palpitations when exercising - 200bpm - British Heart Fou...

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palpitations when exercising - 200bpm

Carly470 profile image
57 Replies

Has anyone suffered from heart palpitations when they exercise? I am 33, I would say I am pretty fit and health and have been running for years. Over the last 6 month I have been suffering with heart palpitations on some occasions when I run. There doesn’t seem to be any pattern to when it happens, it can be on a gentle run or a longer run but my heart rate goes up to around 200 beats per minute. I have to sit down for around 5-10 minutes to get it under control. On the odd occasion, I have also had palpitations when I am not exercising or after I have finished exercising.

I do not have a stressful job and I am not on any medication and there are no heart issues in my family.

I have been to my GP, at first they said it could be my iron levels but it still continued once I got my levels up. I then had an ECG at the doctors surgery and also a portable one for 24 hours, unfortunately I did not have a palpitations during either test.

my doctor has said although I did not have palpitations whilst wearing the device my results look fine. He said he is not worried and doesn’t think there is anything wrong but offered to put me on beta blockers.

I am now questioning if I think this issue has been investigated thoroughly enough and if I should go and see a private specialist. I do not think taking beta blockers is the answer I am looking for.

Does anyone have any advice or thoughts please?

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57 Replies
Yumz199725 profile image
Yumz199725

Hi carly470, All I can advise is that you ask for a 24 hour holter monitor that could maybe pick up the palpitations. Have you been refered to a cardiologist by your gp? Hope the problem gets sorted its not a nice sensation feels like a thud in your chest it's weird in it. Maybe take the beta blockers like your gp advised and see how you go from there.

Carly470 profile image
Carly470 in reply toYumz199725

Hi, thank you for your message. I had the 24 hour holter monitor but unfortunately I didn’t get any palpitations when I was wearing it. The doctor has not referred me to a cardiologist but I have had a recommendation from a friend for a private cardiologist that specialises in this area. My current doctor doesn’t want to do any more tests so this is why I am considering going private but it could be very expensive.

Captain_Birdseye profile image
Captain_Birdseye

Breathing exercises and beta blockers were what helped with my palpitations - I can understand why folk are reluctant to start medication, especially when the issue is intermittent. It's difficult to capture when like this so understand the frustration.

If you can get a longer holter (some do up to 2 weeks) and go running you might stand a better chance of catching them on a monitor.

Carly470 profile image
Carly470 in reply toCaptain_Birdseye

Hi thanks for your message. The doctor hasn’t offered me another holter test for a longer period. I did consider purchasing something like this giftshop.bhf.org.uk/aliveco... so I could capture it myself. But my doctor seemed to think the ECG would have shown something even if I didn’t have the palpitations at the time, so I’m not sure if it’s worth buying?

MichaelJH profile image
MichaelJHHeart Star

Hi! Cutting out caffeine, alcohol, chocolate and spicy foods is always worth a try with palpitations!

Carly470 profile image
Carly470 in reply toMichaelJH

Hi, thanks for your message. My doctor did ask me about my consumption of these, but it is very low. For example I tend to have 2 cups of tea a day and 1 very weak coffee. Do you think it is still worth cutting out completely?

MichaelJH profile image
MichaelJHHeart Star in reply toCarly470

I think you have nothing to lose by trying. Each individual's sensitivity varies so I cannot say if it will work for you. The biggest difference I have seen in sensitivity is that I can take 8 Tramadol a day and function normally, and yet two people I know become zombified if they take one!

Im in the same camp as Thatwasunexpected and have to say that I don't think that you have had enough tests for you Dr to have come to the conclusion he/she has.

I have a feeling that this is an age thing as you say yourself, not only are you young but also above a healthy level.

Push for more tests, you certainly don't have to go down the private route unless you really want to, the NHS service is for all of us.

What you do need to do is rid yourself of the worry that is driving you forward at the moment and have it replaced with answers that you can build your future on.

Welcome to the forum, let us help you with information and support so you feel that your not alone on your journey.

