very strange heart sensation followed by adrenaline rush and fast heartbeat - very worried about this

[Wundergecko]

Hi. I'm a 26 year old female, neither fat nor skinny, no smoking, only occasional alcohol use. Prior to what I'm about to describe, the only heart issues I had were: occasional flip-flopping feeling which knocked the wind out of me but only happened maybe a few times a year, and a sort of flip-flopping or difficulty beating when lying down on my left side (sometimes, not every time I lay this way - started around age 13).

Background: Three years ago something happened to me that I still haven't figured out - my heart started beating very fast and my BP went way up (so high that with every heartbeat I could see the tiny capillaries in my eyes as an overlay on my visual field). Paramedics couldn't bring them down so took me to "A&E" (aka the ER - I'm American but live in England). Absolutely nothing out of the ordinary happened (that I'm aware of) prior to this incident, except for insertion of Mirena IUD one week prior - I do still have it but now think I'll have it removed.

Thus began months of seemingly random 'attacks' during which I'd get varying combinations of tachycardia, high BP, tremors esp in left leg, lightheadedness, inability to fully inhale, feeling of not getting enough oxygen even if I could breathe properly, and the list goes on. I also had a terrible feeling of physical anxiety (churning stomach, agitation, etc) but with no mental anxiety as the apparent cause!!! Attacks could last minutes or hours and any combination of symptoms would happen. And in between attacks, my heart would regularly do many strange things - tachy, brady, irregular rhythm, extremely forceful beats, 'flip-flopping' feelings, etc.

I also sometimes experienced a sensation of the heart stopping and restarting - immediately after the restart I would feel a MASSIVE, uncomfortable surge of adrenaline and the heart would beat very fast for a little while. I could never figure out if I was getting an adrenaline surge that caused some odd heart behaviour that I felt before I actually felt the adrenaline, or what. Sometimes my heart would also start beating EXTREMELY fast from resting for no reason at all - it was literally immediate - this was also accompanied by an adrenaline rush but no preceding feeling of the heart stopping.

These incidents gradually decreased in frequency over time, along w/ the other symptoms, until after three years I was feeling mostly recovered from whatever got me. I viewed myself as not entirely back to normal, but almost there. UNTIL a couple of days ago, when I had another (random as always - I was just riding in the car reading, no stress) heart stoppage -> restart -> adrenaline event. This one was the second most severe one I've ever had and I thought I might die. Luckily the heart DID start pumping again so I'm still here. By now I'm pretty familiar with flip-floppings and extra-strong beats, etc, and this definitely feels very different and much more worrying. I am afraid that if it happens again, the heart might not start on its own.

I should also say that when I say it 'stops', I mean it seems to stop pumping blood...I get the impression there is still activity going on in the heart but that blood is not being circulated. Could it be ventricular fibrillation, or ...? Maybe adrenaline is not causing this, but rather my heart goes into an abnormal rhythm and my body releases adrenaline in an attempt to self-shock into proper rhythm?

During the most severe incident in '06 or '07, my colleagues said I turned "white as a sheet" while it was happening. That time, I was clawing at my chest (reflex reaction, I didn't actually think that would help) and thinking "please start please start please start", knowing I'd die if it didn't. That time, it felt like the heart was quivering/fluttering but not pumping. All other times including the one a couple of days ago, it has sort of felt like the heart is contracting in extreme slow motion, or having some sort of muscle cramp.  

I cannot figure this out and would welcome any insight anyone has to offer. After it all began in 06, I had a stress test (slightly above avg exercise tolerance), echo (normal), stress echo (normal) and many ECGs. The cardio said my heart was perfectly healthy. No evidence of MVP (which I thought I might have). He said the only thing to remark on was that the heart was smallish, but not abnormally so.

My GP diagnosed me w/ 'anxiety attacks' w/out finding it necessary to order any physical testing whatsoever. (The above cardio is a friend of my parents who saw me while I was on vacation in the US). GP put me on citalopram which I went along w/ just to be cooperative, and propranolol to help regulate what he viewed as anxiety-induced tachy. Did not seem to find it significant that symptoms did not occur during periods of actual mental anxiety. Said it might be pheochromocytoma, but that he wouldn't bother testing as that's so rare. Ashamed to say I didn't and still haven't actually demanded said testing.

