What causes severe heart palpitations?

Question

Hello doctor,

Symptoms are heart palpitation and continuous nonstop neck crack that pains my cervical spine also. I randomly have episodes of heart palpitations, one time I jumped 3 feet out of my bed suddenly being shocked by a hard fast-beating heart palpitation that lasted for seven seconds, that was scary, it felt my heart was going to burst out of my chest and the beat reached my upper chest to my throat and neck, it is not a heartbeat that we get from playing sports, it was a weird episode of heart beats. After that incident in months, maybe a year I then got an episode of heart palpitations like that intensity but this time it lasted for 15 minutes going and coming with sweat only. Then after that, I just get them randomly while sleeping and awake for 1 or 2 seconds and now mostly when I pee standing up it also appears for a quick second and goes. I did CT scan and sonar heart tests and all doctors said my heart is fine, I also wore a Holter scan for 24 hours and still results say my heart is normal, but the issue here while doing the tests and wearing the 24-hour Holter I surprisingly had no heart palpitations. I am really worried, can you educate me on what test I have to do. When I shower I get tired a bit and have heartbeats that are not palpitations, they are just heart beating as if I am playing a sport, soccer or something, I get that quick beats when I pee, when I pray going on floor, when I walk up one simple set of stairs, and right before closing my eyes and full crashing to sleep I then suddenly wakeup having heartbeats. It is like brain telling me not to sleep as soon as I close my eyes falling into sleep it starts again, when I laugh hard it beats like I am playing sports, every small activity causes my heart to beat normal but the heartbeat speed is like when I am playing sports and running. And as I mentioned, sometimes I get quick palpitations that are different than fast heartbeats, it is like my heart is racing to get out of throat for second or so. Another really really main concern I am so worried about is that in my chest, in my lungs I feel a window of 1 to 3 seconds of tingly or bubbly feeling that reaches my throat, it has no pain and it is not heartburn, and it appears always, like every 1 minute or sometimes every 5 or 10 minutes or more and sometimes for seconds. It is a feeling of very small lighting or like a line that is slowly traveling from my chest up to my throat then back down to the chest and gives me sometimes a closed throat or cry throat feeling for a split second then goes back down to the chest. What should I do? I have incredible stress and anxiety, I sleep at 10 AM, sometimes 11 AM and wake up by 6 PM and cycle repeats. I think a lot and am afraid of what will happen.

Answer 1

Hello,

Welcome to icliniq.com.

Listening to your symptoms, the possibility which we need to rule out is of cardiac arrhythmia like atrial fibrillation or PSVT (paroxysmal supraventricular tachycardia). They occur intermittently so may not be picked up on Holter monitoring as you did not have those symptoms during Holter monitoring. It is better if you can attach your ECG and other reports if you have. Most of the cases these are not life threatening although it may give uncomfortable sensations. So, firstly calm yourself and stop thinking anything bad. So, if you are having these symptoms on daily basis now, I would advise you repeat holter or even 48 hour Holter or may need long term monitors like implantable loop recorder if Holter is not successful. If it picks then it is fine otherwise you may need elctrophysiological studies which are invasive tests and should be a last option. So, at present, please attach your reports and go for repeat Holter preferably 48 hours. And if this not successful again then we can think of other options.

Answer 2

Hi,

Welcome back to icliniq.com.

I have gone through it. It does not appear serious to me. There is certainly a possibility of cardiac arrhythmia like ventricular ectopics or less likely atrial fibrillation or PSVT (paroxysmal supraventricular tachycardia) which are not life-threatening usually. Ventricular ectopics can cause similar symptoms which may be commonly seen in young individuals like you. Also, anxiety is contributing to your symptoms. You should calm yourself. At present, you do not need any major test other than repeat holter monitoring, because unless and until we confirm the diagnosis, we cannot go ahead. So, in my opinion, it is better to go ahead with repeat Holter only as you did not have symptoms during last Holter monitoring and if it is unsuccessful, then we can go ahead with extended monitors.

What causes severe heart palpitations?

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