My funny heart

[Tyler]

I get funny heartbeats when I work out, something that started in high school. Sometimes I'll be out running and everything is normal, and then WHAM! my heart does this mega-beat thing where it feels like an atomic bomb went off in my chest. It's not painful, it just feels really powerful. And usually there will be a brief pause before it goes back into its regular rhythm.

This started my sophomore year in high school when I ramped up my miles for the first time, and I got myself checked out really well. The doctors ran an EKG, ultra-sound tests, hooked me up to a heart monitor (which turned out to be worthless, all the data it collected was incoherent), and finally ran a stress test without finding anything wrong. During the stress test, though, I didn't reproduce the symptom, so I've always questioned whether or not the results were accurate.

Yesterday, though, I had the same thing happen while I was at work (it's not uncommon for it to happen when I'm not running), only this time I almost passed out, the first time I've ever thought I would lose consciousness. Obviously it scared me a little, and I'm questioning whether the testing I had 5 years ago was adequate, although I don't know what else they could check on me.

Any thoughts?

[Paul Petersen]

Any thoughts?

Scary. See another (better) doctor. Hopefully you can reproduce it.

[ktjo]

I had a friend that was having irregular beats just every once and awhile and she got worried so she went in and they did not find anything,  so they hooked her up to a heart monitor that she wore under her clothes for 1 week. She was to do everything she normally did so they could catch when it was happening.  They found what she was talking about and linked it to her asthma medication and switched it. (She is good now) But the heart monitor she wore was pretty small I could not even tell she had it on her.

[Dale]

The monitors you wear over time are called Halter Monitors.  I had to wear one as part of an extensive testing regime I went thru to prove to the Army that I wouldn't crash one of their shiny helicopters since I was born with a slight heart murmur and have an abnormal EKG.  In any event, they're used to detect the exact type of thing you're experiencing....those irregularities that occur periodically, and usually not in the doctor's office.

You should absolutely talk to your doctor about getting outfitted with one for a period of time, especially since it seems like the symptoms have worsened.  He may refer you to a cardiologist first, be being forearmed with enough information about what to ask for, you should be able to get what you need.  Just don't take no for an answer.

[Tyler]

Any thoughts?

Scary. See another (better) doctor. Hopefully you can reproduce it.

Supposedly I had one of the best doctors available for the stress test, I even drove a couple hours to Sacred Heart in Spokane, Wa to do it.

The heart monitor I had was large and awkward with electrodes that attached to my chest - plus my sweat kept it from getting good readings when I ran... The doctor who gave it to me (different from the Sacred Heart doctor) got the readings from it a freaked out, saying I had to stop running immediately or else I was going to die (he was a little cooky). He sent the results up to Spokane with me, the lady took one look at it and said "I don't know what this is supposed to be, it's totally worthless."

Your point is well taken, Paul. Does anyone know of a good cardiologist in the SL/Provo area?

[Dale]

A cardiac stress test is different from a halter monitor test.  The stress test is designed to induce issues that occur with the onset of strenuous exercise or exertion.  The halter monitor is designed to catch those issues that occur whenever the heck they feel like it.  From your description, it sounds like the stress test was not the test you needed, although they may have assumed it would occur when your body was under load.
The reaction of the stress test administrator is normal....as soon as some values cross certain thresholds, they're designed to automatically terminate the tests.  Usually this is a good thing, but it sounds like you got those readings because of a faulty test, not because they actually indicated a problem.  I would think that the doctor that read it and decided it was worthless would've scheduled you for a retest?  Just saying "Well this is worthless" is *not* an answer I'd accept from a doctor, especially one that was getting paid to diagnose and treat me.  My next question would've been, okay what do we do next, retake the test? 
I learned the hard way that when it comes to health care, you need to be assertive not passive.  Ask questions, make sure you understand what is going on, and if it does not pass the common sense test, don't let it pass and assume they're correct.  Forgive the lecture, I don't mean it that way, but I've learned the hard way that you need to be able to push your own medical case as much as possible.
Good luck.

[Lybi]

When you feel this happen does it usually happen over and over?  It sounds similar to something I've experienced.  Although mine doesn't really feel like a bomb going off, though.  It feels like I skip a beat or something and then have a HUGE beat, and it happens a couple of times in a row once it gets started.  But in my case it is completely non-dangerous.  It's called tri-geminal PVCs.  They can cause slight breathlessness, but I've never felt like I might pass out  EXCEPT the one time when I had a bout of tri-geminal PVCs that corresponded with my very first panic attack. (Speaking of panic attacks, I've only ever had 2, and they were both when I was working under a lot of stress at a job that I HATED with all my heart and soul.  Are you under tons of stress?)   Good luck with your heart, I hope you can find some answers!

