Palpitations and ECG

CRAIGO5000

Hi all,

Im 31 and I've been riding now for well over a year and average 80-90 miles per week. I consider myself physically fit in that respect. My BMI is average and I eat reasonably healthily.

For the last week I've had palpitations come and go and on Monday I had a really bad bout when shopping. It took me to the point of standing still in an aisle and concentrate on breathing as I felt like I was going to pass out.

Today I went to the docs and discussed it all, He's given me the basic blood pressure check (normal) and listened to my heart and then booked me in for blood and a 24-hour ECG. He said it if occurs again in the meantime, go straight to A&E and tell them.

I went for my blood to be taken at the hospital straight after seeing the doctor and I passed out midway through. Now they might not have enough blood to do the required tests but need to wait to see if more is required. I don't normally pass out and when coming round I had palpitations again. This could have been because I had just passed out and my heart was trying to push the oxygen around my body asap or it could be related to my last week of episodes. I told the nurse about why I was there having my blood taken.

I remember seeing a few threads on here regarding ECG. Reading up on them and it seems they might be best testing me while exercising aswell as putting me on a 24 hour one? Has anyone ever had an ECG and if so, what did you have do and what was the outcome?

hamish123

Hi my wife is a cardiac technician and normally the ecg will be done resting unless a exercise ecg is requested and these are done on a tread mill and all depends what they are looking for.

Ands

Hi, 'Ive had the 24-hr tape, echo test, 24 hr BP monitor, treadmill test, stress echo and tilt table test.
My symptoms were ectopic beats (skipped heart beats), sometimes 2-3 in a row, sometimes 10 in a minute. Also dizzy spells, nearly blacking out when I stand up (eyesight and hearing going)

The 24hr tape records your heart rate for 24 hrs. You keep a diary of symptoms and times they occurred so they can x-ref against the tape.

The treadmill test monitors you HR whilst using a treadmill. It starts off really slowly and then the incline increases. I was taken up to max HR, which took about 20 mins. You can yell stop at any time. I was advised beforehand not to drive home afterwards, but if you are used to exercise or going to MHR then there's no real issue with this (I was told it would invalidate my insurance. )

The echo test is an ultrasound of your heart so involves lying on a bed in a dark room whilst they look at the chambers of your heart, how much blood is getting through, etc; the stress echo consists of the treadmill test, up to MHR, with the echo done as soon as you get off. The ultrasound shows heart performance under stress.

The tilt table test was incredibly boring - strapped to a table for 45 mins in an almost-vertical position, in a dimly lit room. BP/HR are monitore throughout. It's designed to see if you pass out. The consultant fell asleep .

The 24hr BP monitor was a pain in the butt - the arm cuff inflates every hour - much to the amusement of my work colleagues who wondered what the strange noises were coming from my desk!

My probs have not resolved but the consultant was not in the least bit concerned about them. I did quit caffeine and alcohol/wine although this made no difference whatsoever to the ectopic beats. My RHR was 44 (42 at night) which was worrying me, because at the time, although I had been cycling regularly, I hadn't done that much due to work, so was feeling anything but fit (plus I was frightened of going too hard in case I had a heart problem). My BP is pretty low (something like 85/55 although it did go down to 70 while sleeping). The consultant described me as very fit and that my low HR was nothing to worry about. Sometimes the skipped beats freak me out as it feels like my heart is jumping out of my chest but the consultant assures me it's nothing to worry about. I still get dizzy spells but was told by the doc that I don't take in enough fluids. So, no real outcome although it gave me the reasurance that I needed that I just need to get on with life and not worry that I am about to keel over and leave my children without a mother.

ShutUpLegs

CRAIGO5000 wrote:

For the last week I've had palpitations come and go and on Monday I had a really bad bout when shopping.

Never ever go shopping again

Bozman

I got palpitations on and off for years, test after test was fine and then I woke up 18mths ago with my ticker all over the place, hospital - cardiac ward - injections - drugs and monitors for 24hrs and lucky for me... My ticker started beating in rhythm again, apparently it was an AF attack probably down to dehydration and touch wood I've only had minor palpitations since.

centimani

I had an ECG after a bout of 'heavy' heartbeat.
I don't know if it was palpitations, but when stressed, my heartbeat often feels heavy, like a thud and occasionally (rarely) i seem to get a fast beat for a second or two, perhaps 4 or 5 beats mega quick.

BP s always been normal, health is generally good, but after the last attack i went to the docs...ECG was normal, BP was normal, although he did say he could see my heart beating through my chest wall (but then i'm slim up top anyway)

For me its stress or emotional upheaval that triggers it, doctor didnt seem concerned...he did give me a fair checkover though.

campagone

At the end of February I had an attack of irregular heartbeat, it came on just before I went to bed on a Sunday night I was just having a wash and shave, so not doing anything strenuous to bring it on. I didn't feel too bad just a bit weak and light headed but I could feel my heart pounding at times. I slept on it hoping it would have passed by the morning but it was still there, I decided to go to work as normal, not the cleverest thing to do I know but I'm always reluctant to go and see the doctor. After work I came home and put my cycling heart rate monitor on and I could see it was all over the place, so it was off to the doctor who gave me a ECG and promptly sent me to hospital.
Kept in over night and hooked up to a monitor. My heart was going from low 60s bpm to the high 150s and back down again constantly and the alarm kept going off on the monitor, I was also skipping heart beats. The next day they were going to give me a shock to get the correct rythm back but they decided to try drugs first and these worked about an hour after taking them.

