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British Heart Foundation
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I'm new here, please help me. When should i worry about heart palpitations?

Hi all, I stumbled across this sight while doing some research about heart problems. I'm a female just turned 22, I've had heart palpertations for as long as I can remember when I was younger I had them only occasionally and I never thought anything of them, since moving out to live with my sister last year I have found that these have gotten a lot worse. I've ended up in a&e in the middle of the night at the beginning of the year the to an episode that lasted 4 days and they were just constant, had an ecg done all okay and told me to get a follow up with doc. Spoke with doc told me they were due to anxiety and stress (I wouldn't consider myself an anxious person until now dealing with this) I got on with things and they seemed to calm down until a few months back then I got another 'episode' that lasted the same amount of time, went back to docs and he said again was due to stress and anxiety, I pushed for a monitor because I feel these are not normal, hearing someone say they are caused by anxiety is so heard to believe. I'm waiting now to get my monitor and things were okay until I had a really bad flutter a couple of days ago that lasted a few seconds and made me want to jump around and cough and it's completely messed me up, for 4 days I've felt skips/flutter nearly every few minutes, I've had a very nervous tummy I think due to worry but no real pain or breathlessness as such just an awful feeling in my chest that sometimes leaves me feeling weak. Sometimes my heart feels so heavy like it's pounding and I can feel it all round my body. Should I go to a&e for this again? What's also concerning is my identical twin sister that I live with experiences the exact same thing and us going through the same tests but we are having the same episode right now. Are we feeding each other's fears or is thing serious? For anyone that's read this super long post I'm very grateful for any feedback, similar stories or advice. Thankyou

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Also wanted to add, as my pals seem to come so often how do I know the difference between a palpetation and a skipped beat. If my beat is irregular is it so dangerous to wait for my test to show this?

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I have cardiomyopathy and almost always feel palps but my cardiologist asked me to tap out on his table the beat of them and the beat was within normal limits for me. I am just aware of them so notice them more that the next person. I have bought a cheap version of a fitbit and monitor my heart rate daily. With this you will need to know what is your normal heart rate and what you were doing when it hits a high. Hopefully it is just down to anxiety as your email does come across anxious. Any issues would have been picked up by your ECG. I would say that you need to calm your beats down by sitting quietly de-stress and then see if you still feel the need to go to a&e. This works for me, I also get palps when my heart rate goes too low but that is due to the meds that I am on. Hope you feel an improvement soon

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Hi Bethan

I am not medically qualified to give advice. However, I believe that palpitations in themselves are harmless; it is simply that you are aware of your own heartbeat. Anxiety and palpitations are rather like chicken and egg and it is common and not unreasonable for doctors and nurses to attribute such experiences to anxiety. Missed and ectopic beats are also common and harmless. Clearly you are worried by your perception of anomalies in your heart rhythm and this is feeding your anxiety. This situation is most likely being exacerbated with your twin sister being the same. Your ECG is OK and you are expecting to have a holter monitor shortly, so any abnormal rhythm will be recorded and any necessary investigation taken from there. The best thing you can both do is to accept that you sometimes experience palpitations and not to worry about it. They are harmless, as are occasional skipped and extra beats.

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Hi Ian, thanks for taking your time to reply to this. I've read so many posts that say the same as what you've said I think it's just me finding it hard to accept something that feels so abnormal might actually be completely harmless. As I said I've ever considered myself to be an anxious person before but this is completely messing with my head, when I get these episodes I can't think of anything else it takes over me like I'm waiting for something to happen. If I get a slight pain or dizzy feeling I go into complete panic mode but i know that tends to make things worse. I constantly feel like I want to go to a doctor for someone to tell me I really am ok.

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Why do you believe that being aware of your heartbeat is abnormal? Many other people experience this. You have experienced bouts of palpitations for as long as you can remember but they didn't used to bother you. What's changed? You realise that panic and anxiety seems to make the situation worse. Look for ways to de-stress. Try slow and deep breathing and try to take your mind off them. You've seen your doc and he's s told you that you're OK. I'm sure that he has seen other patients complaining of palpitations so he must know by now whether there is anything potentially serious needing investigation.

My own concern is that the worry, anxiety and stress that you are subjecting yourself to could increase your blood pressure and lead to other real heart problems.

