told me they were benign and would go away. A week later they hadn't gone away and this time I detected an irregular pulse at my neck so I went back and they did another ECG which again showed the ectopic beats every few seconds but no irregular pulse (this was a bit confused as they seemed to be saying some irregular pulse patterns are nothing to worry about). I was told by that doctor that taking beta-blockers was not a solution and they should try and catch my racing heart. Yesterday I had a racing heart - it went up to 100 while I was sitting so I went back to A and E but it had gone down to 80 by the time I got there. This doctor seemed to think I probably do have AF - stage 1? - given all my symptoms but they haven't caught enough symptoms yet to diagnose this. Today I spoke to the AF organisation who were very helpful and I bought an Alivecor so I can take my heart rate next time it goes up and try and catch it myself. I feel like I'm going round in circles and don't really know what I should do I just don't think it's normal to be experiencing such a big change and for this change in my heart function to have gone on for so long. My father died young (52) from heart disease but also had a pacemaker which is obviously adding to my concern . All my bloods have been taken and everything is clear and I am relatively fit, eat healthily, don't smoke and take no medication. I'm wondering if these can be symptoms of menopause but my current symptoms are so intense and have been going on so long it feels unlikely. If it is Afib I went to get an early diagnosis as everything I've read seems to indicate that this would be beneficial - but how early is early? Mostly I'm feeling upset and frustrated that I'm being told conflicting things and don't want to keep going in and out of A and E - and my instincts are telling me this isn't right/ normal. And if I'm honest I'm also worried that something might happen while I'm sitting here on my own with my 5 year old daughter asleep upstairs. Has anyone else experienced the same thing? I'm thinking I should try and see a private consultant asap but wondering how quick that would really be - weeks? months? Should I be more insistent with my GP? Would really appreciate any advice. Thanks so much.

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AmandaMatDrum
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22 Replies
CDreamer profile image
CDreamer

Hi Amanda and welcome.

Anything that is or feels wrong with your heart is going to make you anxious so yes, I think everyone reading your post will have been were you are now, but we have all learned over time how to cope. Worry in itself, will bring on symptoms so finding a way to relax is really important and there are some simple breathing exercises you can do which will help this but first:-

I'm with you re the Beta-blockers so well done - facing down a so called expert is not easy and I had that row with a consultant on a ward so believe me I know!

Secondly - you are doing all the right things and the Alivecor will be able to give the answers that the other monitors have not been able to.

Thirdly - ectopics are benign but they don't feel it when they come in clusters but without an ECG analysis it is impossible to say if it is an Arrythmia or multiple expctopics.

Fourthly - resting pulse of 100 is a little high and that together with the ectopics could indicate something that may end up down the AF route so could be wise to get a referral to an Electrophysiologist - but wait until you have evidence - i.e. Several good ECG traces - you really are not going to get anywhere otherwise.

Fifthly - from what you describe I don't think you need to panic - unless you have a continuous high heart rate for a long period of time or you have chest pain and/or you feel unwell, clammy and dizzy or faint - then you might think about calling for help immediately.

I have had fast AF - pulse 159-200 - for over 36 hours and nothing bad happened. AF is a chronic condition which is treated because it can lower your quality of life but it is not an immediate life threatening condition, but you obviously want to know and get a treatment plan in place so yes, I think, if you can afford it - a private consultantion can bring some peace of mind. Cost circa- £200-250, but you need to get the evidence first so get using the Alive-cor and read all you can.

Ask any questions here, this is great forum, supportive and informative,

Very best wishes CD,

AmandaMatDrum profile image
AmandaMatDrum in reply toCDreamer

Hi CDreamer

Thank you so much for taking the time to write. It's really reassuring to hear your take on things and that I'm probably doing all I can to get the right diagnosis. I read somewhere that ectopics / palpitations for more than 7 days in a row is concerning - but probably not reliable. Sounds like this Alivecor app is the right way forward for now. Thanks again - will go to bed and sleep a bit easier now.

CDreamer profile image
CDreamer in reply toAmandaMatDrum

Hope you do - try a few breathing exercises breath in slowly for count of 5-7, hold for 1, breath out even slower for count of 9-11 - continue for 5 mins and just keep focussing on your breathing, the important thing is to breath out for longer than breath in. Doing this for 5-10 mins will often stop ectopics and lower heart rate.

xx

BobD profile image
BobDVolunteer

Very briefly as I have just had an 18 hour day and very tired. You are experiencing what most of us have over the years and yes it is very scary but please don't worry too much as this only makes things worse.

Ectopics are benign in that they generally do not cause damage to the heart but I know how irritating and upsetting they can be.

AF is an irregular irregular rhythm with no recognisable pattern and easily seen on an ECG so until you get it caught don;t get ahead of yourself. I would also suggest that at 110 bpm this is not typical AF which generally runs much higher typically 150-200 bpm. although we are all different. . What I would suggest is that you go to AF Association main website and read all you can as I am sure this will help you to find some answer.

