Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes A Pause In The Pulse Rate?
Question: Got a mail saying to ask you again if i wanted.
So you have Gone through these jolts that i spoke og and the heart issues i have.
Further investigations by my self i have found that when i get these feelings i do think there is a pause in the pulse. It is of course hard to time exactly but the last time i could feel the pulse in my Neck i feel with my fingers there was a prolonged between pulses just when i felt this annoying feeling of butterlies on the belly and chest. It is worry some for me.
So you have Gone through these jolts that i spoke og and the heart issues i have.
Further investigations by my self i have found that when i get these feelings i do think there is a pause in the pulse. It is of course hard to time exactly but the last time i could feel the pulse in my Neck i feel with my fingers there was a prolonged between pulses just when i felt this annoying feeling of butterlies on the belly and chest. It is worry some for me.
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello!
I am glad to hear from you again on HCM!
Regarding your concern, I would explain that those pause in the pulse, could also be related to the respiratory changes.
As I have already explained to you the different phases of respiration (inspiration and expiration) cause changes in the venous pressure and in the blood load into the heart.
This may cause a small difference or pause in the heart rate.
But, if you modulate your respiration (depth and frequency) for any other causes (like anxiety, or physical stress), this pause will appear again.
It is quite physiological and it can occur in every normal person during these activities (physical stress, emotional stress, etc.).
Of course, it is more pronounced in sensitive and susceptible persons.
But, it does not indicate any serious medical condition.
So, I think that anxiety may play an important role in all these troubles you are having.
All your performed tests have excluded any serious cardiac disorders.
So, definitely I do not think that your symptoms are related to the heart.
Besides, you should know that a pause of a second is not responsible for such prolonged feelings.
So, in my opinion, you have nothing to worry about!
I would recommend avoiding caffeine intake and perform a lot of physical activity (walking, yoga, recreational sports, etc.) in order to have a healthy mind and body.
I would not recommend straining physical activity (weight lifting, etc.).
Hope you will find this answer helpful!
I remain at your disposal if you have any other uncertainties!
Regards,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello!
I am glad to hear from you again on HCM!
Regarding your concern, I would explain that those pause in the pulse, could also be related to the respiratory changes.
As I have already explained to you the different phases of respiration (inspiration and expiration) cause changes in the venous pressure and in the blood load into the heart.
This may cause a small difference or pause in the heart rate.
But, if you modulate your respiration (depth and frequency) for any other causes (like anxiety, or physical stress), this pause will appear again.
It is quite physiological and it can occur in every normal person during these activities (physical stress, emotional stress, etc.).
Of course, it is more pronounced in sensitive and susceptible persons.
But, it does not indicate any serious medical condition.
So, I think that anxiety may play an important role in all these troubles you are having.
All your performed tests have excluded any serious cardiac disorders.
So, definitely I do not think that your symptoms are related to the heart.
Besides, you should know that a pause of a second is not responsible for such prolonged feelings.
So, in my opinion, you have nothing to worry about!
I would recommend avoiding caffeine intake and perform a lot of physical activity (walking, yoga, recreational sports, etc.) in order to have a healthy mind and body.
I would not recommend straining physical activity (weight lifting, etc.).
Hope you will find this answer helpful!
I remain at your disposal if you have any other uncertainties!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Okay, thanx alot.
So you say that these AV pauses wont be felt in the pulse? They are not prolonged "in between" heartbeats?
So if I had pauses, I would not feel that by checking my pulse?
Yeah I should be more active But why do you not recommend weightlifting?
Yes, XXXXXXX psychological for sure, but the symptoms are first, THEN the anxiety.
So you say that these AV pauses wont be felt in the pulse? They are not prolonged "in between" heartbeats?
So if I had pauses, I would not feel that by checking my pulse?
Yeah I should be more active But why do you not recommend weightlifting?
Yes, XXXXXXX psychological for sure, but the symptoms are first, THEN the anxiety.
Brief Answer:
My opionin as follows:
Detailed Answer:
Hello again!
I totally understand how you feel, but as a cardiologist I would like to reassure you that your symptoms are not indicative of any serious cardiac disorder.
So, relax and try not to think about it.
Your uploaded test reports did not indicate any serious medical condition.
