Palpitations ... Could my doc be missing something?

[JayPalm]

Hello all-
I went to get a EKG yesterday after having frequent "skipped beats" and chest pains that galvanized me to see my doctor, who recommended me for an EKG. Today the results came in, and everything checked out normally. I've had palpitations in the past, but they went away and I attributed them to not enough sleep during the school year. Thing is, when i exert myself at all, even walking my dogs, the palpitations come back. Sometimes its just one isolated skipped beat and sometimes its a string of 3 or four irregular beats- scary stuff. School starts up soon, and I'm signed up for the cross country team. I have an appointment with a cardiologist, but it's at the end of the first school month. I don't know what to do, i feel really uncomfortable exercising, and that really interferes with my day to day life, and will interfere with my life at school/sports too. Could my doctor be missing something, as I didn't have any palpitations during the EKG? Would an EKG pick up irregularities/weakness in my heart even if I didn't have an irregular beat during the exam? Could the chest pains be separate from the heart irregularities (allergies or something)? Sorry for such a long comment, thanks so much for anyone who reads and replies, I'm just a teenager and this is really worrying me. I'm told I'm all clear to go, yet I'm still gripped sometimes by several palpitations in a row... If it helps, I haven't slept well in the past week or so, since I was jet lagged on vacation. But these irregular heartbeats differ from the ones I had during the school year. I don't know, I'm quite confused.

Quick read...
- Irregular heartbeats, feels like my heart skips a beat, loose my breath
- Chest pains
- EKG picked up nothing, but I didn't have any episodes during the EKG ... would it still pick up something wrong?
- Doctor clears me to do normal stuff, but I still have palpitations when I exert myself at all
- Am I just fatigued? Would fatigue lead to all this (palpitations of this frequency)?
- Am I really "cleared" to sports and stuff? School starts soon, so I'm worried if It'll be safe to run and stuff.

[stutterheart]

Hi Jay,
What you have experienced is somewhat normal. Perhaps as many as 1 in 100 have exactly the same thing. I can't promise you that everything is fine but I can say that your symptoms seem to be benign. You should become more concerned if you start to pass out from the arrhythmia. The horror stories you hear about, young athletes dying, tend not to be preceeded by palpitations: they just strike out of the blue.
I think you should, however, have a much more thorough workup to make sure everything is ok. The main things you want to rule out are Wolf Parkinson White syndrom, Brugada Syndrom, Long QT Syndrom and Hypertrophic Cardiomyopathy. The first 3 are recognizable on an ECG although some people get them only occasionaly. For this, you may want to get a 24 hour holter monitor AND a 30 day event monitor. I doubt you would catch much on the event monitor because you will probably be out of arrhythmia by the time you get the monitor out of your pocket. But it seems they've seen your premature beats and have a handle on the morphology. Press them to explain what the morphology is (what type it is). Write it down and research it. They have almost certainly ruled out the 3 syndroms by now but you may want to get a stress echocardiogram to analyze your heart's size, ejection fraction and artery dilation. Those things don't always show up on an ECG. Hypertrophic Cardiomyopathy is the leading cause of sudden cardiac death in young athletes by far and can be diagnosed with an echo. If you are even more paranoid, you can ask for genetic testing to make sure you don't have a slight case of a  cardiomyopathy that is undetectible by the echo. There are no signs to suggest that you have an enlarged heart though.

[SneakyPetemagic]

I recently went for a stress test and experienced a palpitation during the test. The doc told me it was a typical PVC and everyone gets them...it's just I feel them and other people don't. I've had these types of flutters and and palpitations for over 20 years now ( I'm now 42) and they seem to be triggered with stress and exercise or exertion like yourself. My doc was not all that concerned with them even though they feel awful like your losing your breath and  a panicky type feeling like it's not going to stop. My advise is get all your tests done and try to live your life. That's what I'm trying....i recently had an attack of Atrial fibrillation after a night of heavy alcohol consumption..boy now that was scary.... I ended up in the emergency ward and needed to be cardiverted back to regular rhythm, but the bottom line is I'm still here and they tell me there's nothing wrong with my heart structurally or no sign of disease, just a predisposition to irregular heart beats...lucky us. If your tests all prove okay I would keep playing sports...my experience is i get these PVC's with or without exercise so I might as well live life as much as possible. watch your caffeine intake, alcohol and drugs....and maybe try some relaxation exercises like Yoga...good luck...feel free to contct me with any questions...i'd be happy to share my experieces with you as  like I said I've been living with this for 20 plus years.

[MindPieces]

I don't know the answers to all your questions, but I do know that the palpitations wouldn't show up on an EKG if you didn't have them during the test. The best thing to do would be a cardiac stress test or a holter monitor. If you don't want to wait until you see the cardiologist, you may be able to arrange a holter monitor with your regular doctor. That's what I recently did, and am currently awaiting the results.

As for chest pains, those can be either cardiac related or gastrointestinal/skeletal in nature. You should probably describe them to your doc and see what he says.

I also do think lack of sleep could have something to do with it. I've been sleeping terribly for the past few weeks and have also noticed some minor heart palps. I slept better last night and didn't notice any today.