Sent home and told to carry on as normal I've since had an echcardiogram and the 24 hour ecg.
Last Thursday I had a meeting with the consultant. Typically he hadn't been given the results of the tests yet but he did manage to pull up the ultrasound images on his computer. After looking at them he said it all looked pretty normal, there was a slight thickening of the muscle which he said was tyical of an athletes heart and that this can contribute to the Atrial Fibrillation.

Seeing as this was my first bad episode and it hasn't happened since (though I do get flutters/palpitations sometimes which only last seconds and they pass) there wasn't much they need to do at the moment. He gave me three doses of the drug I had in hospital, Flecainide Acetate to carry with me and take if and when necessary. Hopefully it wont get any worse and I consider myself lucky when I read how badly it affects others such as yourself Craig. I'm lucky so far as I haven't passed out or been breathless and I can't say that it's affected me on the bike.
I have read that Magnesium defficency can also cause it and that a magnesium citrate supplement can help, Iv'e just started taking them this week so too early to tell if they work.

I hope you get good news with your tests and that it doesn't keep you off the bike.

Amoger

Apparently the times to worry are very rapid resting HR (eg 200bpm) and blacking out during exercise. I'd not count blacking out during blood-taking. Nor the "head rush" every time you stand up.

Good luck with the tests - per the posts above, amazing how "wrong" the heart can go without there actually being anything amiss. 24 tape will give them a lot of information - 3 pads on chest, and a pretty unobtrusive box on belt. Go for a good ride whilst you're wearing it too (but don't get the wires caught in the handlebars!).

y33stu

I havent had anything that severe but I do frequently have an irregular heartbeat, it will sit at around 60BPM usually, but ill often miss a beat, then come back with a very strong beat and a couple of quick beats to make up for it. I'm a typical bloke, hate going to the docs, but as the mrs could actually see my heart beating in my chest she persuaded me to go. Turns out an irregular heartbeat is very common, most people have one, its just I can feel mine when it happens. Although I'm overweight, the doc said my heart was fine, I just have a strong heartbeat. Hope yours is nothing to worry about.

bendertherobot

I’m about To drag myself off to the dr with this. Came on last night. Fully expect to be in hospital later.

Matthewfalle

bendertherobot wrote:

I’m about To drag myself off to the dr with this. Came on last night. Fully expect to be in hospital later.

if it all goes wrong can I have your shoes and watch/es please?

graeme_s-2

If you're having palpitations, are you taking any medication that has palpitations as a possible side-effect? I got them several winters on the trot, until I realised it was only when I had a cold and was taking Lemsip. Lemsip contains a decongestant and one of the possible side-effects is palpitations.

keef66

I get palpitations pretty regularly, and sometimes they go on for quite a while. If I take my radial pulse at the same time the thumps in my chest correspond with apparent missed beats at my wrist. Couple of times they've hooked me up to a 10 lead ECG at the GPs, but by the time they've done that it's subsided again and all they ever managed to record was one or two ectopic beats. Was referred for a 24 hr Holter monitor, but typically the appointment came through when we were on holiday and I've never bothered to follow it up.

One thing that can trigger mine is eating too much or the wrong things and upsetting my hiatus hernia. The vagus nerve is to blame apparently.

They rarely occur when I'm exercising, and I don't have any other symptoms of a cardiac nature so I'm not unduly worried. Maybe I should be...

Wheelspinner

keef66 wrote:

I get palpitations pretty regularly, and sometimes they go on for quite a while. If I take my radial pulse at the same time the thumps in my chest correspond with apparent missed beats at my wrist. Couple of times they've hooked me up to a 10 lead ECG at the GPs, but by the time they've done that it's subsided again and all they ever managed to record was one or two ectopic beats. Was referred for a 24 hr Holter monitor, but typically the appointment came through when we were on holiday and I've never bothered to follow it up.

One thing that can trigger mine is eating too much or the wrong things and upsetting my hiatus hernia. The vagus nerve is to blame apparently.

They rarely occur when I'm exercising, and I don't have any other symptoms of a cardiac nature so I'm not unduly worried. Maybe I should be...

Hiatus hernia is fairly simply diagnosed, so that can be ruled in or out for others. However I am slowly tracing the cause of my occasional episodes of this to food - red chilli is one that seems to be a trigger, and some spice combinations such as garam masala, but I have a suspicion that there are also a few food additives that really kick it off. Any of the flavour enhancer (MSG replacements such as 631 etc) are especially nasty - avoid them!

