Cardiologists to the forum (both amateur and professional ones)
So in the time honoured tradition of asking STW forum about anything, here’s my latest problem.
I’ve been having occasional heart palpitations since about christmas. A skipped beat (ectopic beat GP thinks) every now and again.
Saw the GP about this, had an ECG (a short one – not long enough to pick up an ectopic) and blood tests. All looked normal, so I was told there was nothing to worry about really. Cut down on caffeine, stress, get enough sleep, reduce alcohol consuption (which I have done all of).
This seemed to improve things – getting some skipped beats still, but fewer of them.
Fast forward to this last Saturday (10th), I’d been on an evening ride 1.5 hrs, nothing particularly strenuous. Noticed a skipped beat or 2 during the ride. Had a shower, sat down in front of the TV and got a period of about 10 minutes where I had loads of skipped beats in quick succession – not had that before – got worried. Phoned 111, by which time all normality was restored (and with a further referral to GP via 111).
Yesterday morning, went out for an hours spin before work. First half of the ride went fine – all pretty much as normal, went up the first climb almost as well as normal however started having a general feeling that ‘something wasn’t quite right’.
Shortly after this (about 2/3 through the ride) I started to really struggle, started getting dizzy. I could feel my body not responding to the requests from my legs.
I wasn’t out of breath – it was like my body just couldn’t respond to the demands. As I pedalled, I could feel the effort in my legs (which was a fraction of what I am normally capable of – I was slowed down to almost crawling) taking blood away from my head, and that my legs just weren’t getting the supply they needed either. (PS, HRM was showing HR of up to 138 on the ride, more generally around 120 – which is very low. Normally I’d expect it to get to about 160 peak)
This got progressively worse, so much so that I was really struggling on the flat. Limped home, collapsed through doorway. 999 trip to A&E.
Given another ECG and blood tests and chest xRay – all looked normal. Enough to send me home.
Whilst at A&E I felt progressively better, to the point that a couple of hours after my near collapse I was pretty much feeling back to normal.
Spent yesterday afternoon feeling sorry for myself and reading worrying things about heart problems on the internet (which didn’t really help!)
I’ve done a 30 mins weight training session this morning. Not enough to raise my heart rate above 90, but felt absolutely fine. No palpitations at all yet today (I have not drunk any caffeine at all, had a good long sleep last night). A bit of a feeling of unease though (maybe just the worry of this little episode)
So, anyone else had anything like this happen?
Would you care to speculate on my diagnosis?
PS have further conversation with the GP lined up for today and I’ll be being referred to the cardiologists – so it’s going the correct route too rather than via just this forum 🙂Posted 1 week ago
TL;DR: Ask them to consider Paroxsysmal Atrial Fibrilation as a cause for this.
You basically listed all the symptoms I had for a while, including a heart rate that seemed low, but not beating properly and, when on an ECG topped out at 210 or so.
FWIW, I think you are doing the right things already with cutting out caffeine and alcohol. Hydration also helps as I found mine was bad if dehydrated (think waking up in a hot tent in summer dehydrated, then having to go do a 10k). And tired. And cold. Tired and cold always used to be a good setup for it.
Anyway, read up a bit on it, but do not get too wrapped up in the details. it is, to some extent, relatively easy to control or treat. A lot of the literatur is US based and it scared the sjit out of me when I read it back in 2000.Posted 1 week ago
Sounds very much like Cat Aids and not the good type either.
NB I am a Cardiologist, but this is my day off.Posted 1 week ago
Thanks Willard, funnily enough it was cold yesterday morning. I was maybe a a bit tired(???) Maybe a bit dehydrated(???)
Puts me also in mind of last Wednesday’s ride in the peak (when it was warm). Started to feel a bit rough towards the end of that ride, but at the time i put it down to it being a tough ish ride and not having enough water with me (so a bit dehydrated at the end).
