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What Causes Ectopic Heartbeats Upon Waking Up?

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Posted on Fri, 21 Jul 2017
Question: Hi. I have been having strange episodes upon waking up of ectopic heartbeats. Sometimes once every 2 to 3 beats. They seem to gradually go away as I get up and go on with my day. Though I do get a random ectopic beat here and there. Ive had an ekg done it revealed nothing. Also a 24h holter monitor which revealed occasion atrial and ventricular ectopics but they were deemed normal as well. Nevertheless its still a scary sensation and it causes me anxiety and fear. Is there a reason this happens so much when ive just woken up?
doctor
Answered by Dr. Ilir Sharka (49 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I passed carefully through your question and would explain that a few ectopic atrial and ventricular heart beats in a healthy and normal heart (resulting from the cardiac ultrasound) are normal in every normal person.

They can be related to physical or emotional stress (anxiety).

Have you performed a cardiac ultrasound to examine your heart?

I would like to directly review your Holter and echo reports for a more professional opinion, if you can upload them.

The reason, we these ectopic heart beats occur mostly after waking up, may be explained by the fact that waking up imposes a great stress to your body. You should know that during sleep your body and mind are in total relax, a state when you are not alert about the external stimuli. But waking up, makes you to pass from this situation to another situation, when your body tries to be alert to every external stimuli (light, noise, walking, moving, thinking, etc.)..

Certainly these changes are more prominent in susceptible sensitive persons.

But, before concluding that it is just anxiety, I would recommend performing further tests to exclude other possible causes:

- a cardiac ultrasound (if you have not performed it yet)
- complete blood count for anemia
- blood electrolytes for possible imbalance
- thyroid hormone levels for possible thyroid dysfunction
- cortisol plasma levels for adrenal gland dysfunction.

You should discuss with your doctor on the above tests.

Hope you will find this answer helpful!

I remain at your disposal for any other questions!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (11 minutes later)
Thank you for your reply. Unfortunately I dont currently have access to my 24h monitor tests as they were done quite a few months back.

I forgot to mention that in addition to the ectopics my heart rate sometimes fluctuates greatly from slow to fast (65bpm to as high as 90bpm) within just a few seconds. Then back to normal.

I havent had a cardiac ultrasound preformed yet but will speak to my GP about it.

Also I am currently taking Synthroid 112mg because i had a very underactive thyroid last year (hypothyroidism) I assumed this wouldnt have an affect as the medication has regulated my thyroid issues.
doctor
Answered by Dr. Ilir Sharka (51 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

A thyroid hormone imbalance could explain all these heart rate fluctuations and the ectopic heart beats.

From the other hand these heart rate fluctuations could be related to anxiety and the stress imposed to your body by the process of waking up. But, they are not indicative of any serious medical disorders (considering also your Holter monitoring results).

Anyway, I would recommend performing a cardiac ultrasound and checking again your thyroid hormone levels.

Hope you will find this answer helpful!

Kind regards,

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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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9544 Questions

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What Causes Ectopic Heartbeats Upon Waking Up?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I passed carefully through your question and would explain that a few ectopic atrial and ventricular heart beats in a healthy and normal heart (resulting from the cardiac ultrasound) are normal in every normal person. They can be related to physical or emotional stress (anxiety). Have you performed a cardiac ultrasound to examine your heart? I would like to directly review your Holter and echo reports for a more professional opinion, if you can upload them. The reason, we these ectopic heart beats occur mostly after waking up, may be explained by the fact that waking up imposes a great stress to your body. You should know that during sleep your body and mind are in total relax, a state when you are not alert about the external stimuli. But waking up, makes you to pass from this situation to another situation, when your body tries to be alert to every external stimuli (light, noise, walking, moving, thinking, etc.).. Certainly these changes are more prominent in susceptible sensitive persons. But, before concluding that it is just anxiety, I would recommend performing further tests to exclude other possible causes: - a cardiac ultrasound (if you have not performed it yet) - complete blood count for anemia - blood electrolytes for possible imbalance - thyroid hormone levels for possible thyroid dysfunction - cortisol plasma levels for adrenal gland dysfunction. You should discuss with your doctor on the above tests. Hope you will find this answer helpful! I remain at your disposal for any other questions! Wishing good health, Dr. Iliri