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Q. Is it possible to have strong heartbeat with normal heart rate?

Answered by
Dr. Salam Salloum
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 01, 2020

Hi doctor,

I am 46 years old, on no medication apart from Zinc daily that seems to help with my low testosterone. BP averages about 110/63 mmHg, resting pulse between 58 and 65 bpm. My height is 5' 10" and weigh about 75 kg.

About five years ago, I noticed odd heart rhythms after playing two hours of badminton. I ignored them for months, but one day after stopping and bending over I had a large clonk in my heart and it took off like a rocket (about 140bpm), after five to ten minutes it clonked back to normal speed. This happened about four times over two to three weeks, and has never happened again for the past four years.

I had a stress test, 12 lead ECG and echo and two weeks Holter. All was fine and no more SVT's. I had a repeat ECG and echo a few months ago, and all is well apart from the odd strong ectopic.

I do however still have an issue, every now and then (like the past two weeks) for no reason at all my heartbeat becomes very strong (still steady and not fast in the 60's at rest), and I feel it almost all the time to the point I can see my handshake to my heartbeat whilst holding a phone, etc. I feel fine, but it is very hard to relax and sleep as it is banging really hard. I am generally aware of my heartbeat, but this is on a different level. It is not linked to stress or any external influence that I know of, and I have checked my BP whilst it feels strong and it is the usual 110/60.

My question is, are there any physical reasons for this (e.g. my dad had angina and triple bypass), and is there anything I can do to help it? Also, if I had blocked arteries would the ECGs, stress test and echo's have picked this up at all? I was offered beta-blockers by my GP which I refused as my heartbeat is not fast.

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Hi,

Welcome to icliniq.com.

It seems that all the tests you had are reassuring. What you are describing seems to me as ectopics and a small dose of beta blockers could help. But if the resting heart rate is less then 65 bpm then better to avoid them. In this case, if the ectopics burden is very high they can be ablated.

Stress tests (except exercise ECG) will pick up old infarct resulted from blocked arteries. I doubt that this is the case here.

Thank you doctor,

If I get an ectopic I normally feel it and my pulse is strong and steady. Also during an ECG a couple of months back I could feel my heart beating strongly like now, however, the ECG was perfect.

Is it possible for someone to simply feel their heartbeat strongly at times without there being any underlying worrying issue? And can there be a reason for having a very strong yet slow heartbeat? A consultant once did say I had a lot of adrenaline, and have had high normal variant Cortisol readings at times.

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Hi,

Welcome back to icliniq.com.

Yes, it is quite common for sporty people mainly to feel their normal heartbeat strong. It is very reassuring that when you felt your heartbeat strong, the ECG was completely normal. In my opinion, if this is the case, you do not need any tablets.


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