Worried about night time palpatations. Advice?
June 16, 2013 5:29 PM   Subscribe

Been having pretty constant heart palpatations. I have had them before, but they have been generally isolated. The ones I'm having during the day are minor, but they are persistent. I went to the hospital, and the doctor said to get a heart monitor. I went to my general practitioner and he said I had already had a heart monitor, so there was no need for one. Anyway, the palps get pretty bad at night to the point where my chest starts to ache. In the past I have also had panic attacks and anxiety problems, some of which during palpatations were present. What do you guys think is going on? What should I do? Any advice is welcome
posted by Thanquol180 to Health & Fitness (26 answers total) 4 users marked this as a favorite
How long has this been going on?
posted by bunderful at 6:07 PM on June 16, 2013

I started to write a big long comment about going to a cardiologist, but on rethinking, if you're having chest pains you should go to the ER. They can monitor you there, can give you meds to calm you if it's anxiety-related (or if you're just having anxiety alongside), and can refer you to a doctor who will take you seriously.
If you don't go back to the hospital, I'd suggest trying to get in to see a cardiologist as soon as possible. Even if you've already had a Holter monitor or other cardiac monitoring test, you're still having symptoms that distress you. This is not something to ignore or downplay.
But really, chest pain is nothing to mess with.
posted by katemonster at 6:09 PM on June 16, 2013 [4 favorites]

Tachycardia can mean that you are bleeding internally. Don't ask me how I know this.

I was also very badly misdiagnosed by a GP before I finally went to the ER. If I had listened to him ... well, who knows.

Katemonster is right. Go to the ER.
posted by bunderful at 6:14 PM on June 16, 2013 [1 favorite]

After your stop at the ER, look into getting a new GP. A good GP is not dismissive and will actually take steps to help you figure out what's wrong.
posted by PorcineWithMe at 6:29 PM on June 16, 2013 [5 favorites]

How are you treating your anxiety and panic attacks? I am not a doctor, but I spent some time working at a cardiologist's office and anxiety was often the cause of palpitations in otherwise healthy young people who had had a Holter monitor that didn't point to other causes. This is far from medical advice and you could and should absolutely see another GP or cardiologist, but be willing to listen if they point to anxiety as the cause of your palpitations.
posted by MadamM at 6:37 PM on June 16, 2013 [1 favorite]

I've had night-time palpitations under periods of intense stress and anxiety, but nothing as severe as yours sound. I agree with everybody else above, but I'm also going to recommend cutting out caffeine entirely, in case you're a four-cups-a-day coffee drinker like I used to be. This made a huge difference for me.
posted by qxntpqbbbqxl at 6:44 PM on June 16, 2013 [3 favorites]

Sleep apnea has been shown to have a relationship to heart dysthymias.
posted by teamnap at 7:11 PM on June 16, 2013

I also think it's likely to be related to anxiety. I have no medical experience whatsoever, but my brother who is otherwise pretty healthily functioning went to the ER twice thinking he was having a heart attack (he is 28 and lean) which turned out to be panic attacks. I also get heart palpitations when I am under stress and wound up.

Yes, also recommending cutting out caffeine. I did and it both reduces heart palpitations and makes it much easier to fall asleep at night.
posted by mermily at 7:30 PM on June 16, 2013

I can't comment directly on your question here, but assuming your symptoms have been going on weeks to months, internal bleeding is highly unlikely. There are many causes for tachycardia (fast heartbeat), and palpitations can happen even with a regular heart rate. Any diagnoses suggested here with the limited information provided should be taken with a grain of salt. IANYD.
posted by treehorn+bunny at 7:44 PM on June 16, 2013 [1 favorite]

Eating a lot of salt or MSG (or both, in case of Chinese takeout) can cause a passing rise in blood pressure. I imagine palpitations could be triggered too. If you eat a lot of crap, try eating less crap.
posted by Nomyte at 8:00 PM on June 16, 2013

Call your doctor. There will be someone on call. If you have palpitations bad enough and long enough to be painful, I'd go to an ER.
posted by theora55 at 8:16 PM on June 16, 2013 [1 favorite]

Are you drinking coffee? If so, stop. Another thing to consider (besides the usual medical possibilities that a doctor should check) is that stress could presumably also be a factor.
posted by Dansaman at 8:35 PM on June 16, 2013 [1 favorite]

I don't think anyone can diagnose you here. If it is making it difficulty for you to sleep or causing anxiety, you can press your doctor until you get a Holter monitor and/or a cardioechogram. I wonder if the pain is in your mind or real, since you associate them with palpitations and I'm not sure if pain and palpitation need to go hand-in-hand if a problem is present. I am not a doctor.