Regarding straining physical activity, I did not recommend it because it lead to wide changes in venous pressure and respiratory phase changes, which can lead to an exaggeration of these feelings.
From the other hand, straining physical activity can lead to a very large quantity of circulating adrenaline in your blood, which can trigger these troubles.
That is why I recommended performing more light physical activity, which can help maintain a healthy body and mind, without any drastic changes in heart rate and blood pressure.
Regarding anxiety, I didn't mean that your symptoms are totally caused by anxiety.
But, I think that some ectopic heart beats and normal heart rate changes during respiration and physical activity can be felt more in susceptible and sensitive persons.
Anxiety can modulate the situation, by making you more sensitive to those changes, but is not the main cause.
Hope to have clarified some of your uncertainties!
Wishing all the best,
Dr. Iliri
My opionin as follows:
Detailed Answer:
Hello again!
I totally understand how you feel, but as a cardiologist I would like to reassure you that your symptoms are not indicative of any serious cardiac disorder.
So, relax and try not to think about it.
Your uploaded test reports did not indicate any serious medical condition.
Regarding straining physical activity, I did not recommend it because it lead to wide changes in venous pressure and respiratory phase changes, which can lead to an exaggeration of these feelings.
From the other hand, straining physical activity can lead to a very large quantity of circulating adrenaline in your blood, which can trigger these troubles.
That is why I recommended performing more light physical activity, which can help maintain a healthy body and mind, without any drastic changes in heart rate and blood pressure.
Regarding anxiety, I didn't mean that your symptoms are totally caused by anxiety.
But, I think that some ectopic heart beats and normal heart rate changes during respiration and physical activity can be felt more in susceptible and sensitive persons.
Anxiety can modulate the situation, by making you more sensitive to those changes, but is not the main cause.
Hope to have clarified some of your uncertainties!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Definately. You are Truly a Great doctor.
I am just so tired of this . It is making life very hard.every night i go to bed with a bad feeling of either dizzyness, ectopics from just turning around, bloodpressure drop, and unwell feeling in the chest and heart . As i am writing this for you now, i am feeling lightheaded and feel Grey. I Wonder if i am really feeling bloodpressure drops or if it indeed is pauses that are causing this feeling instead.
I need something to be done to help me, but there is no one who can it seems. The only finding so far is an inkomplett right block, two pauses during a ECG that May or not be av block grade 2 Mobitz....and if i read about that it all makes sense. I feel like they describe.
My hands and feet are ice cold and i get out of breath by doing very very little and dizzy. So sorry to write so much. The health magic people once shut me out because i ask to much. So i apologize for that
But its my life. Its not just a pain in the foot. U know?
I am just so tired of this . It is making life very hard.every night i go to bed with a bad feeling of either dizzyness, ectopics from just turning around, bloodpressure drop, and unwell feeling in the chest and heart . As i am writing this for you now, i am feeling lightheaded and feel Grey. I Wonder if i am really feeling bloodpressure drops or if it indeed is pauses that are causing this feeling instead.
I need something to be done to help me, but there is no one who can it seems. The only finding so far is an inkomplett right block, two pauses during a ECG that May or not be av block grade 2 Mobitz....and if i read about that it all makes sense. I feel like they describe.
My hands and feet are ice cold and i get out of breath by doing very very little and dizzy. So sorry to write so much. The health magic people once shut me out because i ask to much. So i apologize for that
But its my life. Its not just a pain in the foot. U know?
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
I can understand the way you feel, but you should know that those isolated ECG changes do not indicate any serious medical condition.
But they have lead to a lot of anxiety because you are afraid all the time now that something bad will occur or they will reoccur.
The fact that you are not feeling well now, is because of anxiety. You should know that it can play an important role in your body causing an imbalance in many organs (shortness of breath, lightheadedness, chest pain, elevated heart rate or ectopic heart beats, nausea or vomiting, abdominal discomfort, sleeping troubles, pain in different regions, etc..).
That is why I would recommend taking Xanax for some days (0.25mg two times daily). If your symptoms are relieved by this drug it would indicate an important role of anxiety in your troubles. In such case you would need to consult with a specialist of this field.
I recommended a lot of physical activity, because it can help regain the balance of your body organs (it can help organize their work).
Regarding the ECG changes in your past performed tests, I would not recommend any special treatment.