[Tyler]

Sorry, Dale, I wasn't entirely clear in my first two posts. I saw a local doctor at first who gave me a heart monitor to carry around for a few weeks. I ran every day with it, including workouts and races, but the results turned out extremely fuzzy. When the local doctor got them, he sent me up to Spokane (he wasn't comfortable seeing me in the first place, since I technically fell under the care of a pediatric cardiologist, and he didn't have specialty training to treat me). He interpreted the results (incorrectly) as extreme arrhythmias. In Spokane, the doctor ran the stress test on me; the results were clear here, but I didn't feel like I really reproduced the symptom. This was unusual for me, since I would feel it numerous times on every run -- the harder the run, the more times it happened, so I was surprised it didn't happen during the stress test. She said that all she saw were adrenaline surges here and there, but nothing unusual. I really appreciate your post, Dale (it doesn't feel like a lecture to me), being aggressive with treatment is something I'm coming to understand better these days.

Lybi, the frequency of what I've felt ranges between once or twice during a run to a dozen beats right in a row. It sounds like it could be what you're talking about, but it's hard to be sure. How did you figure out what you were experiencing?

So I actually have a theory of what's going on now. ktjo's post came to mind on a run the other day, since I hadn't ever thought that medication could be the cause. Well, I guess I did take Vioxx back in high school during the time my symptoms started, but supposedly I shouldn't have Vioxx-related symptoms now that I'm not on it.

I was thinking about all the things that have changed in the last few weeks that could explain why I'm having these symptoms so strongly again. I got injured a few weeks ago and have spent some time in the pool, where I first felt it. I thought that maybe the different breathing pace was affecting me, but that didn't make a lot of sense since I was still getting the heartbeats when I began to run again.

It dawned on me, though, that I had been taking a steady dose of ibuprofen since I got injured, and this is a link to my high school days, when I was constantly on ibuprofen for some injury or another (even when I was on Vioxx). Sure enough, I looked up the side-effects for ibuprofen and they included blood thinning and heart-related issues, including heart attack and cardiac arrest. I think there is a good chance that what I'm feeling is related to ibuprofen. I haven't taken any for a few days, and I felt very few irregular heartbeats yesterday during my run. It's not a super strong correlation, but it makes sense.

Has anyone ever heard of ibuprofen causing symptoms like this? I'm going to look into it a little further and see what I can find. Thank you everyone for your help and comments!

[Paul Petersen]

Has anyone ever heard of ibuprofen causing symptoms like this? I'm going to look into it a little further and see what I can find. Thank you everyone for your help and comments!

Interesting. I haven't looked at all of the side effects if ib. too closely, but I do know that it does have potential for dangerous, and even fatal, side effects. Definitely worth examining!!

[Dale]

That's a correlation you probably need to bring up to your doctor....especially before taking ibuprofen again.  My wife is the poster-child for medication side effects so I know they can manifest in subtle ways difficult to detect. 

Irregular heartbeat is one of the standard ibuprofen warnings (http://www.drugs.com/cdi/ibuprofen.html), classified as a SEVERE side effect that you should see your doctor about immediately.  So is fainting. I'd discontinue use immediately and see my doctor. 

Glad you made the connection!

[Dallen]

I oubt its due to ibuprofen, but I will strongly second the fact that you shoud try another doctor. Even if the first guy was a good one, a second try might be better at finding the problem, especially if things are getting worse

[Lybi]

I went to the doctor, and they couldn't reproduce it, and they never observed it.  It happens so infrequently and unpredictably.   They just told me that it was most likely trigeminal pvcs based on how it felt.  This was satisfactory to me since my mom also has them, and did get an actual diagnosis.  The very first time I felt it was during my first ever mile-long run as a 5th grader.  But they seem to happen much more frequently when I am tired or (he he he) pregnant.  Do you normally get enough sleep?

[Jon Allen]

Lybi- he he he?  Does that mean you are expecting male triplets?

[Sasha Pachev]

I've had this happen to me in 2002. The funny skips, and not being able to hold the pace in workouts. I got scared and went to the doctor. They ran a whole bunch of tests, $700 bill after insurance. I even raced a 10 K in Salt Lake Classic with a Holter monitor in 35:11, I think it is the Utah record for the Holter monitor division. I'll claim it until somebody contests it. They found nothing wrong except for what they called "benign preliminary ventrical contractions". The symptoms went away when I made sure to get enough sleep. They do come back occasionally when I do not sleep well over a few nights and try to push myself.

[Tyler]

Unfortunately, I never get enough sleep, so the PVCs sound likely. Although it's all but gone away the last few days, so I still wonder about ibuprofen. I wonder if changing the way you stress your body might cause PVCs as well, like swimming instead of running.