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Forum Name: Cardiology Diagnostics

Question: Persistent Palpitations


 greystones295 - Sun Nov 08, 2009 4:48 pm

I have palpitations at least twice a week and each time they last for approx 10/15 minutes and are uncomfortable (not painful). I have had a 24 holter monitor and during that time I felt no palpitations and none were recorded, as a result my doctor is not concerned. As the palpitations are not stopping I am worried that there is something going on - should I be concerned?
 John Kenyon, CNA - Tue Nov 24, 2009 10:40 pm

User avatar Hi there -- What you describe is infuriatingly common and almost never a cause for concern. It is nice when it can be caught on Holter monitor, but if it is the most common source of palpitations (premature ventricular or atrial contractions, PVCs and PACs) these occur so randomly and can be aggravated by so many innocent things that it's very difficult to know it will happen during a given 24 hour period, so the Holter monitor becomes only about half-useful as proof of what's going on. The good news is if the palpitations are that random they really aren't much of an issue, although the tolerance (emotional) of people can vary tremendously. Nearly all of us have some of these and some of us have them virtually all the time. Some feel them and some don't. If one doesn't feel them they don't even qualify as palpititions, but you do feel them, so you definitely need the reassurance that they are not diagnostic nor are they predictive of anything, even in a clinical setting. That doesn't make them less unpleasant, but knowing they are harmless sometimes is helpful in learning to disregard them.

I hope this answer doesn't sound cavalier, because it isn't intended that way. I'm well aware of the emotional havoc this can cause for some people, and usually it's in part because a clinician fails to adequately explain and reassure the patient. Many doctors either believe they've accomplished this because they are not pressed further by the patient, or simply don't feel it's worth the time. I happen to know it can be worth a good deal of time if it can ease the patient's mind. It is a very nasty sensation at worst, totally imperceptible at best, but it is virtually never of any consequence medically. Only when rapid, sustained palpitation lasting minutes to hours continuously, with other symptoms (lightheadedness, shortness of breath) suggest an irregular or too-fast tachycardia, is further medical exploration or intervention required, and even then half the time (at least) the problem is benign. But simple PVCs and PACs are so common they are almost ubiquitious in the healthy population. If they are a real bother, avoiding caffeine, managing stress, remembering they occur more often in the evening and after meals and at bedtime all may be useful. Other than that, well, it's like sneezing or hiccups. Honest. :)

Hope this is helpful. Good luck to you and please don't hestitate to follow up with us here as needed.
 candyman33 - Fri Jul 23, 2010 10:30 am

i sarted having some sharp pains in my chest in mid Febuary. they would come and go. i got worried so i went to doctor. they ran ekg's and said that it was nothing. long story short i went to ER one noght with this. they ran ultra sound of kindney, gall bladder, and other things and found nothing. they admitted me to hospital overnight and ran cbc on blood and did echo cardiogram, ct scan of heart. i also wore a heart monitor for 24hrs the next day. said that everything looked good and that he saw pvc but nothing to worry about. This has been going on for 4 months now and has about gotten the best of me. i am very stressed about this. i have had more blood work ran since this began and also have had an EDG, CT Scan of head, chest x-rays and been to a pulminary doctor. no answers. i have a wierd sensation in my arms and my heart feels like it is beating alot harder than normal and i feel it all over my body. it happens during the day and when i lay down at night. once i get to sleep, i sleep well. only a few times has this woke me up. i also get a flush to the face a good bit. my blood pressure has always been pretty good. my cardiologist had mentioned something about Beta Blockers. Is this a good idea. i think that my regular physician thinks i am going crazy but something is going on and its about to get the best of me. open for any suggestions please!

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