Palpitations

[cheesus]

Hi, I'm a 30 year old male who is overweight by maybe 50 pounds.   Last year, about October I had a very hard palpitation in my chest followed by alot of fluttering and it layed me out on the floor due to near syncope.     EKG was normal 20 minutes later.   After this,  (and I've never had any palpitations before that)  I started having them all the time,  as well as another feature that came on at the same time,   that is this heavy pressure down in the center of my chest that is there and noticeable most of the time.    I wore an event monitor and it picked up extra beats as the explanation for the thumping i feel in my chest.    Most of the time, it's a 5 second ordeal maybe 1-3 times per day, or sometimes I go a week without feeling anything.     Then, occasionally my heart just goes insane for 30 seconds and races away but never longer than that.    That also happens in my sleep on a very occasional basis, maybe 5 times per year.   I will wake up from my sleep with a racing pulse, and my monitor picked up sinus tacy of 160 during one of those night time events.      

What do you think about the new onset of all these symptoms of palpitations and atypical chest pain together?   I had a normal echo withch only picked up mild mitral and pulmonary regurgitation and have had many normal chest xray's, treadmill test,  very good cholesterol and other blood work including thyroid...  Do you see a complelling reason for me to have an EP study?    What could this be?  I am not comfortable with the chest pressure and the palpitations scare me.

THANKS!

[cheesus]

Thanks for the response,

I would like to mention that the pressure in my chest is not increased with exercise, and it is pretty much constant (is constant reflux possible?),   and also I did wear a 30 day monitor as you suggested.    As I said in my original post, I woke up with a pulse of 160 unable to breath and the monitor showed sinus tachy.    Also, at times my heart just goes crazy for about 30 seconds,  or I will have a single hard palpitation in the center of my chest where the pressure is , in the same location.       AGain, my treadmill test was normal and the pressure isn't associated with worse symptoms.     I do realize that your reaction will be to say this chest pain doesn't sound cardiac,  but it definately did start when the palpitations started.

Does this change any of your thoughts at all?

Thanks!

[Michael J. McWilliams, M.D.]

There is no indication that I see for an EP study.  I would start with a 30 day event monitor to correlate the symptoms with the rhythm.  It sounds like a monitor should pick up the symptoms given the frequency.

You need to talk to your doctor about the chest pain symptoms.  In a 30 year old it is unlikely to be related to coronary heart disease -- could be reflux, anxiety, etc.  You need to talk to your doctor about it just in case.