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As per Ian’s reply, palpitations in and of themselves are not necessarily anything to be concerned about, in quite a few people they have no bearing on there being an issue with your heart and can effect anyone. Even with a fairly minor, diagnosed heart condition that involves palpitations during an episode, I also have ‘regular’ palpitations that after testing are nothing to worry about, simply something I’ve had to learn to live with over the last few years. At best annoying, and at times when they first kicked off pretty damn scary, but normal, and just something my body does. The only good thing is that my palpitations when it is my heart are distinctly different - my heart shoots up to 220+ bpm and gets stuck there. Kind of obvious then that there is a problem, thankfully.

Any concerns about your heart should of course be checked out, absolutely, but seeing as you’ve managed to get an ecg during an active episode, that would go a reasonably long way to reassuring me that the palpitations are not anything to worry about, and either just something you experience for no particular reason, or tied to having unmanaged anxiety. Half the battle for many people with an undiagnosed arrhythmia is successfully catching the episode on an ecg. Even if they fall into the first category, it’s quite often a vicious cycle, particularly when it’s still a relatively new phenomenon - palpitations trigger anxiety (because no one is not going to worry about something possibly being wrong with their heart), which triggers continuing palpitations and a slightly elevated HR, which triggers further anxiety, and round and round you go. And it’s also entirely possible that you and your sister are feeding off each other - one is worrying about the other, and then the other is worrying about the first, and the palpitations continue as per the cycle above, only with both of you rather than only one.

I think that as things stand, you’re doing all you can. You’ve been to the doctor, you’re awaiting a halter. In the meantime, if you’re experiencing palpitations *and* feeling unwell with them (by which I mean sweating, chest, arm or jaw pain, a crushing pressure, intense nausea etc.) then call 999 or present in A&E, but otherwise I’d advise you to look at ways to manage anxiety - even if you feel you’re not anxious, you’ve got nothing to lose in practicing some distress tolerance and relaxation techniques imo, and there’s a lot of information available online. If you have the halter, it catches episodes but it comes back clear, then I’d suggest you speak to your gp about getting some proper help for anxiety.

Good luck, and I hope you both feel better soon, whatever the cause.

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Hi Charlie, thanks for taking the time to reply I really appreciate it. I should have mentioned that although I did get an ecg that came back clear at the time I did not feel a palpetation as the ecg was for I think a matter of seconds.

What you've said about myself and my sister sounds exactly right and it's a cycle that keeps happening and it so so hard to get out of, if I'm not worrying about myself then I'm definitely worrying about her. I'm definitely going to look into ways to reduce anxiety to see if it helps me while awaiting a monitor, just hope that into too long so I can put my mind at rest.

Thanks again for your comment.

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Hi bethanjs, I have had palpitations since a child and was diagnosed as ectopic heart beats early on which are nothing to be worried about. There are triggers such as caffeine (coffee, coke etc), anxiety and some foods. My dr actually said if I do have one at rest, go and run up a flight of steps and it should pass, it did work! That's not to say that you should not get it checked out.

this is the York Cardiologist that is very good. I have recently had a triple heart bypass that has nothing to do with my ectopics. They stopped for a while but come back at times. Good luck and let us know how you get on. xxx

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Thanks for your reply! I'm pretty used to palpetations now so it wouldn't bother me if I knew the frequency in which j have them was normal. I'm trying to stay calm but even today I've had maybe 40/50 some can be so close together that I'm confused whether they are palps or a series of irregular beats which I believe is worse. I genuinely believe I would be completely ok with a doc telling me they've found I have something, I think it would actually be relief that I'm not going completely crazy and that I can actually start getting something done to help with it. Looking at these replies have helped me a lot and made me realise also it might be worth speaking to my doc about anxiety if everything comes back ok. Thanks for the link I'll give the video a watch! Once I have my holtor I'll post the outcome. Thanks again for your comment xx

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I’ve never had them that long at a time and I have a heart condition and I’m gonna be honest I stress a lot. I found stress doesn’t affect heart palpitations as I may be stressed may not be stressed wen they come on.

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Keep pushing for the 24 hour monitor that may shed light on what is going on. Also if you have a bad episode call in to your local hospital to get further readings ... 9 times out of 10 they will find nothing but that doesnt mean to say there isnt an issue . They will also take a blood test to see if an enzyme shows of any issues , but be prepared to wait as it takes 2-3 hours for the first test and may be more if they want another .... If its an emergency then you have no choice anyway , just letting you know in advance . I seem always to pass all tests undertaken yet I have had to have two stents fitted with others possibly imminent so don't get despondent if tests are always negative ... Kind regards

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