Talke care

Seasid profile image
Seasid

Are these palpitations life frethening? If not, why would you use medication which could cause you a heart attack?

I am much older and stopped smoking instead of taking betta blockers. Do you feel bad? Do you have symptoms?

I think you should investigate what is a real problem. My GP said that he is not drinking coffee in order to avoid palpitations. I stopped smoking but still drink lot of coffee. The cardiologists did not recommended to stop smoking, just wanted to put me on life frethening medication for non life frethening palpitations. I am very disappointed. I feel better now. Do you have sleep apnoea? Can you ask for over night sleep study? Your heart is not Happy and you should investigate what is the cause. Maybe you need a CPAP machine?

wischo profile image
wischo in reply toSeasid

You really should have stopped smoking whether or or not you were prescribed beta blockers? especially since you have a cancer diagnosis. It is in my opinion dangerous to put out posts about medication that is mostly hearsay and certainly not clinically proven as people on this forum are taking them for heart failure, high blood pressure, atrial fib etc and the last thing they need is some rubbish unproven article. You are free to either take or refuse to take medication as if you google any of them they can all have adverse effects, but sure people know the benefits far outweigh the risks. Wishing you all the best with your choices in the future.

Seasid profile image
Seasid in reply towischo

I agree what you are saying. My mother had to use it. I don't have to use it. If you have to use the drug better if you known more than less. I am using drugs which have lot of side effects. For me it is good to know that your temperature regulation is effected with the use of statins and betta blockers etc. You should be just more careful.

Seasid profile image
Seasid in reply toSeasid

And you should be even more careful when stopping betta blockers.

Carly470 profile image
Carly470 in reply toSeasid

I dont suffer from sleep apnoea

Seasid profile image
Seasid in reply toCarly470

How do you know?

Carly470 profile image
Carly470

unfortunately I am in Cornwall so not in that area. I did consider purchasing something like this giftshop.bhf.org.uk/aliveco... so I could take it running and try and capture it myself. But my doctor seemed to think the ECG I have already had would have shown something even if I didn’t have the palpitations at the time, so I’m not sure if it’s worth buying?

Seasid profile image
Seasid

You can informe yourselves. I am not rushing to take betta blockers. I would rather stop exercise and investigate further. Sleep apnoea I have and I should treat it. You are free to take your prescribed medication if you wish. I feel perfectly fine without the betta blocker. What's about a sleep apnoea?

MikeThePike profile image
MikeThePike in reply toSeasid

It seems that some GPs are too quick to prescribe beta blockers before doing a proper investigation. I'm really not happy about that. However, I have never heard of beta blockers causing heart attacks. The common cause of heart attacks are blocked arteries. Beta blockers don't block arteries.

Seasid profile image
Seasid in reply toMikeThePike

It can cause heart attack.

Actually maybe it could even help with my cancer, but I am really doing fine without medications. I am on ADT only.

Seasid profile image
Seasid in reply toMikeThePike

I found this:

ysph.yale.edu/news-article/...

You could find more information if you want.

MikeThePike profile image
MikeThePike in reply toSeasid

It's not reasonable to say that beta blockers cause heart attacks. Two paragraphs extracted from the article:

"The study doesn’t prove that these medications caused the heart attacks, nor that they make people more vulnerable to heart attack. Although it’s possible that they did increase the risk of heart attacks triggered by hot weather, it’s also possible that patients’ underlying heart disease explains both the prescriptions and the higher susceptibility to heart attack during hot weather."

"“We hypothesize that some of the medications may make it hard to regulate body temperature,” Chen said. He plans to try to untangle these relationships in future studies."

Seasid profile image
Seasid in reply toMikeThePike

It is up to you. It was not the only warning about heart attacks related to the use of betta blockers.

Seasid profile image
Seasid in reply toMikeThePike

Station use is also problematic during warm whether. I am not jumping into any of these medication. I am using perindopril arginine for high blood pressure. My mother had to use inderal. She had aneurism of the aorta. You can use betta blockers but you should known the full list of side effects in order to decide.