You should just follow up regularly with your doctor (resting ECG, thyroid hormone levels, blood electrolytes, kidney and liver function tests, chest X ray study) every 6-12 months. If you wish, you can repeat the Holter monitoring, but I do not think that it is necessary. But you can do it if it helps reassuring you.
Hope you will find this answer helpful!
I would be happy to answer to your questions at any time! I completely understand your situation, and I do not think that you make many questions. It is good to consult with a specialist time after time about our medical problems, because the material in the Internet is very wide and nonspecific. So, consulting with a doctor who knows your medical history and symptoms, is much better that just some non-specific missleading material in the internet.
So, feel free to ask me again if you like!
Regards,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
I can understand the way you feel, but you should know that those isolated ECG changes do not indicate any serious medical condition.
But they have lead to a lot of anxiety because you are afraid all the time now that something bad will occur or they will reoccur.
The fact that you are not feeling well now, is because of anxiety. You should know that it can play an important role in your body causing an imbalance in many organs (shortness of breath, lightheadedness, chest pain, elevated heart rate or ectopic heart beats, nausea or vomiting, abdominal discomfort, sleeping troubles, pain in different regions, etc..).
That is why I would recommend taking Xanax for some days (0.25mg two times daily). If your symptoms are relieved by this drug it would indicate an important role of anxiety in your troubles. In such case you would need to consult with a specialist of this field.
I recommended a lot of physical activity, because it can help regain the balance of your body organs (it can help organize their work).
Regarding the ECG changes in your past performed tests, I would not recommend any special treatment.
You should just follow up regularly with your doctor (resting ECG, thyroid hormone levels, blood electrolytes, kidney and liver function tests, chest X ray study) every 6-12 months. If you wish, you can repeat the Holter monitoring, but I do not think that it is necessary. But you can do it if it helps reassuring you.
Hope you will find this answer helpful!
I would be happy to answer to your questions at any time! I completely understand your situation, and I do not think that you make many questions. It is good to consult with a specialist time after time about our medical problems, because the material in the Internet is very wide and nonspecific. So, consulting with a doctor who knows your medical history and symptoms, is much better that just some non-specific missleading material in the internet.
So, feel free to ask me again if you like!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Very good to hear.
I spent the night at the hospital. Yesterday I had a doctor appointment, and drove there. When I went out of the car, and started walking, i thought wow Im lightheaded . Not sure if I can make it to the frontdoor. But I did. However, my heartrate went up drastically. And by the time I was at the waitingroom, it was aprox 200 bpm. I could not slow it down...I tried thinking calm down Kaj, calm down this is panic attack, just breath and it will go down. Well it did not. Tried sitting, laying everything for five minutes, and then it started to come down I went in to the doc, and took an ecg. By then I felt relief, and the rate was down to a still very high 120 bpm. So doc said we could go to hospital But he said he could not see that there was any P wave something so no AF he said (not quite sure what he said). So I went to the car, and drove to hospital Same when I had to go out of car, and walk to entrance, it started again. So during some stairs, I ch3ecked pulse on neck and it was FAST and HARD And then it stopped for a second and started beating again.
The docs at hospital said nothing wrong. Of course not, because when I was in, I took ECG while resting and everything had calmed down. So they blamed it on panic attack even without seeing when I had 200+ bpm.
I was pale, lightheaded, but no pain anywhere.
Now, I had bloodwork done nothing wrong, and then a ECG thing all night which showed nothing. But during resting I had 100/59 bloodpressure. And extremely tired.
What is this. I am thinking of course a tachy, but what kind, and where do I take it from here with docs that are 100 percent that its anxiety?
I had panic attacks, and this was not one.
They do know I have arrythmias like bigeminis and ectopics etc, and an incomplete block (right) but they still say no nothing wrong. As you know my life was bad before, so with this new thing happened, its worse..I just dont know where to go or what to do now.....