All ECGs were normal except once at A&E when they caught random very hard beats interspersed w/ regular beats - v. hard beats could be seen as an extra-long downward spike on the readout. Of their own volition (as opposed to at my request), A&E sent this to a cardio (different one) who didn't bother to look at it and just told me not to worry. Thanks, buddy! So, not really knowing how to interpret these readouts, I still don't know if that was significant.

I'm currently seeing a neurologist for delayed sleep phase syndrome. After hearing all this, he very kindly volunteered to arrange for me to use the clinic's Holter monitor; he'll then send the tape to a cardiologist. Not sure when this will happen, though, as it's the NHS (meaning things do not tend to happen promptly).

At the time of the latest incident, I was on amoxicillin but no other meds continuously, although I have been taking lansoprazole at night only, for a week and a half to two weeks. A few days prior to the incident, I had taken myself off of the pramipexole that I'd been on for a week, as I was having trouble swallowing (for which the amoxicillin and lanso were prescribed - possible sinus/throat infection or gastric reflux - doc and I wanted to attack on both fronts in order to avoid the return of the laryngospams I'd had during recent respiratory infection).

Thanks in advance to anyone who might be able to help...

[SassyLassie]

It sounds like anxiety, however, I would see a cardiologist for all this. You said you had seen one in 2006, well, I think I would see one again as your symptoms are not getting better and you are describing things that really only a qualified cardiologist can help you with.

Good luck and please keep us posted. I know how scary these things are, I have them, and at times, you really DO feel like you are going to die, it is the worse feeling ever, in my opinion.

[Wundergecko]

Hi SassyLassie,

Thanks very much for replying! I didn't realize I'd written so much...I doubt anyone else read it :). I may see if I can get to a cardiologist, although unfortunately I can't afford to go private so don't have all that much control over the situation (don't know if you are familiar w/ the British NHS, but your GP has to deem it necessary to refer you to a specialist before you can see one - even then the wait can be long).

I find that some doctors tend not to take me very seriously because I am in my 20s (they assume that the most benign explanation for my symptoms must be the correct one, and say as much). The neurologist I'm seeing seems very good, though, so hopefully he will come through w/ the Holter monitor.

I'm not glad that you have a rambunctious heart too, but I am glad to know I'm not the only one thinking I'm on the verge of death during some of the incidents. Yes, it is the worst feeling ever.

Best of luck to you!

[jkfrench]

I get that same thing about 2 or 3 times a year.  It isn't the same as the pvcs.  You feel your heart pause for at least a couple of seconds.  Then it switches gears and speeds up.  Mine has been clocked at 220 beats per minute after one of those pauses.  My doctor told me not to worry.  I did get the fast rate caught on tape and it was PAT (a form of svt I think)
My doctor said that the pause felt longer because of the timing of the early beat...then because it was a longer pause, it had time to switch pathways..thus the PAT.  I don't feel any quivering but my doctor said even though I feel nothing in my pulse that it could be beating really fast and weak and I just don't realize it.  Anyway, I was told not to worry so I'm passing that to you.  As long as you have been checked out.
Good luck with the monitor.  
Frenchie

[Wundergecko]

Hi Frenchie,

Thanks so much for posting!!! It does sound like we're experiencing something very similar if not the same. It's good to know I'm not alone. Also good to know what your post-pause tachy has been categorized as...this gives me something to look into should I get checked out again.

I'm glad to hear your doc has given you the OK and this is definitely reassuring for me to hear in terms of my own situation as well. It makes more sense and is less worrying to think that the pause is just part of the oncoming tachy and not an actual stoppage in and of itself.

[Wisconsin2007]

I can relate to a lot of what you wrote - I haven't clawed at my chest so much as gone into a catatonic state, frozen, hand over my heart or at my carotid, waiting for my heart to start again.

But I've also experienced that very strange sensation of adrenaline rush - for me it feels like a sickening woooosh, I feel flushed in the neck and face, sometimes I sweat a little.  For me it's usually after the episode is over.  First ten or so times it happened it was pretty frightening.  Then I got an event monitor, was able to record quite a few of them, and my cardiologist was unimpressed when she saw the strips.  Diagnosed as "short bursts of PAT" (aka PSVT).  She said I could go days with my heart in that rhythm and it would not harm me.