It's definitely also stress related for me - more susceptible under those conditions.

bendertherobot

On hospital now. Hr is 170 so need to slow that. But feel OK.

Wheelspinner

bendertherobot wrote:

On hospital now. Hr is 170 so need to slow that. But feel OK.

Best wishes.

bendertherobot

Ta. I'm feeling OK so I'm in good hands

fenix

Good luck BTR - our NHS is amazing. You're in good hands.

keef66

Holy crap! That's higher than my MHR. Hope they get you sorted out ASAP.

Can I have your Easter eggs??

bendertherobot

Coming down. Max now 150 but often down at 100. May need the reset later. 180 only 4 more than my mhr. Gulp.

keef66

They got any idea what's caused it?

bendertherobot

All tests currently clear. I'd wager the 100 miles over Sunday and Monday

haydenm

All the best. A friend of mine collapsed after a race with his HR stuck at max for 2 hours, it calmed down after a while but it was a scary experience while it lasted, he's currently having tests to try and get it sorted.

bendertherobot

It does seem remarkably common!

bianchimoon

bendertherobot wrote:

It does seem remarkably common!

I've a couple of friends been through very similar episodes, sure all will be well

bendertherobot

It's almost 2 am and I appear to have sinus rhythm. 58 bpm

supermurph09

To the OP, sounds more like anxiety to me. Had something similar a few years ago, got to the point (I was out for a family meal) where I had to get up and leave or I was going to pass out (although it felt more like i was going to explode). This then followed with a period of about 9 months of general anxiety and irritability. It still lingers 2 years on but nothing like that period of time. I was put on meds but came off them very quickly as they made me much worse.

bendertherobot

Supermurph09 wrote:

To the OP, sounds more like anxiety to me. Had something similar a few years ago, got to the point (I was out for a family meal) where I had to get up and leave or I was going to pass out (although it felt more like i was going to explode). This then followed with a period of about 9 months of general anxiety and irritability. It still lingers 2 years on but nothing like that period of time. I was put on meds but came off them very quickly as they made me much worse.

I am a bit anxious, presently. Swapping jobs. But, I think that's unlikely. It was full on atrial fibrilation for 24+ hours. Only controlled with drugs. Arthymia as well. 2am yesterday morning, it just reset. Great night for people on the ward with all my alarms going off mind.

supermurph09

bendertherobot wrote:

Supermurph09 wrote:

To the OP, sounds more like anxiety to me. Had something similar a few years ago, got to the point (I was out for a family meal) where I had to get up and leave or I was going to pass out (although it felt more like i was going to explode). This then followed with a period of about 9 months of general anxiety and irritability. It still lingers 2 years on but nothing like that period of time. I was put on meds but came off them very quickly as they made me much worse.

I am a bit anxious, presently. Swapping jobs. But, I think that's unlikely. It was full on atrial fibrilation for 24+ hours. Only controlled with drugs. Arthymia as well. 2am yesterday morning, it just reset. Great night for people on the ward with all my alarms going off mind.

My response was to the OP, apologies for any confusion.

johnmiosh

I started experiencing transient high HR readings in early 2011, but for many reasons I thought it was a faulty strap, so I ignored them and just stopped using the monitor.

Towards the end of 2015, I was starting to feel very unfit and was struggling on hills, so I bought a new sensor with the intention of training properly again. But by then, high HR was consistent throughout my rides with peaks of 250 BPM, although my heart was completely normal when not exercising. A quick bit of research suggested to me that I had paroxysmal Atrial Fibrillation, so I made an appointment at the doctors. I was only able to get in three weeks later.

My pulse was normal at my consultation; the doc wanted to send me for an ECG to check. I suggested an exercise ECG, but this was not possible; I assume NHS protocols force them down the cheapest route first.

Before my hospital appointment my AF became persistent and was obvious from my irregular pulse. I was formally diagnosed in Feb 2016; my ECG showed AF and my echocardiogram showed a Left Atrial volume of 37 compared to a healthy maximum of 27. This is typical of damage done by years of endurance exercise.

Since then it has taken two years to complete the treatment (with a major curb on my cycling). I have just today returned from the hospital after a TOE and ECG. I will see the Cardiologist again in acouple of weeks to get the results. I am expecting and hoping to be as “cured” as it is possible to be.

I would advise CRAIGO5000 to be careful, take rest days and keep hydrated, hopefully, it is a one-off warning.

BTR, You need to see an electrophysiologist and get a treatment plan quickly. Good luck.

One thing I have found useful and would help anyone who has worries about their heart rhythm is the Kardia App https://www.alivecor.com/

I use a portable ECG pad that sticks to the back of my phone (£99), but there are other options such as a wrist band that fits an apple watch. You can use this when you have an attack and print out the trace (medical grade single lead ECG) for the doctor.

bendertherobot

Thanks guys. Bear in mind the OP was 6 years ago!