Heart palpitations, chilly weather - why does this happen?
April 7, 2017 6:19 AM Subscribe
I have a long-standing weird health thing which has been getting, slowly, worse. I have a doctor's appointment coming up but have not had much luck with resolution in the past. Do you have suggestions for further research, questions for the doctor, possibilities?
So I get heart palpitations very easily - the kind where your heart is beating at a normal rate but you get a pounding feeling through your whole body. I get them from stress, I get them if I unwisely eat a large carby meal late at night, I get them if I'm really fatigued and didn't get enough sleep...mysteriously, I do not get them from caffeine. I had an EKG recently which was normal and I had a heart workup some years ago which did not reveal any abnormalities so I try not to worry about them except to avoid carby meals late at night, etc.
However, this thing happens - if I am outside for any length of time but daytime in high summer, I get chilled very easily. If it is very cold, I feel chilled; if it is not very cold, I just feel a little lower-energy - I often don't even realize that I've been feeling cold until I am in bed at night. I can't recover from feeling chilled unless I lie in bed under a lot of blankets. It takes me two or three hours to warm up, and what happens is that I get very hot all at once and my heart starts racing/palpitating. This lasts for a while and then passes off.
When I was younger, it happened only when I was outside for an extended period in winter, but latterly it's been happening even in spring. It does not seem to matter if I dress warmly, wear a hat or keep moving - a bike ride in a warm jacket can really chill me.
It does not seem to have to do with what I've been eating that day, either.
I recently had my thyroid checked and the doctor said it was normal.
What could this be? It was all right when it was just being outside in winter, but it's a drag to feel chilled and fatigued in the spring.
So I get heart palpitations very easily - the kind where your heart is beating at a normal rate but you get a pounding feeling through your whole body. I get them from stress, I get them if I unwisely eat a large carby meal late at night, I get them if I'm really fatigued and didn't get enough sleep...mysteriously, I do not get them from caffeine. I had an EKG recently which was normal and I had a heart workup some years ago which did not reveal any abnormalities so I try not to worry about them except to avoid carby meals late at night, etc.
However, this thing happens - if I am outside for any length of time but daytime in high summer, I get chilled very easily. If it is very cold, I feel chilled; if it is not very cold, I just feel a little lower-energy - I often don't even realize that I've been feeling cold until I am in bed at night. I can't recover from feeling chilled unless I lie in bed under a lot of blankets. It takes me two or three hours to warm up, and what happens is that I get very hot all at once and my heart starts racing/palpitating. This lasts for a while and then passes off.
When I was younger, it happened only when I was outside for an extended period in winter, but latterly it's been happening even in spring. It does not seem to matter if I dress warmly, wear a hat or keep moving - a bike ride in a warm jacket can really chill me.
It does not seem to have to do with what I've been eating that day, either.
I recently had my thyroid checked and the doctor said it was normal.
What could this be? It was all right when it was just being outside in winter, but it's a drag to feel chilled and fatigued in the spring.
Getting chilled will move blood away from your surface skin meaning that there's more blood in the rest of your body raising your blood pressure. Higher blood pressure should make it easier to feel anything todo with your circulatory system.
posted by nobeagle at 7:35 AM on April 7, 2017
posted by nobeagle at 7:35 AM on April 7, 2017
You don't mention if you are on any medications. I sometimes experience both heart palpitations and getting chilled disproportionate to the actual temperature, and I've concluded it's the result of anxiety and the side effects of some medication I'm on. I don't really have any advice for dealing with it though. My symptoms aren't usually as severe or long-lasting as what you're describing, but for me I just try to force myself to relax and distract my mind, which seems to help them pass sooner. Meditation might also help. If you've been cleared of heart problems, don't underestimate the effects physical anxiety can have. Unconsciously tensing your muscles/fight or flight response leads to reduced blood flow, leads to getting chilled and palpitations, etc.
a lot of people tend to assume that anxiety has to come with some sort of mental or emotional aspect or thoughts, but for me it's often purely physical, which can make it hard to identify.
posted by catatethebird at 8:09 AM on April 7, 2017
a lot of people tend to assume that anxiety has to come with some sort of mental or emotional aspect or thoughts, but for me it's often purely physical, which can make it hard to identify.
posted by catatethebird at 8:09 AM on April 7, 2017
I have had this all my life as have a few of my relatives, but rarely get the heart palpitations. Usually it's a rushing sound in my ears, and I can hear my pulse in my ears and my limbs are heavy and dull. I can get overwhelmed with the need to lie down, right now, wherever I am, and if I defy that need I might collapse (but not lose consciousness).
And yes on the cold, my hands and feet are cold even during a heat wave when I'm otherwise miserably hot. Finger less gloves and those rice-filled things you microwave keep me more comfortable.
One thing to be tested for is postural hypo-tension, where your blood pressure drops inappropriately as you change your physical orientation. This is a symptom, rather than a cause, but it made so much sense once I had a nurse checking my blood pressure while I was prone for 10 minutes, then again when i quickly stood up, etc.
I can avoid spells by staying super hydrated and eating protein along with any carbs - never carb only because even just grabbing a couple of crackers will trigger one but spreading some peanut butter on them does not.
My uncle has gotten much better care than I have, a thin athletic male (he was in the army the first time he collapsed) gets better attention from doctors than a fat asthmatic female. But he’s never found a root cause either, and controls his spells through a low carb diet and frequent micro meals with a lot of specific food restrictions; he used an elimination diet with a doctor’s help.
posted by buildmyworld at 8:53 AM on April 7, 2017 [1 favorite]
And yes on the cold, my hands and feet are cold even during a heat wave when I'm otherwise miserably hot. Finger less gloves and those rice-filled things you microwave keep me more comfortable.