Oddly enough, once I learned these couldn't kill me, I started having less and less of them.

[Wisconsin2007]

One other thing - I took a quick look at the side effects of the Mirena IUD, and many of the potential side effects are symptoms you're experiencing:

http://www.drugs.com/sfx/mirena-side-effects.html#system_33551

http://www.drugs.com/cdi/mirena-iud.html

[Wundergecko]

Thank you Wisconsin2007 - I did end up having the Mirena taken out at the beginning of Sept. Unfortunately I've still been having some palpitations and today had another scary stop-start event, but I've just had my first real period w/ PMS & everything in about 5 years, so I'm hoping that once my hormones settle down things may improve. Either way, I am just trying to focus on what you and Jkfrench have said, because it sounds like I've got what you've got and it can't kill us. Still waiting on that Holter...

[Wundergecko]

Also thanks for detailing that you also sometimes get the adrenaline rush - this is has been a worrying aspect of the episodes for me as others don't generally seem to describe this. But if you've got something similar on tape as PVST, I think that's a lot more likely to be the issue for me than my heart stopping and adrenaline being released to achieve a shock-paddle effect, which is what sometimes worries me.

I will post here again if I find out anything further about what's behind my symptoms.

[MapleLeafForever]

You managed to describe your symptoms in a way that I was incapable of  telling my doctor and subsequently cardiologist when the exact episodes started happening to me in 2002. Then, after the ultrasound, EKG and Holter monitor, all the cardiologist could come up with was that one of the chambers of my heart was slightly enlarged, but nothing to worry about.

These attacks went away on their own but came back tonight for the first time in 8 years. The fear of my heart stopping is so great I'm afraid to go back to sleep...  The subsequent "adrenalin surge" is so great that I physically shoot up from bed by the shear force of the momentum of my heart "re-starting".

I can't say I'm under any unusual stress, but I did spend the entire Sunday (today) in the -5C outdoors building an ice rink. I did have about 4 glasses of red wine thereafter though.

Anyways, I'm somewhat relieved that I'm not alone and that the common diagnosis of doctor's is that there is nothing to worry about.

I have a feeling this has something to do with the electrical controls of the heart - perhaps slight changes to diet, environment cause it to temporarily malfunction.

[Mayush]

I completely understand everything you wrote and have had similar symptoms.  I just read for the first time about this 'adrenaline surge' , and that it often happens at 4 - 5 in the morning, which makes a lot of sense, because that is when I have had the attacks I've had.  Almost every morning, I wake up at those times.  I have horrible attacks in which I feel like I'm going to die, I have an intense feeling that my heart doesn't beat enough or properly, and then these adrenaline surges, and then I feel much better.  
What I wonder is if these adrenaline surges happen as our bodies' defense to 're-start' our heart and keep us alive because our hearts really are, as we suspect, stopping... or if it's just anxiety and these sensations that are making our adrenaline surge.  How do you find out which came first??

The advice I want to give you though, is to check out your thyroid if you haven't yet.  Especially because of what you said about not having your period for so long.  I have a thyroid disease and I know that these heart-related attacks are connected to that, so check that out asap!

[Wundergecko]

Hi, thanks for replying to my thread! It really helps to know that others are going through this and have not keeled over from it. Sorry to hear you've had another incident after so long :(. I completely understand about the fear it creates...it's terrible.

I also feel like there is something electrical going on here....just not sure exactly what that is or what triggers it. Perhaps it is PAT as a couple of the others have posted? I think that the tachy of PAT stops abruptly, though, whereas with my episodes it just trails off gradually into a normal speed after the adrenaline rush.

[Wundergecko]

Hi Mayush, glad that you too have contributed your experience with this. It must be very stressful waking up most nights with this problem, not to mention how it must be giving you sleep deprivation. For me it doesn't tend to happen when sleeping, or if it does it doesn't wake me up. I do sometimes get irregular and/or very weak heartbeat at night, though (much more when this all began than recently, thankfully). No adrenaline after that for me, though...I just have to endure it until I fall asleep and then it's gone in the morning.

