?? about palpitations

  1. Ok, I know you guys don't do diagnoses, nor do I think you should. That said, I just want some input/ideas. Here's the scenario (sorry it's so long!)

    A couple weeks ago, I started having palpitations one evening for no particular reason. Never had that before. Kinda scared me, so I hauled my butt to the ER. Doc there told me I have a sinus dysrhythmia and a II/VI systolic murmer. He said my EKG was normal, and didn't do anything else. Didn't seem concerned at all. Said everyone has extra heartbeats now and then. Told me to see my doc and get a Holter and echo done.

    Since I'm at school, (and cuz of SARS precautions- I'm in Ontario) I haven't had the follow-up tests done yet. I went to the student health services, but the doc I saw there told me I could book the tests myself. (?) (also, because of SARS precautions the hospital's closed, so I haven't tried to book the tests through there.) I'm planning on waiting till I go home (end of Apr.) and seeing my family doc then.

    So, my question is basically, any ideas as to what's going on with me? I don't smoke, no ETOH, no caffeine beyond an occasional choc. chip cookie... no meds/drugs... not especially stressed... get 7-8h sleep most nights. No CP, SOB, N/V, dizziness, etc. totally asymptomatic except for feeling the palpitations (I think that's everything they asked!)

    They come and go, usually last ~30 min at a time, and occur about every 4-30th beat (and sometimes 2 in a row). Listening to it, when there's a palpitation it sounds like 2 beats right in a row. Also, after a "double beat"/palpitation, there's a bit longer interval before the next beat. Seems to be worse in the evening, and when I'm really tired.

    Pulse rate is in normal range (~80bpm) although when I am not having the palpitations it sits around 60. BP was high at the ER (~150/100) but is back to normal (100/60). I'm thinking it was high b/c of anxiety.

    Any ideas as to what might be going on? Is this a common thing? I'm not so much worried as curious, so don't bother telling me to stop worrying, etc. And I AM planning on seeing my doc!

    Thanks!
    ~ Maeyken
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    About maeyken

    Joined: Mar '03; Posts: 231; Likes: 31
    Operating Room RN; from CA
    Specialty: 4 year(s) of experience in Operating Room (and a bit of med/surg)

    8 Comments

  3. by   passing thru
    So, what was your diagnosis?
  4. by   gwenith
    Palpatations are SOMETIMES caused by extra beats that the heart does a bit like adding a quick two step while doing a waltz.

    If it is sustained over 10 seconds I would be worried or if you start feeling giddy/dizzy with it then go to the nearest hospital/medical centre. In the meantime go back to the doc who told you to "book it yourself" and explain that you do not know how, at present you are able to do this. Act dumb and don't leave until he is a little more helpful.
  5. by   ton
    there are a lot of people with palpitations, as long as you are not dizzy ,then don't worry about it.
    Your EKG is normal, try to take a little more rest. Be sure your Na K is normal.
    (maybe the little bit stress has something to do with it!)
  6. by   MrDefib
    I assume your are young (<25 yo). It is not uncommon for people your age to have an irregular rhythm. This is callled sinus arrhythmia. As far as the palpitations, they can be caused by stress. As a nursing student, I am sure you are under tremendous stress. You should not be concerned with them and most cardiologist would not treat you for them.

    Lastly, I would not be concerned about your "murmur" unless you are having problems with shortness of breath, fatigue or signs of heart failure.

    Hope this helps and good luck in school.

    :roll
  7. by   maeyken
    Hi everyone,

    Well, I had the tests done, and the conclusion was that nothing is wrong... just extra beats. I had an echo and a 24h holter (which actually turned into a 48h holter cuz the batteries died the first time!!) great fun....

    But my doc said now that I've noticed the extra beats, I'll probably always feel them... kinda annoying! I have noticed though, that I feel them more often if I'm really tired or nervous about something... But at least now I know there's nothing wrong

    Oh, also my NP said she couldn't even hear the murmer... so who knows about that!!

    Thanks for all your comments
    ~ Mae
  8. by   catlabrn
    Try cutting back on caffeine.

    If the palpitations really interfere with your life, call a cardiologist. You may wind up with an implanted loop recorder to watch things for an extended period of time. They're easy to place and easy to remove.
  9. by   maeyken
    No caffeine for me! It makes me all shakey and my heart rate really increases... not for me!! but thanks for the info

    ~ mae
  10. by   MrDefib
    Originally posted by catlabrn
    Try cutting back on caffeine.

    If the palpitations really interfere with your life, call a cardiologist. You may wind up with an implanted loop recorder to watch things for an extended period of time. They're easy to place and easy to remove.
    This is not a good idea. These devices are expensive and cost money to put in and take out. We only use them for patients who have had unexplained syncope and then only after they have had a very complete workup, including EPS. Even after that, our diagnostic yield has been very low.

    We use external event recorders and have very good yield as a fraction of the cost.

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