I simply stopped smoking and I feel better plus it was also good that I am diagnosed with obstructive sleep apnoea.

Carly470 profile image
Carly470

thank you for the recommendation, I will have a look. I currently use a Garmin forerunner 255s but unfortunately there is no ECG capability but I would be able to connect it with a Polar monitor. I have noticed with my Garmin that palpitations tend to happen more when my HRV is low/unbalanced but I am not sure this really tells me anything.

Yumz199725 profile image
Yumz199725

Ooh this looks good is it free on playstore or do you need a device to use it?

Carly470 profile image
Carly470

I have just found out my other half already has the Polar H10, he is using IOS and found the app called "ECG EKG recorder for Polar H10". Once recorded, the data is then saved onto the phone and using these instructions github.com/poml88/ecg-recor... we have been able to create a chart in Excel to view the data. I will be borrowing this off him to investigate further! Thanks again Hidden for your help

ECG
FindingCaradoc profile image
FindingCaradoc in reply toCarly470

That’s the purple one then of the two I found for iOS 🤔 - might give it a go

MummaSoap profile image
MummaSoap

Hi Carly,

Welcome to the forum!

I’m also 33, and regularly experience ectopics, especially when my heart is under stress.

I have been diagnosed with a heart condition and was informed by a letter from my cardiologist that during a holter monitor “observation” that I had had an episode of SVT (supra ventricular tachycardia) but it’s never been discussed with me and I’m not medicated for it (which I assume is because I don’t need to be).

I suppose what I’m getting at is that this was picked up by chance on my 3rd holter monitor and before an exercise stress ECG test. So you can disagree with your GP and say that you’re not satisfied, you can also request a referral to a cardiologist. Maybe as a compromise - gather some data with your partners polar app and return to the GP armed with the information and ask them to review it.

I’m not a dr but in my experience, I have had to persist to get my diagnosis and I’m still pushing to get my ongoing symptoms investigated. It seems that heart conditions ironically are not for the faint hearted!!

Wishing you all the best and hope that you get some answers.

Soap

Carly470 profile image
Carly470 in reply toMummaSoap

Hi MummaSoap thanks for your message and your advice. Yes I think I will try and see if I can capture it happening on my partners monitor so I can take it back to him as evidence. Hopefully that will be enough for him to give me some more tests or a referral.

KimG21 profile image
KimG21

hi Carly , you should look up Dr Sanjay Gupta on your tube - cardiologist from York, he does loads of heart topics and he explains things very well, might relieve some of your anxiety. I know how you feel, I don’t have any (that I know of) heart problems but have been getting ectopic beats constantly that got investigated and like you I had the holter and they said they were not concerned. I went back a few months later as they hadn’t subsided and just pushed for more tests. You know your own body. It could be related to your menstrual cycle as hormones can cause cause all sorts, but obv I’m not a doctor and they should check you out. Since you are fit and young then maybe the rate of your heart rate would be pretty normal when under intense excersion? If you listen to that doctor online he explains a whole lot of issue that woukd help you understand but still push to even see a different doctor. Sometimes with palpitations, your heart rate is regular and normal but just strong and beating fast, we just sense them ‘abnormally’. He talks about gradual and sudden onsets and offsets with them. I am not saying diagnose yourself - it just helps give you an idea of what u may be experiencing and would relieve some anxieties until you see a doctor x

Pollypuss profile image
Pollypuss in reply toKimG21

Sanjay Gupta is amazing . I would like to see him mentioned far more often on this site. He is very encouraging and full oh Common sense

Carly470 profile image
Carly470 in reply toKimG21

Thanks for the recommendation KimG21 I will have a look at Sanjay Grupta's videos. As for the heart rate, it usually doesn't occur when I am under Intense pressure. My current watch captures my heart rate, this image shows when it has occurred. On this particular run I was running on a relatively flat course at a slowish rate and there was no change in my pace. As you can see there is a sudden spike.

heart rate
Seasid profile image
Seasid

I am not a doctor, I have a sleep apnoea and I was smoking. Of course you should take your medication, but I didn't and I am still alive about 2 year later after refusing to take it. I feel reasonably fine. If you could have an overnight sleep study that would be great. I need more a CPAP machine then the beta blocker. I am taking perindopril arginine for high blood pressure and that is also a heart medication. Could help with heart failure. I was prescribed calcium canal blocker and betta blocker and I am not taking it for palpitations. Probably after stooping smoking I hopefully don't have much palpitations. My heart is otherwise fine and I was ordered to see the cardiologist again in 5 years.