Thanks for the tip about thyroid...is yours overactive, or...? When this heart stuff started for me, I thought it might be that my thyroid was overactive, but the blood tests I had (tests as part of investigating my longer-standing night terrors, not the cardiac symptoms) at that time apparently came back normal for thyroid function.

However, I've heard some things about standard thyroid tests not being completely reliable, so I need to investigate that, I think. I did have another round of blood tests last year as part of being diagnosed with Delayed Sleep Phase Syndrome, and the neurologist who reviewed the results said they indicated borderline sluggish thyroid and that I should have that tested again in the future. If your experience has given you any insight on the most accurate testing/interpretation, please share!

Thanks,

wundergecko

[rilesnic]

I too have had similar experiences.  Turned as white as a ghost, where complete strangers were asking me if I was ok.  I do have PAC's and tachy, but this is definitely different.  I am convinced my thyroid has something to do with this, but they just can't seem to catch it.  I am considering going to an endocrinologist to see if they can pinpoint something that my GP and cardio have not been able to catch.  My first episode was in 1997,  Best wishes to you and keep us posted on how you're doing.

[insidescoop1]

Dear Wundergecko,
I'm not a medical doctor and therefore cannot give you any "legal"  medical advice.  However, I can tell you that I've suffered from almost the EXACT same symptoms that you have and the chances are very high that you have an anxiety disorder that is manifesting itself in panic attacks.  The trouble with this disorder is that most people that have it don't want to admit it and will (like I did for years) offer up any number of reasons why they don't have it.  I see myself in many of your comments (I was just sitting around not doing anything stressful, etc;)  Many of my worst attacks would come while I was in a hot bath tub completely relaxed and completely out of the blue.  After pressing the docs here in the United States to run every kind of test they could (several years after a massive panic attack sent me to the ER) they have concluded, and I as well, that i am in fact, a victim of panic attacks.  Tthis disorder is directly connected to some very traumatic events that took place in my childhood.  I am a survivor of sexual abuse as a child.  Sometimes deep trauma's that occurred in times past can cause panic attacks that don't surface until many years later.  In my case some 30 years later.  Here's the thing to know about panic attacks - some people will recover fully, some will recover partially, and some will never recover.  I still have incidences of these attacks and through therapeutic tools I've been given I've learned to cope with them although they are definitely not pleasant.  If you've never considered psychiatric care it might be something you want to look into.  Things to definitely avoid eating or drinking...anything that is spicy and anything that has caffeine in it.  When you begin to experience these symptoms just remind yourself that you're O.K., you're not having a heart attack and that you'll be fine in a minute.  The mind is very powerful drug and much better for you than the synthetic stuff the docs will prescribe.  If you, and your docs, think you would benefit from anti-depressants or drugs that can calm you down like Ativan (sp?) then try them but under direct medical supervision.  ESPECIALLY when it comes to anti-depressants.  Remember, these are psychotropic drugs that change the chemistry of the brain and correct dosages are vital.  It will take some time and experimentation under supervision of your doc to get the dosage right.   Thanks for sharing and hang in there!  You can learn to manage this disorder if in fact you discover that you have it.  i hope this helps you.  PEACE

[vangie2010]

OMG.....I  been having the same thing happen to me for the past 30 years and after doctor after doctor  no one seems to give me a diagnosis other than "anxiety".I dont agree because I work in a Hospital and I am able to take my own vital signs. I have heard my heart beat fast 150bpm then come to a complete stop (no blood pressure) this only last a couple of seconds so it hasnt beed got on monitor or EKG. I am 49 years old and if I have to live like this the rest of my life I sure dont wamt to live it this way. The feeling of an absent of heart beat is very scary so I think the anxiety is second to another cause of disease....
keep me posted on any new diagnosis

[Wundergecko]

Hi Insidescoop1,

Thanks for your comment - it was very interesting to read about your experience. I definitely do have anxiety issues (and OCD) and can get extremely worried on top of my frequent periods of generalised/background anxiety, but the symptoms rarely if ever happen when I'm consciously anxious, so my thinking has been, "If it doesn't happen when I'm extremely worked up, but does happen apparently randomly, how can it be caused by anxiety?" But I don't know. Do you have any thoughts on this issue? Maybe subconscious anxiety can provoke the symptoms, if there is such a thing as subconscious anxiety.