So yeah, definitely bad cat aidsPosted 1 week ago
Ideally you need an ECG to capture the episodes, until then it’s all speculation based on history.Posted 1 week ago
I am a Cataidologist so I suggest you increase your caffeine and stress, reduce your amount of sleep plus, up the units of alcohol and double the intake of coke and hookers….. Might be worth a 1:1 private consultation with Louise…
A general enquiry to Dr google most times ends up with US based info and instant death so I tend to avoid it… hope you get sorted is its definitely unsettling.Posted 1 week ago
Well I was about to respond to this re the ectopic beats and such, but then I’ve never had any kind of dizziness or weakness. I think I had premature ventricular contractions after someone brought it up on here and it exactly matched my experiences; I tried magnesium tabs and it’s really helped. Don’t take this as advice though – ask your doc.Posted 1 week ago
Get it all checked out via your GP / hospital, and stay away from reading anything online. You’ll just increase your stress and anxiety levels which can cause every single that you just described.
Could be one of many non-heart attack related issues. The aforementioned stress and / or anxiety, vitamin deficiency, post-viral syndrome (there’s a nasty one doing the rounds apparently).
Keep off the caffeine and booze. It takes at least a couple of weeks for it to all get out of your system and can cause withdrawal symptoms such as panic attacks, of which the symptoms can exactly match those that you had when you called 999.
Speaking from experience, you’ll be fine. I went through the exact same issues and symptoms in my early 20’s, al caused by stress and anxiety.Posted 1 week ago
Oh yeah. I had it much much worse during stretches of last summer – after I think I got COVID really early on, along with a truckload of weird non-severe symptoms and some fatigue.Posted 1 week ago
Have a couple of mates who had similar issues where they had irregular beats, but fine when tested in a hospital setting on an ECG.Posted 1 week ago
They used a kardio mobile by Alivecor. It is a two pad ECG that attaches to the back of your phone via an app and if you have an incident can be used to get some ECG data for your cardiologist to analyse.
One mate had mainly tachycardia issues, but then another time bradycardia, he stopped on a road ride feeling ‘unwell’ went grey in pallor and rolled into a fetal position until his heart reset. The data showed in down in the late 20’s.
The latest iWatches can do an ECG trace. Colleague at work uses it to send odd traces to his cardiologist.Posted 1 week ago
Back in my day it was 24hr ECG machines that looked like a walkman and pads stuck to your chest.
Them were the daysPosted 1 week ago
Thanks jwt, that sounds interesting. I’m due for one of the Walkman 24hr jobs I thinkPosted 1 week ago
I’ve had some weird after effects of covid as well, though nothing like as bad as the OP. 180bpm climbing (one flight of) stairs etc. Also have had (for as long as I can remember) slight episodes where my ticker could “race” for a few seconds. Covid seems to have made this worse, it now lasts for up to 30 secs or so and takes a while to settle down.
Anyway, long and short is that I got chatting to a neighbour who is a cardiologist and was interested in my post-covid recovery. Explained my symptoms and he’s suggested a heart ultrasound to look for SVT. https://www.nhs.uk/conditions/supraventricular-tachycardia-svt/
Apparently nothing can be done about it, just knowing what it is may be useful. I wouldn’t mind betting I’ve got some underlying issue like that, which has been aggravated by covid.
Certainly I’m struggling with exercise at the mo. 50m sprint on the bike and I have to stop for quite a while to recover!
Edit: and he recommended I get an iwatch to monitor HR as well.Posted 1 week ago
Disagree with the Cat AIDS diagnosis. Sounds more like Badger AIDS. The bad kind.Posted 1 week ago
Being a medical person I’m not touching this with a barge pole other than I advise you speak to your GP ASAP.Posted 1 week ago
If you’re upper arms are feeling both light and swollen and have restricted movement, it’s a sure sign of Swim AIDS.Posted 1 week ago
<span style=”font-size: 0.8rem;”>I’ve had a somewhat similar experience with heart palpitations and a collapse out of nowhere a few years back (young and otherwise healthy).</span>
Had blood tests, ECG, echocardiogram and the cardiologist couldn’t find anything wrong. Still get palpitations occasionally, mostly when I haven’t had enough sleep, but nothing serious since.