One thing to be tested for is postural hypo-tension, where your blood pressure drops inappropriately as you change your physical orientation. This is a symptom, rather than a cause, but it made so much sense once I had a nurse checking my blood pressure while I was prone for 10 minutes, then again when i quickly stood up, etc.
I can avoid spells by staying super hydrated and eating protein along with any carbs - never carb only because even just grabbing a couple of crackers will trigger one but spreading some peanut butter on them does not.
My uncle has gotten much better care than I have, a thin athletic male (he was in the army the first time he collapsed) gets better attention from doctors than a fat asthmatic female. But he’s never found a root cause either, and controls his spells through a low carb diet and frequent micro meals with a lot of specific food restrictions; he used an elimination diet with a doctor’s help.
posted by buildmyworld at 8:53 AM on April 7, 2017 [1 favorite]
Forgot this about the cold triggers: keeping my core warm is the most important, breathing in cold air after being inside somewhere warm is a huge trigger. I guess because all the blood in my body passes through my lungs and gets chilled. If I pull even a thin scarf over my mouth & nose so my body heat/exhalations warm the incoming air it makes a huge difference, especially while I am breathing heavily from activity.
posted by buildmyworld at 9:03 AM on April 7, 2017 [1 favorite]
posted by buildmyworld at 9:03 AM on April 7, 2017 [1 favorite]
However, this thing happens - if I am outside for any length of time but daytime in high summer, I get chilled very easily. If it is very cold, I feel chilled; if it is not very cold, I just feel a little lower-energy - I often don't even realize that I've been feeling cold until I am in bed at night. I can't recover from feeling chilled unless I lie in bed under a lot of blankets. It takes me two or three hours to warm up, and what happens is that I get very hot all at once and my heart starts racing/palpitating. This lasts for a while and then passes off.
This part sounds quite a bit like Raynaud's:
So I get heart palpitations very easily - the kind where your heart is beating at a normal rate but you get a pounding feeling through your whole body.
seem pretty consistent with the bradycardia of the diving reflex to me.
Note that the part of the Wikipedia link I quote above mentions that Raynaud's can be secondary to other conditions, and since rosacea involves heating in the face and nose, I wondered whether the greater contrast of tissue temperature with ambient air temperatures this could cause would make rosacea sufferers more likely to develop Raynaud's :
This part sounds quite a bit like Raynaud's:
Raynaud syndrome, also known as Raynaud's, is a medical condition in which spasm of arteries cause episodes of reduced blood flow. Typically the fingers, and less commonly the toes, are involved. Rarely, the nose, ears, or lips are affected.[1] The episodes result in the affected part turning white and then blue. Often there is numbness or pain. As blood flow returns, the area turns red and burns. The episodes typically last minutes but can last up to several hours.[2]I personally think Raynaud's is a partial and attenuated version of the diving reflex in humans:
Episodes are often triggered by cold or emotional stress.[2] There are two main types: primary Raynaud's when the cause is unknown and secondary Raynaud's which occurs as a result of another condition.[3]
The diving reflex, also known as the diving response and mammalian diving reflex is a response to immersion that overrides the basic homeostatic reflexes, which is found in all air-breathing vertebrates.[1][2] It optimizes respiration by preferentially distributing oxygen stores to the heart and brain which allows staying underwater for extended periods of time. It is exhibited strongly in aquatic mammals (seals,[3] otters, dolphins, muskrats),[4] but exists in other mammals, including humans, in particular babies up to 6 months old (see Infant swimming).and the "heart palpitations" you describe:
. . .
When the face is submerged, receptors that are sensitive to cold within the nasal cavity and other areas of the face supplied by the fifth (V) cranial nerve (the trigeminal nerve) relay the information to the brain and then innervate the tenth (X) cranial nerve, (the vagus nerve), which is part of the autonomic nervous system. This causes bradycardia and peripheral vasoconstriction. Blood is diverted from the limbs and all organs but the heart and the brain (and lungs), concentrating flow in a heart–brain circuit and allowing the animal to conserve oxygen.[2][4]
In humans, the diving reflex is not induced when limbs are introduced to cold water. Mild bradycardia is caused by subjects holding their breath without submerging the face in water.[6] When breathing with face submerged the reflex strength increases proportionally to decreasing water temperature.[5] However the greatest bradycardia effect is induced when the subject is holding breath with face submerged. Both apnea and facial cooling are triggers of this reflex, but actual water contact with the face appears to be unimportant.[5]
So I get heart palpitations very easily - the kind where your heart is beating at a normal rate but you get a pounding feeling through your whole body.
seem pretty consistent with the bradycardia of the diving reflex to me.
Note that the part of the Wikipedia link I quote above mentions that Raynaud's can be secondary to other conditions, and since rosacea involves heating in the face and nose, I wondered whether the greater contrast of tissue temperature with ambient air temperatures this could cause would make rosacea sufferers more likely to develop Raynaud's :
Neurogenic Rosaceaposted by jamjam at 1:33 PM on April 7, 2017
A notably high percentage of patients had neurologic (43% [6 of 14]) or neuropsychiatric (50% [7 of 14]) conditions, including complex regional pain syndrome, essential tremor, depression, and obsessive-compulsive disorder. Neurovascular disorders, including headaches (71% [10 of 14]) and Raynaud phenomenon (29% [4 of 14]), as well as rheumatologic disorders (36% [5 of 14]), including lupus, rheumatoid arthritis, fibromyalgia, mixed connective tissue disease, and psoriatic arthritis, were also common. [my emphasis]
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posted by gregr at 6:47 AM on April 7, 2017