I'm sorry to hear about what you went through as a child, but it is very interesting to see the connection that you have made between that and your panic attacks. I wasn't abused, but I was extremely sensitive as a child and I think that some emotional issues in my family may have damaged me when they would not have done as much damage to most kids. I did get late-onset night terrors (had them aged 17 - 22, now have night-time hallucinations), which apparently are correlated with having experienced extreme trauma.

I have been noticing, since I wrote the original post, that as I am becoming more comfortable socially after a lifetime of being pretty inept, I am getting the heart-stopping-then-adrenaline thing when meeting new people. So that could be a clue that this is an anxiety problem, but in my own case I'm still not fully convinced...I think it is more likely that there is a physical issue that is exacerbated by anxiety and other (unknown) factors.

How long do your panic attacks tend to last? I sometimes get what I call "episodes", where I feel like I'm going to die, get the heart-stopping thing, can't breathe properly, etc - but apparently panic attacks don't last very long, and my episodes can last for a couple of hours.

[Wundergecko]

Hi vangie2010,

That sounds so scary! I've never been taking my pulse or BP while it happens, so haven't actually been able to confirm in that way that the heart stops, but it certainly feels like it.

I will post to this thread if I find out anything more. It's good to know you've made it to 49, although I do get what you mean about not wanting to live with this due to the worry it causes. I was feeling that way when it started, but have made some progress on not worrying as much about it. I try to look at it like, it's happened many times now and I'm always OK, so I'm going to continue being OK as long as the heart itself is healthy. Easier said than done to always remain positive, though. Best of luck to you!

[vangie2010]

I went to see my heart doctor on Friday and he asures me that its not my heart...but the thing is when ever I get the feeling that my heart stops ( and dont get me wrong it only stops for a couple of seconds) it has not been got on EKG or while wearing the heart monitor. When I told the doc about it he blew me off as I were crazy so tomorrow I am going to call to see another specialist to get a third opinion. How do I get these Doctors to understand that the feelings are real and not  made up from anxiety?
Does anyone have a doctor or specialist that really believes that the feelings are real and not just anxiety?
I live in Houston,Texas but I am willing to go were ever it takes to find the right doctor that knows how to treat this medical issue. ( its something more than just anxiety ) it has to be: I have heard it and I have seen it on the B/P machine.
I have been living with this for years but it wasnt til a couple of weeks ago that I found this web site and started to read that I am not alone there are other peolpe out there with the same problem.  I have not read anything positive like "treatments"or surgery that has helped with the symptoms. Has anyone out there found the right doctor that has found the cure for "heart pounding, flip flops,or heart stoppage? Please let me know
I am at my last bit of hope of ever getting better.

Good Luck.....

[Patsm]

This doe NOT sound like anxiety!! .. To many people jump to anxiety when the adrenals are involved.. The heart races, the body sweats, tremors and shakes can occur. Dizziness, foggy-head can happen too... Look into POTS. It is a dysautonomia (dysfunctional autonomic nervous system) ..The blood pressure fluctuates tremendously, and the heart reacts... POTS is similar to Chronic Fatigue Syndrome, or, M.E... It is just centered around the heart and blood pressure. .. Low blood sugar can attribute to this as well perhaps. So eating a diabetic diet can help a lot for some people.

[chicky2001]

Your OP sounds very similar to what I have been going through most of my life.  It's terrible and I don't think many cardios care much about what we go through.  As a matter of fact, something started happening to me last month that was new.  I have been to the emergency room and calling my cardio all the time and requesting emergency appointments too.  I actually am thinking I am the joke of the office.  I think everyone who works there looks at me funny.  You know, like I'm nuts.  

I have had numerous tests.  Some recent tests too.  I was on a monitor for a month, but nothing showed up.  It was a month I wasn't feeling anything either.  Now I'm scheduled for another 24 hour monitor.  Probably nothing will happen then either.

For some reason the medication I have been on for years just seemed to stop working.  I am taking Norpace.  Anyway, I talked the cardio into lowering the dosage.  It doesn't help.

