pulsatile tinnitus with palps

[Madge270]

I recently began having periods during each day when my heart would start to pound hard and I could hear it pounding loudly in my right hear.  My pulse was somewhat faster when this happened, but  not extremely so, and usually it would go away in a little while. Because I sometimes get PVCs (a type of heart arrhythmia), I ignored the pounding episodes at first, because during them my heartbeat is always regular. But lately, I've had short bursts of very loud heart pounding, even thought my heart was only beating  at from 90 to 120 beats a minute.  I will hear the heartbeat very loudly in my ear, a low sound, not a whooshing sensation.  Within a minute or so, it the loud heartbeat stops.

Usually this has happened after a bad dream (at night), or when moving quickly. But there are other times when I walk fast, carry heavy groceries, etc., and the palpitations don't occur. So I am mystified by this.

My ear doctor did do an MRI of my head (with contrast dye) and he found no evidence of an aneurysm or other problem.  My regular doctor listened to my carotid arteries (neck and head) with a stethoscope, and said things were okay. He also noted that I had hadn't had any arrhythmia during the time I was being checked.  Of course, the following day I had the arrhythmia (PVCs) for several hours. I saw a cardiologist two years ago when I first developed the arrhythmia (about 8000 goofy beats a day), and tests showed that (at that time anyway) my heart was structurally normal except for slight mitral valve floppiness. So I was told I didn't need a beta blocker and not to worry. I don't let the PVCs get me down.

But I do wonder why the sudden hard palps with louder pounding in my ear are occuring this last week.  They don't last long, but I have no idea what triggers them or why. Anyone else ever experience this?

[CCF HeartMD6]

Having PVC's can sometimes be left untreated -- but if you are having ongoing symptoms (such as your palpitations), it is best to continue to be followed by a physician (preferrably a cardiologist) who may decide to treat you, especially if it is affecting your quality of life. Other tests such as a holter monitor (or loop recorder) might also be indicated to determine the burden of your PVC's -- as if it is significant, this may potentially lead to more problems later in life.

[Madge270]

Thank you very much for your advice.  My PVCs don't bother me much. In fact I'm often not aware of them unless I notice a tickly cough.  I had on a 48 hour Holter monitor when I as first diagnosed (two years ago), and at that time I had about 8000 PVCs a day.  My cardiologist (EP) noted that I got them when my heart rate was slower, and that they seemed to disappear when my pulse was over 85 beats a minute. He said I needn't take a beta blocker unless I felt the PVCs were uncomfortable.  I was satisfied with not taking a beta blocker since it would just slow my heart rate down (and thus I'd probably have more PVCs).  

Also, I once tried a beta blocker for migraines (a decade ago) and felt like a zombie. I couldn't go to work (very tired) and had problems with very low pulse and blood pressure, I'd rather not take one again.  It also gave me real problems with heartburn, not a good thing for a GERD sufferer.

My cardiologist suggested taking a fairly low-dose combo of calcium, magnesium, and D3, and I've done so for a year.  I don't know whether that has helped, or whether my PVCs just became less frequent on their own, but I now rarely notice them. My doctor hasn't detected any either in my last few checkups.  I do have a pounding heart sometimes now, but the beat is always regular.  Not sure what to make of this.

Maybe, as you suggested, I should have another Holter monitor done sometime, just to be sure that I'm not having PVCs (that they are there but I just don't feel them). I wouldn't want to have more problems later on in life.  (?)  Again, thanks for your input.