Obviously go through with talking to your doctor and any tests they suggest but I’d try not to worry too much until then.Posted 1 week ago
Your symptoms sound similar to mine OP. I’d had a couple of visits to the GP, hospital, wore a 24hr tape, but nothing ever came of it other than a diagnosis of “perfectly healthy”. I was then lucky enough to have an episode whilst offshore and was hooked up to the sickbay ECG within minutes. Had a clear arrhythmia and a good 8+ hours of data/printouts so was easier for the cardiologist to diagnose – paroxysmal atrial fibrillation, as mentioned above. I went for an MRI just to rule out any heart structure issues but that was all clear.Posted 1 week ago
I’m now on bisoprolol daily and have flecainide “pill in the pocket” to take in case I notice any further episodes. The cardiologist did say it was likely I’ll eventually need an ablation but at the moment it’s controlled pretty well with the bisoprolol, and I’m back to doing cardio/weights/general exercise with no issues.
Interesting so many others have had occasional / intermittent symptoms and have had issues getting diagnosed.
I am seriously thinking of getting one of the kardiamobile devices suggested by jwt.
I really want to avoid getting into a time-eating cycle of being tested, told all healthy (when I’m pretty sure I’m not all healthy)
I want as much information lined up as possible for when I get my appointment with the cardiologist or further appointments with the GP.
£150 isn’t a great deal of money to shell out to hopefully get the process sped up by some margin.Posted 1 week ago
I would read a lot that put my mind at rest, and then read one paper that would make me question everything again. A cardiologist is the only answer though. Turns out they’ve read more than I ever could, do it for a living in fact, and probably not at 2 in the morning like I often did… 😉
I’m not sure it matters what you show them in advance really, or how much you spend on devices – at least not at this stage. They’ll arrange a battery of tests (I had ECG, 48 hour trace, echos and one MRI) until they reach a conclusion.
I was getting up to 15,000 ectopics a day (mostly atrial, 20% ventricular) which they still thought were harmless, lots of runs of bigenemy and trigenemy sometimes for hours (so, 20 ectopics a minute), all caught on tape. No fibrillation. Then literally one day they just stopped.
They come and go now, periods of quiet for months on end and then periods where it can get quite bad for a few weeks and then nothing again. Dehydration does me no favours, nor does alcohol and if I haven’t been riding much then I can feel them for a day or two after a really hard ride or turbo session. I ALWAYS get them now if I’m about to get a cold too, I’ll have a day or two of them before the sore throat/runny nose starts.
Sometimes I get them at the start of a ride for the first ten minutes or so, which 20 years later still freak me out (they started when I was 25) and I’ve never really learned to ignore them.
The empty feeling you describe, and the inability to get your HR up, sounds more viral than anything else – definitely something I’ve experienced before – but I don’t think it’s directly heart related. Until you’re told otherwise, try to relax. 🙂Posted 1 week ago
atrial fibrillation can show in a few different ways.
it can come and go sporadically. it can also become permanent to the stage where you heart prefers to be in AF.
i was in permanent af for about 4 years.
i showed the symptoms you are describing. dizziness, to passing out whilst trying to exercise.
racing heart rate, missing heartbeats.
go see a doctor,or go to the hospital, they will do a ecg, and keep you in if it is a serous episode.
oh, and be prepared for PAIN. ;o)Posted 1 week ago
I have been getting what I felt was loads of ectopics so had a 24 hr scan last week. Typically during that 24 hr period I don’t think I felt one missed beat!
Probably going for a echo next week to rule out any structural damage, however the cardiologist has told me if anything was seriously wrong I’d know about it given the amount of exercise I do.
Interestingly I don’t seem to have issues with my heartbeat when on bike, it’s usually when lounging about when my heart rate drops into the 40sPosted 1 week ago
OK, so I’m an actual cardiologist but usual caveats apply with regards to taking advice off someone on the internet etc. See your GP +/- a real life cardiologist is obviously my first piece of advice.
Benign ectopics usually occur at rest as per tpbiker’s experience. They should go away on exertion. You didn’t say whether you got palpitations during your ride when you nearly collapsed? That episode might be unrelated to your ectopics but clearly needs investigating a bit further.