Here's what happened.  My blood pressure started lowering and my heartbeat started slowing down.  My pulse is irregular too.  I feel dizzy sometimes and faint.  My stomach feels weird and I get a shot of adrenaline which I can feel through my chest.  It speeds up my heart and my blood pressure goes up.  I feel better when my blood pressure goes up along with my heartbeat.

I can't seem to make the doctor understand this.  When I'm in the office she sees nothing wrong on my EKG or listening to my heart.  She said there is nothing wrong with my heart rate dropping to the 60s and my blood pressure dropping down to 90/60.  

What's wrong with it is I feel very bad when this happens.  She has lowered my dosage of Norpace at my insistence, but it is still happening.  She said she wants to take me off Norpace altogether and put me on Toprol if it keeps happening.  I have had many medications tried on me over the years.

BTW, taking Xanax has no effect on the heart rate ect. because I tried that too for anxiety.  

My problem is I am to heart aware and feel every single skip ect.  This slowing down stuff is the worst though.  Worse than anything else I have had to live with for years.  It goes on all the time now.  No relief.

[agarriso]

This sounds exactly like whats been happening to me the last few days, though right before the heart "restarts" there is a sharp intense pain that last only a second or less. Followed by a wave of adrenaline and rapid heart beat. This has only occurred while laying down in bed however and every time wakes me up from sleep. It has occurred off and on over the last year or longer seems to happen more often during times of emotional or mental stress (looming deadlines and workload, relationship woes, etc.) The last two nights I've been running on little to no sleep while staying up working on finals, and the incidents both occurred early morning (around 4:45 am) after laying in bed and having only just drifted off to sleep. It is important to mention that I had taken adderrall (20 mg) at roughly 8 pm the evening before both incidents.

Here is my OP:
http://www.medhelp.org/posts/Heart-Rhythm/Woke-up-with-sharp-heart-pain-and-palpitations-back-to-back-mornings/show/1253176

[Wundergecko]

Hi, thanks for posting - you are right, I've got a lot of dysautonomic-type stuff going on. For a while (back when I "just" had unexplained palps, tachy, blood pressure issues, etc) I was convinced that I had mitral valve prolapse syndrome without the mitral valve prolapse. I don't quite fit the profile for POTS, though, as although my BP doesn't always react properly when changing position, it does stabilize OK these days once I stay standing / lying down.

I do think my nervous system is out of balance, but think there are probably also additional things going on as contributing factors...

[Wundergecko]

Hi, thanks for adding your experience. I know what it's like not to have this show up on a monitor - frustrating (even though we don't actually WANT them to happen, of course). Can't remember if I've mentioned this in the thread, but I had a 24-hour Holter courtesy of my neurologist and the start-stop thing didn't happen. I'm not sure if he looked at it himself or if a cardiologist saw it, but he told me that it was normal - there some tachycardia, but the normal and harmless kind (can't remember what that's called now - SVT?).

I do get what feels like low BP and slow & irregular heartbeat sometimes, but thankfully not as much as I used to. This happens mostly at night but doesn't seem to cause the start-stop thing for me. I wish you the best of luck in figuring out your symptoms!!! We have to be our own advocates, although it isn't always easy.

[Wundergecko]

Hi agarriso - read your post - that sounds very unpleasant! I feel for you. I don't get pain with my stop-starts, thankfully, or it would be even more disturbing. I have had pain with a few very hard PVCs/PACs, though - I think in those cases it's probably the heart muscle stretching slightly with the force.

I do have palpitations related to another type of chest pain, though - "trapped wind" as they call it here in England. I don't know what we say in America, but what I'm talking about is having air bubbles pressing on stuff in the abdominal and chest cavities as they're moving on through. This never used to cause palps for me, but it does now, and this freaked me out initially. I have since found that there are plenty of others on the 'net and on these boards who get the same thing, though. I also now sometimes get palps as a result of certain stretching exercises, lying on my left side, being squeezed too tightly, even bending at the waist!

My best guess is that in addition to my acid reflux, I've got a hiatal hernia and this is either causing pressure on the heart or on the vagus nerve or both. So my point is, you may have some kind of internal pressure thing going on, especially in light of your sternum/collarbone issue, and in my experience and that of others, pressure can trigger palps.