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Forum Name: Cardiology Symptoms

Question: Can Feel Heart Beat when at rest, tightness in chest


 plowboy - Thu Sep 25, 2008 9:17 am

I am 44 years old and on 7/31/08, while driving back to work, i felt a flutter in the center of my chest, no pain, just like 3 or 4 bubbles moving up. I started feeling kindof weak and like I needed to catch a breath, I had no pain, just a funny feeling of weakness and shortness of breath, like I might pass out. I drove myself to the ER where i was admitted and they did chest xrays, blood work, and a nuclear stress test the next morning where they got my heart rate up to 167 and the cardiologoit found no abnormalites other than my BP was 179/109 when I walked into the ER. I was released on 5mg of LInsiprol for HBP which I began taking. I felt okay when I left the Hospital but by about the third day I was feeling weak and did not want to eat anything. I also felt my heart beating hard, but not fast when i layed down or sat down. I went back the doctor and told him i still did not feel right. Based on my father's history of heart problems, he sent me to a Cardiologist for a CAth. I had a Heart cath on August 12th and the doctor told me I had "great looking arteiries". I still seem to have trouble getting back to normal. I have started walking/jogging 4 miles a day and haved changed my eating habits. I have lost from 270 on 7/31/08 to 244 as of 9/25/08.(I am 6"2" tall) I came off my BP medicine after the cath and now my bp runs around 135/85 sometimes a little higher sometimes a little lower. My pulse rate in the morning is around the high 50's low 60's. My FBS is around 110 each morning. I still feel tight in my chest, sometimes feel like a lump in the bottom of my throat, and when i am sitting or laying down, I can feel my heart beating hard, but not fast. This is really bothering me. I had a full blood workup done a few weeks ago and everything was normal (Lipids were: LDL 105, HDG: 31, Chol: 155, Trig: 205).
Is it just stress or do you have any suggestions?
 John Kenyon, CNA - Wed Oct 01, 2008 10:19 pm

User avatar Hi plowboy -

The initial sensation you experienced sounds like it was probably a "salvo" of premature heartbeats, something that happens fairly commonly in the general population. Sometimes we notice them, sometimes not. If the timing is right they can be very alarming, and one thing leads to another, anxiety-wise, and we wind up at the ER. You've now had an absolutely complete cardiac workup and have been declared very heart healthy. That's the good news. The bad news is that anxiety will stick with us more tenaciously than heart problems sometimes. Your rather high BP on arrival at the ER was undoubtedly due to your alarm over what you preceived to be something wrong with your heart. This happens to a lot of people, and they usually aren't placed on medication right away, but followed up, usually with a normalization of BP such as you now show.

You've lost a lot of weight in a fairly short time, which will change a lot of things, especially the way you perceive bodily sensations, so that may, in part, account for your newfound awareness of your heartbeat. So long as it's not fast or irregular there's no reason for concern over this, even though it didn't happen before. Oh, and before I forget, congratulations on that big weight loss and keep up the good work!

All your other numbers are absolutely wonderful. Your heart is clearly in excellent health, but you may have now developed some anxiety problems. Hopefully as you continue to improve your overall heatlh by losing weight, staying fit, etc., this will start to go away (you have to get used to the "new body" and its new sensations, which is still a work in progress). If it doesn't go away, by all means bring this to the attention of your doctor. If necessary there are some very effective anti-anxiety medications that can be tried, but it's always better if you can learn to manage anxiety and stress on your own.

I really believe if you can get a handle on the anxiety and stress you will feel like a new man. Concentrate on the awareness that you have been proven to be extremely healthy (you run 4 miles a day! That alone is extremely impressive) and try to just let go of the subjective sensations you have become aware of. I know, it's easy for me to say, but trust me, it can be done, and you'll enjoy life a lot more if you're able to do it. It will also be another tremendous accomplishment in which you can take pride.

Best of luck to you.
 plowboy - Fri Oct 03, 2008 9:42 am

Doc,

Thanks for your response. I went back to my GP for a checkup on 10/1 and he put me on some Prevacid. I did not mention in my other post that about 8 months ago I had woke up in the middle of the night choking on yellow stomach bile. It took me about 45 minutes to get straightned out and it burned my windpipe and throat like you wouldn't believe. I burp and belch constantly and he thinks I probably have GERD, which is probably right. I have felt better already in my chest concerning the tightness, although I sitll notice the "forceful" beat of my heart which I have never noticed before. About a week after the CATH, I called back to the Cardologist office and spoke with a nurse and told her I still had the sensation of my heart beating "strong" and "forceful" but not fast or irregular as best as I could tell. She said that they had checked my "plumbing" and all of that was fine, unless I had an electrical problem. She said I might want to wear an 24 hour holter moniter. I mentioned it on 10/1 to my GP and he did not think it was neccassary to wear a holter moniter since they had monitered my heart for 24 hours back on 7/31 and also did several EKG's and also a cardilogist had monitered my rythem during the treadmill stress test. I don't' know what they check beside your arteries during a CATH, but I guess they check the heart and can tell if if is not pumping right. So I have made up my mind to try to put the "forceful" beat out of my mind and live my normal life and trust in God, since I have done my "due diligence" and look for that awareness to go away. Thanks again for taking the time to respond to my post.

Blessings to you,

PlowBoy
 John Kenyon, CNA - Fri Oct 03, 2008 2:53 pm

User avatar Hello again -

You almost certainly do suffer from GERD. This is usually more of a problem at night because one is horizontal and stomach contents, which are supposed to stay in the stomach, are able to wash back up into the esophagus, as you described. This is what sometimes causes otherwise inexplicable asthma, too.

I'd have to agree with your cardiologist that a Holter monitor would be redundant this soon after the last one, unless, of course, you developed some concrete new symptoms suggesting significant heartbeat irregularity. Forceful beating is not the same, and while it is annoying once it's been noticed (and hard to stop noticing) is is often a simple matter of perception only.

During a cardiac cath (angiogram) the arteries supplying the heart are visualized for shape, smoothness, and the presence or absence of plaque of actual blockages. During this procedure the doctor is also able to measure the size of the chambers, the way they move (normal or sluggish), can visualize the aortic outflow tract for obstruction, and can measure the left ventricular ejection fraction (LVEF). This is very nearly all the important information there is to be known about a given heart. So you're in good shape there.

Best of luck with the plan to start trying to let go of the awareness of your heart's beating, and give the whole thing over to a higher power, as you certainly have done your due diligence. You should do just fine.

You're very welcome. Thanks for using this site, and please follow up with us as needed.

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