Bob..

Vony profile image
Vony in reply toBobD

A certain amount of ectopics per day are usual for many people but over a certain amount daily can be of concern as my EP informed me

AmandaMatDrum profile image
AmandaMatDrum

Thanks Bob - yes I had a quick look today and spoke to them. They are sending me a bunch of stuff to read. I'll do my best not to worry and hope that the Alivecor system can pick up what A and E hasn't managed to yet. Thanks for your bothering to write after such a long day - it's much appreciated.

PeterWh profile image
PeterWh

Amanda

Welcome to the mad world of AF!!!

Don't delay things by going to A&E because that can take a considerable time from decision to being hooked up. Much better to dial 999 and they will send a paramedic (frequently in a car) who will hook you up to monitors straight away. In addition they know more about hearts than most A&E nurses and also more than some doctors. They will also get the ECG evidence and often it is 10 to 20 minutes worth rather than seconds. Also some things are transient and therefore will have ceased by the time you are hooked up in A&E but nevertheless they can be significant.

Goldfish_ profile image
Goldfish_ in reply toPeterWh

Please spare a thought for the overstretched ambulance service and only dial 999 if you also have chest pain, have collapsed or are very breathless with your "racing heart" . If you have an AliveCor you can capture an episode quicker than a paramedic. Emergency treatment will only be required if the episode is prolonged or associated with other symptoms

PeterWh profile image
PeterWh in reply toGoldfish_

The advice given by pdogt is exactly what was given to me and also the comments made by the paramedics. I suspect that's because the approach varies considerably from area to area depending on how they are organised. There is a paramedic car sometimes two based in our town circa 25,000 to 30,000 people. The nearest hospital is about 10 miles away. Specifically told that this approach saves time and money rather and is much safer than turning up at A&E. I was told it has also improved response times at A&E. If it is minor they go away but if it warrants A&E then they call ambulance but all the tests etc are done before arrival (often including taking bloods). Also paramedics trained to a much higher standard re heart and strokes. Also one of the two 999 hospitals for this area operates a policy that they will have a specialist stroke nurse from stroke centre to A&E normally at the time of arrival or within 5 minutes and if stroke or tia is assessed taken straight to stroke unit.

Vony profile image
Vony in reply toGoldfish_

I have been told by paramedics that many cardiac symptoms...especially with a previously undiagnosed condition warrant a 999 call. this is because some people have VT and long QTs and need immediate treatment. Or in the case of severe symptoms, paramedics have always advised me to call 999. I drove myself to A and E in the early days with a heart rate above 200 and the staff told me off for not ringing an ambulance as they said that would have been a stand by call and been a blue light. Switch board triages calls so let them worry about urgency

Pdotg profile image
Pdotg in reply toPeterWh

This is exactly the advice given to me by doctors. Dial 999. You need a proper trace for diagnosis. In the beginning my AF disappeared by the time I got to A&E in a car. The paramedics are great - they will take an ECG and will refer you. In my area the only way you can be admitted to the specialist heart and stroke unit is if you're delivered by an ambulance crew who have made a diagnosis. Once you get get used to AF you will know when to call them out.

When I apologised to various paramedics for calling them out a few times over the years they always say it's the best thing to do. They take a lot of detail over the phone before they decide whether to come out.

Lizty profile image
Lizty

Amanda.....my situation mirrored yours..... with diagnosis of benign ectopics after 24 hour monitors......until af caught with 7 day monitor. Even then my GP could not believe it.

Good luck with the Alivecor!

Mercurius profile image
Mercurius in reply toLizty

This could happen easily. The atrial ectopic (usually called Premature Atrial Complex = PAC) is important. Hovever above 50 pratically everybody has it, without symptom or problem. That's why it is specified as benign. However PACs in the case of aFib they are also present and may trigger the aFib.

Considering the monitoring time the frequency of the complains is decisive. In the case when complains shows up in every day or every second day, the two days Holter monitoring is adequate. If one or two attacks per week is experienced, then one week monitoring is recommended. If the symptoms are more rare it hard task to catch with ECG the arrythmic events.

BUT! aFIb is symptom! It is consequence of pathological eventor state as for example myocardial infarct, or obesity etc. The cardiologist can consider this causative factors even without aFib on ECG records. If these factors aren't present hi will not be very upset about an eventual aFib.