My advice would be to gather as much evidence for the GP/cardiologist as possible. Write down or commit to memory exactly what the near collapse episode felt like – what you were doing beforehand, how the episode started and ended, and how you felt during it. Take along your HR monitor readings – especially as you say that your HR didn’t go as high as you would have expected during the episode.
You’ve probably bought yourself some ambulatory heart rate monitoring (the walkman device described above) and maybe an echo (ultrasound) scan of the heart as well. Investing in a device to monitor your heart rate and rhythm can be a double edged sword – it could be the only way of catching an episode and documenting your heart rhythm, but could also be a significant source of worry for you. Only you know which is more likely!
If another episode happens, have a feel of your pulse if you can and document its rate and whether it feels regular or irregular. That’s low-tech but surprisingly helpful for us. If it’s a prolonged episode, go somewhere that can record an ECG while you still have symptoms (GP, walk-in centre, A+E). If you feel unwell – 999.Posted 1 week ago
The empty feeling you describe, and the inability to get your HR up, sounds more viral than anything else – definitely something I’ve experienced before – but I don’t think it’s directly heart related. Until you’re told otherwise, try to relax. 🙂
Yeah, in general I would probably agree with that. People seem to naturally leap to a presumed worst-case scenario (heart disease) when inability to exercise in otherwise healthy people is most likely something much more benign. But as others have said, AF is a plausible explanation here and it should be looked into. Be prepared for someone to tell you that your heart is fine, and that they don’t have an explanation for your symptoms. Which is a good thing really, but IME often not what people want to hear.
£150 isn’t a great deal of money to shell out to hopefully get the process sped up by some margin.
FYI anyone thinking of buying one, the cheapest I believe is via the Arrhythmia Alliance website @ £80.
I haven’t checked, but I imagine there are used ones on eBay which will work fine too, since I guess people get rid once they have a diagnosis (or not, as the case may be).
The Kardia device is tiny so very portable providing you remember it. They used to do a phone case for it which was pretty cool, not sure if that’s still available. But of course any device is pretty useless if you don’t have it with you. For that reason, the Apple Watch (whichever one has the proper ECG) is not a bad idea if you’re in the market for a smart watch anyway. It additionally has automatic AF detection, I believe.
General thoughts. Not medical advice. I am a heart rhythm doctor, but not your doctor.
EDIT: Also what Lego said ^^^Posted 1 week ago
My friend’s GP practice loan out those kardia devices and have had good success with recording arrhythmias for patients, good bit of gear.Posted 1 week ago
You had an ecg thing – No problems, and it would tell them if there was a problem, or you’d caused any sort of damage. Nothing shows there theres nothing but worry itself maybe driving things
You keep fit, you cycle, workout(whats that exactly 😕 i dunno :lol:)
You probably eat healthily, I dont consider for a minute you are an alcoholic packing away a liter of vodka a day, probably drink more or less the same as most here(a few obvious exceptions aside 😉 )
Indigestion ?, a bit of dehydration , or just worry.
My story is probably worse that everyone else here in that I hardly eat, some days have little more than a bit of cheese. I’ve sat on my lazy arse for the last 18 months, putting on a bit of a gut, I sleep sporadically and smoke like a chimney in the 1800’s. Legs fubar, but thats part and parcel of something else and not heart related, but I can still cycle about a bit, still do say 15 or 20 miles to city center and back and while a struggle, its no more than anyone would really face after a day out and a 7/8 mile home trip up hill into the wind. I aint no spring chicken at er…50 ish
All in all you soumd, at least lifestyle wise fit as a fiddle, so maybe its just a case of worrying needlessly and that in itself is playing in your mind as something its not. The ECG would tell them if you are at risk of a heart attack, and coming back clear its not that and no they havent missed any warning sign.
Keep in mind this last year has been not only a strain but also a total change to routine. And that might be all it is, this past year of doing far less, add some aging, and this worry from the pandemic has everyone in a state, add in some less than active and have an internal hiccup and worry its a sure sign youre going to drop dead by tomorrow lunchtime.
It could even be a sign youre a bit rundown, maybe ever overdoing it, or maybe overdoing it and not getting enough food fuel because thanks to the pandemic your overall intakes are down,stuck in, lack of sunlight, so you go for a blast, totally overdo it and feel knackered because of that.
