Can stress and lack of sleep cause irregular beats on an ECG?

Question

Hello doctor,

I took an ECG using a device. I have been experiencing these irregular beats for about a week. Sometimes, I also feel slight chest pain, though I am not sure if it is just a placebo effect. My uncle, who is a doctor, thinks these might be ectopic beats related to lack of sleep and stress. I often wake up with breathing-related issues, usually just as I am about to fall asleep. Earlier this week, I had a good night’s sleep, and the heart issue seemed to disappear for the day. I have made significant changes to my lifestyle over the past week because this has really freaked me out. I am not overly worried if this is the diagnosis, but I want to check with a cardiologist.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

These extra beats are called premature ventricular complexes (PVCs). Normally, the heartbeat is caused by an electric current in microvolts, which is generated in an area of the heart called the sinus node. This current travels from one part of the heart to another, from the atria to the ventricles. While the sinus node generates the main current, other parts of the heart, including the ventricles, also generate currents, but these are not typically evident on an ECG (electrocardiogram) because they are canceled out by the current from the sinus node. Sometimes, when the sinus node current is slowed or ventricular tissue is irritated, the ventricles generate their own current, which travels through the entire ventricle and causes it to contract. This is called a premature ventricular contraction.

In healthy young people, some PVCs are normal and of no concern. Other common causes, as your uncle mentioned, include anxiety, and excessive consumption of coffee, tea, or certain medications. In your ECG, your heart rate is between 50 and 60, which is normal for fit young people at rest, so some PVCs may appear. These PVCs typically occur at rest when the heart rate is slow, and they tend to disappear when the heart rate increases, such as during walking or exercise, which is normal. I would recommend avoiding anxiety, refraining from alcohol (if you drink), and consuming tea or coffee in moderation. To be on the safe side, a blood test called serum electrolytes may be done to check potassium levels (low or high potassium levels can cause some heart rhythm problems).

To summarize, there is no need to worry; this is normal. For follow-up, please provide the following information so I can guide you further: a complete 12-lead ECG, any family history of sudden death or heart attacks (especially in first-degree relatives), and any history of loss of consciousness.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

It is not urgent, just relax.

Thank you.