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Avatar universal

What rhythm condition can be heard or felt but not seen via ekg or holter monitor?

For over a decade I've had a stutter that feels like a weak miss beat and a strong single pulse after the miss beat before going back to a normal rhythm. Generally happens about every 20 minutes when my blood pressure is high (like 140-160 / 100-125) or after taking stimulants like the caffeine in my migraine meds (suffer from chronic migraines and I do NOT drink caffeine otherwise). My regular doctor and ER doctor both heard it themselves and requested I see a cardiologist. However after wearing a holter monitor for a day the cardiologist said "there's nothing on the monitor out of the ordinary so it must be perception."  By perception he meant "it's all in your heads".  This was 2 days after a supraventricular tachycardia episode that wouldn't stop for almost a half hour.  
So is there a condition that has a normal electrical signal but still has an abnormal beat?

4 Responses
Avatar universal
Perhaps you need to wear a monitor for a longer period of time
9 Comments
During the monitoring I pressed the button 20 times when I felt the stutter and hard pulse but chart showed nothing. It was definitely happening during the monitoring. As it always does when my BP is high. It's the second time I've worn one. The first one I wore for several days. The tachycardia has also landed me in the ER a few times so at least the cardiologist has a record of that (that he believes). But he thinks my doc and ER doc is full of crap on the stutter cause the monitor didn't show it.
Also when I say it can be felt I mean by the doctor not just by myself. After the "hiccup" the hard beat after hits pretty hard. To me it just feels gross like an alien is try'n to get out of my chest.
If you had symptoms while wearing the monitor and the strips show normal sinus rhythm, then whatever your feeling must not be related to the electrical part of your heart.
I have a feeling I'm going to have to trigger this to happen manually with caffeine or something to increase BP just to prove it to him on the next visit but a migraine almost always follows when my BP goes over 135...
"Careful35 43 mins

If you had symptoms while wearing the monitor and the strips show normal sinus rhythm, then whatever your feeling must not be related to the electrical part of your heart. "

That's the whole point of this question.
I understand that????
"Careful35 17 hrs

I understand that???? "

Apparently I didn't word the subject of this question well enough..
"What rhythm condition can be heard or felt but not seen via ekg or holter monitor?"

All you're doing is dancing around the question and pointing out the obvious and already known. What credentials do you even have?


I understood your question and I answered it... Again, if you were having symptoms while wearing the holter monitor and the symptoms were related to your heart rhythm it would have shown up. If your heart was irregular at any time you were wearing the holter monitor it would have shown as such. Since your holter monitor results were normal and showed no rhythm disturbances, the symptoms your feeling must not be related to your heart rhythm. There is NO arrythmia that I am aware of that doesn't show on monitor.
If he was in a hurry and couldn't answer a simple question to help you better understand what's going on then perhaps you should find a new dr. No one should have to leave a drs office feeling unsure or confused and unanswered questions. It's a shame that now a days drs are more about quantity then quality.
To me your description sounds exactly like ectopics (premature beats) but those would deff have showed up on the monitor as would any other rhythm disturbances...
If I were you for peace of mind, I would get a second opinion and another monitor to make certain there wasnt something funky going on with the first one. If that one shows something then you will know what it is and if it shows nothing then you will know that your heart doesn't have an electrical problem (arrythmia)... Either way you will know for sure
Avatar universal
And your aware that this is forum correct? And while I'm sure there are some drs snd nurses on here most of us who comment on posts are not. We just try and help each other out with our experiences. If you want professional advice go to your drs office cause you likely won't get it here.
There is no need for you to be rude to me as I have not once been rude to you. You asked if there is an arrythmia that wouldn't show up on monitors and I answered that there wasnt as far as I know.
Didn't you ask your dr thid question when he/she went over your results?
Avatar universal
Hey op,

So as a patient and previous nurse...

I can tell you holter monitor suck and are surprisingly inaccurate at times.

If you want to check you actual  cardiac electrical conduction circuit you really would need an ep study.

However, my gut tells me you may a murmur from an anomolous return considering it was audible.

Have you had a cardiac mri?
3 Comments
I have not, I do have an endoscopic echocardiogram scheduled for next week though.
My theory is that the electrical signals from the heart my be on point but maybe due to the high BP the heart might be filling too little or too much causing what feels like a miss beat and then a strong or hard push.  When really there was no miss beat.

Kinda like hooking up a electrical diagnostic to to an engine and seeing that the sparkplug's timings are firing exactly when they should but the diagnostics can't see that the carburetor is running rich and pumping in too much or too little fuel which is causing a audible sputter during idle.
I understand what your saying and your not wrong.

You have two separate circulations.

One out of your ra,rv to your pulmonary circulation.  Your la, lv run to your systemic circulation.

I am  assuming you have systemic hypertension and not pulmonary?

With that in mind there are laws of physics at play such as pre load and after load... ala Frank starling mechanism.

Filling pressures may certainly be altered and can increase or reduce sv.

Not to mention we do have the  damned law of laplace to factor as all four chambers do affect one another.

Which brings me to it probably being a murmur which you feel.

The question is why?

Potential valve malfunction, anomolous return, l to r shunt etc.

A transesophogeal echo is an excellent start.

I wish you the best of luck on the journey through cardiac hell.  I've been on it for almost 4 years now lol.

Let me know if you have any other questions ;)




Avatar universal
Mine was resolved by taking 1000 mg of fish oil 2x daily
1 Comments
I already do that. I have a big jar of omega 3-6-9 sitting right in front of me with a bottle multi vitamins next to it. I take both twice a day. Been doing that for about 10 years before and 10 years after I started problems.
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