I am in my late 20s and have had a lot of palpitations throughout adulthood, with them seeming to get worse for stretches. I've had two echocardiograms and two Holter monitors about 6 years apart. I am fine and perfectly healthy. The first time I was tested, I too was experiencing chest pain that really made me scared. I found I was having chest pain when running but it would stop when I stopped running. I thought I had angina. Turned out I get costochondritis pretty easily -- my chest wall gets inflamed and tender and painful when I move certain ways or press it. I take ibuprofen and it disappears, but something can trigger it back and I just have to take ibuprofen until it's gone. Before the last time I was tested (my second time), my palps were frequent enough and strong enough that I just couldn't sleep without feeling afraid I was going to have a heart attack. (I also had recently witnessed a young person my age have a heart attack and die, which was traumatizing and made me irrationally scared of it. He had an undiagnosed arrhythmia. If I had such a thing, my tests would've found it by now. As far as I know, he had never undergone any sort of testing for his heart. He was very active and a runner.)

For me, getting enough sleep/sleeping on a normal schedule and cutting out caffeine greatly reduced my palpitations almost to the point of elimination. I still get them if I have caffeine or get too little sleep, or maybe even feel stressed, but now I can just let it pass through my mind instead of fixating on it and getting anxious.

I'd stop being anxious before you have any reason to be and try to be rational about whether you have the symptoms, lifestyle and odds to worry about a heart problem. But I'd also push your doctor ti get the Holter monitor or an echocardiogram if they are affecting your life. Or else, get a new doctor.
posted by AppleTurnover at 8:42 PM on June 16, 2013

I hope I don't come across as diagnosing. I thought it would be helpful to share my experience with the OP, and that was this:

- I'd had brief palpitations on occasion for a long time. Had it checked out with doc, no big deal.
- Then one night I had steady palpitations that did not go away. I thought this was related to the existing palpitations. But they continued into the next day and then the next.
- Eventually I went to the ER and found that I was bleeding internally.
- The brief palpitations and the steady palpitations were completely unrelated.

Chances are slim that the OP might have exactly the same issue that I had. But I do think s/he should haul ass to the ER.
posted by bunderful at 8:48 PM on June 16, 2013

When I went to the hospital it was the emergency room. I was just a little freaked out by the palpatations I was having during the day. So they did the whole thing where they hooked up my body with electrodes, and left me for a little over an hour.
Afterwards, the doctor at the ER told me that I did have the odd beat here and there, but the patterns of the beats didn't worry him. He told me that palpatations can come and go without us even knowing why. He told me that i could request a heart monitor.
I feel that i made my GP sound dismissive. The hardcore palpatations at night had not started yet.
So, yeah, i will definitely get an appointment with my cardiolologist as fast as possible. When I read 'Internal Bleeding' I nearly jumped out of my skin! Thank you to all of you for your input.
posted by Thanquol180 at 8:49 PM on June 16, 2013 [1 favorite]

Propranolol is one treatment for tachycardia. It's non-habit forming so its generally safe to try out.
posted by Blazecock Pileon at 9:16 PM on June 16, 2013

Does it get worse when you stand up, especially after you've been standing a while? If so, you could have postural orthostatic tachycardia syndrome, a benign but seriously annoying and scary condition. I had years of chest pain, a racing heart, etc., and after endless tests that's what they finally came up with. Until I got on medication, my heart was going faster and faster, it was horrifying. Now I take the blood pressure med Atenolol, and while it hasn't cured me it's made life much more livable. Talk to your doctor about it. Trying it probably won't hurt you, and it may get this under control.

When your heart is wonky but there is no immediate explanation for why, your doctors can become almost as much of a hindrance as a help. They may keep telling you it's just anxiety, even if it's not. They may refuse to run more tests, even though you feel like shit. You have to do your own homework, and keep nagging them. You may even need to ditch your current doctors and get new ones. Get a halter monitor test. Get an echocardiogram. Do whatever it takes to rule out that this is something dangerous.

