Sometimes I feel my heartbeat (more as a 'thumping' in my ears or chest, not audibly from outside my body) and think 'It's about to come out of my chest!' - it doesn't but my cardiologist said mine beats 'exceptionally strong' and he put me on a low-dose beta blocker in hopes of calming things down a bit. That has worked but you're on the same beta blocker on a higher dose than mine so clearly it's not 'calming things' as much as you'd like, any road.
Have you told the doctor(s) about the loud heartbeat so early in the morning? Is 0400h (4am) your usual waking time?
Only your medical team can advise you regarding your heart health, especially on the right timing for taking your medications. I'm on Bisoprolol 1.25mg and usually take it every morning around 0600 (6am) and for me it's working wonders - I haven't felt this well since 2010! But we're all different and again, the best and only advise you should take is from your medical team.
Be sure to tell him if 0400 is your usual wake-up time, or if it isn't your daily wake-up hour, he especially needs to know if the 0400 loud heartbeat wakes you up from a sound sleep.
Are you in the UK, or somewhere else?
If you're in the UK your cardiologist may order a 24hour Holter device to see what's going on - it's a wearable device that monitors and records your heartbeat as you go through a 24-48 hour period (sometimes longer) and can give the medics valuable information about what's going on with your heart.
I also have a strong , fast heartbeat which sometime feels like it's going to thud out of my chest. This is especially when I walk or carry things. Lately I have been hearing my heartbeat in my ears like a whooshing kind of heartbeat. Hard to explain! Has your cardiologists every explained to you what this is? I might mention it at my appointment on 27th xx
No explanation for why my heart beats so strongly, the cardiologist seems to think as long as the beta blocker is slowing it down a bit that the strength of it might be a good thing (and no explanation for that reasoning, either ).
I should be receiving the letter booking notice for the angiogram, he thinks that will answer all his questions as to 'what and why', maybe one of the things he's looking for is why my heart beats so strongly?
ETA: (not had enough tea this morning, obviously, or I wouldn't have hit submit too soon!) Definitely say something to the cardiologist when you go in - whooshing is an important (but stay calm, from personal experience 'whooshing' is not 'life-threatening', just an important diagnostic clue).
I will mention it. Anything that helps to get to the bottom of it. I also have been hearing the 'whoosing' heartbeat in ears, when I first lie down to go to bed. Its as if the blood is flowing hard through my neck resulting in me hearing my heartbeat (in my ears) . Don't know if this makes sense but only way I can describe it lol. Hopefully you will get your angiogram appointment through soon. Waiting is difficult. When I had my appointment at doctor , who discovered the high bnp levels and swelling , I thought it would be a case of , go to cardiologist, get a scan then start treatment (if needed). How wrong was I lol. Good luck anyway and to you rahouda xx
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