Lilypocket profile image
Lilypocket

I think the way to go is to try to see a cardiologist or better still an Electrophysiologist. Also an exercise test would be good as it seems to come on more frequently when you make an effort. This will give your Dr valuable information and pinpoint any problems.Take care x

Identiy profile image
Identiy

Having palpitations and a heart rate going up to 200 /min are two different issues.

Although it is possible to get "skipped beats ' -what you are labelling as palpitations but which are medically called ectopics or VPCs, - arising from the atria, they much more commonly arise from the ventricles.

In the absence of any structural heart disease - which is rare - they are caused by caffeine, nicotine, alcohol, full stomach , stress, side effects of medication and most commonly, by worrying about them occurring.

If they are seen occasionally on a routine resting ECG done for life insurance purposes, the insurance company will not load your policy

Your heart rate of 200/min is a separate issue and almost certainly arising from you atrium , and unless you have been exercising very hard, will be as described above a form of SVT - supraventricular tachycardia which can be caused by the same agents that cause VPCs

However, this is all supposition and it is important that you have a maximal effort ECG and if these arrhythmias are not picked up on that, a seven day Holger monitor is necessary

Statistically this is likely to be benign, but an accurate diagnosis is needed .

firstlight40 profile image
firstlight40

Exercise stress test is the way to go if I had the same issue knowing what I do now. I now have one regularly after my mild HA as they are an early marker for my arteries getting blocked again. I think private hospitals do them for £400 approx with a cardiologist consultation for £240. If they show something you will have more peace of mind.

Pollypuss profile image
Pollypuss

Hi Carly

Well I’ve had a triple bypass over 3 years ago and last year I had a phase of having palpitations for a couple of weeks. Eventually I thought I had better tell a doctor. I had a ECG and everything was fine. So they stopped. I was also drinking more tea than I should and also I am a born worrier . I am learning to cope with stress better now. Exercise is paramount for me. At 80 years old I play tennis twice a week and fast walk a mile a day. Sure if you are really worried and they don’t stop then seek further advice. This is only my story

FindingCaradoc profile image
FindingCaradoc

interesting-I have a H10 strap-found this for iOS in App Store

Screenshot
FindingCaradoc profile image
FindingCaradoc

There appear to be two options for iOS - this is the second

Screenshot
Carly470 profile image
Carly470 in reply toFindingCaradoc

This is the one I used

FindingCaradoc profile image
FindingCaradoc in reply toCarly470

Thanks 😊

MikeThePike profile image
MikeThePike

Hi there, an intermittent HR rate of 200 bpm could suggest paroxysmal ventricular or supraventricular tachycardia. If a 24HR monitor did not detect it then you simply request a 72 HR monitor. Doctors rarely inform patients that these devices are programmable and have huge internal data memories that can record heart beats for days, even weeks. Just request a 72 HR or even a 5 day monitor. I strongly urge you to purse this seriously as 200 bpm is a very dangerous heart rate.

Laurap18 profile image
Laurap18

Hi Carly! Are you sure that they were palpitations or just your heart beating faster? When I exercise, my heart rate increases quite a lot, the maximum has been 197 beats per minute. But my cardiologist told me that as long as the heart rate increases and decreases slowly and you feel fine, it's nothing to be concerned. Maybe you could try to run or exrcise for a shorter period of time, or to go a little slower than usual.

