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What Causes Ectopic Heartbeats And Palpitations During Physical Activity?
Question: I worked out yesterday and felt a few PVCs during my strength training and lightheaded again. I went home and felt tightness in my back and left arm for most of the day. This morning my arm and back are bothering me and i feel extra jittery with the pain in my left back and arm again. I talked to my cardiologist on Thursday and based on my blood work, ecg, and CT angiogram is not concerned and he does not want me to get an echo. I am so worried that i have an underlying heart issue that is undetected and do not know what to do. Should i request another doctor?
Brief Answer:
Your symptoms are not cardiac related.
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would agree with your doctor on the fact that your symptoms are not related to any cardiac disorder.
Your performed cardiac tests have excluded possible myocardial ischemia.
In such case there is no need to perform a cardiac ultrasound.
Your should know that some ectopic heartbeats and palpitations are quite normal during physical activity.
Regarding the pain, it could be related to a musculoskeletal disorder related to the straining physical activity.
So, there is nothing to worry about!
I recommend having some rest and taking ibuprofen for the pain.
If the pain persists, I would recommend performing inflammation tests( complete blood count, PCR, sedimentation rate).
A cervical column X ray study coupled with a nerve conduction study would help exclude possible backbone disorder (slipped cervical disc) leading to radicular pain in this region.
You should discuss with your doctor on the above issues.
Hope to have been helpful!
Kind regards,
Dr. Iliri
Your symptoms are not cardiac related.
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would agree with your doctor on the fact that your symptoms are not related to any cardiac disorder.
Your performed cardiac tests have excluded possible myocardial ischemia.
In such case there is no need to perform a cardiac ultrasound.
Your should know that some ectopic heartbeats and palpitations are quite normal during physical activity.
Regarding the pain, it could be related to a musculoskeletal disorder related to the straining physical activity.
So, there is nothing to worry about!
I recommend having some rest and taking ibuprofen for the pain.
If the pain persists, I would recommend performing inflammation tests( complete blood count, PCR, sedimentation rate).
A cervical column X ray study coupled with a nerve conduction study would help exclude possible backbone disorder (slipped cervical disc) leading to radicular pain in this region.
You should discuss with your doctor on the above issues.
Hope to have been helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He said that since i had an echo 7 years ago he didn't think one was necessary. How often are echos usually ordered for changes?
So since the only pain is in my back and arm and does not seem to follow a pattern - it actually gors away when i change positions/move my arm and all tests have been negative i guess it is something else. I will see if he decides anything else is necessary .
So since the only pain is in my back and arm and does not seem to follow a pattern - it actually gors away when i change positions/move my arm and all tests have been negative i guess it is something else. I will see if he decides anything else is necessary .
Brief Answer:
If sufficient suspicions are raised, then ECHO would be necessary.
Detailed Answer:
Hello again, dear XXXX!
In general, a cardiac ECHO is performed when there are sufficient suspicions of an ongoing cardiac disorder.
When chronic cardiomyopathy is present then Echo is used on a periodic schedule (every year up to several months) for reviewing its clinical course and properly addressing therapeutic issues.
But, in your case, as no clinical evidence for chronic or acute cardiac involvement has been concluded by your doctor, probably a cardiac ECHO would not bring additional information in concluding a better clinical decision.
Nevertheless, if your chest pain would appear with certain characteristics, like modulation by respiratory phases (increasing with inspiration) or posture changes, coupled with auscultatory findings of pericardial friction rubs (during doctor auscultation), suggestive pattern in ECG and medical evidence of a recent acute inflammation, then ECHO would be a valuable tool in ruling in/out a possible pericardial inflammation.
Also, ECHO would be helpful in investigating the possibility of an acute aortic syndrome, which could be responsible for chest pain and discomfort even in young individuals as well.
So, in my opinion, although it seems that your chest discomfort is much likely to be related to an extra-cardiac disorder (as I explained you at the beginning of our thread), if the above mentioned clinical elements are present and raise suspicions of a pericardial inflammation or aortic syndrome, then ECHO is necessary for differential diagnosis regardless when the previous test was done (before 3, 5 or 7 years).
You need to discuss with your doctor on the above mentioned issues in order to find the best diagnostic strategy.
Feel free to discuss with me again, in case of any further uncertainties.
Regards,
Dr. Iliri
Brief Answer:
A muscular-skeletal cause is possible.
Detailed Answer:
You are right!
Such a pain pattern is more likely to be of muscular-skeletal origin.
A cardiac implication doesn't seem to be a rationale explanation in this case.
Let me know how things will go on!
Best wishes,
Dr. Iliri
If sufficient suspicions are raised, then ECHO would be necessary.
Detailed Answer:
Hello again, dear XXXX!
In general, a cardiac ECHO is performed when there are sufficient suspicions of an ongoing cardiac disorder.
When chronic cardiomyopathy is present then Echo is used on a periodic schedule (every year up to several months) for reviewing its clinical course and properly addressing therapeutic issues.
But, in your case, as no clinical evidence for chronic or acute cardiac involvement has been concluded by your doctor, probably a cardiac ECHO would not bring additional information in concluding a better clinical decision.
Nevertheless, if your chest pain would appear with certain characteristics, like modulation by respiratory phases (increasing with inspiration) or posture changes, coupled with auscultatory findings of pericardial friction rubs (during doctor auscultation), suggestive pattern in ECG and medical evidence of a recent acute inflammation, then ECHO would be a valuable tool in ruling in/out a possible pericardial inflammation.
Also, ECHO would be helpful in investigating the possibility of an acute aortic syndrome, which could be responsible for chest pain and discomfort even in young individuals as well.
So, in my opinion, although it seems that your chest discomfort is much likely to be related to an extra-cardiac disorder (as I explained you at the beginning of our thread), if the above mentioned clinical elements are present and raise suspicions of a pericardial inflammation or aortic syndrome, then ECHO is necessary for differential diagnosis regardless when the previous test was done (before 3, 5 or 7 years).
You need to discuss with your doctor on the above mentioned issues in order to find the best diagnostic strategy.
Feel free to discuss with me again, in case of any further uncertainties.
Regards,
Dr. Iliri
Brief Answer:
A muscular-skeletal cause is possible.
Detailed Answer:
You are right!
Such a pain pattern is more likely to be of muscular-skeletal origin.
A cardiac implication doesn't seem to be a rationale explanation in this case.
Let me know how things will go on!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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