This may turn out to be panic. It may turn out to be the symptom of a relatively mild and correctable medical condition, like thyroid dysfunction. Whatever it is, just remember that your heart can feel like total shit, and still basically be working fine. The body is fun, that way.
posted by Ursula Hitler at 9:35 PM on June 16, 2013

I have heart palpitations at night and when I first complained to my GP I was told it was anxiety. But I wasn't feeling anxious until I looked up my symptoms on the internet. A racing heartbeat combined with dizziness could be a panic attack or a heart attack. My symptoms have never been as bad as yours but they were bad enough for me to talk to the Dr and look them up.

Time passes. I live with it, feeling anxious when it hits but telling myself it is not a problem. Then I had a physical with another GP and then first thing they said to me was "can you feel your heartbeat?" I told them my story and they sent me to a cardiologist. I do not need medication at this point but most likely will in the future. It is not anxiety.

So I guess what I am trying to say is, don't let them dismiss you because you do have a history of anxiety. Make them find out what it is so you won't be left wondering what the hell is happening. Too much wondering along with too much internet makes me anxious.
posted by cairnoflore at 10:27 PM on June 16, 2013

Post-heart-palpitations-worrier here. It sounds like you're getting an appointment with a cardiologist, which is great. When he/she tells you you're fine, do your best to truly internalize that. Anxiety can be triggered by anything, and when it is, it takes control of your mental *and physiological* state. You're going to live for a long time.
posted by mcav at 10:38 PM on June 16, 2013

They may be from anxiety or they may be from something wrong with your heart. The only way to tell what the problem is is to go to the ER when you're having the palpitations and push them if necessary to define the problem and rule out a heart problem. If they don't get excited about your EKG results when you arrive at the ER, that's a good sign, but there could still be something electrical going on that needs to be addressed. If they won't do any more at the ER, I'd insist to my regular doctor that I have a cardiac workup. Hopefully, nothing will show up and a pill to fight anxiety will fix the whole problem. Good luck. Physicians need to understand that even people with anxiety and panic attacks can get serious illness right along with everyone else.
posted by aryma at 10:42 PM on June 16, 2013

Is atrial fibrillation a possibility? (Called a fib) The symptom is a kind of fluttering instead of a regular heartbeat. I agree that your GP has dismissed you without a thorough check up. Ask your gatekeeper for a referral to a cardiologist.
posted by Cranberry at 12:15 AM on June 17, 2013

Make sure you are getting enough magnesium in your diet.
posted by gjc at 5:28 AM on June 17, 2013

One trick is to rub your neck where you have a vein (where some people press to check their pulse) and kinda massage it. It's a trick a doctor showed me when I was having similar issues, and might help to stop them at night if they are bothering you while you are having them checked out otherwise.

Also, approaching menopause I have more of these and apparently this is normal for "the change." YMMV.
posted by St. Alia of the Bunnies at 11:05 AM on June 17, 2013

Go back to the doctor/ER and get re-checked, but also get your iron levels checked. I had a lot palpitations and it turned out I was anemic. Anemia can cause palpitations. Taking an iron supplement every day has made them basically stop.
posted by disaster77 at 11:52 AM on June 17, 2013

I had a similar experience (maybe not as extreme) back when I was in grad school. They did various diagnostics including an ekg (and indicated that they pretty much always take heart complaints seriously) but in the end, suggested that it was most likely an anxiety symptom. And you know what? They were absolutely, completely, right. In fact, anxiety was enhancing (probably my perception of) the symptoms, which enhanced my anxiety, creating a cycle; not only that, but a cycle interacted with insomnia and so was worst at night.

Definitely continue getting your heart checked out etc., I don't mean this to say anything remotely like I think you should stop that process. However, I agree with some of the other posters you should be open to considering the possibility that this is a result of anxiety, and if this is what doctors continue to tell you, find ways to accept/internalize that.
posted by advil at 1:41 PM on June 17, 2013

yesterday it got bad, and i took some anxiety medication and it most definitely helped. So that makes me feel good, knowing that it most probably could be due to my nerves. However, my psychiatrist does not want want me taking that pill anymore, so now i have to find some natural ways of coping with this. I'm more positive about it now. I think I can do it!
She said 'meditation'. Like relax my mind before sleep. I will try the neck massage trick if it happens again. I have an appointment in about a week with my cardiologist (she had a cancellation) I really do want to internalize that there is nothing wrong with me. You guys rock!
posted by Thanquol180 at 3:38 PM on June 17, 2013

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