Carly470 profile image
Carly470 in reply toLaurap18

Hi Laurap18 thanks for your message. The increase in heart rate comes on very suddenly and is usually not when I am working very hard. My current watch captures my heart rate, this image shows when it has occurred. On this particular run I was running on a relatively flat course at a slowish rate and there was no change in my pace. As you can see there is a sudden spike from nowhere, I got a fluttering sensation in my chest then I had to stop as I was very out of breath and needed to sit down for 5-10 minutes. After I felt tired but I was able to carry on. When I explained these symptoms to my doctor he told me it was palpitations.

heart rate
Reggaelover profile image
Reggaelover

Hi Carly470,

I wonder if you might be suffering from paroxysmal atrial fibrillation (AF), which could be exercise induced. A friend of mine suffered from this problem some years ago. In his case the AF was brought on by exercise at the gym but wasn’t permanent. He was diagnosed by a cardiologist and was treated successfully by a catheter ablation procedure. A referral to a cardiologist would be ideal, but failing that, there are some smartphone apps that you can get. Some of these apps have finger monitors, so that when you have symptoms, you put your fingertips on the monitors and the app monitors your heart rate and rhythm, and is able to diagnose the presence of arrhythmias.

Very best wishes and I hope all works out for you.

Qualipop profile image
Qualipop

|When I started having palpitations years ago it took a year to get a test that actually caught them. AN ECG is only a couple of seconds so unlikely to see them. Even when I had a 24 hour holter monitor I still didn't have any. Did a stress test which also showed nothing but thankfully, after the test, when I sat down to rest, they left the machine attached and running and I had a huge long run of ectopic beats and they could finally see where they were coming from and said they were completely harmless. I suggest you ask for a holter monitor then a stress test. The stress test for you is more likely to show them since you get them during exercise. Personally I wouldn't want to start tablets without knowing exactly what they are.

MWIC profile image
MWIC

Agree with you - think you need to get it checked out properly by a Cardiologist - I was also told that GP can only prescribe beta blockers if advised by a Cardiologist to do so. long wait on NHS but a private consultation is @ £200-£240 - I went down this route but also had evidence to present via a Kardia devices ECG as similarly when I was there I had nothing present on a ECG (aFib properly diagnosed and treatment route in place now) - good luck but don’t wait get it checked out properly either privately or NHS - ask for a referral

RG72 profile image
RG72

Hi Carly.! Also an athlete with palpitation issues. Really good advice here and the main things is, you need to find out more.

Could be any number of imbalances for a simple fix - a blood test could uncover this, have you had one? But equally could be something more complex. There are so many things that can cause/trigger ectopics and whilst everyone on here might be right about their different triggers, only you and your doctor can identify yours. Some good suggestions on things to try.

Would also recommend the book ‘The Haywire Heart’ for deeper understanding (it was recommended to me on this forum). There are a number of issues that can be caused by endurance sports over time, all of which are also worth investigating.

As recommended by many, push for some more tests.

Carly470 profile image
Carly470 in reply toRG72

Hi RG72 Thank you for your message. I have had blood tests, the only thing it showed was low iron and I got this sorted but the palpitations continued. I requested a copy of the results myself to double check but everything looked ok. Thanks for the book recommendation, I will get a copy!

Persevere99 profile image
Persevere99

Hi

I am a lifelong high level exerciser. Some years back, I noted the occasional missed beat, not palpitations like you.

Tried lots of stuff and finally found hawthorn berry and that did the trick after a few days - no more missed beats.

My beat is very regular now whether exercising or resting.

Persevere

Carly470 profile image
Carly470 in reply toPersevere99

Thanks Persevere99 I will have a look into hawthorn berry!

Persevere99 profile image
Persevere99 in reply toCarly470

I have been using H+B hawthorn extract at 150 mgs a day at breakfast.

The instructions on the bottle suggest 4 a day, but that’s way too much.

I tried that but it brings the missed beats back.

Persevere

LindyMc profile image
LindyMc

I was getting tachycardia before I had any other symptoms and downloaded fibricheck on my phone. It helped me track the tachycardia and showed up some arrhythmias, and after I had covid several weeks later, it showed up atrial fibrillation which I took to my GPs and was given an ECG which showed it up. Beta blockers might not be a bad idea as one of their prime roles is to slow down heart rate.