As above see a dr, though sounds as if you have and they’re reporting nothing as a surety so why continue to worry about it. Ask for a blood test(or 3) and im sure its nothing, innocuous.
” Being tired all the time can also be a sign of vitamin deficiency. This could include low levels of vitamin D, vitamin B-12, iron, magnesium, or potassium. A routine blood test can help identify a deficiency. ”Posted 1 week ago
Have some bananas and a slice of cow 😕
Thanks for the responses everyone, I really appreciate it.
Regarding Legolam’s questions:
When I first noticed the ectopics around Christmas, I was pretty certain they were only at rest. However more recently I have caught them happening a few times when exercising, generally when working pretty hard 150-160bpm ish up a climb when I can feel my heart pounding (as I would feel it pounding normally – just a momentary gap)
I’ve never noticed it racing or being irregular (other than the missed beat ectopics)
Was my heart irregular when I nearly collapsed?
I’m pretty sure it wasn’t, but I can’t be certain about that. I’m fairly attuned to what it’s doing and it ‘seemed’ to be beating regularly.
In other news I went for a moderately fast hour’s walk this evening to see what happened (a&e and gp both said fine to keep on exercising moderately).
At heart rate of about 90bpm I did notice a few feelings of my heart ‘dropping out’ (could be ectopics?).
It was a similar feeling as I got at the beginning when I nearly collapsed, except it didn’t deteriorate from there (as it did yesterday morning) and instead was just a momentary thing and recovered with no ill effects beyond.
Decided to buy the KardiaPosted 1 week ago
I’ve been getting quite a few ectopic beats lately, which is unusual for me (though I did go through a phase a few years back). I can feel them clearly, and have had them whilst feeling my pulse, and they fit very well with descriptions that I’ve read of PVCs so I’m not overly concerned. I had a COVID vaccine a couple of weeks back, and also there’s a cold going round our household (we’ve done lateral flow tests so unlikely to be the ‘rona!) so I’m wondering if it’s related to my immune system being taxed.
I wondered about getting one of those Kardia devices, but one thing I wondered is how much more useful the 6 lead one is. On the face of it, the app only uses lead 1 to spot AF and not much else, so without access to an expert the extra leads are useless. But supposing I ended up showing the data to a cardiologist, would the extra channels be very useful?Posted 1 week ago
Decided to buy the Kardia
Problem there is you might find yourself using it more and more. Maybe addictively so, which in itself can cause a problem.
I’d a bout of something a bit back, seemingly running a temperature so i bought one of those ear thermometers. Couldnt stop using it, I was worried something was seriously amiss, even though it gave me a normal reading. I must have been taking my temperature 20 times a day.
Turned out to be nothing and in a few days whatever it was had passed.Posted 1 week ago
But supposing I ended up showing the data to a cardiologist, would the extra channels be very useful?
Barely useful at all for heart rhythm stuff – just get the basic one.Posted 1 week ago
Problem there is you might find yourself using it more and more. Maybe addictively so, which in itself can cause a problem.
Yeah agree that is a risk. I wouldn’t bother if it was just the occasional benign ectopic, seems like it is something more significant.Posted 1 week ago
Ultimately I’d rather risk being worried for the chance of logging data that could help pinpoint something that may be serious
A collague has recently had trouble with palpitations and he was recommended this app for getting a record of them by a doctor (a GP I believe):
It uses the accelerometers in your smartphone to detect heart activity. You lie down and place the phone on your chest. Free version allows two recordings, have to pay if you want more.Posted 1 week ago
Taking an ECG with the ECG app on Apple Watch Series 4, Series 5, or Series 6
One mate got the kardio mobile as when he was on an ecg, or given a 24 ecg to wear at home he never had an ‘episode’, eventually it provided enough data for him to have an ablation and he hasn’t had trouble since.Posted 1 week ago
The other guy has borrowed his kardio and is collecting data for similar reasons.
Our local NHS trust CIU unit loan these to patients for similar reasons along with the usual 24 hr ecg Willard mentions.