AmandaMatDrum profile image
AmandaMatDrum

Thanks so much everyone - I'm so glad I called the AF Org and that they told me about this forum. It's super helpful and reassuring to hear of your experiences and to get your advice.

jwsonoma profile image
jwsonoma

I started getting rapid HR a couple of years ago. I would have episodes that lasted 3 days. My resting pulse was 55 and it would go to 80. My BP would rise from 110/65 to 140/80. Strangely episodes dropped way down when I quit taking large doses of Vitamin D but I am now more susceptible. Stress definitely causes it. So if I freakout when it starts it gets worse. I now have a beta blocker as a "pill on a pocket" which I take one time if I have a SVT and it goes away in 30-40 min. There are 2 week HR monitors which caught a unnoticed daily short term episode of Paroxysmal Supraventricular Tachycardia (SVT) at140 BMP for less than 9 sec. They said it was not a problem. No A Fib. I

Look up vagal maneuvers on You tube. They can stop the SVT. One such video youtube.com/watch?v=SczifZR...

They don't always work but can be informative. Keep in mind Dr Google is not always right so bounce everything off your doc.

I learned and helped my doctors get me on the right track with the help of boards like this.

Mercurius profile image
Mercurius in reply tojwsonoma

Just a short question. Resting pulse 55 bpm is bardicardy. Did you practised some short of high endurance sport?

jwsonoma profile image
jwsonoma in reply toMercurius

I am 61 and my wife and I just walk our dog up and down hills by our house for 50 min every day. My wife's resting HR is close to 50. She walks more than me.

If I was a couch potato I think the 55 could indicate a problem.

expences profile image
expences

Hi, in my experience with palpitations, they would just start at any time of day or night ( wake me up) and I thought I was going nuts. Went to hospital a few times and even with ectopic beats and bigeminy, nothing was found on angiogram. My GP thought it was panic attacks and gave me beta blockers and antidepressants which I took for a week very reluctantly. I didn't think I was a panicky person having been a paramedic for 14 years!

Anyway, a few days later in conversation with an acquaintance, she suggested it may be coffee, we had bought a Nespresso pod machine and loved strong coffee. (her husband had the same problem). I stopped coffee and tea and went onto decaf. The palpitations also stopped! I couldn't believe it! Did a bit of googling and found out that one can lose the ability to metabolize caffeine and now I am super sensitive to it. Also could be the dehydrating effect in some people.

This was back in 2010, and then last year, I got given two full cups of the real stuff by mistake, ... 5am the next morning I had my first and only episode of AF....

I have actually met someone else with the same problem so it could be more common than we think. I wonder how many people out there are taking meds for anxiety and panic attacks unneccessarily.

I avoid anything with caffeine in it like the plague.

Hope this works for you :))

AmandaMatDrum profile image
AmandaMatDrum in reply toexpences

Hi thanks - that's really useful to know. I've stopped drinking coffee these past weeks but it hasn't gone away I'm afraid. Worth knowing though.

jwsonoma profile image
jwsonoma

Some one mentioned caffeine was a trigger.

There are all kinds that may or may not be a problem.

I have pretty much stopped drinking. I work in the Napa Valley love wine and beer so this kills me. It's amazing how many people will med up so they can continue to drink. With drinking a lot of people wake up in the middle of the night or in the morning with an event.

By reading warning labels and boards like this I became aware of more triggers - cold meds, decongestants, bronchial inhalers, some sleep, anti nausea and anxiety meds,

Also maybe gluten, excessive exercise, exhaustion, even chocolate - all the fun stuff.

I was scuba diving in Mexico and took a decongestant and anti nausea pill, a wake up coffee ( 2 hr time change) then had a couple of post dive drinks and right after a big bowl of chocolate ice cream my HR went to 150 and me to the emergency room.

It is pretty easy to stack a few triggers, add a little stress or fatigue and bingo.

My doc describes it as opening up a pathway.

Vony profile image
Vony

This is often the frustrating nature of arrythmias...capturing them. i had symptoms for 5 years and reported it countless times to GPs and endocrine doctors who I was seeing...and nothing captured. it did come to a head one day though and I am now on the complex case list. Not that I hope that for you..but my point is, I knew instinctively that something was wrong for a long time..and I was right. Rest assured it will be captured...keep persisting...go to A and E...call 999...do whatever you have to for diagnosis. If this does end up to be ectopics (which, by the way, are bloody horrible) then all well and good. But you are important and you matter. I started to feel like a fraud always going on about my heart...I felt like a time waster and used to be stoic. I learned how to advocate for myself and even had a GP who encouraged me to fight my own corner more. best wishes and I hope it is nothing but if it is, you will feel peace of mind for finding out and adapt to whatever it is xxx

AmandaMatDrum profile image
AmandaMatDrum

Thanks Vony - I'll keep persisting, it's in my nature, luckily. I'm waiting for the Alivecor and will call out medics if my heart rate goes very high. Like you I feel instinctively that something isn't right and already feel like a nuisance - so it's really good to hear your experience. After 2 solid weeks (except for 24 hours in the middle) of ectopics every few seconds they have stopped again today.... so we'll see

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