Thecyclist profile image
Thecyclist

I had a similar experience four years ago but am no nearer the answer. I was on a bike ride and was regularly cycling 100+km a week, doing loads of hills, I was late 40's in age at the time with no prior health issues. (I am no athlete either just another mamil who got back into cycling. )

I started to feel palpitations when exerting my self on the odd ride, was happening once or twice a ride. I have always had ectopics but always at rest and these felt different, in that they were in my throat more. I wore a Garmin HR monitor on all rides. On one ride it started again, every time I came to a hill and exerted myself my HR would spike from 120-180 in seconds. No syncope. No dizziness and no chest pain. I curtailed the ride as it was very worrying and decided to go to the doctors, my first visit in 10 years! My BP was through the roof and I ended up in A&E over a weekend whilst they tried too get it under control. Once it was down I was allowed home. Doc said no more cycling for a while.

During the ensuing weeks I had a 48hr holter and it was uneventful apart from a 10 beat run of NSVT, they weren't overly concerned and I was put on 5mg of Bisoprolol as well as an ACE and CCB for the high BP.

The long and short was after a multiple holters and 1000's of PVC's/Couplets I didn't get any more NSVT, Angiogram was all clear so no heart disease, the only problem found was mild LVH found on an echo, a result of hypertension I was told.

I still suffer PVC's, some times days worse than others and they have got worse since the incident and I now get them when exercising. I was eventually referred to an EP who doesn't seem to bothered as no CHD found.

I am back cycling albeit on an e bike now, but I still get them when out. I was also on the lookout for a chest strap ECG, so the H10 route looks interesting as the Kardia is no good when moving.

Not sure of any of that is helpful, but is broadly similar!

On the wearable ECG front the only alternative I found was this. Pricey.

uk.fourthfrontier.com/produ....

MumaLines profile image
MumaLines

Hi Carly

Thinking you could be like I was, is your cholesterol level normal?

Carly470 profile image
Carly470 in reply toMumaLines

Yes cholesterol is normal

Drizzt profile image
Drizzt

It is important that you find out what is happening. 12 years ago I was a keen runner. Then one day looking at my garmin watch results. I noticed that my HR was peaking above 200 for small period of time. So I set my HR alarm on the watch to look out for them as I thought I was over doing it. I continued on and spoke to my GP who referred me. I had a ecg and stress test both were clear so I asked if I was ok to continue running and they said Yes. Less than a week later I went to my local running club and did a gentle run because we had new members. Half way along I became out of breath so as we had new runners we took a little walk. At the end of the run only 3k I got back into the changing room felt dizzy and passed out. They called an ambulance and unfortunately it was an old one so only had a two lead ECG machine. But the ticker tape showed that my HR was above 300 and I was in SVT. This was called a technical heart attack because as that rate the blood is not pumping around your body. In hospital they tried beta blockers but that gave me problems when I was asleep my HR would drop to less than 50 according to nurse. I eventually ended up with an ICD. But my warning is take it seriously.

DaleMarch4HA2023 profile image
DaleMarch4HA2023

Last year... twice I went to my Dr. with occasioanl heart pals. ECG showed nothing. Was told stressful job. 6 montha later.. went back again. ECG nothing. Had bloods done for evwrything! Came back.. high cholesterol. Showed kidneys weren't working properly.. not enough water being consumed. Kindney issues cause pals and heart skips. So drank 2 litres extra a day.. and weeks later... bloods fine. March 23... HA!

Clearly warning signs all last year. My body hid the real reasons for the pals.

Even when having the HA and after... ECGs showed nothing. Only trop levels in blood proved the HA.

My wife is having a full private screening.. bluecrestscreening.com 080 8168 7256 that looks at everything.. due to my recent surprise!

I too was fit, gym most days and aged 50. All the best. Hope you get some answers asap.

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