I am not clinical and would advise you to seek professional help, the frustrating part can be you’ll be fine on the day they examine you, but if you have data from something like the kardio it may help point the clinicians in the right direction.
Hope it all works out.
Echocardiogram in Cardiology as soon as possible after referral from GP. Detect any abnormalities then further investigation if needed. I recently met someone who had cardiac amyloidosis which is thickening of the heart muscle walls making it more difficult to breathe.Posted 1 week ago
Hi O.P, your symptoms sound very much the same as how mine started out around 2 years ago. I don’t intend to cause alarm at all, I think you are doing the right thing in paying attention to whats going on here.Posted 1 week ago
I put my symptoms down to getting older, riding less and being unfit, and perhaps a bit of stress caused by our upcoming wedding.
To cut a very long story short I ignored it for around a year, and eventually, one morning when my wife was away skiing with her brother I ended up with palpitations so bad that I was at home alone and unable to get off the living room floor. A neighbour took me to A&E where they diagnosed anxiety – this was after I told them that my GP had done and ecg and diagnosed an arrythmia…. 5 minutes after making his anxiety diagnosis I passed out in front of him. He quickly changed his mind and I ended up being sent to a bigger hospital. I continued to pass out multiple times and eventually they diagnosed A.F, prescribed some bisoprolol and a couple of weeks off work. The palpitations hadn’t disappeared, but they seemed a lot better, then, a few days after starting back at work I got really light headed and started passing out again. I then spent another week in the hospital where the guys in the cardiology department were scratching their heads for a while. They eventually diagnosed atrial tachycardia and for over 12 months now I’ve been on Flecanide and Bisoprolol whilst waiting for an ablation, but covid has delayed that somewhat.
Because I’d left it so long before going to the G.P and things escalated to the point where I ended up passing out I lost my driving licence for a year. If I’d been medicated sooner and not passed out it would’ve only been a month without driving.
My advice would be keep doing what you’re doing and don’t be tempted to ignore it. These things can change, and professionals can miss things.
I can attest to Legolamb’s qualifications – PhD, Consultant and provides informal calm re my own PVC related anxiety.
Good luck OP – when my Ectopics (when I got briefly admitted to a ward they were 20 per min) were really bad (mine came on at rest after intense exercise or stress/cold/tiredness), my BP was in my boots and my radial pulse vanished (according to medically trained p20). I felt shit. MRI, echo, several 24 hour tapes, stress test and all has come back fine. I now take low level of beta blockers every day and haven’t had an episode for over a year. On legolambs advice I ensure I keep up my hydration and regularly use hydration salts in my water bottle.
Totally my own personal experience but wishing you the best of luck as it’s unpleasant and scary.Posted 1 week ago
So I’ve been taking it steady the last few days, a few light effort walks and rides.
Whatever it is, it seems like it might be brought on with exercise now.
If I’m just sitting down or if I keep my effort very low I don’t get any problems, however if that goes up to moderate then I get a fluttering in my chest and a kind of thumping feeling.
I don’t know whether actually it was doing this before (but possibly less so) when I was exercising. I may just have been mentally blocking it out, not wanting to believe it.
At no point do I seem to get a tachycardia (racing heart) response.
Anyway I’m keeping a diary of everything that goes on now.Posted 1 week ago
ECG at the GP tomorrow. I wonder if they can wheel it around after me while I try to provoke the response.
Not got cardiology referral date yet, hope it comes quickly.
I too have been experiencing sporadic and intermittent heart issues the latest of which was in January.Posted 1 week ago
This occurred whilst sat working at my desk and felt like stabbing pain in my chest and very sweaty palms for 5 minutes or so. I spoke with my GP and had an ECG which came back normal.
I felt like I was being fobbed off a bit tbh so arranged a referral and saw a cardiologist the following week.
We discussed health and family history which fir me is relevant due to my dad having a fatal heart attack out of the blue at 55. Anyway, he performed an ECG, Echocardiogram, ECG on a treadmill, xrays and a 48 hour ECG. He found nothing wrong and I was diagnosed with sporadic ectopic heartbeats. I’ve not had any noticable occurrences since but worth while getting a referral.
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