I spent the night at the hospital. Yesterday I had a doctor appointment, and drove there. When I went out of the car, and started walking, i thought wow Im lightheaded . Not sure if I can make it to the frontdoor. But I did. However, my heartrate went up drastically. And by the time I was at the waitingroom, it was aprox 200 bpm. I could not slow it down...I tried thinking calm down Kaj, calm down this is panic attack, just breath and it will go down. Well it did not. Tried sitting, laying everything for five minutes, and then it started to come down I went in to the doc, and took an ecg. By then I felt relief, and the rate was down to a still very high 120 bpm. So doc said we could go to hospital But he said he could not see that there was any P wave something so no AF he said (not quite sure what he said). So I went to the car, and drove to hospital Same when I had to go out of car, and walk to entrance, it started again. So during some stairs, I ch3ecked pulse on neck and it was FAST and HARD And then it stopped for a second and started beating again.
The docs at hospital said nothing wrong. Of course not, because when I was in, I took ECG while resting and everything had calmed down. So they blamed it on panic attack even without seeing when I had 200+ bpm.
I was pale, lightheaded, but no pain anywhere.
Now, I had bloodwork done nothing wrong, and then a ECG thing all night which showed nothing. But during resting I had 100/59 bloodpressure. And extremely tired.
What is this. I am thinking of course a tachy, but what kind, and where do I take it from here with docs that are 100 percent that its anxiety?
I had panic attacks, and this was not one.
They do know I have arrythmias like bigeminis and ectopics etc, and an incomplete block (right) but they still say no nothing wrong. As you know my life was bad before, so with this new thing happened, its worse..I just dont know where to go or what to do now.....
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
I totally understand your clinical situation.
I would explain that the maximal heart rate for a healthy person is calculated as 260-age (years), which in your case would be around 220bpm.
You can achieve this maximal heart rate during anxiety or physical activity.
From the other hand, the fact that both these episodes occurred while going to the doctor the first time and the second while going to the Hospital, makes me think of White Coat Syndrome, which is an spike in the blood pressure and heart rate at the doctor office, which can be explained with the fear and anxiety from doctor consultation (or that something will be wrong with you).
Your performed ECG show nothing normal. That is why they think that this is all about anxiety.
Coming to this point, I would recommend to perform a loop monitoring test, which is like a Holter monitoring, but the difference is that it does not register your heart rate all the time, but only when you decide to switch it on. So, you can hold if for a long time, and if you feel similar symptoms you can just press the button and then switch off when the situation is improved. All these recordings can be sent by phone to your doctor and he can examine them in some minutes from the hospital, while you are home and tell if your heart rate and ECG is normal or indicates any arrhythmia.
In my opinion, this test would definitely help clarify your situation and exclude any possible cardiac arrhythmia.
Hope to have been helpful!
Regards,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
I totally understand your clinical situation.
I would explain that the maximal heart rate for a healthy person is calculated as 260-age (years), which in your case would be around 220bpm.
You can achieve this maximal heart rate during anxiety or physical activity.
From the other hand, the fact that both these episodes occurred while going to the doctor the first time and the second while going to the Hospital, makes me think of White Coat Syndrome, which is an spike in the blood pressure and heart rate at the doctor office, which can be explained with the fear and anxiety from doctor consultation (or that something will be wrong with you).
Your performed ECG show nothing normal. That is why they think that this is all about anxiety.
Coming to this point, I would recommend to perform a loop monitoring test, which is like a Holter monitoring, but the difference is that it does not register your heart rate all the time, but only when you decide to switch it on. So, you can hold if for a long time, and if you feel similar symptoms you can just press the button and then switch off when the situation is improved. All these recordings can be sent by phone to your doctor and he can examine them in some minutes from the hospital, while you are home and tell if your heart rate and ECG is normal or indicates any arrhythmia.
In my opinion, this test would definitely help clarify your situation and exclude any possible cardiac arrhythmia.
Hope to have been helpful!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Oh sorry if you read that i wrote going to the docs for first time. I was there many many many times before this. Nothing special about this time. I was not scared to go to doctor i was looking forward to talking to him. He is my friend AS well.
Yes a long monitor is logical i think AS well.
Yes a long monitor is logical i think AS well.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
Coming to this point a Loop monitor would help clarify your situation and totally exclude any possible serious cardiac arrhythmia.
Hope to have been helpful!
Let me know about everything!
Wishing all the best!
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Coming to this point a Loop monitor would help clarify your situation and totally exclude any possible serious cardiac arrhythmia.
Hope to have been helpful!
Let me know about everything!
Wishing all the best!
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
